title: Glucose effectiveness in obese children: relation to degree of obesity and dysglycemia.
abstract: OBJECTIVE
  Impaired glucose effectiveness (GE) plays a role in the deterioration of glucose metabolism. Our aim was to validate a surrogate of GE derived from an oral glucose tolerance test (OGTT) and to assess the impact of degrees of obesity and of glucose tolerance on it.
  
  
  METHODS
  The OGTT-derived surrogate of GE (oGE) was validated in obese adolescents who underwent an OGTT and an intravenous glucose tolerance test (IVGTT). We then evaluated anthropometric determinants of the oGE and its impact on the dynamics of glucose tolerance in a cohort of children with varying degrees of obesity.
  
  
  RESULTS
  The correlation of oGE and IVGTT-derived GE in 98 obese adolescents was r = 0.35 (P < 0.001) as a whole and r = 0.51 (P < 0.001) in subjects with normal glucose tolerance. In a cohort of 1,418 children, the adjusted GE was associated with increasing obesity (P < 0.001 for each category of obesity). Quartiles of oGE and the oral disposition index were associated with 2-h glucose levels (P < 0.001 for both). Among 421 nondiabetic obese subjects (276 subjects with normal glucose tolerance/145 subjects with impaired glucose tolerance who repeated their OGTT after a mean time of 28 ± 16 months), oGE changes were tightly associated with weight (r = 0.83, P < 0.001) and waist circumference changes (r = 0.67, P < 0.001). Baseline oGE and changes in oGE over time emerged as significant predictors of the change in 2-h glucose levels (standardized B = -0.76 and B = -0.98 respectively, P < 0.001 for both).
  
  
  CONCLUSIONS
  The oGE is associated with the degree of and changes in weight and waist circumference and is an independent predictor of glucose tolerance dynamics.
authors: Department of Human Metabolism and Nutrition, Hebrew University, Jerusalem, Israel ram.weiss@ekmd.huji.ac.il.
authors: Ram
authors: R
authors: Weiss
authors: Division of Endocrinology and Diabetes, Center for Translational Science, Children's National, Washington, DC.
authors: Sheela N
authors: SN
authors: Magge
authors: Department of Pediatrics, Yale University, New Haven, CT.
authors: Nicola
authors: N
authors: Santoro
authors: Department of Pediatrics, Yale University, New Haven, CT.
authors: Cosimo
authors: C
authors: Giannini
authors: School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA.
authors: Raymond
authors: R
authors: Boston
authors: Department of Pediatrics, Yale University, New Haven, CT.
authors: Tara
authors: T
authors: Holder
authors: Department of Pediatrics, Yale University, New Haven, CT.
authors: Melissa
authors: M
authors: Shaw
authors: Department of Pediatrics, Yale University, New Haven, CT.
authors: Elvira
authors: E
authors: Duran
authors: Department of Human Metabolism and Nutrition, Hebrew University, Jerusalem, Israel.
authors: Karen J
authors: KJ
authors: Hershkop
authors: Department of Pediatrics, Yale University, New Haven, CT.
authors: Sonia
authors: S
authors: Caprio
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism*; D001835:Body Weight; D002648:Child; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000175:diagnosis / Q000378:metabolism; D005260:Female; D018149:Glucose Intolerance / Q000150:complications / Q000175:diagnosis / Q000378:metabolism; D044882:Glucose Metabolism Disorders / Q000150:complications / Q000175:diagnosis / Q000378:metabolism*; D005951:Glucose Tolerance Test / Q000379:methods; D006801:Humans; D008297:Male; D063766:Pediatric Obesity / Q000150:complications / Q000378:metabolism*; D011379:Prognosis; D012720:Severity of Illness Index; D055105:Waist Circumference
chemical_list: D001786:Blood Glucose
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