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Evaluating a pragmatic estimate of insulin sensitivity in Latino youth with obesity

Armando Peña1,2, Micah L Olson1,3, Erica G Soltero1,4

  • 1Center for Health Promotion and Disease Prevention, Arizona State University, Phoenix, Arizona.

Clinical Obesity
|January 22, 2020
PubMed

Insights

The whole-body insulin sensitivity index (WBISI) can be accurately estimated using fewer measurements (WBISI120) in obese Latino adolescents. This simplified method is cost-effective and shows similar changes after lifestyle intervention.

Area of Science:

  • Metabolic Health
  • Paediatric Endocrinology
  • Clinical Diagnostics

Background:

  • The whole-body insulin sensitivity index (WBISI) is a key indicator of insulin sensitivity, typically requiring multiple measurements during an oral glucose tolerance test (OGTT).
  • Reduced sampling models for WBISI have not been validated in paediatric populations, particularly in those with obesity.
  • Assessing insulin sensitivity is crucial for understanding metabolic health in adolescents at risk for type 2 diabetes.

Purpose of the Study:

  • To compare the cross-sectional agreement between the original WBISI and a reduced sampling model (WBISI120) in Latino adolescents with obesity.
  • To evaluate changes in insulin sensitivity as measured by both WBISI and WBISI120 following a lifestyle intervention.
  • To determine the cost-effectiveness of WBISI120 compared to the full WBISI in this demographic.

Main Methods:

  • Cross-sectional analysis of baseline OGTT data from 148 Latino adolescents (14-16 years) with obesity (BMI ≥95th percentile).
  • Analysis of data from 65 participants who completed a 12-week lifestyle intervention to assess changes in WBISI and WBISI120.
  • Comparison of research costs associated with obtaining WBISI and WBISI120 values.

Main Results:

  • WBISI120 demonstrated strong cross-sectional agreement with the full WBISI (ICCagreement = 0.88).
  • Following intervention, WBISI120 showed a significant increase (62.5%), while WBISI increased by 25.0%, with no significant difference in the rate of change between the two measures.
  • WBISI120 was approximately 70% less costly to determine than the full WBISI.

Conclusions:

  • The WBISI120 provides a reliable and cost-effective surrogate for estimating whole-body insulin sensitivity in obese Latino adolescents.
  • This simplified measure can facilitate more accessible metabolic health assessments in paediatric populations.
  • The findings support the use of WBISI120 in clinical trials and practice for evaluating insulin sensitivity changes in youth with obesity.

Keywords:
insulin sensitivitylifestyle interventionmeasureobesityyouth

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