Parameters of Glucose Homeostasis in the Recognition of the Metabolic Syndrome in Young Adults with Prader-Willi Syndrome.

Graziano Grugni,Silvia Longhi,Antonio Fanolla,Antonella Saezza,Giorgio Radetti,Alessandro Sartorio,Fiorenzo Lupi

doi:10.3390/jcm10235635

Abstract

To verify the accuracy of different indices of glucose homeostasis in recognizing the metabolic syndrome in a group of adult patients with Prader–Willi syndrome (PWS), 102 PWS patients (53 females/49 males), age ±SD 26.9 ± 7.6 yrs, Body Mass Index (BMI) 35.7 ± 10.7, were studied. The following indices were assessed in each subject during an oral glucose tolerance test (OGTT): 1 h (>155 mg/dL) and 2 h (140–199 mg/dL) glucose levels, the oral disposition index (ODI), the insulinogenic index (IGI), the insulin resistance (HOMA-IR) were evaluated at baseline, 1 h and 2 h. Although minor differences among indices were found, according to the ROC analysis, no index performed better in recognizing MetS. Furthermore, the diagnostic threshold levels changed over the years and therefore the age-related thresholds were calculated. The easily calculated HOMA-IR at baseline may be used to accurately diagnose MetS, thus avoiding more complicated procedures.

Highlights

Several indices have been developed and tested in order to predict the presence of metabolic syndrome (MetS) both in children and adults, mainly those related to body composition and adiposity [3,4], as well as those derived from the oral glucose tolerance test (OGTT)
Complications associated with morbid weight excess are recognized as the main risk factors for death throughout the life span of subjects with Prader–Willi syndrome (PWS) [28]
The causes of premature mortality, in adult patients, are mainly related to cardiovascular and respiratory problems, as well as to comorbidities associated with type 2 diabetes mellitus (T2DM) [29]

Summary

Introduction

Recognition of MetS allows an intensive treatment of these patients, avoiding the worst consequences In this context, several indices have been developed and tested in order to predict the presence of MetS both in children and adults, mainly those related to body composition and adiposity [3,4], as well as those derived from the oral glucose tolerance test (OGTT). Several indices have been developed and tested in order to predict the presence of MetS both in children and adults, mainly those related to body composition and adiposity [3,4], as well as those derived from the oral glucose tolerance test (OGTT) Among the latter, postload glucose levels after two hours (2 h PG) >140 mg/dL and 155 mg/dL during OGTT seemed to be more accurate in detecting MetS than the 2 h PG [6]

Objectives

Methods

Results

Conclusion