High normal fasting glucose level in obese youth: a marker for insulin resistance and beta cell dysregulation.

Hdl Handle:
http://hdl.handle.net/10147/188313
Title:
High normal fasting glucose level in obese youth: a marker for insulin resistance and beta cell dysregulation.
Authors:
O'Malley, G; Santoro, N; Northrup, V; D'Adamo, E; Shaw, M; Eldrich, S; Caprio, S
Affiliation:
Department of Pediatrics, Yale University School of Medicine, 330 Cedar Street, PO Box 208064, New Haven, CT 06520, USA.
Citation:
High normal fasting glucose level in obese youth: a marker for insulin resistance and beta cell dysregulation. 2010, 53 (6):1199-209 Diabetologia
Journal:
Diabetologia
Issue Date:
Jun-2010
URI:
http://hdl.handle.net/10147/188313
DOI:
10.1007/s00125-010-1693-0
PubMed ID:
20204321
Additional Links:
http://www.ncbi.nlm.nih.gov/pubmed/20204321
Abstract:
A high but normal fasting plasma glucose level in adults is a risk factor for future development of type 2 diabetes mellitus and cardiovascular disease. We investigated whether normal fasting plasma glucose levels (<5.60 mmol/l) are associated with decreases in insulin sensitivity and beta cell function, as well as an adverse cardiovascular profile in obese youth.; We performed a cross-sectional analysis in a multiethnic sample of 1,020 obese youth (614 girls and 406 boys; mean age 12.9 years [CI 95% 12.7-13.1], BMI z score 2.34 [CI 95% 2.31-2.38]) with normal fasting plasma glucose. All participants had a standard OGTT, with calculation of indices of insulin sensitivity and beta cell function. For the analysis, prepubertal and pubertal participants were stratified into quartiles of normal fasting plasma glucose.; We observed a significant increase in fasting insulin and AUC 2 h glucose across quartiles. Pronounced changes were observed in insulin sensitivity and secretion, particularly in the pubertal group. Moreover, the odds of presenting with impaired glucose tolerance increased by 4.5% with each 0.06 mmol/l increase in fasting plasma glucose. No significant differences in cardiovascular indices were seen across quartiles.; These data suggest that in obese youth, independent of age, BMI z score, sex, family history and ethnicity, insulin sensitivity and secretion decline when moving from low to high normal fasting plasma glucose. The simple measure of fasting plasma glucose could assist clinicians in identifying children for targeted diabetes screening and subsequent lifestyle management.
Item Type:
Article In Press
Language:
en
MeSH:
Adolescent; Analysis of Variance; Area Under Curve; Blood Glucose; Child; Cross-Sectional Studies; Fasting; Female; Humans; Insulin; Insulin Resistance; Insulin-Secreting Cells; Male; Obesity; Predictive Value of Tests; Regression Analysis; Risk Factors
ISSN:
1432-0428
Sponsors:
Irish Fulbright Commission

Full metadata record

DC FieldValue Language
dc.contributor.authorO'Malley, Gen
dc.contributor.authorSantoro, Nen
dc.contributor.authorNorthrup, Ven
dc.contributor.authorD'Adamo, Een
dc.contributor.authorShaw, Men
dc.contributor.authorEldrich, Sen
dc.contributor.authorCaprio, Sen
dc.date.accessioned2011-11-01T12:19:36Z-
dc.date.available2011-11-01T12:19:36Z-
dc.date.issued2010-06-
dc.identifier.citationHigh normal fasting glucose level in obese youth: a marker for insulin resistance and beta cell dysregulation. 2010, 53 (6):1199-209 Diabetologiaen
dc.identifier.issn1432-0428-
dc.identifier.pmid20204321-
dc.identifier.doi10.1007/s00125-010-1693-0-
dc.identifier.urihttp://hdl.handle.net/10147/188313-
dc.description.abstractA high but normal fasting plasma glucose level in adults is a risk factor for future development of type 2 diabetes mellitus and cardiovascular disease. We investigated whether normal fasting plasma glucose levels (<5.60 mmol/l) are associated with decreases in insulin sensitivity and beta cell function, as well as an adverse cardiovascular profile in obese youth.-
dc.description.abstractWe performed a cross-sectional analysis in a multiethnic sample of 1,020 obese youth (614 girls and 406 boys; mean age 12.9 years [CI 95% 12.7-13.1], BMI z score 2.34 [CI 95% 2.31-2.38]) with normal fasting plasma glucose. All participants had a standard OGTT, with calculation of indices of insulin sensitivity and beta cell function. For the analysis, prepubertal and pubertal participants were stratified into quartiles of normal fasting plasma glucose.-
dc.description.abstractWe observed a significant increase in fasting insulin and AUC 2 h glucose across quartiles. Pronounced changes were observed in insulin sensitivity and secretion, particularly in the pubertal group. Moreover, the odds of presenting with impaired glucose tolerance increased by 4.5% with each 0.06 mmol/l increase in fasting plasma glucose. No significant differences in cardiovascular indices were seen across quartiles.-
dc.description.abstractThese data suggest that in obese youth, independent of age, BMI z score, sex, family history and ethnicity, insulin sensitivity and secretion decline when moving from low to high normal fasting plasma glucose. The simple measure of fasting plasma glucose could assist clinicians in identifying children for targeted diabetes screening and subsequent lifestyle management.-
dc.description.sponsorshipIrish Fulbright Commissionen
dc.language.isoenen
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pubmed/20204321en
dc.subject.meshAdolescent-
dc.subject.meshAnalysis of Variance-
dc.subject.meshArea Under Curve-
dc.subject.meshBlood Glucose-
dc.subject.meshChild-
dc.subject.meshCross-Sectional Studies-
dc.subject.meshFasting-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshInsulin-
dc.subject.meshInsulin Resistance-
dc.subject.meshInsulin-Secreting Cells-
dc.subject.meshMale-
dc.subject.meshObesity-
dc.subject.meshPredictive Value of Tests-
dc.subject.meshRegression Analysis-
dc.subject.meshRisk Factors-
dc.titleHigh normal fasting glucose level in obese youth: a marker for insulin resistance and beta cell dysregulation.en
dc.typeArticle In Pressen
dc.contributor.departmentDepartment of Pediatrics, Yale University School of Medicine, 330 Cedar Street, PO Box 208064, New Haven, CT 06520, USA.en
dc.identifier.journalDiabetologiaen
dc.description.provinceLeinster-
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