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[Insulin resistance in obese children: debate on assessment]

O V Vasyukova1, A V Vitebskaya1

  • 1Endocrinology Research Centre.

Problemy Endokrinologii
|October 2, 2019
PubMed

Insights

Diagnosing insulin resistance (IR) in obese children is challenging due to a lack of standardized criteria. The study found that oral glucose tolerance tests (OGTT) provide more reliable IR assessments than fasting measurements alone.

Area of Science:

  • Pediatrics
  • Endocrinology
  • Metabolic Disorders

Context:

  • Assessing insulin resistance (IR) in children and adolescents is hindered by the absence of age- and gender-specific criteria.
  • Obesity in pediatric populations presents unique challenges for accurate IR diagnosis.

Purpose:

  • To compare various insulin resistance indices in 63 children and adolescents with simple obesity.
  • To evaluate the diagnostic accuracy and reproducibility of different IR estimation methods.

Summary:

  • Baseline insulin and glucose measurements showed low reproducibility (26%) for IR indices.
  • Forty percent of obese children had discordant IR index results compared to oral glucose tolerance test (OGTT) findings, leading to potential diagnostic errors (12% hyperdiagnosis, 18% hypodiagnosis).
  • Stimulated insulin release and the Matsuda index derived from OGTT demonstrated the highest diagnostic value.

Impact:

  • Highlights the limitations of fasting-based IR indices in pediatric obesity.
  • Emphasizes the superior diagnostic utility of OGTT-derived measures for IR in this population.
  • Informs clinical practice and future research for more accurate pediatric IR assessment.

Keywords:
insulin resistanceinsulin resistance indexes

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