Insulin Resistance In Obese Children Research Articles

Detection of the Association between Osteocalcin Level and Insulin Resistance in Obese Children

Abstract Background There is an increasing incidence of obesity among children which is associated with increasing occurrence of diseases which were originally adult diseases. Among these diseases is insulin resistance which was recently found to be related to osteocalcin level. Aim of Work Detect the association between osteocalcin level and insulin resistance among obese children. Subjects and Methods The study included 40 obese children and 20 age and sex matched controls who were recruited from the Clinical Nutrition Clinic, Children`s Hospital, Ain Shams University. All children were subjected to full history taking, dietary history and anthropometric measurements including weight, height, waist circumference, and hip circumference with calculation of body mass index (BMI), waist hip ratio (WHR) and waist height ratio (WHtR). Laboratory tests included fasting glucose, fasting insulin, HOMA-IR and osteocalcin level. Results Obesity was more prevalent among boys (57.5%) in the study population.. Insulin, fasting glucose and HOMA-IR were significantly higher in the obese children compared to the controls with p- values 0.000, 0.007 and 0.000 respectively.Serum insulin ranged between 7.8-37.55 mIU/L, with mean±SD 17.11±7.22 mIU/L in patients, compared to 3.03-9.21 mIU/L, with mean±SD 6.47±1.89 mIU/L in the controls. Fasting glucose ranged between 73-127 mg/dl with mean±SD 96.90±14.41 mg/dl in patients compared to 75-105 mg/dl with mean±SD 87.15±8.79 mg/dl in the controls. HOMA IR in patients ranged between 1.85-11.35 with mean±SD 4.19±2.12 compared to 0.6-1.85 with mean±SD 1.38±0.39 in the controls. Osteocalcin levels were lower ranging between 1.2-94.5 ng/ml with mean±SD of 57.66±28.43 ng/ml in patients compared to a range of 7.2-91 ng/ml with mean±SD of 66.21±19.71 ng/ml in controls, the difference was distinct, but not statistically significant with P-value of 0.233. There were non significant negative correlations between osteocalcin level and each of BMI, WHR and WHtR with r-values -0.136, -0.171 and -0.085 and p-values 0.404, 0.291 and 0.601 respectively. Additionally, there were negative correlations with no statistically significant difference between osteocalcin level and each of fasting glucose, insulin level and HOMA-IR as P-values were 0.687,0.977 and 0.790 respectively; and r - values were -0.066, -0.005 and -0.043 respectively. Conclusion Insulin resistance is demonstrated in pediatric obesity and correlated with osteocalcin levels. Additionally, osteocalcin was distinctly lower in patients and although it didn’t reach statistical significance further larger scale studies are recommended to highlight its possible role as a marker of comorbidities especially insulin resistance in paediatric obesity.

TG/HDL-C Ratio for Predicting Insulin Resistance in Obese Children from Beijing, China.

International studies have found that the blood triglycerides to highdensity lipoproteins (TG/HDL-C) ratio predicted insulin resistance in children with overweight and obesity. However, there is a lack of such reports on children from China. The objective of this study is to explore the ability of the TG/HDL-C ratio as a blood biomarker for insulin resistance (IR) in obese children in Beijing. We evaluated 262 children with obesity from our paediatric outpatient clinic in a cross-sectional study. Detailed medical histories of all children were ascertained, as were clinical examination and laboratory test results, including blood lipids, fasting glucose, insulin, and glycated haemoglobin. We divided them into age groups of 6-9 and 10-13.5 years and then into IR and non-IR groups based on the homeostatic model assessment for IR (HOMA-IR). Analysis was accomplished with SPSS software (version 22.0). The TG/HDL-C ratio was higher in children with IR in the 6-9 and 10-13.5-year age groups (p < 0.001). Univariate and multivariate analyses displayed that the TG/HDL-C ratio and HOMA-IR were correlated in the 6-9 and 10-13.5-year-old groups (p < 0.05). In the 6-9-yearold group, IR identified by a TG/HDL-C ratio ≥ 0.645 had a sensitivity, specificity, and an area under the curve (AUC) of 79.1%, 60.9%, and 0.734, respectively. In the 10-13.5-year-old group, IR identified by a TG/HDL-C ratio ≥ 0.725 had a sensitivity, specificity, and an AUC of 79.4%, 62.9%, and 0.724, respectively. We showed the application of the TG/HDL-C ratio to predict insulin resistance in obese children in Beijing with different diagnostic thresholds based on age (6-9-year-old group with TG/HDL-C ≥ 0.645; 10-13.5-year-old group with TG/HDL-C ≥ 0.725), which were lower compared with the diagnostic threshold for insulin resistance in children reported in other countries.

