[Glucose intolerance in obese children: a preliminary study].
BACKGROUND
Glucose intolerance (GI) is preceded by a prolonged period of Insulin Resistance (IR) and is an advanced stage towards the development of Type 2 Diabetes Mellitus (NIDDM), whose incidence is increasing in the pediatric population, along with obesity.


OBJECTIVE
To describe clinical and metabolic characteristics of obese children according to their glucose tolerance.


METHODS
We studied 52 obese children, aged 8 to 17 years, with a body mass index z-score of 4.7 +/- 1.6. An oral glucose tolerance test with insulin measurements in the basal period and at 30 minutes, was done. IR was estimated through the Homeostasis Model Assessment index (HOMA) and insulin secretion through the Insulinogenic Index.


RESULTS
Six children (11.5%) had GI. When compared with children with normal glucose tolerance, children with GI had similar clinical features, similar HOMA (5.4 +/- 3.3 and 5.2 +/- 2.0 respectively) and basal insulinemia (23.4 +/- 11 and 24.6 +/- 10 microU/ml). But they had lower insulin level at 30 min (128 +/- 61 and 253.7 +/- 357 microU/ml respectively, p > 0.05) a lower Insulinogenic Index (1.44 +/- 0.4 and 4.4 +/- 1.0 microU/ml/mg/dl, p < 0.05), a higher total cholesterol (192 +/- 37 vs 168 +/- 34 mg/dl, p < 0.05) and a higher LDL cholesterol (123 +/- 35 and 101 +/- 28 mg/dl, respectively, p < 0.05).


CONCLUSIONS
Obese children with or without GI have similar clinical features and body mass index. In severe obese children with marked IR, the appearance of Glucose Intolerance seems to be associated to a decrease in insulin secretion and not to an increase in IR.
Barja
Salesa
S
Departamento de Pediatría, Facultad de Medicina, Pontificia Universidad Católica de Chile. sbarja@puc.cl
Hodgson
M Isabel
MI
Acosta
Ana M
AM
Arteaga
Antonio
A
D000293:Adolescent; D002648:Child; D002677:Chile / Q000453:epidemiology; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology / Q000378:metabolism*; D005260:Female; D005947:Glucose / Q000378:metabolism*; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008297:Male; D009765:Obesity / Q000453:epidemiology / Q000378:metabolism; D012307:Risk Factors; D018709:Statistics, Nonparametric
D007328:Insulin; D005947:Glucose