title: Can the insulin sensitivity index (ISI) in association with insulin-like growth factor binding protein-1 identify insulin resistance early in overweight children?
abstract: Association between insulin resistance (IR) and non-alcoholic fatty liver disease (NAFLD) has been reported. This prompted us to evaluate the power of the insulin sensitivity index (ISI) in association with IGFBP-1 to identify IR early in obese children/adolescents. OGTT was performed in 34 obese/overweight children/adolescents. Glucose, insulin and IGFBP-1 were measured in serum samples and ISI was calculated. Considering the presence of three or more risk factors for IR as a criterion for IR, ISI < 4.6 showed 87.5% sensitivity and 94.5% specificity in diagnosing IR. IGFBP-1 was lower in the group with ISI < 4.6 (p < 0.01). In this group, three patients had higher than expected IGFBP-1, suggesting hepatic IR, while three patients with ISI > 4.6 showed very low IGFBP-1 levels.
  
  
  CONCLUSIONS
  ISI < 4.6 is a good indicator of early peripheral IR and, associated with IGFBP-1, can identify increased risk of hepatic IR. Low IGFBP-1 levels among non-IR children may indicate increased portal insulin levels.
authors: Department of Pediatricse, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
authors: Alexsandra C
authors: AC
authors: Malaquias
authors: Paula C
authors: PC
authors: Bezzan
authors: Renan
authors: R
authors: Montenegro
authors: Júlio C
authors: JC
authors: Daneluzzi
authors: Rubens G
authors: RG
authors: Ricco
authors: Luis A
authors: LA
authors: Del Ciampo
authors: Ivan S
authors: IS
authors: Ferraz
authors: Jorge
authors: J
authors: Elias
authors: Ana L C
authors: AL
authors: Martinelli
authors: Carlos E
authors: CE
authors: Martinelli
mesh_terms: D002648:Child; D015331:Cohort Studies; D005951:Glucose Tolerance Test; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D018970:Insulin-Like Growth Factor Binding Protein 1 / Q000097:blood*; D008055:Lipids / Q000097:blood; D009765:Obesity / Q000097:blood*; D050177:Overweight / Q000097:blood*
chemical_list: D018970:Insulin-Like Growth Factor Binding Protein 1; D008055:Lipids