Limited accuracy of surrogates of insulin resistance during puberty in obese and lean children at risk for altered glucoregulation

被引:37
作者
Brandou, F [1 ]
Brun, JF [1 ]
Mercier, J [1 ]
机构
[1] Ctr Hosp Univ Lapeyronie, Ctr Explorat & Readaptat Anomalies Metab Musculai, Serv Cent Physiol Clin, Equipe Accueil Physiol Interact 701, F-34295 Montpellier, France
关键词
D O I
10.1210/jc.2004-0329
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
This study evaluated the accuracy of surrogate indexes of insulin sensitivity (SI) in children. Surrogates (homeostasis model assessment index of insulin resistance, quick insulin sensitivity index, and 40/insulin ratio index) were cross-sectionally investigated in 66 obese and lean children (17 Tanner stage 1, 19 Tanner stage II-III, and 30 Tanner stage IV-V) as indexes of insulin resistance in comparison with the minimal model. The pubertal decrease in SI was found with the minimal model (-47%; P = 0.01), but not with surrogates, which were not correlated to SI. Baseline insulin (Ib) did not mirror the decrease in SI, did not significantly change when plotted against pubertal stage or age, and was not correlated to SI. Ib and surrogates were positively correlated with the body mass index. The disposition index, which quantifies the feedback between SI and insulin release, was widely scattered and decreased during puberty (P = 0.05). The specificity and sensitivity of surrogates as predictors of insulin resistance were poor (e.g. 81.1% and 30.7%, respectively, for the homeostasis model assessment index of insulin resistance). Thus, during puberty, surrogates are not accurate predictors of insulin resistance. Because reference methods are rather expensive and invasive, additional studies of alternative techniques for evaluating SI are needed to allow accurate measurement of insulin resistance in children.
引用
收藏
页码:761 / 767
页数:7
相关论文
共 41 条
[1]   IMPORTANCE OF GLUCOSE PER SE TO INTRAVENOUS GLUCOSE-TOLERANCE - COMPARISON OF THE MINIMAL-MODEL PREDICTION WITH DIRECT MEASUREMENTS [J].
ADER, M ;
PACINI, G ;
YANG, YJ ;
BERGMAN, RN .
DIABETES, 1985, 34 (11) :1092-1103
[2]   THE INSULIN SENSITIVITY INDEX IN NONDIABETIC MAN - CORRELATION BETWEEN CLAMP-DERIVED AND IVGTT-DERIVED VALUES [J].
BEARD, JC ;
BERGMAN, RN ;
WARD, WK ;
PORTE, D .
DIABETES, 1986, 35 (03) :362-369
[3]   The evolution of β-cell dysfunction and insulin resistance in type 2 diabetes [J].
Bergman, RN ;
Finegood, DT ;
Kahn, SE .
EUROPEAN JOURNAL OF CLINICAL INVESTIGATION, 2002, 32 :35-45
[4]   EQUIVALENCE OF THE INSULIN SENSITIVITY INDEX IN MAN DERIVED BY THE MINIMAL MODEL METHOD AND THE EUGLYCEMIC GLUCOSE CLAMP [J].
BERGMAN, RN ;
PRAGER, R ;
VOLUND, A ;
OLEFSKY, JM .
JOURNAL OF CLINICAL INVESTIGATION, 1987, 79 (03) :790-800
[5]   PUBERTY DECREASES INSULIN SENSITIVITY [J].
BLOCH, CA ;
CLEMONS, P ;
SPERLING, MA .
JOURNAL OF PEDIATRICS, 1987, 110 (03) :481-487
[6]   HOMA-estimated insulin resistance is an independent predictor of cardiovascular disease in type 2 diabetic subjects - Prospective data from the Verona Diabetes Complicated Study [J].
Bonora, E ;
Formentini, G ;
Calcaterra, F ;
Lombardi, S ;
Marini, F ;
Zenari, L ;
Saggiani, F ;
Poli, M ;
Perbellini, S ;
Raffaelli, A ;
Cacciatori, V ;
Santi, L ;
Targher, G ;
Bonadonna, R ;
Muggeo, M .
DIABETES CARE, 2002, 25 (07) :1135-1141
[7]   THE MAGNITUDE, THE KINETICS AND THE METABOLIC EFFICIENCY OF 1ST-PHASE INSULIN-RESPONSE TO INTRAVENOUS GLUCOSE ARE RELATED [J].
BOUIX, O ;
BRUN, JF ;
ORSETTI, A .
HORMONE AND METABOLIC RESEARCH, 1993, 25 (06) :312-316
[8]   INFLUENCE OF SHORT-TERM SUBMAXIMAL EXERCISE ON PARAMETERS OF GLUCOSE ASSIMILATION ANALYZED WITH THE MINIMAL MODEL [J].
BRUN, JF ;
GUINTRANDHUGRET, R ;
BOEGNER, C ;
BOUIX, O ;
ORSETTI, A .
METABOLISM-CLINICAL AND EXPERIMENTAL, 1995, 44 (07) :833-840
[9]   Increased insulin sensitivity and basal insulin effectiveness in postprandial reactive hypoglycaemia [J].
Brun, JF ;
Bouix, O ;
Monnier, JF ;
Blachon, C ;
Jourdan, N ;
Baccara, MT ;
Fedou, C ;
Orsetti, A .
ACTA DIABETOLOGICA, 1996, 33 (01) :1-6
[10]   INCREASED INSULIN-SECRETION IN PUBERTY - A COMPENSATORY RESPONSE TO REDUCTIONS IN INSULIN SENSITIVITY [J].
CAPRIO, S ;
PLEWE, G ;
DIAMOND, MP ;
SIMONSON, DC ;
BOULWARE, SD ;
SHERWIN, RS ;
TAMBORLANE, WV .
JOURNAL OF PEDIATRICS, 1989, 114 (06) :963-967