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Impaired fasting glucose and impaired glucose tolerance in children and adolescents with overweight/obesity

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Abstract

Objective

To investigate in a large sample of overweight/obese (OW/OB) children and adolescents the prevalence of prediabetic phenotypes such as impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), and to assess their association with cardiometabolic risk (CMR) factors including hepatic steatosis (HS).

Methods

Population data were obtained from the CARdiometabolic risk factors in children and adolescents in ITALY study. Between 2003 and 2013, 3088 youths (972 children and 2116 adolescents) received oral glucose tolerance test (OGTT) and were included in the study. In 798 individuals, abdominal ultrasound for identification of HS was available.

Results

The prevalence of IFG (3.2 vs. 3.3%) and IGT (4.6 vs. 5.0%) was similar between children and adolescents. Children with isolated IGT had a 2–11 fold increased risk of high LDL-C, non-HDL-C, Tg/HDL-C ratio, and low insulin sensitivity, when compared to those with normal glucose tolerance (NGT). No significant association of IFG with any CMR factor was found in children. Among adolescents, IGT subjects, and to a lesser extent those with IFG, showed a worse CMR profile compared to NGT subgroup. In the overall sample, IGT phenotype showed a twofold increased risk of HS compared to NGT subgroup.

Conclusions

Our study shows an unexpected similar prevalence of IFG and IGT between children and adolescents with overweight/obesity. The IGT phenotype was associated with a worse CMR profile in both children and adolescents. Phenotyping prediabetes conditions by OGTT should be done as part of prediction and prevention of cardiometabolic diseases in OW/OB youth since early childhood.

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Authors’ contribution

PDB, LP, CC, GV, and MGB made substantial contributions to the conception and design of the study and wrote and edited the manuscript. MM, MRL, CM, LP, EMdG, AM, FF, SL, GT, and CI collected, analyzed, and interpreted the data and wrote the manuscript. All authors reviewed and accepted the final version of the manuscript. PDB, GV, and MGB are guarantors of this work.

Funding

This work was funded by research grants from the Regione Autonoma della Sardegna (Grant RAS 2007 n.CRP-59453), and from the Foundation Banca d’Italia (Projects 2015), all awarded to Marco G. Baroni.

Author information

Authors and Affiliations

  1. Department of Internal Medicine, “S. Maria delle Grazie”, Pozzuoli Hospital, Naples, Italy

    P. Di Bonito

  2. Policlinico Umberto I Hospital, Sapienza University of Rome, 00161, Rome, Italy

    L. Pacifico

  3. Institute of Translational Pharmacology, National Research Council, Rome, Italy

    C. Chiesa

  4. Department of Movement and Wellness Sciences, Parthenope University, Naples, Italy

    G. Valerio

  5. Department of Woman, Child and General and Specialized Surgery, Second University of Naples, Naples, Italy

    E. Miraglia del Giudice

  6. Pediatric Diabetes and Metabolic Disorders Unit, University of Verona, Verona, Italy

    C. Maffeis & A. Morandi

  7. Department of Medical Sciences and Rehabilitation, IRCCS Istituto Auxologico Italiano, Milan, Italy

    C. Invitti

  8. Department of Pediatrics, AORN Santobono-Pausilipon, Naples, Italy

    M. R. Licenziati

  9. Pediatric Endocrine Unit, Regional Hospital for Microcitemia, Cagliari, Italy

    S. Loche

  10. Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy

    G. Tornese

  11. Pediatric Unity, AOU Udine, Udine, Italy

    F. Franco

  12. IRCCS Bambino Gesù Children’s Hospital, Rome, Italy

    M. Manco

  13. Department of Medical Sciences, University of Cagliari, Cagliari, Italy

    M. G. Baroni

  14. Endocrinology, Department Experimental Medicine, Sapienza University of Rome, Rome, Italy

    M. G. Baroni

Authors
  1. P. Di Bonito
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Consortia

for the “CARdiometabolic risk factors in overweight and obese children in ITALY” (CARITALY) Study Group

  • D. Driul
  • , A. Grandone
  • , M. Incani
  • , M. G. Pani
  • , Michela Tomat
  • , E. Sanguigno
  • , L. Gilardini
  •  & M. C. Pellegrin

Corresponding author

Correspondence to L. Pacifico.

Ethics declarations

Conflict of interest

The authors have no conflicts of interest relevant to this manuscript to disclose.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

All participating centers obtained informed consent from parents of subjects included in the study.

Additional information

See “Appendix” for a detailed list of CARITALY investigators, who belong to the Childhood Obesity Study Group of the Italian Society of Pediatric Endocrinology and Diabetology.

Appendix

Appendix

The CARdiometabolic risk factors in overweight and obese children in ITALY (CARITALY) Investigators:

D. Driul, Pediatric Unity, AOU Udine, Udine, Italy.

A. Grandone, Department of Woman, Child and General and Specialized Surgery, SUN, Naples, Italy.

M. Incani and M. G. Pani, Department of Medical Sciences, University of Cagliari, Cagliari, Italy.

Michela Tomat, Pediatric Unit, AOU Udine, Udine, Italy.

E. Sanguigno, Pediatric Unit, “S. Maria delle Grazie”, Pozzuoli Hospital, Naples, Italy.

L. Gilardini, IRCCS Istituto Auxologico Italiano, Department of Medical Sciences & Rehabilitation, Milan, Italy.

M. C. Pellegrin, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy.

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Di Bonito, P., Pacifico, L., Chiesa, C. et al. Impaired fasting glucose and impaired glucose tolerance in children and adolescents with overweight/obesity. J Endocrinol Invest 40, 409–416 (2017). https://doi.org/10.1007/s40618-016-0576-8

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  • DOI: https://doi.org/10.1007/s40618-016-0576-8

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