title: Whole-body and hepatic insulin resistance in obese children.
abstract: BACKGROUND
  Insulin resistance may be assessed as whole body or hepatic.
  
  
  OBJECTIVE
  To study factors associated with both types of insulin resistance.
  
  
  METHODS
  Cross-sectional study of 182 obese children. Somatometric measurements were registered, and the following three adiposity indexes were compared: BMI, waist-to-height ratio and visceral adiposity. Whole-body insulin resistance was evaluated using HOMA-IR, with 2.5 as the cut-off point. Hepatic insulin resistance was considered for IGFBP-1 level quartiles 1 to 3 (<6.67 ng/ml). We determined metabolite and hormone levels and performed a liver ultrasound.
  
  
  RESULTS
  The majority, 73.1%, of obese children had whole-body insulin resistance and hepatic insulin resistance, while 7% did not have either type. HOMA-IR was negatively associated with IGFBP-1 and positively associated with BMI, triglycerides, leptin and mother's BMI. Girls had increased HOMA-IR. IGFBP-1 was negatively associated with waist-to-height ratio, age, leptin, HOMA-IR and IGF-I. We did not find HOMA-IR or IGFBP-1 associated with fatty liver.
  
  
  CONCLUSIONS
  In school-aged children, BMI is the best metric to predict whole-body insulin resistance, and waist-to-height ratio is the best predictor of hepatic insulin resistance, indicating that central obesity is important for hepatic insulin resistance. The reciprocal negative association of IGFBP-1 and HOMA-IR may represent a strong interaction of the physiological processes of both whole-body and hepatic insulin resistance.
authors.affiliation: Department of Medical Sciences, University of Guanajuato, Campus León, 20 de Enero 929, León Guanajuato, México.
authors.forename: Lorena del Rocío
authors.initials: Ldel R
authors.lastname: Ibarra-Reynoso
authors.affiliation: Department of Medical Sciences, University of Guanajuato, Campus León, 20 de Enero 929, León Guanajuato, México.
authors.forename: Liudmila
authors.initials: L
authors.lastname: Pisarchyk
authors.affiliation: Department of Medical Sciences, University of Guanajuato, Campus León, 20 de Enero 929, León Guanajuato, México.
authors.forename: Elva Leticia
authors.initials: EL
authors.lastname: Pérez-Luque
authors.affiliation: Department of Medical Sciences, University of Guanajuato, Campus León, 20 de Enero 929, León Guanajuato, México.
authors.forename: Ma Eugenia
authors.initials: ME
authors.lastname: Garay-Sevilla
authors.affiliation: Department of Medical Sciences, University of Guanajuato, Campus León, 20 de Enero 929, León Guanajuato, México.
authors.forename: Juan Manuel
authors.initials: JM
authors.lastname: Malacara
mesh_terms: D050154:Adiposity; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007328:Insulin / Q000032:analysis; D007333:Insulin Resistance; D018970:Insulin-Like Growth Factor Binding Protein 1 / Q000097:blood; D020738:Leptin / Q000097:blood; D008099:Liver / Q000000981:diagnostic imaging; D008297:Male; D009765:Obesity / Q000473:pathology*; D014280:Triglycerides / Q000097:blood; D014463:Ultrasonography; D055105:Waist Circumference
chemical_list: D001786:Blood Glucose; D007328:Insulin; D018970:Insulin-Like Growth Factor Binding Protein 1; D020738:Leptin; D014280:Triglycerides