title: Glucose homeostasis and insulin resistance: prevalence, gender differences and predictors in adolescents.
abstract: BACKGROUND
  Adolescence, due to transient pubertal insulin resistance (IR), is associated with a higher risk for disturbances of glucose metabolism. The aim of our study was 1) to investigate the prevalence of disturbances of glucose metabolism, 2) to define gender specific homeostasis model assessment of insulin resistance (HOMA-IR) thresholds associated with increased cardiometabolic risks and 3) to provide predictors of HOMA-IR.
  
  
  METHODS
  The studied cohort consisted of Czech adolescents aged 13.0-17.9 years: 1,518 individuals of general population and three studied groups according weight category (615 normal weight, 230 overweight and 683 obese). The prevalence of IR, impaired fasting glucose (IFG) and type 2 diabetes was assessed. Risky HOMA-IR thresholds based on components of metabolic syndrome were investigated. HOMA-IR prediction was calculated taking into account age, blood pressure, multiple anthropometric, biochemical and hormonal parameters.
  
  
  RESULTS
  In general population cohort, the prevalence of IFG and type 2 diabetes was 7.0% and <0.5%, respectively. Boys regardless of weight presented significantly higher levels of blood glucose and higher prevalence of IFG than girls. Obese boys were found more insulin resistant than obese girls. HOMA-IR thresholds of 3.6 for girls and 4.4 for boys were associated with increased cardiometabolic risks. For both genders, the model of HOMA-IR prediction was composed of age, BMI, ratio of free triiodthyronine to free thyroxine, gamma-glutamyltransferase activity and levels of triglycerides and sex hormone-binding globulin.
  
  
  CONCLUSIONS
  The type 2 diabetes in adolescents, including those who were obese, was rarely diagnosed. Obese adolescent boys were at greater risk for IR and for IFG than obese girls. In adolescence, thresholds of HOMA-IR in contrast to predictors were found gender specific.
authors.affiliation: Institute of Endocrinology, Obesity Management Center, Národní 8, 116 94 Prague 1, Czech Republic ; Department of Pediatrics and Center for Research of Diabetes, Metabolism and Nutrition, Third Faculty of Medicine, Charles University, Šrobárova 50, 100 34 Prague 10, Czech Republic.
authors.forename: Irena
authors.initials: I
authors.lastname: Aldhoon-Hainerová
authors.affiliation: Institute of Endocrinology, Obesity Management Center, Národní 8, 116 94 Prague 1, Czech Republic.
authors.forename: Hana
authors.initials: H
authors.lastname: Zamrazilová
authors.affiliation: Institute of Endocrinology, Obesity Management Center, Národní 8, 116 94 Prague 1, Czech Republic ; Faculty of Science, Charles University, Albertov 6, 128 43 Prague 2, Czech Republic.
authors.forename: Lenka
authors.initials: L
authors.lastname: Dušátková
authors.affiliation: Institute of Endocrinology, Obesity Management Center, Národní 8, 116 94 Prague 1, Czech Republic ; Faculty of Science, Charles University, Albertov 6, 128 43 Prague 2, Czech Republic.
authors.forename: Barbora
authors.initials: B
authors.lastname: Sedláčková
authors.affiliation: Institute of Endocrinology, Obesity Management Center, Národní 8, 116 94 Prague 1, Czech Republic.
authors.forename: Petr
authors.initials: P
authors.lastname: Hlavatý
authors.affiliation: Institute of Endocrinology, Obesity Management Center, Národní 8, 116 94 Prague 1, Czech Republic.
authors.forename: Martin
authors.initials: M
authors.lastname: Hill
authors.affiliation: Institute of Endocrinology, Obesity Management Center, Národní 8, 116 94 Prague 1, Czech Republic.
authors.forename: Richard
authors.initials: R
authors.lastname: Hampl
authors.affiliation: Institute of Endocrinology, Obesity Management Center, Národní 8, 116 94 Prague 1, Czech Republic.
authors.forename: Marie
authors.initials: M
authors.lastname: Kunešová
authors.affiliation: Institute of Endocrinology, Obesity Management Center, Národní 8, 116 94 Prague 1, Czech Republic.
authors.forename: Vojtěch
authors.initials: V
authors.lastname: Hainer
keywords: Adolescence; Glucose homeostasis; HOMA-IR prediction; Insulin resistance; Metabolic syndrome; Obesity; Type 2 diabetes