The Influence of Obesity on Puberty and Insulin Resistance in Mexican Children

Obesity is considered the main risk factor associated with the development of insulin resistance (IR). The aim of this study was to evaluate the influence of obesity on puberty onset and IR in Mexican children. A total of 378 children (189 boys and 189 girls) aged 8–14 years participated in the study. IR was estimated using the homeostasis model assessment for IR (HOMA-IR). The mean fasting glucose (FG) and basal insulin levels were 82 mg/dl and 11.0 μIU/ml in boys and 77.3 mg/dl and 12.3 μIU/ml in girls (P<0.05). Subjects with obesity at Tanner stages II–V showed increased FG levels (P<0.05). In boys with obesity, there was a decrease in HOMA-IR in Tanner stage IV and differences in age between boys with normal weight and those with obesity in Tanner V, being older the boys with obesity. Obesity in children and adolescents was associated with higher HOMA-IR values. In boys with obesity, IR increased at the end of pubertal maturation, with a delay in puberty. These findings should be considered on the establishment of IR cutoff values for pubertal population in Mexico and in the establishment of strategies to prevent the health problems related to obesity.

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Distribution of the homeostasis model assessment of insulin resistance in Mexican children and adolescents

Acta Endocrinologica ◽

10.1530/eje-11-0844 ◽

2012 ◽

Vol 166 (2) ◽

pp. 301-306 ◽

Cited By ~ 27

Author(s):

Celia Aradillas-García ◽

Martha Rodríguez-Morán ◽

María Eugenia Garay-Sevilla ◽

Juan Manuel Malacara ◽

Ramón Alberto Rascon-Pacheco ◽

...

Keyword(s):

Insulin Resistance ◽

Children And Adolescents ◽

Fasting Glucose ◽

Population Based ◽

Healthy Children ◽

Model Assessment ◽

Homeostasis Model Assessment ◽

Cross Sectional ◽

Glucose Levels ◽

Mexican Children

ObjectiveSeveral cutoff points of the homeostasis model assessment of insulin resistance (HOMA-IR; varying from 2.5 to 4.0) have been suggested for diagnosing IR in youth. In this study, we determined the distribution of the HOMA-IR in Mexican children and adolescents.Design and methodsA total of 6132 children and adolescents from San Luis Potosi, León, Queretaro, and Durango, which are cities in central and northern Mexico, were enrolled in a population-based cross-sectional study. Eligible participants were apparently healthy children and adolescents aged 6–18 years. Pregnancy and the presence of chronic illnesses were exclusion criteria.ResultsA total of 3701 (60.3%) girls and 2431 (39.7%) boys were included in this study. In the overall population, the mean body mass index, insulin levels, and fasting glucose levels were 21.8±1.3 kg/m2, 7.1±3.2 μU/ml, and 86.2±10.0 mg/dl respectively. The concentrations of insulin and fasting glucose gradually increased from 6 to 12 years of age, whereas the concentrations tended to plateau in the 13- to 18-year-old population. The absolute mean of the HOMA-IR was 2.89±0.7. The HOMA-IR gradually increased with age and reached a plateau at 13 years of age.ConclusionsBecause the insulin concentrations, glucose levels, and HOMA-IR exhibited a gradual increase with age that was not related to obesity, our results suggested that the evaluation of IR in children should be based on percentiles of the HOMA-IR rather than a dichotomous value derived from a single cutoff point.

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Association between Myeloperoxidase Levels and Risk of Insulin Resistance in Egyptian Obese Women

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2018.164 ◽

2018 ◽

Vol 6 (4) ◽

pp. 629-633 ◽

Cited By ~ 2

Author(s):

Moushira Zaki ◽

Walaa Basha ◽

Hanaa Reyad ◽

Ramy Mohamed ◽

Naglaa Hassan ◽

...

