title: Insulin resistance in obese children and adolescents: HOMA-IR cut-off levels in the prepubertal and pubertal periods.
abstract: OBJECTIVE
  Childhood obesity is associated with an increased risk for insulin resistance. The underlying mechanism for the physiological increase in insulin levels in puberty is not clearly understood. The aim of the present study was to determine the cut-off values for homeostasis model assessment for insulin resistance (HOMA-IR) in obese children and adolescents according to gender and pubertal status.
  
  
  METHODS
  Two hundred and eight obese children and adolescents (141 girls, 127 boys) aged between 5 and 18 years were included in the study. The children were divided into prepubertal and pubertal groups. A standard oral glucose tolerance test (OGTT) was carried out in all children. A total insulin level exceeding 300 μU/mL in the blood samples, collected during the test period, was taken as the insulin resistance criterion. Cut-off values for HOMA-IR were calculated by receiver operating characteristic (ROC) analysis.
  
  
  RESULTS
  In the prepubertal period, the rate of insulin resistance was found to be 37% in boys and 27.8% in girls,while in the pubertal period, this rate was 61.7% in boys and 66.7% in girls. HOMA-IR cut-off values for insulin resistance in the prepubertal period were calculated to be 2.67 (sensitivity 88.2%, specificity 65.5%) in boys and 2.22 (sensitivity 100%, specificity 42.3%) in girls, and in the pubertal period, they were 5.22 (sensitivity 56%, specificity 93.3%) in boys and 3.82 (sensitivity 77.1%, specificity 71.4%) in girls.
  
  
  CONCLUSIONS
  Since gender, obesity and pubertal status are factors affecting insulin resistance, cut-off values which depend on gender and pubertal status, should be used in evaluation of insulin resistance.
authors.affiliation: Erciyes University Faculty of Medicine, Department of Pediatric Endocrinology, Kayseri, Turkey.
authors.forename: Selim
authors.initials: S
authors.lastname: Kurtoğlu
authors.forename: Nihal
authors.initials: N
authors.lastname: Hatipoğlu
authors.forename: Mümtaz
authors.initials: M
authors.lastname: Mazıcıoğlu
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kendirici
authors.forename: Mehmet
authors.initials: M
authors.lastname: Keskin
authors.forename: Meda
authors.initials: M
authors.lastname: Kondolot
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D005260:Female; D005951:Glucose Tolerance Test; D006706:Homeostasis; D006801:Humans; D006946:Hyperinsulinism / Q000097:blood; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D009765:Obesity / Q000503:physiopathology*; D011627:Puberty / Q000502:physiology*; D012372:ROC Curve; D012727:Sex Characteristics; D014421:Turkey
chemical_list: D001786:Blood Glucose; D007328:Insulin