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1-hour postload hyperglycaemia in obese children tied to unfavourable metabolic profile

07 Nov 2018

Plasma glucose levels at 1 hour (1h-GL) of ≥8.6 mmol/L during an oral glucose tolerance test (OGTT) in obese children appear to be associated with hyperinsulinaemia, insulin resistance (IR), elevated levels of interleukin (IL)-6 and visfatin, and reduced adiponectin, a study has found.

Researchers classified 88 obese children according to 1h‐GL during an OGTT: group 1 comprised those with 1h‐GL <8.6 mmol/L (n=57) while group 2 included those with 1h‐GL ≥8.6 mmol/L (n=31). Outcomes investigated included specific IR indices (HOMA‐IR, Matsuda index and Cederholm insulin sensitivity index [ISI]), lipid levels and proinflammatory biomarkers correlated with obesity complications (adiponectin, leptin, visfatin and IL‐6).

Compared with those in group 1, children in group 2 had higher insulin (median, 15.5 vs 10.9 μU/mL) and HOMA‐IR (median, 3.41 vs 2.34), as well as lower Matsuda index (median, 4.7 vs 18.4) and Cederholm ISI (38 vs 56; p<0.001 for all).

Moreover, group 2 vs 1 showed greater levels of visfatin (15.4 vs 10.1 ng/mL) and IL‐6 (12.5 vs 4.8 pg/mL), and lower adiponectin concentration (5.9 vs 11.8 μg/mL; p<0.001 for all).

Logistic regression analysis showed that the between-group differences persisted independent of age, sex, Tanner stage, body mass index and waist circumference z‐scores.

The present data indicate that 1h-GL hyperglycaemia in obese children is associated with an unfavourable overall metabolic profile that may lead to overt type 2 diabetes and cardiovascular disease later in life, researchers said. Therefore, 1h-GL>8.6 mmol/L during OGTT could be used as an additional marker to help identify those who are at increased risk of developing obesity complications.

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