Homeostasis Model Assessment - Insulin Resistance and Sensitivity (HOMA-IR and IS) Index in Overweight Children Born Small for Gestational Age (SGA)

Abstract

Introduction: Children born small for gestational age (SGA) have increased prevalence of metabolic syndrome, diabetes mellitus type 2 (DM2), hypertension and cardiovascular and cerebrovascular events in adulthood. Patients and Methods: In 100 children born SGA, and in second cohort having 32 obese children born in term with normal birth weight and height, anthropometric measurements and biochemical metabolic profiles were analysed. The Homeostasis Model Assessment - Insulin Resistance and Sensitivity (HOMA-IR and IS) were calculated. Results: Four overweight/obese children (M:F=3:1) with normal height were found among 100 SGA children. The body mass index (BMI) in all 4 children was above the 98th percentile and the mean BMI z-score was (2.04±0.30 SDS). The HOMA-IR index in all four children was increased: 1.26-2.65 (>1). Two teenagers had significant hyperinsulinemia (198.00 uIU/ml and 275 uIU/ml) and were treated with metformin. Two girls needed only a diet and increased physical activity. The mean values of HOMA-IR (1.26-2.65; N< 1) and IS (58 ±17.12) in fo-ur SGA overweight/obese children who caught-up growth had indistinguishable values with the group of 32 (M: F=21:11) obese children (HOMA-IR 1.83±1.2 SDS; IS 82.99±64.53 SDS) born in term with normal birth weight and height. Conclusions: SGA born children are usually thin; nevertheless we found overweight and obesity in 4% of the patients. Two of those children have metabolic syndrome. Excess weight, obesity and metabolic syndrome in SGA children result with increase of their inherent risk for DM2, cardiovascular and cerebrovascular diseases in adulthood.

Association of TyG index with prehypertension or hypertension: a retrospective study in Japanese normoglycemia subjects

“…Specifically, the main limitations of the HIEC are that it is time-consuming, labor-intensive, expensive, and requires an experienced operator to manage the technical difficulties, which constrain its usefulness in clinical practice ( 10 ). Many simplified mathematical models for assessing insulin resistance have been derived in recent years ( 11 ), such as the steady-state model insulin resistance index (HOMA-IR), which is a valid method for assessing insulin resistance calculated from serum glucose and fasting serum insulin ( 12 ). However, HOMA-IR requires a serum insulin test, and not all primary care hospitals are able to perform this program, so we need a simpler and more applicable index.…”

“…Tao et al. summarized the application value of the TyG index for a variety of CVD types and to explore the potential limitations of using this index as a predictor for cardiovascular diseases ( 12 ). But studies on the relationship between TyG and hypertension are less common.…”

In Memoriam Academic Momir Polenakovic, Pediatric Nephrology, Rare Diseases and Publishing in Macedonia

“…Between 2011 and 2019, he assisted in organizing six meetings on rare diseases, attended by some of most prestigious scholars and scientists of Europe [13][14][15][16][17]. The meetings resulted in international projects (IC-GEB), important publications [18][19][20][21][22][23][24][25][26][27][28][29], increased social awareness for the rare diseases, and, finally, the successful treatment of some patients with rare diseases with specific, and often, very expensive medications. The rare diseases community (medical professionals, patient organizations and patients) will sorely miss his civility, kindness, and good will.…”