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Erschienen in:
13.03.2019 | Original Article
Oral glucose effectiveness and metabolic risk in obese children and adolescents
Erschienen in: Acta Diabetologica | Ausgabe 8/2019
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Aim
To investigate whether GE is affected in children/adolescents with obesity and abnormalities of the metabolic syndrome (MetS).
Methods
Cross-sectional study of oral GE (oGE), insulin sensitivity and secretion (calculated on 5 time-points oral glucose tolerance test) and metabolic abnormalities in 1012 patients with overweight/obesity (aged 6.0–17.9 years old). A MetS risk score was calculated on the basis of distribution of fasting glucose, triglycerides, HDL-cholesterol, total cholesterol, systolic and diastolic blood pressure. Non-alcoholic fatty liver disease (NAFLD) was suspected based on thresholds of alanine aminotransferases.
Results
Four-hundred and eighty patients (47.73%) had low-MetS risk score, 488 medium (48.22% with 1–2 risk factors) and 41 (4.05% with ≥ 3 factors) high risk. oGE was significantly lower in subjects with obesity [3.81 (1.46) mg/dl/min− 1] than in those with overweight [4.98 (1.66) mg/dl/min− 1; p value < 0.001]. oGE was negatively correlated with BMI (ρ = − 0.79; p < 0.001) and BMI z score (ρ = − 0.56; p < 0.001) and decreased significantly among MetS risk classes (p = 0.001). The median difference of oGE from low to medium risk was estimated to be as − 4.9%, from medium to high as − 13.38% and from low to high as − 17.62%. oGE was not statistically different between NAFLD+ and NAFLD− cases.
Conclusions
In children and adolescents with obesity oGE decreases. Noteworthy, it decreases as the Met score increases. Therefore, reduced oGE may contribute to the higher risk of these individuals to develop type 2 diabetes.