Oral glucose effectiveness and metabolic risk in obese children and adolescents
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To investigate whether GE is affected in children/adolescents with obesity and abnormalities of the metabolic syndrome (MetS).
Cross-sectional study of oral GE (oGE), insulin sensitivity and secretion (calculated on 5 time-points oral glucose tolerance test) and metabolic abnormalities in 1012 patients with overweight/obesity (aged 6.0–17.9 years old). A MetS risk score was calculated on the basis of distribution of fasting glucose, triglycerides, HDL-cholesterol, total cholesterol, systolic and diastolic blood pressure. Non-alcoholic fatty liver disease (NAFLD) was suspected based on thresholds of alanine aminotransferases.
Four-hundred and eighty patients (47.73%) had low-MetS risk score, 488 medium (48.22% with 1–2 risk factors) and 41 (4.05% with ≥ 3 factors) high risk. oGE was significantly lower in subjects with obesity [3.81 (1.46) mg/dl/min− 1] than in those with overweight [4.98 (1.66) mg/dl/min− 1; p value < 0.001]. oGE was negatively correlated with BMI (ρ = − 0.79; p < 0.001) and BMI z score (ρ = − 0.56; p < 0.001) and decreased significantly among MetS risk classes (p = 0.001). The median difference of oGE from low to medium risk was estimated to be as − 4.9%, from medium to high as − 13.38% and from low to high as − 17.62%. oGE was not statistically different between NAFLD+ and NAFLD− cases.
In children and adolescents with obesity oGE decreases. Noteworthy, it decreases as the Met score increases. Therefore, reduced oGE may contribute to the higher risk of these individuals to develop type 2 diabetes.
KeywordsGlucose effectiveness Glucose metabolism Metabolic syndrome
Area under curve
Body mass index
Euglycemic Hyperinsulinemic Clamp
High-density lipoprotein cholesterol
Hepatic glucose production
Hepatic Insulin Resistance Index
Homeostasis model assessment for insulin resistance
Intravenous glucose tolerance test
Insulin sensitivity index
Impaired fasting glucose
Impaired glucose tolerance
Non-alcoholic fatty liver disease
Normal glucose tolerance
Oral disposition index
Oral glucose tolerance test
Type 2 diabetes
There was no fund supporting the study.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in the study were in accordance with the ethical standards of the Ethics Committee of Bambino Gesù Children’s Hospital, which approved the study, and with the 1964 Helsinki Declaration and the European Convention of Human Rights and Biomedicine for Research in Children as revised in 2008. To ensure data protection and confidentiality, data extracted from the medical records were de-identified before analysis.
Written informed consent was obtained from the parents before any testing procedure.
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