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PLoS One. 2013 Jul 31;8(7):e68628. doi: 10.1371/journal.pone.0068628. Print 2013.

Insulin sensitivity from preschool to school age in patients with severe obesity.

Author information

  • 1Scientific Directorate, Research Unit for Multifactorial Disease, Bambino Gesù Children Hospital, Rome, Italy. melania.manco@opbg.net

Abstract

BACKGROUND:

Insulin sensitivity decreases at puberty transition, but little information has been provided on its earlier time-course. Aim of the present study was to describe the time-course of insulin sensitivity in severely obese children at the transition from preschool to school age.

RESEARCH DESIGN AND METHODS:

Retrospective study of a cohort of 47 severely obese [Body Mass Index (BMI) ≥99° percentile] preschoolers evaluated twice, once between 2 and 6 years of age, and once before age 8. Glucose tolerance, Whole Body Insulin Sensitivity Index (WBISI), Insulinogenic Index (IGI); β-cell demand index (BCDI) and Insulin Secretion-Sensitivity Index 2 (ISSI-2) were longitudinally estimated during the oral glucose tolerance test.

RESULTS:

After a median follow-up of 2.23 (1-4.52) y, obese patients showed significant decrease in WBISI (p<0.0001), and increase in fasting (p = 0.005) and 2 h glucose (2HG, p = 0.001). One child in preschool age and 4 school age children presented with 2HG between 7.8-11.1 mmol/l. Best predictors of WBISI, 2HG and BCDI in the school age were changes in BMI z-score (R(2) = 0.309; p = 0.002; β = -0.556), ISSI-2 (R(2) = 0.465; p<0.0001; β = -0.682), and BMI z-score (R(2) = 0.246; p = 0.008; 0.496), respectively.

CONCLUSIONS:

In morbidly obese children, insulin sensitivity seems to decline even before pubertal transition, but changes in total adiposity can only partially explain this variation.

PMID:
23935878
[PubMed - indexed for MEDLINE]
PMCID:
PMC3729946
Free PMC Article
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