Endocrine Abstracts

JOINT2347

Objective: Childhood obesity is a major global health concern, closely linked to insulin resistance, dysglycemia, and increased cardiometabolic risk. The COVID-19 pandemic has further exacerbated these issues, leading to a higher prevalence of obesity-related metabolic disorders. This study aimed to assess the predictive ability of fasting glucose, fasting insulin, HOMA-IR, HOMA-β, and HbA1c for insulin resistance and dysglycemia in children and adolescents with overweight or obesity before (BPD, 2019) and after (APD, 2021) the pandemic.

Methods: A total of 392 patients (146 BPD, 246 APD) aged 5–18 years underwent oral glucose tolerance tests (OGTT). Insulin resistance and dysglycemia were defined based on OGTT Results The 90th and 97. 5th percentiles for fasting glucose, fasting insulin, HOMA-IR, and HOMA-β, as established by Hammel et al., were evaluated as predictors of insulin resistance and dysglycemia. ROC analysis was conducted to determine optimal cut-off values for these markers.

Results: Insulin resistance was detected in 74. 7% of BPD and 83. 3% of APD patients, while dysglycemia was observed in 11. 6% and 19. 1%, respectively. We demonstrated that the 90th and 97. 5th percentiles for fasting insulin, HOMA-IR, and HOMA-β, as established by Hammel et al., effectively predict insulin resistance, while fasting glucose is an effective predictor of dysglycemia in youth with excess body weight. Additionally, an HbA1c level of ≥5. 7% was a reliable predictor of dysglycemia detected by OGTT. ROC analysis revealed optimal cut-offs for fasting insulin (13. 65–25. 05 μU/mL), HOMA-IR (3. 35–5. 30), and HOMA-β (156. 34–318. 41) in detecting insulin resistance, while fasting glucose (89. 50–94. 50 mg/dL) and HbA1c (≥5. 61%) were effective in identifying dysglycemia.

Conclusion: Fasting glucose, fasting insulin, HOMA-IR, HOMA-β, and HbA1c serve as valuable non-invasive markers for predicting insulin resistance and dysglycemia in children and adolescents with overweight or obesity. Their consistency before and after the pandemic highlights their clinical utility and potential as alternatives to OGTT for early detection. Integrating these markers into routine clinical practice could facilitate timely intervention and personalized management strategies, particularly in resource-limited settings, to address the growing burden of obesity-related metabolic disorders in pediatric populations.