Association of glycosylated hemoglobin (HbA1c) levels with Iinsulin resistance in obese children

Objectives

We investigated the relationship between insulin resistance reflected by homeostasis model assessment (HOMA-IR) index and serum HbA1c levels of obese children.

Material and Methods

This study included 70 obese and 60 normal weight healthy children between the ages of 3 and 15. Anthropometric measures and biochemical tests (fasting glucose, fasting insulin, HbA1c) were performed on all subjects. Plasma glucose levels were measured by the glucose oxidase method. Plasma insulin concentrations were measured by radioimmunoassay (RIA). HOMA-IR index was used to estimate insulin resistance. A cut-off HOMA-IR level of ≥2.5 was accepted. The HbA1c analysis was performed using high-pressure liquid chromatography. The statistical analysis was performed using SPSS 5. Student''s unpaired t-test and the Mann-Whitney U test were used to determine statistical significance.

Results

Gender distribution did not reveal significant difference among the obese (F: 48.6%, M: 51.4%) and the non-obese (F: 46.7%, M: 53.3%) groups. The mean age value was significantly higher in the obese group (10.09± 3.09) (p>0.005) than the non-obese group (8.31±3.14) (p<0.05). The mean value of body mass index (BMI) was 25.55±4.3 in the obese group and 16.63±2.3 in the non-obese group. The mean HOMA-IR values of obese group (2.84±1.77) was significantly higher than the non-obese group (1.50±0.95) (p<0.005). Insulin resistance was significantly higher in the obese group. Subjects with HOMA-IR ≥2.5 levels in the obese group had significantly higher HbA1c values than those with HOMA-IR <2.5 levels.

Conclusions

High HbA1c levels in obese children can be used as a screening tool to detect insulin sensitivity and resistance at an early stage.