The Incidence of Metabolic Syndrome in Obese Czech Children: the Importance of Early Detection of Insulin Resistance Using Homeostatic Indexes HOMA-IR and QUICKI

Pastucha, Dalibor; Filipčíková, Radka; Horáková, D; Radová, Lenka; Marinov, Zlatko; Malinčíková, Jana; Kocvrlich, Marek; Horák, Stanislav; Bezdickova, Marcela; Dobias, Mira

doi:10.33549/physiolres.932438

Cited by 17 publications

(13 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Next to establishing utility of HOMA-TG index, we observed QUICKI and G/I ratio to be least effective with lowest AUC in ROC curve analysis. This data contrasts to some of the previous finding as demonstrated by Pastucha et al [24] where the researchers identified insulin resistance in 86% of children in comparison to 56% by HOMAIR. Similarly, Bahijri et al [25] who found over estimation of insulin resistance by using QUICKI equation than HOMAIR.…”

Section: Discussioncontrasting

confidence: 99%

Comparison of various steady state surrogate insulin resistance indices in diagnosing metabolic syndrome

Khan¹,

Khan

Chaudhry

et al. 2019

Diabetol Metab Syndr

View full text Add to dashboard Cite

Background Insulin resistance is core cause of metabolic syndrome. Determining insulin resistance is one of the foremost requirements imperative to understanding the pathophysiology of disease. The gold standard “Euglycaemic clamp test” is cumbersome, long and non-feasible in routine clinical setups to diagnose metabolic syndrome. Various continuous and steady state insulin resistance indices are now available in literature. We plan to evaluate commonly utilized steady state insulin resistance indices directly and Homeostasis Model Assessment for Insulin Resistance (HOMAIR) with added triglyceride (HOMA-TG index). Methods The cross-sectional study was carried from Jan-2016 to Dec-2018 at PNS HAFEEZ and department of chemical pathology, AFIP with following objectives: (1) To evaluate steady state insulin resistance markers for diagnosing metabolic syndrome as per IDF defined criteria by ROC curve analysis, (2) to measure Kendal Concordance between various insulin resistance indices and (3) to correlate steady state insulin resistance markers with anthropometric and lipid indices. After several exclusions we selected 224 subjects based upon “non-probability convenience sampling” for inclusion in study. Clinical history, anthropometric measures were calculated and sampling was done for insulin, glucose and other biochemical parameters. Metabolic syndrome was diagnosed as per IDF criteria, while HbA1c was utilized to diagnose diabetes mellitus. Pearson correlation was used to correlate various steady state insulin resistance indices including HOMAIR, HOMA2 index, QUICKI, G/I ratio, HOMA-TG index and serum insulin. AUC was calculated by ROC analysis for all surrogate insulin measures in diagnosis of metabolic syndrome. Results “HOMA-TG index” has shown the highest AUC for diagnosing metabolic syndrome along with higher correlation with lipid markers and anthropometric indices in comparison to other steady-state insulin resistance markers. Furthermore, QUICKI and G/I ratio showed the lowest AUC for detection of metabolic syndrome. Conclusion “HOMA-TG index” has shown highest AUC for metabolic syndrome diagnosis. However, QUICKI and G/I ration showed the lowest AUC for detection of metabolic syndrome. It is hoped that the potential “HOMA-TG index” may provide better diagnostic efficiency for diagnosing metabolic syndrome.

show abstract

Section: Discussioncontrasting

confidence: 99%

Comparison of various steady state surrogate insulin resistance indices in diagnosing metabolic syndrome

Khan¹,

Khan

Chaudhry

et al. 2019

Diabetol Metab Syndr

View full text Add to dashboard Cite

show abstract

“…Studies have been conducted in order to define the diagnostic criteria and cutoff points to determine IR using Homeostatic model assessment (HOMA)-IR, or fasting plasma insulin, although the first is controversial [ 18 ]. The hyperinsulinemic- euglycemic clamp, the gold standard for the diagnosis of IR, is not applicable in clinical practice due to its technical complexity, especially in the pediatric age group [ 9 19 20 21 22 23 24 25 ]. According to Sinaiko [ 13 ], the values of fasting glucose and plasma insulin are the only ones required to calculate HOMA-IR, which intends to demonstrate the correlation between pancreatic capability of insulin production and the capacity of maintaining adequate glucose.…”

Section: Introductionmentioning

confidence: 99%

Different Criteria for the Definition of Insulin Resistance and Its Relation with Dyslipidemia in Overweight and Obese Children and Adolescents

