{"id":1460,"date":"2024-03-18T12:36:00","date_gmt":"2024-03-18T10:36:00","guid":{"rendered":"https:\/\/pediatria-spisanie.eu\/2024\/03\/18\/ocenka-na-insulinovata-rezistehntnost-v-zavisimost-ot-zatlustiavaneto\/"},"modified":"2025-05-16T13:36:28","modified_gmt":"2025-05-16T10:36:28","slug":"ocenka-na-insulinovata-rezistehntnost-v-zavisimost-ot-zatlustiavaneto","status":"publish","type":"post","link":"https:\/\/pediatria-spisanie.eu\/en\/2024\/03\/18\/ocenka-na-insulinovata-rezistehntnost-v-zavisimost-ot-zatlustiavaneto\/","title":{"rendered":"Assessment of Insulin Resistance in relation to Obesity and Pubertal Development in Children and Adolescents"},"content":{"rendered":"\n\n\t\t
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R. Savova, S. Chipatiso E. Nolan, I. Modeva, N. Yaneva, O. Slavcheva, V. Manolov, A. Banchev, \u041c. Archinkova <\/h3>\n

University Specialized Pediatric Hospital \u201cProf. Ivan Mitev\u201d – Sofia <\/br>\n<\/p>\n\t\t<\/div>\n\t<\/div>\n\t\n\t\n

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Abstract<\/h2>\n\n\n\n

Aim: <\/em><\/strong>To establish the impact of degree of obesity and pubertal development on insulin resistance in obese children.<\/p>\n\n\n\n

Material and methods<\/em><\/strong>: This transversal study included 164 hospitalized overweight or obese   children. Analysis was made for height, weight, evaluation of the degree of obesity- body mass index (BMI, kg\/m2<\/sup>), percentile values (P), and BMI standard deviation score (BMI SDS),  pubertal staging by Tanner scale (T1-T5).<\/p>\n\n\n\n

The dynamics of plasma glucose and insulin during an oral glucose tolerance test (OGTT) were investigated by calculating the homeostatic index for insulin resistance HOMA- IR and categorizing it with literature-derived reference values for age and pubertal stage.<\/p>\n\n\n\n

Results:<\/em><\/strong> Mean age of children was 12.38 \u00b13.09 years (4-17), 68 (41.5%) boys and 96 (58.5%) girls; 9.1% overweight (BMI 85-95 percentile) and 90.9% obese (BMI>95 percentile). The mean BMI-SDS for the whole group was 2.31\u00b11.02, higher in boys than in girls: 2.44\u00b10.91 vs 2.22\u00b11.03, \u0440 <0.005. The mean value of HOMA IR was 4.50\u00b11.16 with high variation from 0.4 to 27.9, without significant difference between boys and girls (\u0440=0.907), and without  correlation with the degree of obesity BMI-SDS (p=0.096). The highest degree of obesity in prepubertal (T1) children 2.55\u00b10.37 was gradually decreasing during pubertal development T2,3,4 to the lowest value at T5, p<0.05,  but with insignificant tendency of increasing HOMA-IR, p=0.062  during pubertal periods T2,3,4.<\/p>\n\n\n\n

Different influences of gender on BMI SDS and HOMA-IR were observed during pubertal development: BMI SDS droped significantly in boys during linear growth T2,3,4 compared to pre- and post-pubertal stage T1,5: 2.28\u00b10.35 vs. 2.52\u00b10.41, p=0.009 but without significant increaisng of HOMA-IR (p=0.593). In contrast, the pubertal period in girls \u04222,3,4 did not change BMI-SDS signicantly (p=0.780), but  significantly increased HOMA-IR: 4.33\u00b12.53 vs. 3.25\u00b11.86 for T1,5, p=0.043.  According to accepted criteria for HOMA-IR evaluation, we found 102\/164 children (62.2%) with an increased index (conditional>95 p) and 62 children with a normal index (conditionally <95 p). When comparing the results of OGTT between the two subgroups, significantly higher values of fasting plasma glucose mmol\/L were found in children with increased HOMA-IR compared to those with normal one – 4.66\u00b10.72 mmol\/L vs. 4.15\u00b10.62 mmol\/L, p=0.0001; 10\/102 children (9.8%) with HOMA-IR>95P had impaired fasting glucose (IFG) ranged 5.6 to 6.9 mmol\/L, another 14 (13.7%) had impaired glucose tolerance (IGT), and 2 children corresponded to subclinical diabetes mellitus (DM). In the group of children with normal HOMA-IR there was no IFG, those with IGT were only 5\/62 (8.1%).<\/p>\n\n\n\n

