Indexes of insulin resistance and secretion in obese children and adolescents: A validation study

Louise S. Conwell*, Stewart G. Trost, Wendy J. Brown, Jennifer A. Batch

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

258 Citations (Scopus)

Abstract

OBJECTIVE - To assess the concurrent validity of fasting indexes of insulin sensitivity and secretion in obese prepubertal (Tanner stage 1) children and pubertal (Tanner stages 2-5) adolescents using estimates from the modified minimal model frequently sampled intravenous glucose tolerance test (FSIVGTT) as a criterion measure. 

RESEARCH DESIGN AND METHODS - Eighteen obese children and adolescents (11 girls and 7 boys, mean age 12.2 ± 2.4 years, mean BMI 35.4 ± 6.2 kg/m2, mean BMI-SDS 3.5 ± 0.5, 7 prepubertal and 11. pubertal) participated in the study. All participants underwent an insulin-modified FSIVGTT on two occasions, and 15 repeated this test a third time (mean 12.9 and 12.0 weeks apart). Si measured by the FSIVGTT was compared with homeostasis model assessment (HOMA) of insulin resistance (HOMA-IR), quantitative insulin-sensitivity check index (QUICKI), fasting glucose-to-insulin ratio (FGIR), and fasting insulin (estimates of insulin sensitivity derived from fasting samples). The acute insulin response (AIR) measured by the FSIVGTT was compared with HOMA of percent β-cell function (HOMA-β%), FGIR, and fasting insulin (estimates of insulin secretion derived from fasting samples). 

RESULTS - There was a significant negative correlation between HOMA-IR and Si (r = -0.89, r = -0.90, and r = -0.81, P < 0.01) and a significant positive correlation between QUICKI and Si (r = 0.89, r = 0.90, and r = 0.81, P < 0.01) at each time point. There was a significant positive correlation between FGIR and Si (r = 0.91, r = 0.91, and r = 0.82, P < 0.01) and a significant negative correlation between fasting insulin and Si (r = -90, r = -0.90, and r = -0.88, P < 0.01). HOMA-β% was not as strongly correlated with AIR (r = 0.60, r = 0.54, and r = 0.61, P < 0.05). 

CONCLUSIONS - HOMA-IR, QUICKI, FGIR, and fasting insulin correlate strongly with Si assessed by the FSIVGTT in obese children and adolescents. Correlations between HOMA-β%, FGIR and fasting insulin, and AIR were not as strong. Indexes derived from fasting samples are a valid tool for assessing insulin sensitivity in prepubertal and pubertal obese children.

Original languageEnglish
Pages (from-to)314-319
Number of pages6
JournalDiabetes Care
Volume27
Issue number2
DOIs
Publication statusPublished - Feb 2004
Externally publishedYes

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