Reexploration of glucose metabolism in childhood obesity

Acta Universitatis Medicinalis Anhui 2023 06 v.58 1016-1020     font:big middle small

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Authors:Peng Wu; Liu Deyun; Yang Liqi; Yu yue

Keywords:obese children;prediabetes;impaired fasting blood glucose;impaired glucose tolerance;insulin resistance

DOI:10.19405/j.cnki.issn1000-1492.2023.06.023

〔Abstract〕 Objective To analyze the status of glucose metabolism in obese children. Methods 266 cases of obese children were included in the study, fasting plasma glucose(FPG), fasting insulin(FINS), glycosylated hemoglobin(HbA1c) were measured, Oral glucose tolerance test(OGTT) and insulin release test(IRT) were carried out, insulin resistance index(HOMA-IR), quantified insulin sensitivity index(QUICKI) and peak insulin/fasting insulin(Ip/I0) were calculated. Two hundred non-obese healthy children were used as control group, and glucose metabolism indexes were compared between the two groups. Glucose metabolism indexes and the incidence of insulin resistance(IR) were compared in children with different degrees of obesity. Prediabetes risk factors and body mass index( BMI) correlation were analyzed in obese children. Results The proportion of prediabetes and type 2 diabetes mellitus in obese children was 18. 0%( 48/266). FINS,HOMA-IR and Hb A1c in obesity group were higher than those in the control group,but QUICKI was lower than that in the control group( P<0. 05). There was no significant difference in FPG between the two groups( P = 0. 423). FINS and HOMA-IR of severe obesity group were higher than those of mild to moderate obesity group,Ip/I0was lower than that of mild to moderate obesity group( P<0. 05),and there was no significant difference in FPG,QUICKI,Hb A1c and 2h PG of severe obesity group. There was no significant difference in IR incidence between mild to moderate obesity group and severe obesity group( P = 0. 163). Logistic regression indicated that BMI and acanthosis nigricans was great influential on prediabetes with no statistical significance( P>0. 05). Correlation analysis showed that BMI had no correlation with FPG( P = 0. 160),but was positively correlated with FINS,HOMA-IR,2h PG and Hb A1c( P<0. 05),and negatively correlated with QUICKI and Ip/I0( P<0. 05). Conclusion Abnormal glucose metabolism is available in nearly 20% of obese children. The prevalence of insulin resistance in obese children is not affected by the degree of obesity.