title: A novel, non-invasive 13C-glucose breath test to estimate insulin resistance in obese prepubertal children.
abstract: Insulin resistance (IR) is an important risk factor for the development of type 2 diabetes mellitus in obese boys and girls. Because needle-associated fear and anxiety are common in children, non-invasive methods to determine IR are desirable. Our objective in this cross-sectional study of obese prepubertal children (n = 39) was to compare estimates of IR using a novel, non-invasive technique (13C-glucose breath test) with common indices of IR derived from an oral glucose tolerance test (OGTT). For the 13C-glucose breath test, samples were collected before and 90 minutes after ingestion of 25 mg 13C-labelled glucose. For the OGTT, glucose and insulin samples were collected at 0, 15, 30, 45, 60, 90 and 120 minutes. The homeostatic model assessment of insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), insulin area-under-the-curve (AUC), and sum-of-insulin were calculated as indices of IR. Pearson correlations revealed significant, but moderate, associations between the 13C-glucose breath test and fasting insulin (r = -0.50; p < 0.01), 2-hour insulin (r = plots showed acceptable levels of agreement between indices of IR. In obese prepubertal children, the 13C-glucose breath test can provide a proxy estimate of IR when gold-standard techniques are either unavailable or impractical.
authors.affiliation: Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
authors.forename: Mary M
authors.initials: MM
authors.lastname: Jetha
authors.forename: Ugo
authors.initials: U
authors.lastname: Nzekwu
authors.forename: Richard Z
authors.initials: RZ
authors.lastname: Lewanczuk
authors.forename: Geoff D C
authors.initials: GD
authors.lastname: Ball
mesh_terms: D001944:Breath Tests; D002247:Carbon Isotopes; D002648:Child; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis*; D005260:Female; D005508:Food Deprivation; D005947:Glucose / Q000032:analysis*; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008297:Male; D009765:Obesity / Q000378:metabolism*
chemical_list: D002247:Carbon Isotopes; D007328:Insulin; D005947:Glucose