Assessing insulin resistance: application of a fasting glucose to insulin ratio in growth hormone-treated children.
BACKGROUND
Insulin resistance (IR) is an important risk factor for cardiovascular disease and type-2 diabetes mellitus. Therefore simple measures of IR have been proposed to screen the at-risk patient. A fasting serum glucose (mg/dl) to plasma insulin (microU/ml) ratio (FGIR) of < 7 was recently suggested as a screening tool for IR in certain pediatric patients.


METHODS
To determine the utility of simple indicators of IR, the FGIR of < 7 was applied to a group of patients with established risk for IR. The study group was comprised of non-growth hormone (GH)-deficient patients with Turner syndrome (TS, n = 92) and idiopathic short stature (ISS, n = 73) receiving GH. The occurrence of a FGIR of < 7 in these cohorts was compared to data from previous publications.


CONCLUSIONS
The application of a FGIR of < 7 confirmed a rise in IR with GH therapy in both groups as well as a higher occurrence in the TS group, rising from 22 to 48% between 12 and 24 months of GH therapy. We conclude that simple measures of IR such as the FGIR may be useful in screening and following patients at risk for IR.
Burgert
Tania S
TS
Division of Pediatric Endocrinology, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY 10467, USA.
Vuguin
Patricia M
PM
DiMartino-Nardi
Joan
J
Attie
Kenneth M
KM
Saenger
Paul
P
D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism*; D002648:Child; D015331:Cohort Studies; D005215:Fasting / Q000097:blood*; D005260:Female; D006130:Growth Disorders / Q000188:drug therapy; D013006:Growth Hormone / Q000009:adverse effects* / Q000627:therapeutic use; D019382:Human Growth Hormone / Q000172:deficiency; D006801:Humans; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D012189:Retrospective Studies; D018570:Risk Assessment; D014424:Turner Syndrome / Q000097:blood / Q000188:drug therapy
D001786:Blood Glucose; D007328:Insulin; D019382:Human Growth Hormone; D013006:Growth Hormone