What Is the Clinical Significance of Insulin Resistance?

Abstract Background We assessed differences in plasma levels of metabolic health and inflammation biomarkers during mid-childhood and early adolescence between children born by cesarean section vs. vaginal delivery. Methods Mother–child pairs (N = 942) enrolled during pregnancy in obstetric practices and child follow-up started at birth. Risk biomarkers were assessed in blood samples collected at the mild-childhood (median = 7 years) and early adolescence (median = 13 years) in-person visits. Results Two hundred and six children (22%) were born by cesarean section. There were no significant differences in biomarker levels between children born by cesarean and children born vaginally in mid-childhood. However, adolescents born by cesarean section had significantly lower adiponectin [% difference (95% confidence interval (CI)) = −11.3 (−18.1, −4.0) µg/mL] compared to vaginal delivery. We also found some suggestion of higher insulin resistance [insulin levels % difference (95% CI) = 11.5 (−0.40, 25.0) µU/mL and HOMA-IR (homeostatic model assessment of insulin resistance) % difference (95% CI) = 9.1 (−2.30, 21.8) U] in adolescents born by cesarean section compared to those born vaginally. Conclusions We found suggestive evidence that adolescents born by cesarean section show differences in certain metabolic health biomarkers relative to adolescents born by vaginal delivery. Further studies are needed to reevaluate these associations since the clinical significance of these differences is unclear. Impact Multiple studies show that children born by cesarean section are at higher risk of obesity compared to those born vaginally. It is unclear yet to what extent this elevated risk may extend to a more adverse profile of biomarkers of metabolic health and inflammation. Adolescents born by cesarean section show small differences in adiponectin and insulin relative to adolescents born by vaginal delivery. Adolescents born by cesarean section may be at higher risk to a more adverse profile of biomarkers of metabolic health and inflammation, but the clinical significance of these differences is uncertain.

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Evaluation of insulin resistance in children and adolescents with obesity

Problems of Endocrinology ◽

10.14341/probl11742 ◽

2003 ◽

Vol 49 (6) ◽

pp. 8-11 ◽

Cited By ~ 1

Author(s):

O. V Borodina ◽

Ye. A. Odud ◽

A. V. Timofeyev ◽

L. Yu. Zhuleva ◽

E. P. Kasatkina

Keyword(s):

Insulin Resistance ◽

Children And Adolescents ◽

Clinical Significance ◽

Time Course ◽

Oral Glucose ◽

Fatty Tissue ◽

Third Stage ◽

Glucose Test ◽

Obesity Indices ◽

Two Parameters

The purpose of the study was to compare the clinical significance of two parameters of insulin resistance (HOMAR and ISI) in children and adolescents with obesity. Sixty-six children and adolescents aged 11-16 years, including 48 individuals with obesity and 18 healthy individuals, were examined. Anthropometric indices, the time course of changes in the concentrations of insulin and glucose during a three-hour oral glucose test, and the fasting serum concentrations of triglycerides, cholesterol, high- and low- density lipoproteins, and leptin were determined. The evaluation of the clinical significance of HOMAR and ISI consisted of three stages. A relationship between HOMAR and ISI to the most studied risk factors of insulin resistance (IR), such as obesity and the pattern of fatty tissue distribution, was studied at the first stage. Correlations of HOMAR and ISI with the anthropometric obesity indices and hormonal and metabolic parameters whose impairment is pathognomonic for IR were determined at the second stage. The spread of IR-associated disorders in children and adolescents with normal and abnormal HOMAR and ISI were compared at the third stage. The analysis has indicated that in obese children and adolescents, HOMAR is higher and ISI is lower than those in normally weighing children and adolescents of the same age, the value of ISI being inversely proportional to the excess of fatty tissue. It has been found that ISI is more closely related with the anthropometric and hormonometabolic signs of IR than HOMAR. The findings have led to the conclusion that in children and adolescents with obesity, a decrease in ISI is a more significant indicator of IR than an increase in HOMAR.

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Insulin resistance: Assessment and clinical significance

Clinical Biochemistry ◽

10.1016/j.clinbiochem.2013.05.006 ◽

2013 ◽

Vol 46 (12) ◽

pp. 1146

Author(s):

Giulio Marchesini

Keyword(s):

Insulin Resistance ◽

Clinical Significance ◽

Resistance Assessment

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CLINICAL SIGNIFICANCE OF INSULIN RESISTANCE SYNDROME IN DEVELOPMENT OF ENDOTHELIAL DYSFUNCTION IN PATIENTS WITH PRIMARY GOUT

Annals of the Russian academy of medical sciences ◽

10.15690/vramn.v67i2.123 ◽

2012 ◽

Vol 67 (2) ◽

pp. 60-63

Author(s):

N. N. Kushnarenko ◽

A. V. Govorin ◽

O. A. Shcherbakova ◽

S. G. Sotnikova ◽

O. V. Ivanitskaya

Keyword(s):

Insulin Resistance ◽

Endothelial Dysfunction ◽

Endothelial Function ◽

Carbohydrate Metabolism ◽

Clinical Significance ◽

Clinical Course ◽

Insulin Resistance Syndrome ◽

Close Link ◽

Chronic Gout ◽

Primary Gout

Endothelial function has been studied in 175 males with primary gout. It has been established that incidence of endothelial dysfunction in patients with primary gout was associated with the clinical course and was marked most of all in patients who had a chronic gout. The correlations found between the parameters of endothelial dysfunction and impaired carbohydrate metabolism suggest close link and coordination between the above processes which contribute greatly to development and progress of atherosclerosis in such patients.

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