A Comprehensive Study on the Association between Plasma NOV/CCN3 Levels and Insulin Resistance in Childhood Obesity

Introduction: Childhood obesity is a global health problem that is associated with various metabolic complications, such as insulin resistance, type 2 diabetes, dyslipidemia, and cardiovascular diseases. The mechanisms underlying the development of insulin resistance in childhood obesity are not fully understood. Nephroblastoma overexpressed gene (NOV), also known as CCN3, is a member of the CCN family of matricellular proteins that modulate cell proliferation, differentiation, adhesion, migration, and survival. Previous studies have shown that NOV/CCN3 is involved in glucose metabolism and insulin signaling in various tissues and cell types. However, the role of NOV/CCN3 in childhood obesity and insulin resistance remains unclear. Methods: In this study, we aimed to investigate the association between plasma NOV/CCN3 levels and insulin resistance in 58 obese and 43 non-obese children aged 6–12 years. We measured plasma NOV/CCN3 levels by enzyme-linked immunosorbent assay and assessed insulin resistance by homeostasis model assessment of insulin resistance (HOMA-IR). We also collected clinical and biochemical data, such as body mass index (BMI), waist circumference (WC), blood pressure (BP), fasting glucose (FG), fasting insulin (FI), lipid profile, and inflammatory markers. Results: We found that plasma NOV/CCN3 levels were significantly higher in obese children than in non-obese children (p r = 0.42, p r = 0.38, p r = 0.35, p r = 0.31, p r = 0.45, p r = 0.48, p r = 0.28, p r = 0.26, p r = 0.32, p p Conclusion: These results suggest that plasma NOV/CCN3 levels are elevated in childhood obesity and are associated with insulin resistance, indicating that NOV/CCN3 may play a role in the pathogenesis of metabolic disorders in obese children.

Steroid metabolomic signature of insulin resistance in childhood obesity

Steroid metabolomic signature of insulin resistance in childhood obesity

Assessment of Fibroblast Growth Factor- 21 and Visfatin as Potential Predictors for Insulin Resistance in Obese Children

Assessment of Fibroblast Growth Factor- 21 and Visfatin as Potential Predictors for Insulin Resistance in Obese Children

