The incidence of insulin resistance based on indices calculated using the HOMA and Belfiore methods and its impact on the occurrence of metabolic complications in prepubertal children born small for gestational age.

Abstract

Children born small for gestational age (SGA) are predisposed to obesity, insulin resistance (IR), and lipid disorders. TheHOMA-IR index is commonly used to assess IR (IRIHOMA), calculated from fasting glucose and insulin. However, sometimes, during the oral glucose tolerance test (OGTT), elevated and prolonged postprandial insulin secretion is observed despite normal fasting insulin levels. IRIBelfioreis an IR index that analyses glucose and insulin levels during OGTT according to the method proposed by Belfiore. was to assess the frequency of IR based on IRIHOMAand IRIBelfioreresults in SGA children aged 6-8 years, after catch-up phenomenon, to determine the usefulness of IRIBelfiorein diagnosis of IR and in predicting future metabolic complications. In 129 SGA normal-height children, aged 6-8 years, height, weight, waist circumference, blood pressure, as well as lipids, IGF-1, cortisol, C-peptide, leptin, adiponectin, and resistin concentrations were measured.The glucose and insulin concentrations were evaluated at 0, 60,and 120minutes of OGTT. IRIHOMAwas normal in all children, while elevated IRIBelfiorewas found in 22.5% of them. Children with IR diagnosed by IRIBelfiorewere taller, had higher blood pressure, higher leptin, and lower HDL-cholesterol concentrations. It seems worth recommending IRIBelfiore derived from OGTT asavaluable diagnostic tool for identifying IR in SGA prepubertal children. Abnormal IRIBelfiore is related to higher blood pressure and lower HDL-cholesterol concentration in this group.