Glucose homeostasis and insulin resistance: prevalence, gender differences and predictors in adolescents

Diabetology & Metabolic Syndrome

Vojtěch Hainer¹  Marie Kunešová¹  Richard Hampl¹  Martin Hill¹  Petr Hlavatý¹  Barbora Sedláčková²  Lenka Dušátková²  Hana Zamrazilová¹  Irena Aldhoon-Hainerová³ 

[1] Institute of Endocrinology, Obesity Management Center, Národní 8, 116 94 Prague 1, Czech Republic;Faculty of Science, Charles University, Albertov 6, 128 43 Prague 2, Czech Republic;Department of Pediatrics and Center for Research of Diabetes, Metabolism and Nutrition, Third Faculty of Medicine, Charles University, Šrobárova 50, 100 34 Prague 10, Czech Republic

关键词: Type 2 diabetes;    Obesity;    Metabolic syndrome;    Insulin resistance;    HOMA-IR prediction;    Glucose homeostasis;    Adolescence;   

Others  :  1114991
DOI  :  10.1186/1758-5996-6-100

 received in 2014-06-08, accepted in 2014-08-16,  发布年份 2014

【 摘 要 】

Background

Adolescence, due to transient pubertal insulin resistance (IR), is associated with a higher risk for disturbances of glucose metabolism. The aim of our study was 1) to investigate the prevalence of disturbances of glucose metabolism, 2) to define gender specific homeostasis model assessment of insulin resistance (HOMA-IR) thresholds associated with increased cardiometabolic risks and 3) to provide predictors of HOMA-IR.

Methods

The studied cohort consisted of Czech adolescents aged 13.0-17.9 years: 1,518 individuals of general population and three studied groups according weight category (615 normal weight, 230 overweight and 683 obese). The prevalence of IR, impaired fasting glucose (IFG) and type 2 diabetes was assessed. Risky HOMA-IR thresholds based on components of metabolic syndrome were investigated. HOMA-IR prediction was calculated taking into account age, blood pressure, multiple anthropometric, biochemical and hormonal parameters.

Results

In general population cohort, the prevalence of IFG and type 2 diabetes was 7.0% and <0.5%, respectively. Boys regardless of weight presented significantly higher levels of blood glucose and higher prevalence of IFG than girls. Obese boys were found more insulin resistant than obese girls. HOMA-IR thresholds of 3.6 for girls and 4.4 for boys were associated with increased cardiometabolic risks. For both genders, the model of HOMA-IR prediction was composed of age, BMI, ratio of free triiodthyronine to free thyroxine, gamma-glutamyltransferase activity and levels of triglycerides and sex hormone-binding globulin.

Conclusions

The type 2 diabetes in adolescents, including those who were obese, was rarely diagnosed. Obese adolescent boys were at greater risk for IR and for IFG than obese girls. In adolescence, thresholds of HOMA-IR in contrast to predictors were found gender specific.

【 授权许可】

   
2014 Aldhoon-Hainerová et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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