This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Purchase Article View Shopping Cart 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 Silfen, M. E. Articles by Oberfield, S. E. Search for Related Content PubMed PubMed Citation Articles by Silfen, M. E. Articles by Oberfield, S. E.

Comparison of Simple Measures of Insulin Sensitivity in Young Girls with Premature Adrenarche: The Fasting Glucose to Insulin Ratio May Be a Simple and Useful Measure¹

Departments of Pediatric Endocrinology (M.E.S., A.M.M., L.S.L., A.R.M., S.E.O.) and Medicine (D.J.M.), Columbia University, New York, New York 10032

Address all correspondence and requests for reprints to: Sharon E. Oberfield, M.D., 630 West 168th Street, PH-5E-522, New York, New York 10032. E-mail: seo8{at}columbia.edu

Abstract

Insulin resistance is a strong predictor of the development of type 2 diabetes mellitus and cardiovascular disease. Girls with premature adrenarche (PA) or obesity may be at an increased risk for the development of insulin resistance. Recently, in prepubertal girls with PA, a fasting glucose to insulin ratio (FGIR) of less than 7 was found to be predictive of insulin resistance as determined by the frequently sampled iv glucose tolerance test. We sought to compare the FGIR with 2 insulin sensitivity measures, SiM (an adjusted mean measure of insulin sensitivity based on fasting and 2 h post glucose load insulin sensitivity measures) and the composite whole body insulin sensitivity index, ISI(comp), both derived from the 2-h oral glucose tolerance test in 2 groups of children at risk: girls with PA and obese girls. We studied 25 prepubertal girls with PA and/or obesity and further classified them as insulin resistant (IR) or insulin sensitive (IS) based on the FGIR. Four simple measures of insulin sensitivity [FGIR, quantitative insulin sensitivity check index (QUICKI), fasting insulin resistance index, and fasting insulin] were compared with SiM and ISI(comp). Additionally, we characterized the subjects in terms of risk factors associated with insulin resistance according to their insulin resistance status based on the FGIR.

In our subjects the strongest correlations overall appeared to be between FGIR and SiM, FGIR and ISI(comp), QUICKI and SiM, and QUICKI and ISI(comp) [correlations (r) ranged from 0.81–0.84]. Furthermore, the IR group had higher body mass index and body mass index z-scores and triglyceride levels than the IS group and were over 3 times more likely to have triglycerides greater than the 95th percentile compared with national norms.

We conclude that the FGIR and QUICKI are highly correlated with oral glucose tolerance test measures of insulin sensitivity. An FGIR less than 7 in young girls with PA or obesity may be helpful in the early identification of children at risk for complications of insulin resistance.

This article has been cited by other articles:

				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]

				R. Rosso, A. Parodi, G. d'Annunzio, F. Ginocchio, L. Nicolini, C. Torrisi, M. P. Sormani, R. Lorini, C. Viscoli, and M. Vignolo Evaluation of insulin resistance in a cohort of HIV-infected youth Eur. J. Endocrinol., November 1, 2007; 157(5): 655 - 659. [Abstract] [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]

				M. Rosenbaum, C. Nonas, M. Horlick, I. Fennoy, I. Vargas, H. Schachner, P. Kringas, K. Stanton, R. Weil, and and the El Camino Diabetes Prevention Group {beta}-Cell Function and Insulin Sensitivity in Early Adolescence: Association with Body Fatness and Family History of Type 2 Diabetes Mellitus J. Clin. Endocrinol. Metab., November 1, 2004; 89(11): 5469 - 5476. [Abstract] [Full Text] [PDF]

				H. M. Domene, S. V. Bengolea, A. S. Martinez, M. G. Ropelato, P. Pennisi, P. Scaglia, J. J. Heinrich, and H. G. Jasper Deficiency of the Circulating Insulin-like Growth Factor System Associated with Inactivation of the Acid-Labile Subunit Gene N. Engl. J. Med., February 5, 2004; 350(6): 570 - 577. [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]

				L. S. Conwell, S. G. Trost, W. J. Brown, and J. A. Batch Indexes of Insulin Resistance and Secretion in Obese Children and Adolescents: A validation study Diabetes Care, February 1, 2004; 27(2): 314 - 319. [Abstract] [Full Text] [PDF]

