High normal fasting glucose level in obese youth: a marker for insulin resistance and beta cell dysregulation.
O'Malley, G Santoro, N Northrup, V D'Adamo, E Shaw, M Eldrich, S Caprio, S
O'Malley, G
Santoro, N
Northrup, V
D'Adamo, E
Shaw, M
Eldrich, S
Caprio, S
Advisors
Editors
Other Contributors
Date
2010-06
Date Submitted
Keywords
Other Subjects
Subject 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
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
Planned Date
Start Date
Collaborators
Principal Investigators
Alternative Titles
Publisher
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.
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.
Language
en
ISSN
1432-0428
eISSN
ISBN
DOI
10.1007/s00125-010-1693-0
PMID
20204321
PMCID
Sponsorships
Irish Fulbright Commission