ИНДЕКСЫ СУРРОГАТНОЙ ОЦЕНКИ ИНСУЛИНОРЕЗИСТЕНТНОСТИ У ДЕТЕЙ И ПОДРОСТКОВ С ОЖИРЕНИЕМ

Obesity is the most common reason for the insulin resistance (IR) though obesity in children is not always associated with IR. The markers based on fasting glucose and/or insulin levels and alternative parameters with conventional lipid-based indexes are used in assessing the IR in clinical practice. The purpose of the research was to assess the relationship between alternative IR surrogate biomarkers as follows: triglycerides (TG) to high-density lipoprotein cholesterol (HDL-C), TG/HDL-C ratio; single-point insulin sensitivity estimator (SPISE) index; triglyceride-glucose index (TyG), with generally accepted indices based on the insulin/glucose ratios, such as HOMA-IR, QUICKI, Caro, in a cohort of obese children and adolescents. Materials and methods used: a single-stage multicenter comparative study was conducted involving 127 patients aged 6 to 17 y/o with simple obesity of varying degrees. The following indices were calculated: HOMA-IR = fasting insulin (mU/ml) x fasting plasma glucose (FPG) (mmol/L) / 22.5; QUICKI = 1/Log (Fasting Insulin, µU/ml) + Log (Fasting Glucose, mg/dl); Caro = fasting plasma glucose (mmol/l) / fasting insulin (μU/ml); TG/HDL-C = TG (mmol/L) / HDL-C (mmol/L); triglyceride-glucose index TyG = Ln [fasting TG (mg/dl) x fasting plasma glucose (mg/dl)/2], where Ln is the logarithm; SPISE = 600 × HDL-C0.185/(TG0.2 x BMI1.338). Results: 75 (59%) boys and 52 (41%) girls were included in the study; the median age was 12.9 [10.4; 14.9] y/o. Pre-pubertal development was recorded in 25 (19.7%), pubertal - in 102 (80.3%). The prevalence of impaired glucose tolerance (IGT) was 5.5%. In children with IGT, the SPISE index was lower than in children with normal glucose tolerance (3.69 [3.49; 4.37] vs. 4.8 [3.99; 5.55], p=0.021) with no statistically significant differences between these groups in other markers. In the IGT subgroup, a high negative correlation was found between SDS BMI and SPISE (R=-0.97). In the general SDS group, BMI correlated with insulin (R=+0.24), TG (R=+0.2), HOMA (R=+0.24), Caro (R=-0.26), TG/HDL-C (R=+0.28) and SPISE (R=-0.65). The SPISE index was lower in girls than in boys (4.94 [3.63; 5.73] vs. 4.07 [3.59; 5.16], p = 0.045). No statistically significant differences were recorded for other gender-related markers. A negative correlation was also found between the obesity degree and SPISE in the subgroups of girls (R=-0.49) and boys (R=-0.70) as well as among pre-pubertal children of both genders (R=-0.61). The maximum correlation between SDS BMI and SPISE was recorded in the subgroup of teenagers of both genders (R=-0.88). In the general group, TyG was weakly correlated with HOMA-IR (R=+0.26) and QUICKI (R=-0.24), while SPISE showed a weak association with all studied insulin indices; no statistically significant correlation between insulin indices and TG/HDL-C was found. In the subgroup of girls, no significant relationships between the evaluated markers were found, in the subgroup of boys, TyG weakly correlated with HOMA-IR (R=+0.29) and QUICKI (R=-0.32). Stronger correlations were recorded in boys between SPISE and all studied insulin indices. In the subgroup of prepubertal patients, a correlation was found between TyG and QUICKI (R=-0.44), SPISE and Caro (R=+0.56), SPISE and HOMA-IR (R=-0.50). The TG/HDL-C ratio did not statistically significantly correlate with traditional IR markers. TyG showed weak correlations with HOMA-IR and QUICKI in the general group and the boys’ subgroup. In the prepubertal period, TyG only weakly correlated with QUICKI and did not show strong associations with insulin-based indices in pubertal children. The SPISE index showed correlations with insulin markers both in the main group and in individual subgroups. Conclusion: the SPISE index can be considered as a relatively simple and accessible method for assessing IR in obese children and adolescents.

Nomogram model for the risk of insulin resistance in obese children and adolescents based on anthropomorphology and lipid derived indicators

ObjectiveThis study aims to screen for measures and lipid-derived indicators associated with insulin resistance (IR) in obese children and adolescents and develop a nomogram model for predicting the risk of insulin resistance.MethodsA total of 404 eligible obese children and adolescents aged 10–17 years were recruited for this study from a summer camp between 2019 and 2021. The risk factors were screened using the least absolute shrinkage and selection operator (LASSO)-logistic regression model, and a nomogram model was developed. The diagnostic value of the model was evaluated by plotting the receiver operator characteristic curve and calculating the area under the curve. Internal validation was performed using the Bootstrap method, with 1000 self-samples to evaluate the model stability. The clinical applicability of the model was assessed by plotting the clinical decision curve.ResultsOn the basis of the LASSO regression analysis results, three lipid-related derivatives, TG/HDL-c, TC/HDL-c, and LDL-c/HDL-c, were finally included in the IR risk prediction model. The nomogram model AUC was 0.804 (95% CI: 0.760 to 0.849). Internal validation results show a C-Index of 0.799, and the mean absolute error between the predicted and actual risks of IR was 0.015. The results of the Hosmer–Lemeshow goodness-of-fit test show a good model prediction (χ2 = 9.523, P = 0.300).ConclusionThree early warning factors, TG/HDL-c, TC/HDL-c, and LDL-c/HDL-c, were screened, which can effectively predict the risk of developing IR in obese children and adolescents, and the nomogram model has an eligible diagnostic value.