				M. T. Sheehan Polycystic Ovarian Syndrome: Diagnosis and Management Clin. Med. Res., February 1, 2004; 2(1): 13 - 27. [Abstract] [Full Text] [PDF]

				J. Sheeder, S. H. Travers, and C. Stevens-Simon Is This Patient Insulin Resistant? How Much Does It Matter? Clinical Pediatrics, November 1, 2003; 42(9): 835 - 839. [PDF]

				R. Rabasa-Lhoret, J.-P. Bastard, V. Jan, P.-H. Ducluzeau, F. Andreelli, F. Guebre, J. Bruzeau, C. Louche-Pellissier, C. MaItrepierre, J. Peyrat, et al. Modified Quantitative Insulin Sensitivity Check Index Is Better Correlated to Hyperinsulinemic Glucose Clamp than Other Fasting-Based Index of Insulin Sensitivity in Different Insulin-Resistant States J. Clin. Endocrinol. Metab., October 1, 2003; 88(10): 4917 - 4923. [Abstract] [Full Text] [PDF]

				H. Chen, G. Sullivan, L. Q. Yue, A. Katz, and M. J. Quon QUICKI is a useful index of insulin sensitivity in subjects with hypertension Am J Physiol Endocrinol Metab, April 1, 2003; 284(4): E804 - E812. [Abstract] [Full Text] [PDF]

				L. K. Midyett, W. V. Moore, and J. D. Jacobson Are Pubertal Changes in Girls Before Age 8 Benign? Pediatrics, January 1, 2003; 111(1): 47 - 51. [Abstract] [Full Text] [PDF]

				L Jackson, A Burchell, A McGeechan, and R Hume An inadequate glycaemic response to glucagon is linked to insulin resistance in preterm infants? Arch. Dis. Child. Fetal Neonatal Ed., January 1, 2003; 88(1): F62 - 66. [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]

				G. I. Uwaifo, E. M. Fallon, J. Chin, J. Elberg, S. J. Parikh, and J. A. Yanovski Indices of Insulin Action, Disposal, and Secretion Derived From Fasting Samples and Clamps in Normal Glucose-Tolerant Black and White Children Diabetes Care, November 1, 2002; 25(11): 2081 - 2087. [Abstract] [Full Text] [PDF]

				D. Chin, S. E. Oberfield, M. E. Silfen, D. J. McMahon, A. M. Manibo, D. Accili, and L. S. Levine Proinsulin in Girls: Relationship to Obesity, Hyperinsulinemia, and Puberty J. Clin. Endocrinol. Metab., October 1, 2002; 87(10): 4673 - 4677. [Abstract] [Full Text] [PDF]

				A. Katsuki, Y. Sumida, E. C. Gabazza, S. Murashima, H. Urakawa, K. Morioka, N. Kitagawa, T. Tanaka, R. Araki-Sasaki, Y. Hori, et al. QUICKI Is Useful for Following Improvements in Insulin Sensitivity after Therapy in Patients with Type 2 Diabetes Mellitus J. Clin. Endocrinol. Metab., June 1, 2002; 87(6): 2906 - 2908. [Abstract] [Full Text] [PDF]

				M. J. Quon QUICKI Is a Useful and Accurate Index of Insulin Sensitivity J. Clin. Endocrinol. Metab., February 1, 2002; 87(2): 949 - 950. [Full Text]

				G. E. Duncan, A. D. Hutson, and P. W. Stacpoole QUICKI Is Not a Useful and Accurate Index of Insulin Sensitivity following Exercise Training J. Clin. Endocrinol. Metab., February 1, 2002; 87(2): 950 - 951. [Full Text]

				M. E. Silfen, A. M. Manibo, M. Ferin, D. J. McMahon, L. S. Levine, and S. E. Oberfield Elevated Free IGF-I Levels in Prepubertal Hispanic Girls with Premature Adrenarche: Relationship with Hyperandrogenism and Insulin Sensitivity J. Clin. Endocrinol. Metab., January 1, 2002; 87(1): 398 - 403. [Abstract] [Full Text] [PDF]