Relationship between body mass index and insulin measured during oral glucose tolerance testing in severely obese children and adolescents |
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| Authors: | L Iughetti M De Simone S Bernasconi B Predieri N Battistini G Bedogni |
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| Institution: | 1. Paediatrics Clinic, University of Modena and Reggio Emilia, Modena, Italygiorgiobedogni@libero.it;3. Paediatrics Chair, University of L’Aquila, L'Aquila, Italy;4. Paediatrics Chair, University of Parma, Parma, Italy;5. Paediatrics Clinic, University of Modena and Reggio Emilia, Modena, Italy;6. Human Nutrition Chair, University of Modena and Reggio Emilia, Modena, Italy |
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| Abstract: | Primary objective: The study evaluated the accuracy of body mass index (BMI) in detecting hyperinsulinaemia during oral glucose tolerance testing (OGTT) in severely obese children.Research design: A cross-sectional study was carried out.Materials and methods: A total of 118 obese children and adolescents (49 females and 69?males) aged 6–19 years were consecutively studied at an outpatient paediatric clinic. Hyperinsulinaemia was defined as a value of log-transformed fasting insulin ≥?80th percentile and OGTT hyperinsulinaemia as a value of the log-transformed area under the curve (AUC) of insulin ≥?80th percentile. The study hypothesis was tested using a logistic regression model with hyperinsulinaemia as the outcome variable and the z-score of BMI corrected for age (z-BMIage) as the predictor variable. Receiver-operator characteristic (ROC) curves were used to evaluate accuracy.Results: The mean (SD) BMI for age of the children was 28.6 (4.0)?kg?m?2, corresponding to 2.2 (0.5) standard deviation scores. The odds ratio (OR) of OGTT hyperinsulinaemia was 2.0 (95% CI 1.2–3.3; p = 0.007) for each unit increase of z-BMIage and the corresponding ROC-AUC was 0.74 (95% CI 0.61–0.86; p = 0.0001). In comparison, the OR of fasting hyperinsulinaemia was 1.1 (95% CI 0.7–1.7; p = 0.716) for each unit increase of z-BMIage and the corresponding ROC-AUC was 0.49 (95% CI 0.35–0.62; p = 0.863).Conclusion: BMI is reasonably accurate in detecting OGTT hyperinsulinaemia in severely obese children. |
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