[Insulin sensitivity in children aged 6 to 16 years: association with nutritional status and pubertal development].
BACKGROUND
There is a high prevalence of obesity and hyperinsulinism among Chilean prepuberal children.


OBJECTIVE
To evaluate insulin sensitivity (IS) using fasting insulin, the Homeostasis Model Assessment (HOMA) and quantitative insulin-sensitivity check index (QUICKI) in Chilean children.


METHODS
Body mass index (BMI), total body fat percentage (%TBF) using the sum of 4 skin folds, abdominal obesity determined through waist circumference (WC), pubertal maturation using five Tanner stages, fasting glucose (Glu) and insulin (Ins), were measured in 354 children aged 6 to 15 years (173 males). IS was evaluated using HOMA and QUICKI.


RESULTS
IS was strongly associated with %TBF and WC. Ins, HOMA and QUICKI were significantly correlated with BMI (r =0.412; 0.405 y -0.442, respectively), %TBF (r =0.370; 0.367 y -0.394, respectively), and WC (r =0.452; 0.446 y -0.481, respectively). Ins and HOMA increased and QUICKI decreased significantly (p <0.0001) with age. Children in a similar Tanner stage did not have differences in Ins, HOMA and QUICKI. No differences in Ins, HOMA and QUICKI were observed between children in Tanner stages 1 and 2. However, children in Tanner stages 1 and 2, had significantly lower Ins and HOMA and higher QUICKI than those in Tanner 3 to 5 stages. The highest Ins quartile for Tanner stages 1 and 2 was 10.0 micro UI/dl; for Tanner stages 3 to five, the figure was 15.6 microUI/dl.


CONCLUSIONS
These results confirm the relationship of IS with BMI, %TBF, WC and pubertal maturation. IS decreases significantly and fasting Ins levels increase approximately 50% with puberty. This fact must be considered for the diagnosis of hyperinsulinism and insulin resistance in children.
Burrows A
Raquel
R
Instituto de Nutrición y Tecnología de los Alimentos, Universidad de Chile, José Pedro Alessandri 5540, Macul, Chile. rburrows@uec.inta.uchile.cl
Leiva B
Laura
L
Burgueño A
Medardo
M
Maggi M
Aida
A
Giadrosic R
Vinka
V
Díaz B
Erick
E
Lera M
Lydia
L
Albala B
Cecilia
C
D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis*; D015992:Body Mass Index; D002648:Child; D005260:Female; D005951:Glucose Tolerance Test; D006706:Homeostasis; D006801:Humans; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance; D008297:Male; D009752:Nutritional Status; D009765:Obesity / Q000097:blood*; D011627:Puberty / Q000097:blood*; D012016:Reference Values; D012307:Risk Factors
D001786:Blood Glucose; D007328:Insulin