Abstract
New indexes of adiposity have been introduced to evaluate body-fat distribution and cardiometabolic risk. However, data on the correlation between Insulin Resistance (IR) and these new indexes are limited. We therefore evaluated the relationship between IR and adiposity indexes in children and adolescents with obesity, focusing on gender differences. We retrospectively enrolled 586 patients with obesity (10.80 ± 2.63; 306F/279M). As adiposity indexes we considered body mass index (BMI), BMI-z score, WC, waist-to-height ratio (WHtR), a body shape index (ABSI), triponderal mass index (TMI), visceral adiposity index (VAI) and conicity index (ConI). The homeostasis model assessment for insulin resistance (HOMA-IR), HOMA of percentage β-cell function (HOMA-β), quantitative insulin sensitivity check index (QUICKI), and triglyceride and glucose index (TyG-index) were measured and recorded as IR surrogates. In both sexes, WC and VAI significantly correlated with all IR measurements (p < 0.001). BMI significantly correlated (p < 0.001) with all IR parameters except for the TyG-index in females. Fat mass and TMI correlated with IR parameters only in females, BMI-z score with IR markers except for HOMA-β in males, WHtR with HOMA-β in both sexes (p < 0.05), free fat mass with HOMA-IR and QUICKI only in females (p < 0.01), ConI correlated with the TyG index in females (p = 0.01). Tryglicerides and SBP were correlated with all IR measurements (p < 0.001), in both sexes. Correlations between different sex parameters were significantly more evident in middle puberty. The relationship between IR surrogates and obesity indexes is influenced by gender in pediatrics. Sex-specific differences in obesity-related complications should be considered in preventive intervention decision-making.
Highlights
Insulin resistance (IR) is a crucial factor contributing to the pathogenetic mechanism of several disorders, including type 2 diabetes mellitus (DMT2), hypertension, dyslipidemia, cardiovascular disease, and metabolic syndrome [1,2,3]
Considering that IR is partly attributed to sex differences in fat mass, we focused the evaluation on sex differences
We retrospectively enrolled 586 Caucasian children and adolescents (376 females and 279 males) with obesity (BMI-z score ≥ 2 according to the World Health Organization), aged 10.80 ± 2.63 years referred to the Outpatient Clinics of the Vittore Buzzi Children’s Hospital, Milano, Fondazione IRCCS Policlinico S
Summary
Insulin resistance (IR) is a crucial factor contributing to the pathogenetic mechanism of several disorders, including type 2 diabetes mellitus (DMT2), hypertension, dyslipidemia, cardiovascular disease, and metabolic syndrome [1,2,3]. Euglycemic-hyperinsulinemic clamp is the gold standard method for determining insulin sensitivity. It is invasive, time intensive and not practical in the pediatric age [6,7]. Several indirect methods have been proposed for clinical studies and epidemiological evaluations. Surrogate measures, based on fasting levels of insulin and glucose are validated tools that simplify IR measurement and are used in epidemiological studies and in clinical practice [8,9,10]; these include the homeostasis model assessment for insulin resistance (HOMA-IR), HOMA of percentage β-cell function (HOMA-β) and quantitative insulin sensitivity check index (QUICKI). The triglyceride and glucose index (TyG-index) may be useful for IR prediction in large-scale studies or screening of populations at high risk of diabetes, as they are more sensitive in recognizing IR compared with HOMA-IR [11,12]
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