Keyword(s):

Insulin Resistance ◽

Roc Analysis ◽

Blood Lipids ◽

Fasting Glucose ◽

Model Assessment ◽

Obese Women ◽

Homeostasis Model Assessment ◽

Lower Tertile ◽

Egyptian Women ◽

The Mean

BACKGROUND: Myeloperoxidase (MPO) is an enzyme involved in the pathogenesis of several diseases.AIM: The current study aimed to investigate serum MPO levels in obese Egyptian women and assess its relation with insulin resistance (IR) and other biochemical risk parameters.METHODS: The study included 80 obese women and 50 age-and-sex-matched healthy controls. Insulin resistance (IR) was evaluated by the Homeostasis Model Assessment-Insulin Resistance (HOMA-IR). Serum MPO, fasting glucose, insulin and blood lipids and anthropometry were measured. Obese cases were divided into three groups based on MPO tertiles. ROC analysis was performed to obtain the optimal cut-off values of MPO to predicate IR in obese women.RESULTS: The mean serum MPO was significantly higher in obese cases than controls. Cases in the highest MPO tertile had higher HOMA-IR, blood lipids and pressure levels compared with those in the lower tertile. The cutoff point of MPO was > 87.8 (ng/mL) and area under curves was 0.82 (p < 0.01) for diagnosis of IR. MPO levels were higher in obese Egyptian women than healthy controls.CONCLUSION: Elevation of MPO was associated with abnormal metabolic parameters. MPO might be used as an earlier biomarker for IR and metabolic disturbance in obese women.

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Homeostasis model assessment of insulin resistance (HOMA-IR) and metabolic syndrome at baseline of a multicentric Brazilian cohort: ELSA-Brasil study

Cadernos de Saúde Pública ◽

10.1590/0102-311x00072120 ◽

2020 ◽

Vol 36 (8) ◽

Author(s):

Maria de Fátima Haueisen Sander Diniz ◽

Alline Maria Rezende Beleigoli ◽

Maria Inês Schmidt ◽

Bruce B. Duncan ◽

Antônio Luiz P. Ribeiro ◽

...

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Normal Weight ◽

Overweight And Obesity ◽

Model Assessment ◽

Adult Health ◽

Homeostasis Model Assessment ◽

The Metabolic Syndrome ◽

Brazilian Cohort ◽

Overweight Or Obesity

Abstract: Homeostasis model assessment of insulin resistance (HOMA-IR) is a method to measure insulin resistance. HOMA-IR cut-offs for identifying metabolic syndrome might vary across populations and body mass index (BMI) levels. We aimed to investigate HOMA-insulin resistance cut-offs that best discriminate individuals with insulin resistance and with metabolic syndrome for each BMI category in a large sample of adults without diabetes in the baseline of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Among the 12,313 participants with mean age of 51.2 (SD 8.9) years, the prevalence of metabolic syndrome was 34.6%, and 60.1% had overweight or obesity. The prevalence of metabolic syndrome among normal weight, overweight and obesity categories were, respectively, 13%, 43.2% and 60.7%. The point of maximum combined sensitivity and specificity of HOMA-IR to discriminate the metabolic syndrome was 2.35 in the whole sample, with increasing values at higher BMI categories. This investigation contributes to better understanding HOMA-IR values associated with insulin resistance and metabolic syndrome in a large Brazilian adult sample, and that use of cut-off points according to ROC curve may be the better strategy. It also suggests that different values might be appropriate across BMI categories.

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Pharyngeal collapsibility during sleep is elevated in insulin-resistant females with morbid obesity

European Respiratory Journal ◽

10.1183/13993003.00918-2015 ◽

2016 ◽

Vol 47 (6) ◽

pp. 1718-1726 ◽

Cited By ~ 1

Author(s):

Oscar L. Llanos ◽

Panagis Galiatsatos ◽

Edmarie Guzmán-Vélez ◽

Susheel P. Patil ◽

Philip L. Smith ◽

...

