Oral glucose effectiveness and metabolic risk in obese children and adolescents

Nicola Spreghini, Stefano Cianfarani, Maria Rita Spreghini, Claudia Brufani, Giuseppe Stefano Morino, Elena Inzaghi, Alessio Convertino, Danilo Fintini, Melania Manco

Research output: Contribution to journalArticle

Abstract

AIM: To investigate whether GE is affected in children/adolescents with obesity and abnormalities of the metabolic syndrome (MetS).

METHODS: Cross-sectional study of oral GE (oGE), insulin sensitivity and secretion (calculated on 5 time-points oral glucose tolerance test) and metabolic abnormalities in 1012 patients with overweight/obesity (aged 6.0-17.9 years old). A MetS risk score was calculated on the basis of distribution of fasting glucose, triglycerides, HDL-cholesterol, total cholesterol, systolic and diastolic blood pressure. Non-alcoholic fatty liver disease (NAFLD) was suspected based on thresholds of alanine aminotransferases.

RESULTS: Four-hundred and eighty patients (47.73%) had low-MetS risk score, 488 medium (48.22% with 1-2 risk factors) and 41 (4.05% with ≥ 3 factors) high risk. oGE was significantly lower in subjects with obesity [3.81 (1.46) mg/dl/min- 1] than in those with overweight [4.98 (1.66) mg/dl/min- 1; p value < 0.001]. oGE was negatively correlated with BMI (ρ = - 0.79; p < 0.001) and BMI z score (ρ = - 0.56; p < 0.001) and decreased significantly among MetS risk classes (p = 0.001). The median difference of oGE from low to medium risk was estimated to be as - 4.9%, from medium to high as - 13.38% and from low to high as - 17.62%. oGE was not statistically different between NAFLD+ and NAFLD- cases.

CONCLUSIONS: In children and adolescents with obesity oGE decreases. Noteworthy, it decreases as the Met score increases. Therefore, reduced oGE may contribute to the higher risk of these individuals to develop type 2 diabetes.

Original languageEnglish
JournalActa Diabetologica
DOIs
Publication statusE-pub ahead of print - Mar 13 2019

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Glucose
Pediatric Obesity
Obesity
Blood Pressure
Glucose Tolerance Test
Alanine Transaminase
Type 2 Diabetes Mellitus
HDL Cholesterol
Insulin Resistance
Fasting
Triglycerides
Cross-Sectional Studies
Cholesterol
Non-alcoholic Fatty Liver Disease

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Oral glucose effectiveness and metabolic risk in obese children and adolescents. / Spreghini, Nicola; Cianfarani, Stefano; Spreghini, Maria Rita; Brufani, Claudia; Morino, Giuseppe Stefano; Inzaghi, Elena; Convertino, Alessio; Fintini, Danilo; Manco, Melania.

In: Acta Diabetologica, 13.03.2019.

Research output: Contribution to journalArticle

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title = "Oral glucose effectiveness and metabolic risk in obese children and adolescents",
abstract = "AIM: To investigate whether GE is affected in children/adolescents with obesity and abnormalities of the metabolic syndrome (MetS).METHODS: Cross-sectional study of oral GE (oGE), insulin sensitivity and secretion (calculated on 5 time-points oral glucose tolerance test) and metabolic abnormalities in 1012 patients with overweight/obesity (aged 6.0-17.9 years old). A MetS risk score was calculated on the basis of distribution of fasting glucose, triglycerides, HDL-cholesterol, total cholesterol, systolic and diastolic blood pressure. Non-alcoholic fatty liver disease (NAFLD) was suspected based on thresholds of alanine aminotransferases.RESULTS: Four-hundred and eighty patients (47.73{\%}) had low-MetS risk score, 488 medium (48.22{\%} with 1-2 risk factors) and 41 (4.05{\%} with ≥ 3 factors) high risk. oGE was significantly lower in subjects with obesity [3.81 (1.46) mg/dl/min- 1] than in those with overweight [4.98 (1.66) mg/dl/min- 1; p value < 0.001]. oGE was negatively correlated with BMI (ρ = - 0.79; p < 0.001) and BMI z score (ρ = - 0.56; p < 0.001) and decreased significantly among MetS risk classes (p = 0.001). The median difference of oGE from low to medium risk was estimated to be as - 4.9{\%}, from medium to high as - 13.38{\%} and from low to high as - 17.62{\%}. oGE was not statistically different between NAFLD+ and NAFLD- cases.CONCLUSIONS: In children and adolescents with obesity oGE decreases. Noteworthy, it decreases as the Met score increases. Therefore, reduced oGE may contribute to the higher risk of these individuals to develop type 2 diabetes.",
author = "Nicola Spreghini and Stefano Cianfarani and Spreghini, {Maria Rita} and Claudia Brufani and Morino, {Giuseppe Stefano} and Elena Inzaghi and Alessio Convertino and Danilo Fintini and Melania Manco",
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T1 - Oral glucose effectiveness and metabolic risk in obese children and adolescents