The Relationship between Anthropometric Measurements and Vitamin D Levels and Insulin Resistance in Obese Children and Adolescents.

Our investigation aimed to determine the effect of vitamin D levels on the development of insulin resistance in obese adolescents and children and the influences of anthropometric measurements on predicting the development of insulin resistance. In this study, demographic data, laboratory findings, and anthropometric measurements of 150 adolescents and children that had obesity diagnoses between May 2021 and September 2022 were evaluated retrospectively. Those with and without insulin resistance were studied with regard to vitamin D levels, biochemical parameters, and anthropometric measurements. Three groups of patients were created: those with low levels of vitamin D (&lt;20 ng/mL), those with insufficient levels (20-30 ng/mL), and those having normal levels (≥30 ng/mL). Groups were compared in terms of homeostatic model score (HOMA-IR) and anthropometric measurements. Correlation analysis was carried out to ascertain the correlation of anthropometric measurements with HOMA-IR. To ascertain the cutoff, specificity, and sensitivity values of anthropometric parameters in predicting insulin resistance in patients, receiver operating characteristic (ROC) analysis was carried out. Vitamin D levels of obese adolescents and children with insulin resistance were substantially lower than those without insulin resistance (p &lt; 0.001). As the vitamin D level increased, all anthropometric measurements except for the body fat percentage decreased significantly with the HOMA-IR score (p &lt; 0.05). HOMA-IR demonstrated a strong positive relation with waist circumference (rs = 0.726, p &lt; 0.001). Waist circumference had high specificity and sensitivity in predicting insulin resistance (87.3% and 87.4%, respectively). A significant relationship was observed between insulin resistance development and low levels of vitamin D in obese children and adolescents. As vitamin D levels increase, anthropometric measurements are more stable and do not increase. Waist circumference is the most effective anthropometric measurement for predicting the development of insulin resistance in obese adolescents and children.

Branched-chain α-keto acids and glutamate/glutamine: Biomarkers of insulin resistance in childhood obesity.

Insulin resistance (IR) in adolescents with obesity is associated with a sex-dependent metabolic 'signature' comprising the branched-chain amino acids (BCAAs), glutamate/glutamine, C3/C5 acylcarnitines and uric acid. Here, we compared the levels of branched-chain α-keto acids (BCKAs) and glutamate/glutamine, which are the byproducts of BCAA catabolism and uric acid among adolescents with obesity prior to and following a 6-month lifestyle-intervention program. Fasting plasma samples from 33 adolescents with obesity (16 males, 17 females, aged 12-18 year) were analysed by flow-injection tandem MS and LC-MS/MS. Multiple linear regression models were used to correlate changes in BCKAs, glutamate/glutamine and uric acid with changes in weight and insulin sensitivity as assessed by HOMA-IR, adiponectin and the ratio of triglyceride (TG) to HDL. In predictive models, BCKAs, glutamate/glutamine and uric acid at baseline were used as explanatory variables. Baseline BCKAs, glutamate/glutamine and uric acid were higher in males than females despite comparable BMI-metrics. Following lifestyle-intervention, α-keto-β-methylvalerate (α-KMV, a metabolic by product of isoleucine) decreased in males but not in females. The ratio of BCKA/BCAA trended lower in males. In the cohort as a whole, BCKAs correlated positively with the ratio of TG to HDL at baseline and HOMA-IR at 6-month-follow-up. Glutamate/glutamine was positively associated with HOMA-IR at baseline and 6-month-follow-up. A reduction in BCKAs was associated with an increase in adiponectin, and those with higher BCKAs at baseline had higher adiponectin levels at 6-month-follow-up. Interestingly those adolescents with higher uric acid levels at baseline had greater reduction in weight. BCKAs and glutamate/glutamine may serve as biomarkers of IR in adolescents with obesity, and uric acid might serve as a predictor of weight loss in response to lifestyle-intervention. Differential regulation of BCAA catabolism in adolescent males and females implicates critical roles for sex steroids in metabolic homeostasis.