Keyword(s):

Insulin Resistance ◽

Fasting Glucose ◽

Sleep Apnoea ◽

Model Assessment ◽

Rapid Eye Movement Sleep ◽

Homeostasis Model Assessment ◽

Tonsillar Hypertrophy ◽

Insulin Resistant ◽

Bariatric Patients ◽

Respiratory Disturbance

Insulin resistance is associated with sleep apnoea, leading us to hypothesise that it is also associated with elevations in pharyngeal collapsibility, even in the absence of sleep apnoea.90 bariatric patients were characterised for sleep apnoea, pharyngeal collapsibility and insulin resistance. Patients with a respiratory disturbance index (RDI) >10 events·h−1, diabetes mellitus, tonsillar hypertrophy and pulmonary disease were excluded. The remaining 14 females underwent collapsibility measurements (passive critical pressure, Pcritp) during non-rapid eye movement sleep. The homeostasis model assessment (HOMA) index, a measure of insulin resistance, was derived from measurements of fasting glucose and insulin levels, and compared to Pcritp.Groups with high Pcritp compared to low Pcritp did not differ in age, body mass index or RDI. HOMA and insulin were elevated in the high Pcritp group compared to the low Pcritp group (p<0.02). Pcritp correlated with HOMA (Spearman's ρ=0.565, 95% CI 0.104–0.862; p=0.035) and insulin (Spearman's ρ=0.609 95% CI 0.196–0.835; p=0.021).Obese insulin-resistant subjects without frank diabetes or sleep apnoea demonstrate preclinical elevations in pharyngeal collapsibility, which may increase their susceptibility to sleep apnoea. Our findings suggest that insulin resistance could play a significant role in sleep apnoea pathogenesis by generating requisite elevations in pharyngeal collapsibility.

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Sustained Decrease of Early-Phase Insulin Secretion in Japanese Women with Gestational Diabetes Mellitus who Developed Impaired Glucose Tolerance and Impaired Fasting Glucose Postpartum

Japanese Clinical Medicine ◽

10.4137/jcm.s32743 ◽

2015 ◽

Vol 6 ◽

pp. JCM.S32743 ◽

Cited By ~ 4

Author(s):

Hiroko Katayama ◽

Daisuke Tachibana ◽

Akihiro Hamuro ◽

Takuya Misugi ◽

Koka Motoyama ◽

...

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Insulin Secretion ◽

Glucose Tolerance ◽

Plasma Glucose Level ◽

Fasting Glucose ◽

Japanese Women ◽

Insulinogenic Index ◽

Model Assessment ◽

Homeostasis Model Assessment

Objective The aim of this study was to compare glucose intolerance in the antenatal and the postpartum periods using a 75-g oral glucose tolerance test (OGTT) in the Japanese women with gestational diabetes mellitus (GDM) using a retrospective design. Patients and Methods Data were obtained from 85 Japanese women with GDM who delivered from April 2011 through April 2015 and who underwent an OGTT 6–14 weeks postpartum. The women were divided into two groups based on the results of the postpartum OGTT: one group with normal glucose tolerance (NGT) and the other with impaired glucose tolerance (IGT) as well as impaired fasting glucose (IFG). We analyzed the associations between postpartum IGT–IFG and various factors. Results Antenatally, a significant difference was observed between the groups only in the 1-hour plasma glucose level of the 75-g OGTT. Postpartum results of plasma glucose level were significantly higher at 0.5, 1, and 2 hours in the IGT–IFG group than those in the NGT group. Moreover, a significant decrease in the levels of 0.5-hour immunoreactive insulin and insulinogenic index was observed in the IGT–IFG group compared to those in the NGT group. Homeostasis model assessment-insulin resistance and homeostasis model assessment β-cell function of both groups were found to significantly decrease in the postpartum period; however, there was no significant change in the insulinogenic index of either group. Conclusions Our study clearly showed that the postpartum IGT and IFG levels of Japanese women with GDM are affected by impaired early-phase insulin secretion; however, insulin resistance promptly improves.

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Acylated and nonacylated ghrelin levels and their associations with insulin resistance in obese and normal weight children with metabolic syndrome

Acta Endocrinologica ◽

10.1530/eje-09-0375 ◽

2009 ◽

Vol 161 (6) ◽

pp. 861-870 ◽

Cited By ~ 60

Author(s):

Lucia Pacifico ◽

Eleonora Poggiogalle ◽

Francesco Costantino ◽

Caterina Anania ◽

Flavia Ferraro ◽

...