AU - Spreghini, Nicola

AU - Cianfarani, Stefano

AU - Spreghini, Maria Rita

AU - Brufani, Claudia

AU - Morino, Giuseppe Stefano

AU - Inzaghi, Elena

AU - Convertino, Alessio

AU - Fintini, Danilo

AU - Manco, Melania

PY - 2019/3/13

Y1 - 2019/3/13

N2 - AIM: To investigate whether GE is affected in children/adolescents with obesity and abnormalities of the metabolic syndrome (MetS).METHODS: Cross-sectional study of oral GE (oGE), insulin sensitivity and secretion (calculated on 5 time-points oral glucose tolerance test) and metabolic abnormalities in 1012 patients with overweight/obesity (aged 6.0-17.9 years old). A MetS risk score was calculated on the basis of distribution of fasting glucose, triglycerides, HDL-cholesterol, total cholesterol, systolic and diastolic blood pressure. Non-alcoholic fatty liver disease (NAFLD) was suspected based on thresholds of alanine aminotransferases.RESULTS: Four-hundred and eighty patients (47.73%) had low-MetS risk score, 488 medium (48.22% with 1-2 risk factors) and 41 (4.05% with ≥ 3 factors) high risk. oGE was significantly lower in subjects with obesity [3.81 (1.46) mg/dl/min- 1] than in those with overweight [4.98 (1.66) mg/dl/min- 1; p value < 0.001]. oGE was negatively correlated with BMI (ρ = - 0.79; p < 0.001) and BMI z score (ρ = - 0.56; p < 0.001) and decreased significantly among MetS risk classes (p = 0.001). The median difference of oGE from low to medium risk was estimated to be as - 4.9%, from medium to high as - 13.38% and from low to high as - 17.62%. oGE was not statistically different between NAFLD+ and NAFLD- cases.CONCLUSIONS: In children and adolescents with obesity oGE decreases. Noteworthy, it decreases as the Met score increases. Therefore, reduced oGE may contribute to the higher risk of these individuals to develop type 2 diabetes.

AB - AIM: To investigate whether GE is affected in children/adolescents with obesity and abnormalities of the metabolic syndrome (MetS).METHODS: Cross-sectional study of oral GE (oGE), insulin sensitivity and secretion (calculated on 5 time-points oral glucose tolerance test) and metabolic abnormalities in 1012 patients with overweight/obesity (aged 6.0-17.9 years old). A MetS risk score was calculated on the basis of distribution of fasting glucose, triglycerides, HDL-cholesterol, total cholesterol, systolic and diastolic blood pressure. Non-alcoholic fatty liver disease (NAFLD) was suspected based on thresholds of alanine aminotransferases.RESULTS: Four-hundred and eighty patients (47.73%) had low-MetS risk score, 488 medium (48.22% with 1-2 risk factors) and 41 (4.05% with ≥ 3 factors) high risk. oGE was significantly lower in subjects with obesity [3.81 (1.46) mg/dl/min- 1] than in those with overweight [4.98 (1.66) mg/dl/min- 1; p value < 0.001]. oGE was negatively correlated with BMI (ρ = - 0.79; p < 0.001) and BMI z score (ρ = - 0.56; p < 0.001) and decreased significantly among MetS risk classes (p = 0.001). The median difference of oGE from low to medium risk was estimated to be as - 4.9%, from medium to high as - 13.38% and from low to high as - 17.62%. oGE was not statistically different between NAFLD+ and NAFLD- cases.CONCLUSIONS: In children and adolescents with obesity oGE decreases. Noteworthy, it decreases as the Met score increases. Therefore, reduced oGE may contribute to the higher risk of these individuals to develop type 2 diabetes.

U2 - 10.1007/s00592-019-01303-y

DO - 10.1007/s00592-019-01303-y

M3 - Article

C2 - 30868315

JO - Acta Diabetologica

JF - Acta Diabetologica

SN - 0940-5429

ER -