Insulin sensitivity in skinny, normal weight, overweight and obese children

Abstract

Burden of non-infection diseases of the world population is mainly represented by combination of problems which together are the components of metabolic syndrome. Insulin resistance is recognized as a key pathogenic element of those problems. It takes a long time to develop a full cluster of metabolic syndrome, which leads to some diagnostic difficulties. The insulin sensitivity is the cornerstone of the burden of non-communicable diseases, which is not really well studied. In order to study early cardiovascular risk markers, insulin sensitivity parameters before and after the standard glucose load were analyzed in skinny (Body mass index Z-score < -1.0 SD, n=6), normal weight (BMI Z-score BMI+1.0 SD, n=12), overweight (BMI Zscore +1.1-2.0 SD) and obese (BMI Z-score +2.1-3.0 SD, n=18) children. Anthropometric measurements were performed using standardized devices with further calculation of body mass index and assessment of abdominal adiposity by waist-to-height-ratio. The laboratory assessment of metabolic profile included fasting blood glucose and insulin followed by standard oral glucose tolerance test with 0, 15, 30, 60, 90, 120 time points. Insulin sensitivity has been studied by surrogate coefficients of fasting (central), tissue (peripheral) and whole body components. Fasting insulin sensitivity assessed by homeostasis model assessment of insulin resistance and quantitative insulin sensitivity check indices. Peripheral insulin sensitivity was assessed by insulin sensitivity index (ISI 0.120) suggested by J. Cederholm in M. Gutt modification. It was established that insulin sensitivity varies among adolescents with different trophological status. Whole body and fasting (central) insulin sensitivity decrease with growing visceral adiposity. Peripheral insulin sensitivity is decreased in skinny and severely obese children, but triggered by different causes. Impaired relations between hepatic glucose production and insulin secretion seem the target points for therapeutic metabolic correction in overweight and obese