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Fasting Blood Glucose ◽

Tanner Stage ◽

Normal Subjects ◽

Normal Weight ◽

Healthy Children ◽

Model Assessment ◽

Obese Children ◽

The Impact

BackgroundGhrelin, a peptide mainly derived from the stomach, plays a pivotal role in the regulation of food intake, energy metabolism, and storage, as well as in insulin sensitivity. Ghrelin circulates in acylated (A-Ghr) and nonacylated (NA-Ghr) forms, and their potential differential associations with insulin resistance (IR) in childhood obesity remain undefined.ObjectiveWe investigated the associations of ghrelin forms with IR in normal weight and obese children and the impact of metabolic syndrome (MS) on their plasma values.DesignA total of 210 children in four subgroups of normal weight/obese children with and without components of MS were studied. Fasting blood glucose, insulin, lipid profile, and acylated and total ghrelin were examined. IR was determined by a homeostasis model assessment (HOMA) of IR.ResultsIn the entire population, plasma insulin and HOMA-IR were associated negatively with T-Ghr and NA-Ghr, but positively with the ratio of A/NA-Ghr after adjustment for age, gender, and Tanner stage. Obese metabolically abnormal children had lower T-Ghr and NA-Ghr, but comparable A-Ghr and a higher A/NA-Ghr ratio than obese metabolically normal subjects. Compared with lean healthy children, lean metabolically abnormal subjects had higher A-Ghr and the A/NA-Ghr ratio, but comparable T-Ghr and NA-Ghr. A multiple regression analysis showed that A-Ghr and the A/NA-Ghr ratios were positively associated with HOMA-IR, independent of age, gender, Tanner stage, and body mass index (or waist circumference) and other components of MS.ConclusionsA-Ghr excess may negatively modulate insulin action in obese and nonobese children, and may contribute to the association of IR and MS.

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Vitamin D Supplementation Does Not Impact Insulin Resistance in Black and White Children

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2015-3687 ◽

2016 ◽

Vol 101 (4) ◽

pp. 1710-1718 ◽

Cited By ~ 15

Author(s):

Ashley J. Ferira ◽

Emma M. Laing ◽

Dorothy B. Hausman ◽

Daniel B. Hall ◽

George P. McCabe ◽

...

Keyword(s):

Insulin Resistance ◽

Vitamin D ◽

Dose Response ◽

Fasting Glucose ◽

Vitamin D Supplementation ◽

Model Assessment ◽

Homeostasis Model Assessment ◽

White Children ◽

Black And White ◽

Surrogate Measure

Abstract Context: Vitamin D supplementation trials with diabetes-related outcomes have been conducted almost exclusively in adults and provide equivocal findings. Objective: The objective of this study was to determine the dose-response of vitamin D supplementation on fasting glucose, insulin, and a surrogate measure of insulin resistance in white and black children aged 9–13 years, who participated in the Georgia, Purdue, and Indiana University (or GAPI) trial: a 12-week multisite, randomized, triple-masked, dose-response, placebo-controlled vitamin D trial. Design: Black and white children in the early stages of puberty (N = 323, 50% male, 51% black) were equally randomized to receive vitamin D3 (0, 400, 1000, 2000, or 4000 IU/day) for 12 weeks. Fasting serum 25-hydroxyvitamin D (25(OH)D), glucose and insulin were assessed at baseline and weeks 6 and 12. Homeostasis model assessment of insulin resistance was used as a surrogate measure of insulin resistance. Statistical analyses were conducted as intent-to-treat using a mixed effects model. Results: Baseline serum 25(OH)D was inversely associated with insulin (r = −0.140, P = 0.017) and homeostasis model assessment of insulin resistance (r = −0.146, P = 0.012) after adjusting for race, sex, age, pubertal maturation, fat mass, and body mass index. Glucose, insulin, and insulin resistance increased (F > 5.79, P < .003) over the 12 weeks, despite vitamin D dose-dependent increases in serum 25(OH)D. Conclusions: Despite significant baseline inverse relationships between serum 25(OH)D and measures of insulin resistance, vitamin D supplementation had no impact on fasting glucose, insulin, or a surrogate measure of insulin resistance over 12 weeks in apparently healthy children.