Insulin resistance and intestinal microbial metabolites in childhood obesity

The article deals with the study on the content of fecal short-chain fatty acids (SCFA) and their association with insulin resistance in obese children. It was found that intestinal microflora in obese children is characterized by changes in the qualitative composition and increased metabolic activity of the intestinal microflora. A moderate increase of HOMA-IR is accompanied by elevated concentration of anti-inflammatory cytokines, the content of which correlates with that of acetic, propionic acid and a decrease in the metabolic activity of intestinal microflora. The progression of insulin resistance is accompanied by a further increase in the concentration of anti-inflammatory cytokines, the level of HOMA-IR correlates with the level of propionic SCFA. Thus, modulation of SCFA content may be a promising way of therapeutic influence to correct insulin resistance and obesity in children.

Utility of Adipokines and IL-10 in Association with Anthropometry in Prediction of Insulin Resistance in Obese Children

AimThis is a case-controlled study, with two hundred children enrolled. They were divided into an obese group of 100 children who had BMI ≥ 95th percentile according to CDC criteria and a group of 100 children with normal weight. All enrolled children were subjected to detailed medical history and clinical examination, in addition to measuring fasting blood sugar, fasting serum insulin, HOMA-IR calculation, lipid profile analysis, total serum cholesterol, low- and high-density lipoproteins (LDL and HDL), and serum triglyceride (TG). Two adipokines (lipocalin-2 and adipsin) serum levels plus IL-10 serum level were assessed.ResultsHigher Z score of weight, MI, and waist/height ratio and high serum cholesterol, LDL, TG, and low HDL were observed in obese children. Higher levels of serum lipocalin-2 and adipsin and lower IL-10 blood level were observed in the obese group in comparison with the normal weight children. Higher insulin resistance index was observed in the obese group, with positive correlation of HOMA-IR with the anthropometric measurements and lipocalin serum level, while negative correlation was observed between IL-10 and fasting insulin in obese children.ConclusionSimple measurement of general and central adiposity markers and serum lipocalin-2 can predict insulin resistance in obese children while serum adipsin and IL-10 had no association with insulin resistance.

Visceral Adipose Tissue Molecular Networks and Regulatory microRNA in Pediatric Obesity: An In Silico Approach.

Childhood obesity carries an increased risk of metabolic complications, sleep disturbances, and cancer. Visceral adiposity is independently associated with inflammation and insulin resistance in obese children. However, the underlying pathogenic mechanisms are still unclear. We aimed to detect the gene expression pattern and its regulatory network in the visceral adipose tissue of obese pediatric individuals. Using differentially-expressed genes (DEGs) identified from two publicly available datasets, GSE9624 and GSE88837, we performed functional enrichment, protein–protein interaction, and network analyses to identify pathways, targeting transcription factors (TFs), microRNA (miRNA), and regulatory networks. There were 184 overlapping DEGs with six significant clusters and 19 candidate hub genes. Furthermore, 24 TFs targeted these hub genes. The genes were regulated by miR-16-5p, miR-124-3p, miR-103a-3p, and miR-107, the top miRNA, according to a maximum number of miRNA–mRNA interaction pairs. The miRNA were significantly enriched in several pathways, including lipid metabolism, immune response, vascular inflammation, and brain development, and were associated with prediabetes, diabetic nephropathy, depression, solid tumors, and multiple sclerosis. The genes and miRNA detected in this study involve pathways and diseases related to obesity and obesity-associated complications. The results emphasize the importance of the TGF-β signaling pathway and its regulatory molecules, the immune system, and the adipocytic apoptotic pathway in pediatric obesity. The networks associated with this condition and the molecular mechanisms through which the potential regulators contribute to pathogenesis are open to investigation.

