Elevated glucose concentrations during an oral glucose tolerance test are associated with the presence of metabolic syndrome in childhood obesity

• Published in: Diabetic medicine 2008-03, Vol.25 (3), p.289-295
• Main Authors: Sabin, M. A., Hunt, L. P., Ford, A. L., Werther, G. A., Crowne, E. C., Shield, J. P. H.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Biological and medical sciences; Blood Glucose - metabolism; Child; Child, Preschool; children; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Epidemiologic Methods; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Glucose Tolerance Test; Humans; insulin resistance; Male; Medical sciences; metabolic syndrome; Metabolic Syndrome - blood; Metabolic Syndrome - metabolism; obesity; Obesity - metabolism; oral glucose tolerance test; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Vertebrates: endocrinology
• ISSN: 0742-3071; 1464-5491
• DOI: 10.1111/j.1464-5491.2007.02380.x

Aims  To investigate whether changes in glucose concentrations during an OGTT in obese children reflect the presence of peripheral insulin resistance and/or cardiovascular risk factors more closely than single measurements of fasting plasma glucose (FPG). Methods  One hundred and twenty‐two obese children attending our Paediatric Obesity Service underwent formal OGTTs, following the measurement of blood pressure and fasting levels of insulin, glucose and lipid profiles in the majority. Fasting insulin was used as a surrogate measure of insulin sensitivity. Three different child‐specific definitions for metabolic syndrome were used to identify clustering of cardiovascular risk factors in 65 of these children. Results  In the whole group, 10.7% had IGT but changes in glucose during the OGTT were not influenced by age, sex, pubertal status or raw (or age‐ and sex‐adjusted) body mass index (BMI). During the OGTT, FPG, glucose at 60 min and area under the glucose curve correlated highly with fasting insulin. Children with metabolic syndrome (defined using any of three definitions) had comparable FPG levels to those without metabolic syndrome, but they demonstrated significantly elevated glucose levels at 60 min. On sub‐group analysis, obese children with normal carbohydrate metabolism were significantly more likely to have a 1 h glucose level ≥ 7.8 mmol/l if they had metabolic syndrome (P = 0.026). Conclusions  These data suggest that an elevated 1 h post‐load glucose measurement is seen in obese children who have a coexistent clustering of cardiovascular risk factors.