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O0057 OBESE CHILDREN WITH HIGH RISK OF DIABETE HAVE A REAL INSULIN RESISTANCE (IR) BUT NO DETERIORATION OF GLUCOSE TOLERANCE

Druet, C.1; Baltaksé, V.2; Dabbas, M.3; Sebag, G.4; Dorgeret, S.4; Hankard, R.2; Chevenne, D.5; Polak, M.3; Levy-Marchal, C.5

Journal of Pediatric Gastroenterology and Nutrition: June 2004 - Volume 39 - Issue - p S29
ABSTRACTS: Oral Presentation Abstracts
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1INSERM Unit 457,2Pediatric Clinic, Robert Debre Hospital,3Pediatric Endocrinology, Diabetic Unit, INSERM EMI 0363, Hôpital des Enfants-Malades,4Pediatric Radiology,5INSER Unit 457, Robert Debre Hospital, Paris, France

Submitted by: drucel@yahoo.fr

Introduction: First cases of type 2 diabetes mellitus (T2D) in children have been reported in France, where we know that obesity increases in this age group. The objective is To evaluate glucose tolerance disorders and IR indices in obese children.

Methods: We studied 98 children and adolescents (48 girls and 50 boys; age = 7 to 17 years; BMI = 29,7 ± 5,3 kg/m2 or 6,8 ± 2,6 DS for age and sex), 52 of which are prepubertal. 18 have a family history of T2D. 21 are subsaharian, 37 are European Caucasian, 18 are African, 17 are Creole and 5 are from an other origin.

All had an OGTT. Body fat was assessed by dual energy x-ray absorptiometry (DEXA) and its abdominal distribution by MRI.

Results: According to the 97 ADA criteria, no case with overt diabetes nor with impaired glucose tolerance was observed. There was a significant difference between mean areas under the curve of glucose during OGTT (AUCG) in patients with or without family history of T2D (815 vs 741; p = 0,003; means adjusted for sex, ethnicity and puberty). AUCG was also influenced although not significantly by Tanner stages of puberty (p = 0.08) and was not by ethnicity nor by body fat mass. IR, assessed by HOMA, was clearly evidenced in 37% of the parients (HOMA > 2,5). IR was highly and significantly influenced by puberty (p = 0.0001), body size (p =0.002) and body fat (p = 0.001) but not significantly by family history of T2D or ethnicity.

Conclusion: In contrast to what observed in some countries like USA, disorders of glucose tolerance do not seem highly frequent in children with high risk for developing T2D, including in pubertal obese adolescents. IR is frequent and influenced by usual risk factors, except ethnicity, which doesn’t seem to be a preponderant factor.

© 2004 Lippincott Williams & Wilkins, Inc.