Nogueira‐de‐Almeida

Mello

2018

Pediatr Gastroenterol Hepatol Nutr

View full text Add to dashboard Cite

Purpose: to compare cut off points corrected for age and gender (COOP) with fixed cut off points (FCOP) for fasting plasma insulin and Homeostatic model assessment-insulin resistance (HOMA-IR) for the diagnosis of IR in obese children and adolescents and their correlation with dyslipidemia. Methods: A multicenter, cross-sectional study including 383 subjects aged 7 to 18 years, evaluating fasting blood glucose, plasma insulin, and lipid profile. Subjects with high insulin levels and/or HOMA-IR were considered as having IR, based on two defining criteria: FCOP or CCOP. The frequency of metabolic abnormalities, the presence of IR, and the presence of dyslipidemia in relation to FCOP or CCOP were analyzed using Fisher and Mann-Whitney exact tests. Results: Using HOMA-IR, IR was diagnosed in 155 (40.5%) and 215 (56.1%) patients and, using fasting insulin, 150 (39.2%) and 221 (57.7%), respectively applying FCOP and CCOP. The use of CCOP resulted in lower insulin and HOMA-IR values than FCOP. Dyslipidemia was not related to FCOP or CCOP. Blood glucose remained within normal limits in all patients with IR. There was no difference in the frequency of IR identified by plasma insulin or HOMA-IR, both for FCOP and CCOP. Conclusion: The CCOP of plasma insulin or of HOMA-IR detected more cases of IR as compared to the FCOP, but were not associated with the frequency of dyslipidemia. As blood glucose has almost no fluctuation in this age group, even in the presence of IR, fasting plasma insulin detected the same cases of IR that would be detected by HOMA-IR.

show abstract

“…The need for evidence-based treatment recommendations is a critical healthcare issue because obese children and adolescents are at risk for developing many co-morbidities observed in obese adults. This increase in weight, as well as the decrease in physical activity and cardiorespiratory fitness levels [ 6 ], are in direct proportion to an increasing prevalence of impaired glucose tolerance (IGT) [ 7 ], metabolic syndrome (MetS) [ 8 , 9 ], and type 2 diabetes (T2DM) [ 10 ]. Nevertheless, many data show lower rates in Europe compared to North American data [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Policaptil Gel Retard® significantly reduces body mass index and hyperinsulinism and may decrease the risk of type 2 diabetes mellitus (T2DM) in obese children and adolescents with family history of obesity and T2DM

et al. 2015

View full text Add to dashboard Cite

BackgroundTreatments for childhood obesity are critically needed because of the risk of developing co-morbidities, although the interventions are frequently time-consuming, frustrating, difficult, and expensive.Patients and methodsWe conducted a longitudinal, randomised, clinical study, based on a per protocol analysis, on 133 obese children and adolescents (n = 69 males and 64 females; median age, 11.3 years) with family history of obesity and type 2 diabetes mellitus (T2DM). The patients were divided into three arms: Arm A (n = 53 patients), Arm B (n = 45 patients), and Arm C (n = 35 patients) patients were treated with a low-glycaemic-index (LGI) diet and Policaptil Gel Retard®, only a LGI diet, or only an energy-restricted diet (ERD), respectively. The homeostasis model assessment of insulin resistance (HOMA-IR) and the Matsuda, insulinogenic and disposition indexes were calculated at T0 and after 1 year (T1).ResultsAt T1, the BMI-SD scores were significantly reduced from 2.32 to 1.80 (p < 0.0001) in Arm A and from 2.23 to 1.99 (p < 0.05) in Arm B. Acanthosis nigricans was significantly reduced in Arm A (13.2% to 5.6%; p < 0.05), and glycosylated-haemoglobin levels were significantly reduced in Arms A (p < 0.005). The percentage of glucose-metabolism abnormalities was reduced, although not significantly. However, the HOMA-IR index was significantly reduced in Arms A (p < 0.0001) and B (p < 0.05), with Arm A showing a significant reduction in the insulinogenic index (p < 0.05). Finally, the disposition index was significantly improved in Arms A (p < 0.0001) and B (p < 0.05).ConclusionsA LGI diet, particularly associated with the use of Policaptil Gel Retard®, may reduce weight gain and ameliorate the metabolic syndrome and insulin-resistance parameters in obese children and adolescents with family history of obesity and T2DM.

show abstract

The Incidence of Metabolic Syndrome in Obese Czech Children: the Importance of Early Detection of Insulin Resistance Using Homeostatic Indexes HOMA-IR and QUICKI

Cited by 17 publications

References 28 publications

Comparison of various steady state surrogate insulin resistance indices in diagnosing metabolic syndrome

Comparison of various steady state surrogate insulin resistance indices in diagnosing metabolic syndrome

Different Criteria for the Definition of Insulin Resistance and Its Relation with Dyslipidemia in Overweight and Obese Children and Adolescents

Policaptil Gel Retard® significantly reduces body mass index and hyperinsulinism and may decrease the risk of type 2 diabetes mellitus (T2DM) in obese children and adolescents with family history of obesity and T2DM

Contact Info

Product

Resources

About