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Glucose tolerance status in 510 children and adolescents attending an obesity clinic in Central Italy

Authors

  • Claudia Brufani,

    Corresponding author
    1. Endocrinology and Diabetes Unit, Department of Paediatric Medicine, Bambino Gesù Children's Hospital IRCCS, Piazza S. Onofrio 4, Rome, Italy
      Claudia Brufani Bambino Gesù Children's Hospital IRCCS Department of Paediatric Medicine, Endocrinology and Diabetes Unit Piazza S. Onofrio 4 00165 Rome Italy.
      Tel: +39 6 68593322;
      fax: +39 6 68593374;
      e-mail: cbrufani@libero.it
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  • Paolo Ciampalini,

    1. Endocrinology and Diabetes Unit, Department of Paediatric Medicine, Bambino Gesù Children's Hospital IRCCS, Piazza S. Onofrio 4, Rome, Italy
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  • Armando Grossi,

    1. Endocrinology and Diabetes Unit, Department of Paediatric Medicine, Bambino Gesù Children's Hospital IRCCS, Piazza S. Onofrio 4, Rome, Italy
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  • Rossana Fiori,

    1. Endocrinology and Diabetes Unit, Department of Paediatric Medicine, Bambino Gesù Children's Hospital IRCCS, Piazza S. Onofrio 4, Rome, Italy
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  • Danilo Fintini,

    1. Endocrinology and Diabetes Unit, Department of Paediatric Medicine, Bambino Gesù Children's Hospital IRCCS, Piazza S. Onofrio 4, Rome, Italy
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  • Alberto Tozzi,

    1. Epidemiology Unit, Department of Paediatric Medicine, Bambino Gesù Children's Hospital IRCCS, Piazza S. Onofrio 4, Rome, Italy
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  • Marco Cappa,

    1. Endocrinology and Diabetes Unit, Department of Paediatric Medicine, Bambino Gesù Children's Hospital IRCCS, Piazza S. Onofrio 4, Rome, Italy
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  • Fabrizio Barbetti

    1. Laboratory of Molecular Endocrinology and Diabetes, Bambino Gesù Children's Hospital IRCCS, Piazza S. Onofrio 4, Rome, Italy
    2. Department of Internal Medicine, University of Tor Vergata, Viale Oxford 81, Rome, Italy
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Claudia Brufani Bambino Gesù Children's Hospital IRCCS Department of Paediatric Medicine, Endocrinology and Diabetes Unit Piazza S. Onofrio 4 00165 Rome Italy.
Tel: +39 6 68593322;
fax: +39 6 68593374;
e-mail: cbrufani@libero.it

Abstract

Brufani C, Ciampalini P, Grossi A, Fiori R, Fintini D, Tozzi A, Cappa M, Barbetti F. Glucose tolerance status in 510 children and adolescents attending an obesity clinic in Central Italy.

Childhood obesity is epidemic in developed countries and is accompanied by an increase in the prevalence of type 2 diabetes (T2DM).

Aims: Establish prevalence of glucose metabolism alterations in a large sample of overweight/obese children and adolescents from Central Italy.

Methods: The study group included 510 overweight/obese subjects (3–18 yr). Oral glucose tolerance test (OGTT) was performed with glucose and insulin determination. Homeostatic model assessment of insulin resistance (HOMA-IR) and insulin sensitivity index (ISI) were derived from fasting and OGTT measurements. Beta-cell function was estimated by insulinogenic index. Fat mass was measured by dual-energy x-ray absorptiometry.

Results: Glucose metabolism alterations were detected in 12.4% of patients. Impaired glucose tolerance (IGT) was the most frequent alteration (11.2%), with a higher prevalence in adolescents than in children (14.8 vs. 4.1%, p < 0.001); silent T2DM was identified in two adolescents (0.4%). HOMA-IR and glucose-stimulated insulin levels were higher in patients with IGT than individuals with normal glucose tolerance (HOMA-IR = 4.4 ± 2.5 vs. 3.4 ± 2.3, p = 0.001). Fat mass percentage and insulinogenic index were not different between the two groups. In multivariate analysis, age, fasting glucose, and insulin resistance influenced independently plasma glucose at 120 min of OGTT. Individuals with combined impaired fasting glucose/IGT (IFG/IGT) and T2DM were older and had reduced plasma insulin values at OGTT when compared to patients with simple IGT.

Conclusions: Glucose metabolism alterations are frequently found among children and adolescents with overweight/obesity from Central Italy. Age, fasting glucose, and insulin resistance are main predictors of IGT. We suggest the use of OGTT as a screening tool in obese European adolescents.

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