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Insulin-sensitive obese children display a favorable metabolic profile

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Abstract

Most of what is known about the metabolically healthy obese phenomenon is derived from studies in the adult population and no standardized criteria to identify these individuals exist to date. The aim of this study was to determine if the preserved insulin sensitivity evaluated by homeostatic model assessment of insulin resistance (HOMA-IR) index is associated with favorable metabolic profile in the obese children. We studied a group of 248 children and adolescents (150 female, 98 male), aged 5.9–18.9 years with diet-induced obesity (BMI >95th percentile). The entire cohort was divided into quartiles based on levels of insulin resistance determined by HOMA-IR index. Subjects in the lower quartile of HOMA-IR were classified as insulin-sensitive group (ISG), whereas children in the upper quartile were categorized as insulin-resistant group (IRG). The ISG subjects had values of HOMA-IR ≤2.75 while the children from the IRG group had HOMA-IR ≥6.16. Subjects from ISG group had lower basal β-cell activity and were less likely to have impaired fasting glucose or impaired glucose tolerance. Concentrations of LDL and total cholesterol, triglycerides, and transaminases were lower and HDL cholesterol levels were higher in ISG subjects. Findings obtained by the use of Matsuda index correlated well with the findings obtained by the use of HOMA-IR. Conclusion: Lower HOMA-IR values were significantly associated with favorable metabolic profile in studied children, which correlates with findings in the adult population and emphasizes the need for further, longitudinal studies of insulin resistance development in childhood obesity.

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Acknowledgments

This study was supported by the Ministry of Education and Science of the Republic of Serbia through project no. 175042, 2011–2014.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Endocrinology, Mother and Child Health Care Institute of Serbia “Dr Vukan Cupic”, 11070, Belgrade, Serbia

    Rade Vukovic, Katarina Mitrovic, Tatjana Milenkovic, Sladjana Todorovic & Dragan Zdravkovic

  2. Institute of Medical Statistics, School of Medicine, Belgrade University, 11000, Belgrade, Serbia

    Ivan Soldatovic

  3. Institute of Epidemiology, School of Medicine, Belgrade University, 11000, Belgrade, Serbia

    Sandra Sipetic-Grujicic

  4. School of Medicine, Belgrade University, 11000, Belgrade, Serbia

    Dragan Zdravkovic

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  1. Rade Vukovic
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  2. Katarina Mitrovic
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  3. Tatjana Milenkovic
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  4. Sladjana Todorovic
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  5. Ivan Soldatovic
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Correspondence to Rade Vukovic.

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Vukovic, R., Mitrovic, K., Milenkovic, T. et al. Insulin-sensitive obese children display a favorable metabolic profile. Eur J Pediatr 172, 201–206 (2013). https://doi.org/10.1007/s00431-012-1867-5

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  • DOI: https://doi.org/10.1007/s00431-012-1867-5

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