Endocrine Abstracts

JOINT2229

Objective: The increasing prevalence of childhood obesity and the development of insulin resistance (IR) and type 2 diabetes mellitus (T2D) are major public health concerns. The aim of this study was to compare the HOMA, FGIR and QUICKI indices for measuring IR in obese children and adolescents according to oral glucose tolerance test (OGTT) Results

Methods: Patients attending the Pediatric Endocrinology Clinic with exogenous obesity and undergoing OGTT in the last 10 years were included in the study. Patients’ data were obtained retrospectively from hospital records. The children were divided into two groups according to the presence or absence of IR. The HOMA, FGIR and QUICKI methods were analysed to confirm the OGTT findings of IR in these groups. Receiver operating characteristic curve (ROC) analysis was used to determine cut-off points and to calculate sensitivity and specificity for IR.

Results: A total of 899 obese children (568 girls and 331 boys, mean age 14. 06±2. 06 years) were included in the study. IR was diagnosed in 76. 3%, impaired fasting glucose (IFG) in 11. 3%, impaired glucose tolerance (IGT) in 13. 9% and T2D in 5. 8% of the children. 708 cases were assessed for metabolic syndrome and 195 (27. 5%) children were diagnosed with MS. The rates of akantozis nigrikans (60. 5% & 17. 2%) and hepatic steatosis on ultrasound (50. 7% & 12. 8%) were higher in the IR group (p:0. 045 and p:0. 009). Triglycerides were higher in the IR group than in the non-IR group, while other cholesterol levels were similar (P < 0. 001). Notably, the rates of IFG, IGT and T2D were not significantly different between groups (p>0. 05). The HOMA and QUICKI indices were higher in the IR group, while the FGIR values were similar (P < 0. 001, P < 0. 001 and p:0. 057, respectively). Among the incidences, the area under the curve (AUC) was higher for HOMA-IR (0. 711 for girls and 0. 7 for boys) compared to FGIR (0. 278 for girls and 0. 262 for boys) and QUICKI (0. 289 for girls and 0. 306 for boys). The HOMA-IR cut-off value was 4. 22 (70% sensitivity and 30% specificity) in pubertal girls and 4. 18 (70% sensitivity and 30% specificity) in pubertal boys.

Conclusions: HOMA is a more accurate measure of IR in children and adolescents than FGIR and QUICKI. For the diagnosis of IR, the HOMA threshold is 4. 22 in girls and 4. 18 in boys based on OGTT Results The OGTT remains important in the diagnosis of insulin resistance, pre-diabetes and T2D, despite being an invasive method.