This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Vuguin, P. Articles by Dimartino-Nardi, J. Search for Related Content PubMed PubMed Citation Articles by Vuguin, P. Articles by Dimartino-Nardi, J.

Fasting Glucose Insulin Ratio: A Useful Measure of Insulin Resistance in Girls with Premature Adrenarche

Department of Pediatrics, Division of Pediatric Endocrinology, Albert Einstein College of Medicine/Children’s Hospital, Montefiore Medical Center, Bronx, New York 10467

Address all correspondence and requests for reprints to: Joan DiMartino-Nardi, M.D., Division of Pediatric Endocrinology, Albert Einstein College of Medicine/Children’s Hospital, Montefiore Medical Center, 111 East 210th Street, Bronx, New York 10467. E-mail: jdimartinonardi{at}aol.com

Abstract

The purpose of this study was to determine whether the fasting glucose/insulin ratio is a useful screening test for insulin resistance in prepubertal girls with premature adrenarche. The glucose/insulin ratio was compared with the insulin sensitivity index calculated from the frequently sampled iv glucose tolerance test with tolbutamide using the minimal model computer program. Thirty-three prepubertal girls (22 Caribbean Hispanic and 11 African American; mean age, 6.8 yr; bone age, 8 yr) were studied. All underwent a 60-min ACTH stimulation test. The fasting glucose/insulin ratio was also compared with IGF-binding protein-1 and ACTH-stimulated androgen levels. Insulin sensitivity correlated significantly with the glucose/insulin ratio (0.76; P < 0.001), fasting insulin (0.75; P < 0.001), and IGF-binding protein-1 (0.59; P < 0.005). Stepwise regression analysis with the insulin sensitivity index as the dependent variable showed that the fasting glucose/insulin ratio was significantly predictive of the insulin sensitivity index (P < 0.002). When viewed as a screening test, setting a value of the fasting glucose/insulin ratio of less than 7 as abnormal and of less than 5.7 x 10^-4 min/µU·ml for the insulin sensitivity index as evidence of insulin resistance (normal prepubertal insulin sensitivity index, >5.7 x 10^-4 min/ µU·ml), the sensitivity of the fasting glucose/insulin ratio was 87%, and the specificity was 89%. Furthermore, those girls with a low glucose/insulin ratio (<7) had higher body mass index, fasting insulin, free T, and ACTH-stimulated 17-hydroxypregnenolone and lower fasting IGF-binding protein-1 and SHBG than those girls with a glucose/insulin ratio greater than 7. The fasting glucose/insulin ratio is a useful screening test for insulin resistance in prepubertal Caribbean Hispanic and African American girls with premature adrenarche.

This article has been cited by other articles:

				M. M. Nur, I. M. Newman, and L. M. Siqueira Glucose Metabolism in Overweight Hispanic Adolescents With and Without Polycystic Ovary Syndrome Pediatrics, September 1, 2009; 124(3): e496 - e502. [Abstract] [Full Text] [PDF]

				R. Muniyappa, S. Lee, H. Chen, and M. J. Quon Current approaches for assessing insulin sensitivity and resistance in vivo: advantages, limitations, and appropriate usage Am J Physiol Endocrinol Metab, January 1, 2008; 294(1): E15 - E26. [Abstract] [Full Text] [PDF]

				M. B. Schneider and S. R. Brill Obesity in Children and Adolescents Pediatr. Rev., May 1, 2005; 26(5): 155 - 162. [Full Text] [PDF]

				M. Keskin, S. Kurtoglu, M. Kendirci, M. E. Atabek, and C. Yazici Homeostasis Model Assessment Is More Reliable Than the Fasting Glucose/Insulin Ratio and Quantitative Insulin Sensitivity Check Index for Assessing Insulin Resistance Among Obese Children and Adolescents Pediatrics, April 1, 2005; 115(4): e500 - e503. [Abstract] [Full Text] [PDF]

				C. M. Boney, A. Verma, R. Tucker, and B. R. Vohr Metabolic Syndrome in Childhood: Association With Birth Weight, Maternal Obesity, and Gestational Diabetes Mellitus Pediatrics, March 1, 2005; 115(3): e290 - e296. [Abstract] [Full Text] [PDF]

				G. Carbunaru, P. Prasad, B. Scoccia, P. Shea, N. Hopwood, F. Ziai, Y. T. Chang, S. E. Myers, J. I. Mason, and S. Pang The Hormonal Phenotype of Nonclassic 3{beta}-Hydroxysteroid Dehydrogenase (HSD3B) Deficiency in Hyperandrogenic Females Is Associated with Insulin-Resistant Polycystic Ovary Syndrome and Is Not a Variant of Inherited HSD3B2 Deficiency J. Clin. Endocrinol. Metab., February 1, 2004; 89(2): 783 - 794. [Abstract] [Full Text] [PDF]

				S. Cianfarani, A. Maiorana, C. Geremia, G. Scire, G. L. Spadoni, and D. Germani Blood Glucose Concentrations are Reduced in Children Born Small for Gestational Age (SGA), and Thyroid-Stimulating Hormone Levels are Increased in SGA with Blunted Postnatal Catch-up Growth J. Clin. Endocrinol. Metab., June 1, 2003; 88(6): 2699 - 2705. [Abstract] [Full Text] [PDF]

				M. R. Denburg, M. E. Silfen, A. M. Manibo, D. Chin, L. S. Levine, M. Ferin, D. J. McMahon, C. Go, and S. E. Oberfield Insulin Sensitivity and the Insulin-Like Growth Factor System in Prepubertal Boys with Premature Adrenarche J. Clin. Endocrinol. Metab., December 1, 2002; 87(12): 5604 - 5609. [Abstract] [Full Text] [PDF]

				M. J. Quon Limitations of the Fasting Glucose to Insulin Ratio as an Index of Insulin Sensitivity J. Clin. Endocrinol. Metab., October 1, 2001; 86(10): 4615 - 4617. [Full Text] [PDF]