title: One-hour post-load plasma glucose levels associated with decreased insulin sensitivity and secretion and early makers of cardiometabolic risk.
abstract: OBJECTIVE
  Obese adults with normal glucose tolerance (NGT) but with 1-hour post-load plasma glucose (1hPG) ≥ 155 mg/dl are at higher risk of developing type 2 diabetes (T2D) and cardiometabolic complications. Little information is available for the pediatric population, where recently, a lower cutoff, 132.5 mg/dl, has been suggested as being more sensitive to identify subjects at risk of T2D. Our aim was to assess whether obese Caucasian youth with 1hPG ≥ 132.5 mg/dl have worse insulin sensitivity and secretion and a worse cardiometabolic profile compared to obese youth with 1hPG < 132.5 mg/dl.
  
  
  METHODS
  Medical records of 244 (43% male; age: 11.1 ± 2.7years) overweight/obese children and adolescents, who had undergone an oral glucose tolerance test (OGTT), were retrieved. Anthropometric and biochemical data were collected from the hard copy archive. Indexes of insulin resistance (HOMA-IR), insulin sensitivity (WBISI), and insulin secretion (Insulinogenic Index, Disposition Index) were calculated.
  
  
  RESULTS
  Of the 244 records analyzed, 215 fulfilled criteria for NGT and had complete biochemical data. Among NGT patients, 42 (19.5%) showed 1hPG ≥ 132.5 mg/dL (high-NGT), while the remaining had 1hPG < 132.5 mg/dL (low-NGT). The high-NGT group showed a higher male prevalence (59.5 vs 37%), lower Disposition Index (0.54 [0.39-0.71] vs 0.79 [0.47-1.43]), and WBISI (0.24 [0.18-0.35] vs 0.33 [0.23-0.50]) than the low-NGT group. High-NGT subjects also showed a trend towards lower HDL-cholesterol and higher triglycerides/HDL-cholesterol ratio (2.13 [1.49-3.41] vs 1.66 [1.24-2.49]).
  
  
  CONCLUSIONS
  In overweight/obese NGT Caucasian youth a 1hPG ≥ 132.5 mg/dL was able to identify those with impaired insulin sensitivity and secretion and a trend towards a worse cardio-metabolic profile, a group likely at risk for future T2D.
authors.affiliation: Department of Paediatrics, "G. d'Annunzio" University, Chieti-Pescara, via dei Vestini 5, 66100, Chieti, Italy. m.marcovecchio@unich.it.|Center of Excellence on Aging, "G. d'Annunzio" University Foundation, Chieti, Italy. m.marcovecchio@unich.it.
authors.forename: M L
authors.initials: ML
authors.lastname: Marcovecchio
authors.affiliation: Department of Paediatrics, "G. d'Annunzio" University, Chieti-Pescara, via dei Vestini 5, 66100, Chieti, Italy.|Center of Excellence on Aging, "G. d'Annunzio" University Foundation, Chieti, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Bagordo
authors.affiliation: Department of Paediatrics, "G. d'Annunzio" University, Chieti-Pescara, via dei Vestini 5, 66100, Chieti, Italy.|Center of Excellence on Aging, "G. d'Annunzio" University Foundation, Chieti, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Marisi
authors.affiliation: Department of Paediatrics, "G. d'Annunzio" University, Chieti-Pescara, via dei Vestini 5, 66100, Chieti, Italy.|Center of Excellence on Aging, "G. d'Annunzio" University Foundation, Chieti, Italy.
authors.forename: T
authors.initials: T
authors.lastname: de Giorgis
authors.affiliation: Department of Paediatrics, "G. d'Annunzio" University, Chieti-Pescara, via dei Vestini 5, 66100, Chieti, Italy.|Center of Excellence on Aging, "G. d'Annunzio" University Foundation, Chieti, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Chiavaroli
authors.affiliation: Department of Paediatrics, "G. d'Annunzio" University, Chieti-Pescara, via dei Vestini 5, 66100, Chieti, Italy.|Center of Excellence on Aging, "G. d'Annunzio" University Foundation, Chieti, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Chiarelli
authors.affiliation: Department of Paediatrics, "G. d'Annunzio" University, Chieti-Pescara, via dei Vestini 5, 66100, Chieti, Italy.|Center of Excellence on Aging, "G. d'Annunzio" University Foundation, Chieti, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Mohn
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000378:metabolism*; D001786:Blood Glucose / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000097:blood* / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D018149:Glucose Intolerance / Q000097:blood* / Q000209:etiology; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000378:metabolism*; D007333:Insulin Resistance; D000078790:Insulin Secretion; D008297:Male; D008659:Metabolic Diseases / Q000097:blood* / Q000209:etiology; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D007328:Insulin
keywords: 1-H plasma glucose; Adolescents; Cardio-metabolic risk; Children; Insulin secretion; Insulin sensitivity; Obesity