All insulin values in the course of OGTT were significantly elevated in children with insulin resistance (p=0.0001), but with different dynamics of increasing after stimulation and reduced reserves compared to the initial basal value.<\/p>\n\n\n\n

Conclusion: <\/em><\/strong>Insulin resistance is not a simple function of obesity and is influenced by gender and pubertal development. The latter gives a chance to reduce obesity significantly in boys but increases the risk of insulin resistance in girls. Children with insulin resistance meet more often the criteria for a prediabetes state-IFG and IGT, probably the result of a limited capacity of basal and stimulated insulin secretion in relation to the level of resistance. Obesity requires assessment of insulin resistance and the accompanying metabolic syndrome in view of the optimal therapeutic model.<\/p>\n\n\n\n

Key words: <\/em><\/strong>Children, adolescents, obesiy, pubertal stage, insulin resistance (HOMA IR)<\/em>.<\/p>\n\n\n

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    <\/div>\n\n\n\n

    Address for correspondence:<\/em><\/strong><\/strong><\/p>\n\n\n\n

    University Specialized Pediatric Hospital<\/em><\/p>\n\n\n\n

    \u201cProf. Ivan  Mitev\u201d – Sofia<\/em><\/p>\n\n\n\n

    11, <\/em>\u201c\u0410cad. Ivan Geshov\u201d, Str.<\/em><\/p>\n\n\n\n

    1606, Sofia<\/em><\/p>\n\n\n\n

    Bulgaria<\/em><\/p>\n\n\n\n

    e-mail: savova_radka@yahoo.com<\/em>\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"

    R. Savova, S. Chipatiso E. Nolan, I. Modeva, N. Yaneva, O. Slavcheva, V. Manolov, A. Banchev, \u041c. Archinkova<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_pediatria_doi":"","footnotes":""},"categories":[1301,1333],"tags":[1438,1439,1440,1441,1442,1443,1444,1445,1446,1447,1448,1449,1450,1451,1452,1453,1454,1455,1456],"class_list":["post-1460","post","type-post","status-publish","format-standard","hentry","category-articles","category-issue-1-2024","tag-adolescents-en","tag-children-en","tag-insulin-resistance-homa-ir-en","tag-obesiy-en","tag-pubertal-stage-en","tag-a-banchev-en","tag-v-manolov-en","tag-decza-en","tag-e-nolan-en","tag-zatlastyavane-en","tag-i-modeva-en","tag-insulinova-rezistentnost-homa-ir-en","tag-n-yaneva-en","tag-o-slavcheva-en","tag-oczenka-na-insulinovata-rezistentnost-v-zavisimost-ot-zatlastyavaneto-i-pubertetnoto-razvitie-pri-decza-i-podrastvasthi-en","tag-puberteten-stadij-en","tag-r-savova-en","tag-s-chipatiso-en","tag-yunoshi-en"],"_links":{"self":[{"href":"https:\/\/pediatria-spisanie.eu\/en\/wp-json\/wp\/v2\/posts\/1460","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pediatria-spisanie.eu\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/pediatria-spisanie.eu\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/pediatria-spisanie.eu\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/pediatria-spisanie.eu\/en\/wp-json\/wp\/v2\/comments?post=1460"}],"version-history":[{"count":1,"href":"https:\/\/pediatria-spisanie.eu\/en\/wp-json\/wp\/v2\/posts\/1460\/revisions"}],"predecessor-version":[{"id":1464,"href":"https:\/\/pediatria-spisanie.eu\/en\/wp-json\/wp\/v2\/posts\/1460\/revisions\/1464"}],"wp:attachment":[{"href":"https:\/\/pediatria-spisanie.eu\/en\/wp-json\/wp\/v2\/media?parent=1460"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/pediatria-spisanie.eu\/en\/wp-json\/wp\/v2\/categories?post=1460"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/pediatria-spisanie.eu\/en\/wp-json\/wp\/v2\/tags?post=1460"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}