Comparison of Tp-e Interval Between Obese and Healthy Children in Adolescence and its Correlation with Insulin Resistance in Obese Children

Background: Prolonged cardiac repolarization may increase cardiovascular susceptibility to ventricular arrhythmias, leading to sudden cardiac death. This condition in obese children is not clearly demonstrated in childhood. Objectives: This study aimed to investigate the effect of obesity on cardiac electrical activity in children by comparing Tp-e intervals between obese and healthy children and evaluating the correlation between Tp-e intervals and insulin resistance in obese children. Methods: The study enrolled 50 obese and 50 healthy children. A pediatric cardiologist assessed electrocardiograms and echocardiographs. Electrocardiographic, demographic, and laboratory parameters were analyzed statistically. Results: There was no statistically significant difference between the two groups in age and gender (P &gt; 0.05). The Tp-e intervals were statistically higher in the obese group than in the control group (P = 0.001). A statistically significant difference was found between the obese group with or without insulin resistance and the control group in Tp-e intervals (P = 0.001 for all). All other ECG parameters were similar in the patient and control groups. Conclusions: It is essential to recognize the early symptoms of future cardiovascular events in childhood obesity cases. Repolarization differences in obese children, when compared with the normal population, may reflect obesity-related early-stage subclinical findings. Prospective broad-based studies are needed to recognize these early changes.

Fasting Serum IGFBP-1 as a Marker of Insulin Resistance in Diverse School Age Groups.

IntroductionThe known markers of insulin resistance in obese children are well studied. However, they require serial measurements and complicated calculations. The objective is to study IGFBP-1 and its relation with other known risk measures.Materials and MethodsThe study included 98 New York City school students of diverse ethnic/racial backgrounds (57 males and 41 females), 11–15 years of age. Subjects were enrolled in a cross-sectional study, and anthropometric measures were collected. They underwent fasting intravenous glucose tolerance tests (IVGTT), and glucose, insulin, lipids, IGFBP-1, adiponectin and inflammatory markers were collected.ResultsThe subjects were stratified into 3 groups based upon the BMI Z-score. Out of all the subjects, 65.3% were in the group with a BMI Z-score <1 SDS, 16.3% subjects were in the group with a BMI Z-score of 1 to 2 SDS, and 18.4% of the subjects were in the group with a BMI Z-score of more than 2 SDS. The group with a BMI Z-score of more than 2 SDS had increased waist circumference (WC), body fat, increased fasting insulin, and triglycerides (TG). This group had decreased levels of adiponectin and HDL and low IGFBP-1 as compared to the group with BMI <1 SDS. The group with a BMI Z-score of 1 to 2 SDS had a decreased level of IGFBP-1 as compared to the group with a BMI Z-score less than 1 SDS. IGFBP-1 inversely correlated with age, WC, BMI, body fat, TG, and insulin levels. IGFBP-1 positively correlated with adiponectin and HDL levels.ConclusionIGFBP-1 in children can identify the presence of insulin resistance in the group with BMI 1 to 2 SDS, even before the known markers of insulin resistance such as elevated triglycerides and even before decreased HDL and adiponectin levels are identified.