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Adolescents with Mild Stunting Show Alterations in Glucose and Insulin Metabolism

Journal of Nutrition and Metabolism ◽

10.1155/2010/943070 ◽

2010 ◽

Vol 2010 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Carla Danusa da Luz Santos ◽

Ana Paula Grotti Clemente ◽

Vinicius José Baccin Martins ◽

Maria Paula Albuquerque ◽

Ana Lydia Sawaya

Keyword(s):

Insulin Resistance ◽

Cell Function ◽

Normal Weight ◽

Model Assessment ◽

Homeostasis Model Assessment ◽

Insulin Metabolism ◽

Z Scores ◽

Study Population ◽

Normal Stature ◽

Height For Age

Purpose. To evaluate glucose and insulin profiles in adolescents with mild stunting and overweight in order to assess the possibility of increased predisposition to diabetes.Subjects and Methods. The study population consisted of 66 pubertal adolescents classified as mildly stunted (height-for-age z scores ≥−2 and <−1) or of normal stature, as well as overweight (body mass index ≥85th percentile) or normal weight. Beta-cell function and insulin resistance were evaluated according to the homeostasis model assessment (HOMA).Results. In the group with mild stunting, glucose, insulin, and HOMA-IR levels were significantly higher in overweight adolescents compared with those of normal weight, whereas HOMA-B levels were significantly lower. Adolescents with mild stunting showed significantly higher accumulations of body and abdominal fat than their normal stature counterparts.Conclusions. The presence of mild stunting was associated with higher levels of glucose and insulin, diminished function of beta cells, and increased insulin resistance. These results reinforce the need for intervention in adolescents with mild stunting.

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Effect of Magnesium Loading Dose on Insulin Resistance in Patients With Stress-Induced Hyperglycemia: A Randomized Clinical Trial

Journal of Intensive Care Medicine ◽

10.1177/0885066618777431 ◽

2018 ◽

Vol 35 (7) ◽

pp. 687-693 ◽

Cited By ~ 2

Author(s):

Zinat Heidary ◽

Hossein Khalili ◽

Mostafa Mohammadi ◽

Mohammad-Taghi Beigmohammadi ◽

Alireza Abdollahi

Keyword(s):

Insulin Resistance ◽

Critically Ill ◽

Critically Ill Patients ◽

Model Assessment ◽

Loading Dose ◽

Homeostasis Model Assessment ◽

Magnesium Supplementation ◽

Intracellular Magnesium ◽

The Mean ◽

To Receive

Objectives: There is currently no evidence that whether magnesium supplementation would improve stress-induced hyperglycemia (SIH) in critically ill patients. In this study, effects of magnesium loading dose on insulin resistance (IR) indices were evaluated in critically ill patients without diabetes having SIH. Methods: Seventy critically ill patients with SIH were assigned to receive a loading dose of magnesium (7.5 g of magnesium sulfate in 500 mL normal saline as intravenous infusion over an 8-hour period) or placebo. Changes in baseline of serum and intracellular magnesium and serum adiponectin (AD) levels, homeostasis model assessment of IR (HOMA-IR), and HOMA-AD ratio were assessed in this study. Results: Serum and intracellular magnesium levels increased significantly in patients in the magnesium group ( P < .001). At day 3, there were significant differences between the magnesium group and the placebo group in the mean changes from baseline in the HOMA (between-group difference: −0.11; 95% confidence interval [CI]: −0.19 to −0.01; P = .02), the AD (between-group difference: 0.94; 95% CI: 0.41-1.48; P = .04), and the HOMA-AD ratio (between-group difference: −0.03; 95% CI: −0.04 to −0.01; P < .001). Conclusion: In the present study, a single-loading dose of intravenous magnesium improved IR indices in critically ill patients with SIH.

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