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Int J Obes (Lond). 2014 Sep;38 Suppl 2:S39-47. doi: 10.1038/ijo.2014.134.

Percentiles of fasting serum insulin, glucose, HbA1c and HOMA-IR in pre-pubertal normal weight European children from the IDEFICS cohort.

Author information

1
Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.
2
GENUD (Growth, Exercise, Nutrition and Development) Research Group, School of Health Sciences, University of Zaragoza, Zaragoza, Spain.
3
Research & Education Institute of Child Health, Strovolos, Cyprus.
4
Medizinisches Versorgungszentrum (MVZ), Dr Eberhard und Partner Dortmund, Dortmund, Germany.
5
Epidemiology and Population Genetics, Institute of Food Science, CNR, Avellino, Italy.
6
Centre for High Technology Research and Education in Biomedical Sciences, Universita Cattolica del Sacro Cuore, Campobasso, Italy.
7
National Institute for Health Development (NIHD), Tallinn, Estonia.
8
Department of Public Health, Ghent University, Ghent, Belgium.
9
Department of Paedriatrics, The Queen Silvia Children's Hospital, Gothenburg, Sweden.
10
Chronic Diseases Department, National Institute of Health Promotion, University of Pécs, Pécs, Hungary.
11
1] Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany [2] Institute of Statistics, Faculty of Mathematics and Computer Science, University Bremen, Bremen, Germany.

Abstract

OBJECTIVES:

The aim of this study is to present age- and sex-specific reference values of insulin, glucose, glycosylated haemoglobin (HbA1c) and the homeostasis model assessment to quantify insulin resistance (HOMA-IR) for pre-pubertal children.

METHODS:

The reference population consists of 7074 normal weight 3- to 10.9-year-old pre-pubertal children from eight European countries who participated in at least one wave of the IDEFICS ('identification and prevention of dietary- and lifestyle-induced health effects in children and infants') surveys (2007-2010) and for whom standardised laboratory measurements were obtained. Percentile curves of insulin (measured by an electrochemiluminescence immunoassay), glucose, HbA1c and HOMA-IR were calculated as a function of age stratified by sex using the general additive model for location scale and shape (GAMLSS) method.

RESULTS:

Levels of insulin, fasting glucose and HOMA-IR continuously show an increasing trend with age, whereas HbA1c shows an upward trend only beyond the age of 8 years. Insulin and HOMA-IR values are higher in girls of all age groups, whereas glucose values are slightly higher in boys. Median serum levels of insulin range from 17.4 and 13.2 pmol l(-1) in 3-<3.5-year-old girls and boys, respectively, to 53.5 and 43.0 pmol l(-1) in 10.5-<11-year-old girls and boys. Median values of glucose are 4.3 and 4.5 mmol l(-1) in the youngest age group and 49.3 and 50.6 mmol l(-1) in the oldest girls and boys. For HOMA-IR, median values range from 0.5 and 0.4 in 3-<3.5-year-old girls and boys to 1.7 and 1.4 in 10.5-<11-year-old girls and boys, respectively.

CONCLUSIONS:

Our study provides the first standardised reference values for an international European children's population and provides the, up to now, largest data set of healthy pre-pubertal children to model reference percentiles for markers of insulin resistance. Our cohort shows higher values of Hb1Ac as compared with a single Swedish study while our percentiles for the other glucose metabolic markers are in good accordance with previous studies.

PMID:
25376219
DOI:
10.1038/ijo.2014.134
[Indexed for MEDLINE]

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