Follistatin-Like 1 and Family with Sequence Similarity to 19 Member A5 Levels Are Decreased in Obese Children and Associated with Glucose Metabolism

Introduction: Childhood obesity is a significant and growing problem worldwide. Recent evidence suggests Follistatin-like 1 (FSTL1) and family with sequence similarity to 19 member A5 (FAM19A5) to be novel adipokines. However, very few studies have examined the plasma levels of FSTL1 and FAM19A5 in children. Therefore, this cross-sectional study evaluated the association between serum FSTL1 and FAM19A5 levels and obesity in children and investigated the relationship between FSTL1 and FAM19A5 and glucose metabolism or endothelial injury. Methods: Fifty-five obese children and 48 healthy controls were recruited. Plasma FSTL1 and FAM19A5 levels were detected using ELISA. In addition, the association between the clinical data and anthropometric parameters was analyzed. Results: Serum FAM19A5 levels were significantly decreased in the obese children, at 189.39 ± 19.10 pg/mL, compared with those without obesity, at 211.08 ± 38.09 pg/mL. Serum concentrations of FSTL1 were also significantly lower in the obese children, at 0.64 (0.37–0.64) ng/mL, compared with those without obesity, at 1.35 (1.05–2.12) ng/mL. In addition, FAM19A5 (OR = 0.943; p = 0.003) was a predictor of insulin resistance in obese children compared with healthy controls. Lastly, serum FAM19A5 and FSTL1 played mediating roles in insulin resistance in children. Conclusion: The serum levels of FAM19A5 and FSTL1 were decreased in obese children; therefore, FAM19A5 and FSTL1 likely play important roles in glucose metabolism in obese children.

Effects of Taekwondo Exercise on Body Composition and Insulin Resistance in Obese Children

The purpose of this study was to investigate effects of Taekwondo exercise on body composition and insulin resistance in obese children located in Busan city. Experimental groups were exercise group(A, n=8), and the control group(B, n=8). The total experimental period was 12 weeks. The %fat in A group had significantly decreased. The muscle mass in A and B group had significantly increased. A group had significantly decreased in TG than B group. The HDL-C in A group had significantly increased in than B group. The insulin in A group had significantly decreased in B group. B group had significantly increased in HOMA-IR. There were significant interaction effect in the %fat, TG, HDL-C, insulin and HOMA-IR. In conclusion, results of this study showed that Taekwondo exercise improve body composition and insulin resistance in obese children.

Urinary C-peptide and urinary C-peptide creatinine ratio as markers for insulin resistance in obese children and adolescents.

Obesity is associated with insulin resistance (IR). Identifying high-risk obese children affected with IR is crucial to apply preventive management. We aimed to assess the diagnostic value of urinary C-peptide (UCP) and urinary C-peptide creatinine ratio (UCPCR) to diagnoseIR in obese children. This prospective cross-sectional study was performed on 60 children with obesity as the study group. Sixty healthy children of matched age and sex with normal body mass index (BMI) served as the control group. Hemostasis model for the assessment of IR (HOMA-IR), glycated hemoglobin (HbA1c), fasting blood glucose and insulin, UCP, and UCPCR were assessed in all included children. UCP and UCPCR were significantly higher in children with obesity (2.075 ± 0.783) ng/ml, (0.200 ± 0.021) nmol/mmol compared to the control group (1.012 ± 0.465) ng/ml, (0.148 ± 0.016) nmol/mmol, respectively. Both UCP and UCPCR were positively correlated with each other and with HOMA-IR, HbA1c, acanthosis nigricans, waist circumference, and BMI. At cutoff ≥2.45, the sensitivity of UCP to diagnose IR in obese children was 71.4%. At cutoff ≥0.20, the sensitivity of UCPCR to diagnose IR in obese children was 87.6%. UCP and UCPCR are promising surrogate markers of IR in children and adolescents with obesity. However, UCPCR is a better marker than UCP. Obesity is associated with IR. Identifying high-risk obese children affected with IR is crucial to apply preventive management. We aimed to assess the diagnostic value of UCP and UCPCR to detect IR in obese children. To the best of our knowledge, we are the first to use UCP and UCPCR to assess IR in obese children. We found that UCP and UCPCR are practical, easy, dependable noninvasive markers to assess IR in children with obesity and could potentially be useful in epidemiological studies and clinical practice.

