A cross sectional study of fasting and post prandial insulin level as a predictor of insulin resistance with hyperinsulinemia with HOMA-IR >2.5 among overweight and obese prepubertal children in a tertiary care Hospital of Bangalore, India

Sujith K. R.; Kiran Raj H.

doi:10.18203/2349-3291.ijcp20182532

Authors

Sujith K. R. Department of Pediatrics, Cloud Nine Kids Hospital, Jayanagar, Bangalore, India
Kiran Raj H. Department of Pediatrics, Srinivas Institute of Medical Sciences, Mukka, Mangalore, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20182532

Keywords:

Adoloscents, Hyperinsulinemia, Insulin resistance, Obese, Overweight

Abstract

Background: Overweight and obesity has reached epidemic proportions in developed countries and is rapidly increasing. The proportion of children in the general population who are overweight and obese has doubled over the past two decades in developed and developing countries including India and have a rising prevalence of diabetes. Insulin resistance if detected early, we can intervene early to slow or halt the progression of the associated co morbidities. Dynamic phase of juvenile obesity is initially characterized by an abnormal postprandial profile of plasma insulin, even when fasting insulin levels are still normal and insulin sensitivity is slightly increased. Objective of present study was to find out the occurrence of hyperinsulinemia and Insulin Resistance Markers among overweight and obese children between 7 to 11 years.

Methods: A cross sectional study was carried out in the Bangalore Baptist Hospital, Hebbal, Bangalore from September 2013 to May 2014. Children in the age group of 7 to 11 years who are overweight or obese admitted in the as per WHO Growth Charts were included in the study.A total of 51 Cases were included.

Results: In present study the 21 (41.2%) of the study subjects were classified as Overweight and 30 (58.8%) were Obese. The association between level of HOMA-IR and the study variables like age, weight, Height, BMI, FBS, PPBS were found to not significant statistically with p value being more than 0.5. The Pearson Corelation between HOMA-IR and Fasting Blood Glucose, Post Prandial Blood Glucose level, Fasting Basal Insulin Level and Post Prandial Basal Insulin Level were found to statistically significant.

Conclusions: Hyperinsulinism and insulin resistance is a concern not only in obese but also in overweight children as shown by the occurrence of insulin resistance.

Metrics

Metrics Loading ...

References

Chopra M, Galbraith S, Darnton-Hill I. A global response to a global problem: the epidemic of overnutrition. Bull World Health Organ. 2002;80(12):952-8.

Bundred P, Kitchiner D, Buchan I. Prevalence of overweight and obese children between 1989 and 1998: population based series of cross sectional studies. BMJ. 2001 Feb;322(7282):326.

Ogden CL, Flegal KM, Carroll MD, Johnson CL. Prevalence and trends in overweight among US children and adolescents, 1999-2000. JAMA. 2002 Oct;288(14):1728-32.

King H, Aubert RE, Herman WH. Global burden of diabetes, 1995-2025: prevalence, numerical estimates, and projections. Diabetes Care. 1998 Sep;21(9):1414-31.

Ramachandran A, Snehalatha C, Latha E, Vijay V, Viswanathan M. Rising prevalence of NIDDM in an urban population in India. Diabetologia. 1997 Feb;40(2):232-7.

Gortmaker SL, Dietz WH Jr, Cheung LW. Inactivity, diet, and the fattening of America. J Am Diet Assoc. 1990 Sep;90(9):1247-52, 1255.

Power C, Lake JK, Cole TJ. Measurement and long-term health risks of child and adolescent fatness. Int J Obes Relat Metab Disord. 1997 Jul;21(7):507-26.

Stunkard AJ. Book Review. New Engl J Med. 1998;338(14):998-9.

Must A, Strauss RS. Risks and consequences of childhood and adolescent obesity. Int J Obes Relat Metab Disord. 1999 Mar;23 Suppl 2:S2-11.

Stunff CL, Bougnères P. Early changes in postprandial insulin secretion, not in insulin sensitivity, characterize juvenile obesity. Diabetes. 1994 May;43(5):696-702.

Guo SS, Wu W, Chumlea WC, Roche AF. Predicting overweight and obesity in adulthood from body mass index values in childhood and adolescence. Am J Clin Nutr. 2002 Sep 1;76(3):653-8.

Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. Adults. New Engl J Med. 2003;348(17):1625-38.

Bacha F, Saad R, Gungor N, Arslanian SA. Are obesity-related metabolic risk factors modulated by the degree of insulin resistance in adolescents? Dia Care. 2006 Jul 1;29(7):1599-604.

Healthy Weight: Assessing Your Weight: BMI: About BMI for Children and Teens | DNPAO | CDC [Internet]. [cited 2014 Jun 19]. Available at http://www.cdc.gov/healthyweight/assessing/BMI/childrens_BMI/about_childrens_BMI.html

WHO | Obesity and overweight [Internet]. WHO. [cited 2014 Jun 19]. Available at http://www.who.int/mediacentre/factsheets/fs311/en

Reaven GM, Chen YD, Hollenbeck CB, Sheu WH, Ostrega D, Polonsky KS. Plasma insulin, C-peptide, and proinsulin concentrations in obese and nonobese individuals with varying degrees of glucose tolerance. J Clin Endocrinol Metab. 1993 Jan;76(1):44-8.

Wallace TM, Levy JC, Matthews DR. Use and Abuse of HOMA Modeling. Dia Care. 2004 Jun 1;27(6):1487-95.

Kanauchi M. A New index of insulin sensitivity obtained from the oral glucose tolerance test applicable to advanced type 2 diabetes. Dia Care. 2002 Oct;25(10):1891-2.

Yashpal S, Mk G, Nikhil T, Kumar MR. A study of insulin resistance by HOMA-IR and its cut-off value to identify metabolic syndrome in urban indian adolescents. J Clin Res Pediatr Endocrinol. 2013;5(4):245-51.

Lee S, Choi S, Kim HJ, Chung Y-S, Lee KW, Lee HC, et al. Cutoff values of surrogate measures of insulin resistance for metabolic syndrome in Korean non-diabetic adults. J Korean Med Sci. 2006 Aug;21(4):695-700.

Matsuda Index. Available at http://mmatsuda.diabetes-smc.jp/english.html

Galli-Tsinopoulou A, Karamouzis M, Nousia-Arvanitakis S. Insulin resistance and hyperinsulinemia in prepubertal obese children. J Pediatr Endocrinol Metab. 2003 May;16(4):555-60.

Singh B, Saxena A. Surrogate markers of insulin resistance: A review. World J Diabetes. 2010 May 15;1(2):36-47.

Sinaiko A. Obesity, insulin resistance and the metabolic syndrome. Jornal de Pediatria. 2007 Feb;83(1):3-5.

Hanson RL, Pratley RE, Bogardus C, Narayan KMV, Roumain JML, Imperatore G, et al. Evaluation of Simple Indices of Insulin Sensitivity and Insulin Secretion for Use in Epidemioiogic Studies. Am J Epidemiol. 2000 Jan;151(2):190-8.

Stunff CL, Bougnères P. Early changes in postprandial insulin secretion, not in insulin sensitivity, characterize juvenile obesity. Diabetes. 1994 May;43(5):696-702.