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 Brandou, F. Articles by Mercier, J. Search for Related Content PubMed PubMed Citation Articles by Brandou, F. Articles by Mercier, J. Related Collections Pediatric Endocrinology Diabetes and Insulin Obesity

Limited Accuracy of Surrogates of Insulin Resistance during Puberty in Obese and Lean Children at Risk for Altered Glucoregulation

Equipe d’Accueil 701, Physiologie des Interactions, Service Central de Physiologie Clinique, Centre d’Exploration et de Réadaptation des Anomalies du Métabolisme Musculaire, Centre Hospitalier Universitaire Lapeyronie (F.B., J.-F.B., J.M.), 34295 Montpellier, France

Address all correspondence and requests for reprints to: Dr. Frédérique Brandou, Institut de Biologie, boulevard Henry IV, 34060 Montpellier, France. E-mail: fredbrandou{at}yahoo.fr.

This study evaluated the accuracy of surrogate indexes of insulin sensitivity (SI) in children. Surrogates (homeostasis model assessment index of insulin resistance, quick insulin sensitivity index, and 40/insulin ratio index) were cross-sectionally investigated in 66 obese and lean children (17 Tanner stage I, 19 Tanner stage II–III, and 30 Tanner stage IV–V) as indexes of insulin resistance in comparison with the minimal model. The pubertal decrease in SI was found with the minimal model (–47%; P = 0.01), but not with surrogates, which were not correlated to SI. Baseline insulin (Ib) did not mirror the decrease in SI, did not significantly change when plotted against pubertal stage or age, and was not correlated to SI. Ib and surrogates were positively correlated with the body mass index. The disposition index, which quantifies the feedback between SI and insulin release, was widely scattered and decreased during puberty (P = 0.05). The specificity and sensitivity of surrogates as predictors of insulin resistance were poor (e.g. 81.1% and 30.7%, respectively, for the homeostasis model assessment index of insulin resistance). Thus, during puberty, surrogates are not accurate predictors of insulin resistance. Because reference methods are rather expensive and invasive, additional studies of alternative techniques for evaluating SI are needed to allow accurate measurement of insulin resistance in children.

This article has been cited by other articles:

				R. H. Willemsen, S. P. Willemsen, and A. C. S. Hokken-Koelega Longitudinal Changes in Insulin Sensitivity and Body Composition of Small-For-Gestational-Age Adolescents after Cessation of Growth Hormone Treatment J. Clin. Endocrinol. Metab., September 1, 2008; 93(9): 3449 - 3454. [Abstract] [Full Text] [PDF]

				B. Schwartz, D. R. Jacobs Jr., A. Moran, J. Steinberger, C.-P. Hong, and A. R. Sinaiko Measurement of Insulin Sensitivity in Children: Comparison between the euglycemic-hyperinsulinemic clamp and surrogate measures Diabetes Care, April 1, 2008; 31(4): 783 - 788. [Abstract] [Full Text] [PDF]

				S. M. Rossner, M. Neovius, S. M. Montgomery, C. Marcus, and S. Norgren Alternative Methods of Insulin Sensitivity Assessment in Obese Children and Adolescents Diabetes Care, April 1, 2008; 31(4): 802 - 804. [Abstract] [Full Text] [PDF]

				P. J. Bingley, J. L Mahon, E. A.M. Gale, and for the European Nicotinamide Diabetes Interventio Insulin Resistance and Progression to Type 1 Diabetes in the European Nicotinamide Diabetes Intervention Trial (ENDIT) Diabetes Care, January 1, 2008; 31(1): 146 - 150. [Abstract] [Full Text] [PDF]

				D. A Lawlor, M. Harro, N. Wedderkopp, L. B. Andersen, L. B Sardinha, C. J Riddoch, A. S Page, S. A Anderssen, K. Froberg, D. Stansbie, et al. Association of socioeconomic position with insulin resistance among children from Denmark, Estonia, and Portugal: cross sectional study BMJ, July 23, 2005; 331(7510): 183. [Abstract] [Full Text] [PDF]

				R. J. Karne, H. Chen, G. Sullivan, and M. J. Quon Letter re: Limited Accuracy of Surrogates of Insulin Resistance during Puberty in Obese and Lean Children at Risk for Altered Glucoregulation J. Clin. Endocrinol. Metab., July 1, 2005; 90(7): 4418 - 4419. [Full Text] [PDF]

				F. Brandou, J. F. Brun, E. Raynaud, and J. Mercier Authors' Response: Limited Accuracy of Surrogates of Insulin Resistance during Puberty in Obese and Lean Children at Risk for Altered Glucoregulation J. Clin. Endocrinol. Metab., July 1, 2005; 90(7): 4419 - 4419. [Full Text] [PDF]