A novel diagnostic tool in determining insulin resistance in obese children: Triglyceride / HDL ratio

Background/Aim: It is known that the frequency of obesity and insulin resistance is increased in children. Diagnostic laboratory criteria of insulin resistance are unclear in children despite the widespread use of the Homeostasis model assessment for insulin resistance (HOMA-IR). Serum triglyceride (TG)/high-density lipoprotein (HDL) ratio is reported to reflect insulin resistance in recent studies. We aimed to investigate the usefulness of the TG/HDL ratio in determining insulin resistance and its correlation with the HOMA-IR index in overweight/obese children. Methods: Patients who presented to the Pediatric Endocrinology outpatient clinic with excessive weight were examined in this retrospective cohort study. The patients were divided into subgroups according to BMI, sex, pubertal stage, and presence of hepatosteatosis, and the HOMA-IR index and TG/HDL ratios were compared. Results: One hundred and fifty-nine patients aged 5-18 years, with a mean age of 11.4 (3.13) years, were included in the study. Of the patients, 93 (58%) were girls, 99 (62%) were pubertal, and 141 (88.6%) were obese. Seventy-nine (49.6%) patients had insulin resistance. The mean HOMA-IR and TG/HDL were 3.89 (2.29) and 2.71 (1.86), respectively. A positive correlation was found between HOMA-IR value and TG / HDL ratio (r= 0.283, P

The effect of different adiposity factors on insulin resistance in obese children and adolescents.

Insulin resistance (IR) has been common in obese children, but the effect of different adiposity factors on IR is still unclear. To evaluate the associations between IR with body mass index (BMI), waist circumference (WC), body fat mass (BFM), and body fat percentage (BFP) in obese children and adolescents. A total of 224 simple obese children were included in this study, including 150 boys and 74 girls, aged 3-18 who were seen in the clinical nutrition outpatient of Xinhua Hospital from September 2012 to December 2019. Basic information, body composition and laboratory tests were collected. Compared with girls, boys had higher height, weight, BMI, WC, and BFM (P<0.05), but on the contrary, boys' FINS and HOMA- IR were lower than girls' (P>0.05). With the age increasing, height, weight, BMI, BFM, WC, HC, WHtR, FINS and HOMA-IR increased accordingly (P<0.05). The results from univariate analysis and multiple linear regression analysis showed that the impact of BMI on IR was slightly lower than BFM, WC and HC, but higher than BFP, with adjusting for the effects of age, sex and lipid metabolism (P<0.01). Overall adipose tissue, especially abdominaladiposetissue, is a powerful marker in inducing IR in obese children and adolescents. In addition, more attention should be paid to WC and BFM than BMI in obese people with IR.

Relationship Between Vitamin D Deficiency And Insulin Resistance In Obese Children

INTRODUCTION: Obesity represents the major risk factor for development of insulin resistance during childhood and adolescents. In obesity, adipose tissue release free fatty acids, various hormones, and cytokines, resulting in insulin resistance. This study aimed to establish the correlation between vitamin D deficiency and the incidence of insulin resistance in obese children.&#x0D; &#x0D; DESIGN AND METHOD: This analytical cross-sectional study was arranged from December 2019 - February 2020 included 96 students aged 11 - 17 years old from junior and senior high school who met the criteria for obesity in Makassar. The study subjects were parted into two groups, obese children with vitamin D deficiency (levels of 25-hydroxyvitamin D &amp;le; 20 ng/ml) and obese children without vitamin D deficiency group (levels of 25-hydroxyvitamin D &amp;gt; 20 ng/ml). Data were analyzed using univariate and bivariate analysis.&#x0D; &#x0D; RESULTS: The frequency of insulin resistance in obese children with vitamin D deficiency was 28 (54.9%), while obese children without vitamin D deficiency was 10 (22.2%). Based on statistical analysis, the frequency of the occurrence of insulin resistance in vitamin D deficiency obese children was higher than in obese children without vitamin D deficiency with OR = 4.261 (95% CI 1.744 &amp;ndash; 10.411), p = 0.001.&#x0D; &#x0D; CONCLUSION: The risk of insulin resistance in obese children with vitamin D deficiency is 4.261 times higher than obese children without vitamin D deficiency.