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Published on: January 7, 2018
Definition of insulin resistance affects prevalence rate in pediatric patients: a systematic review and call for
Insights
Childhood obesity is rising, increasing interest in insulin resistance (IR). This study reviewed IR definitions in children, finding wide variations that impact prevalence rates, highlighting the need for a standardized definition.
Area of Science:
- Pediatric Endocrinology
- Metabolic Disorders
Background:
- Rising childhood obesity rates correlate with increased interest in insulin resistance (IR), a precursor to type 2 diabetes mellitus.
- Understanding and accurately defining IR in pediatric populations is crucial for early intervention and management.
Purpose of the Study:
- To systematically review various definitions, including methods and cutoff values, used to define IR in children.
- To apply these diverse definitions to a specific cohort of obese pediatric patients to assess their impact on prevalence rates.
Main Methods:
- Conducted a systematic literature review to identify prevalence and/or incidence rates of IR in children.
- Extracted and categorized 146 distinct IR definitions from 103 identified articles.
- Applied the gathered definitions to a previously characterized obese pediatric population.
Main Results:
- A wide array of 14 different methods were used to define IR, with fasted definitions being most common (137 instances).
- Homeostasis model assessment of insulin resistance (HOMA-IR) and fasted plasma insulin (FPI) were the most frequently employed fasted methods.
- Applying different definitions resulted in a broad spectrum of IR prevalence, ranging from 5.5% to 72.3% in the studied obese pediatric group.
Conclusions:
- The heterogeneity in IR definitions and cutoff values significantly impacts reported prevalence rates in pediatric populations.
- A standardized, uniform definition for IR in children is essential for accurate comparisons and reliable epidemiological data.
Background:
As a result of the rising prevalence of childhood obesity, there is an increasing interest in the type 2 diabetes mellitus precursor insulin resistance (IR). The aim of this study is to review definitions (methods and cutoff values) to define IR in children and to apply these definitions to a previously described obese pediatric population.
Methods:
A systematic literature review on prevalence and/or incidence rates in children was performed. The extracted definitions were applied to an obese pediatric population.
Results:
In the 103 identified articles, 146 IR definitions were reported based on 14 different methods. Fasted definitions were used 137 times, whereas oral/intravenous glucose tolerance test-derived methods were used nine times. The homeostasis model for the assessment of insulin resistance (HOMA-IR) and fasted plasma insulin (FPI) were the most frequently used fasted methods (83 and 37 times, respectively). A wide range in cutoff values to define IR was observed, resulting in prevalence rates in the predefined obese pediatric population between 5.5% (FPI>30 mU/L) and 72.3% (insulin sensitivity indexMatsuda≤7.2).
Conclusions:
To compare IR incidence and prevalence rates in pediatric populations, a uniform definition of IR should be defined.
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