Insulin resistance: metabolic and somatic changes in children




insulin resistance, metabolic risk factors, children


Background. Insulin resistance is the major sign of etiology and pathogenesis of type 2 diabetes mellitus and metabolic syndrome and can precede its development for many years. Early identifying the beginning of insulin resistance in children is important to prevent diabetes mellitus in adult life. The purpose was to identify metabolic and somatic changes in children with insulin resistance. Material and methods. Out of 182 children of the general sample, who was estimated fasting plasma insulin and glucose, HOMA-IR, and glucose/insulin ratio, 2 groups were formed: group 1 — children with IR — 56 (30.8 %) and group 2 — 126 (69.2 %) children with normal insulin sensitivity. In children anthropometric data, lipid metabolism (total cholesterol, triglycerides, HDL-C, LDL-C, VLDL-C), blood pressure, leptin were determined. Results. From examined subjects 56 children were generally obese (BMI > 95th percentile), 71 children were abdominally obese (WC > 90th percentile), 55 children were with normal body mass (BMI < 90th percentile). Insulin resistance was identified in 21 (37.5 %) children with general obesity more rarely, than in 38 (39.4 %) children with abdominal obesity (p = .049) and in 7 (12.7 %) children with normal BMI (p = .003). In insulin-resistant children BMI, waist and hip circumference was larger than in children with normal insulin sensitivity. The lipid profile in children with different insulin sensitivity did not differ, but in insulin-resistant children an association of basal glucose with TG/HDL-C ratio (r = .53; p = .001), blood insulin with TG (r = .34; p = .018), and TG/HDL-C ratio (r = .54; p = .001) was estimated. The HOMA-IR significantly correlated with VLD-C (r = .40; p = .005), TG (r = .49; p = .001), TG/HDL-C ratio (r = .43; p = .002). The glucose/insulin ratio was in significant association with the TG/non-HDL-C ratio. The incidence of hypetension (> 95th percentile) diagnosis in insulin-resistant children was by 33.8 % higher (p = .001). Blood leptin concentration was 1.8 falled higher in insulin-resistant children and significantly correlates with waist circumference, fasting insulin, HOMA-IR, and diastolic blood pressure. Conclusions. Insulin resistance is related to cardiometabolic risks, such as general and abdominal obesity, hypertension, dyslipidemia, hyperleptinemia, and leptin resistance, and is a screening biomarker for children and adolescents with an increased risk of cardiometabolic diseases.


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Rehman K, Akash MS. Mechanisms of inflammatory responses and development of insulin resistance: how are they interlinked? J Biomed Sci. 2016 Dec 3;23(1):87. doi: 10.1186/s12929-016-0303-y.

Martín-Timón I, Sevillano-Collantes C, Segura-Galindo A, Del Cañizo-Gómez FJ. Type 2 diabetes and cardiovascular disease: Have all risk factors the same strength? World J Diabetes. 2014;5(4):444-70. doi: 10.4239/wjd.v5.i4.444.

Gayoso-Diz P, Otero-González A, Rodriguez-Alvarez MX, et al. Insulin resistance (HOMA-IR) cut-off values and the metabolic syndrome in a general adult population: effect of gender and age: EPIRCE cross-sectional study. BMC Endocr Disord. 2013 Oct 16;13:47. doi: 10.1186/1472-6823-13-47.

Aslan Çin NN, Yardımcı H, Koç N, Uçaktürk SA, Akçil Ok M. Triglycerides/high-density lipoprotein cholesterol is a predictor similar to the triglyceride-glucose index for the diagnosis of metabolic syndrome using International Diabetes Federation criteria of insulin resistance in obese adolescents: a cross-sectional study. J Pediatr Endocrinol Metab. 2020 May 24;33(6):777-784. doi: 10.1515/jpem-2019-0310.

Sorokman T, Makarova O. Somatic and mental health of obese children. International Journal of Endocrinology (Ukraine). 2020;16(7):543-550. doi: 10.22141/2224-0721.16.7.2020.219008.

Bolshova O, Malinovska T. The Content of Ghrelin and Leptin in the Blood Plasma of Children and Adolescents With Hypothalamic Dysfunction. International Journal of Endocrinology (Ukraine). 2018;14(8):719-724. doi: 10.22141/2224-0721.14.8.2018.154849.

Falalyeyeva T, Mamula Y, Scarpellini E, Leshchenko I, Humeniuk A, Pankiv I, Kobyliak N. Probiotics and obesity associated disease: an extended view beyond traditional strains. Minerva Gastroenterol (Torino). 2021;67(4):348-356. doi: 10.23736/S2724-5985.21.02909-0.

Castorani V, Polidori N, Giannini C, Blasetti A, Chiarelli F. Insulin resistance and type 2 diabetes in children. Ann Pediatr Endocrinol Metab. 2020;25(4):217-226. doi: 10.6065/apem.2040090.045.

Manios Y, Moschonis G, Kourlaba G, et al. Prevalence and independent predictors of insulin resistance in children from Crete, Greece: the Children Study. Diabet Med. 2008;25(1):65-72. doi:10.1111/j.1464-5491.2007.02318.

Grant AM, Taungapeau FK, McAuley KA, et al. Body mass index status is effective in identifying metabolic syndrome components and insulin resistance in Pacific Island teenagers living in New Zealand. Metabolism. 2008 Apr;57(4):511-6. doi: 10.1016/j.metabol.2007.11.013.

Hirscler V, Maccalini G, Karam C, et al. Age girls are insulin resistant than boys? Clin Biochem. 2009; 42(10-11):1051-6. doi10.1016/j.clinbiochem.2009.03.002.

Gromnatska N, Cherkas A, Lemishko B, Kulya O. The pattern of metabolic syndrome in children with abdominal obesity. Georgian Med News. 2019;289:68-72.

Petersen MC, Shulman GI. Mechanisms of Insulin Action and Insulin Resistance. Physiol Rev. 2018;98(4):2133-2223. doi: 10.1152/physrev.00063.2017.

Czech MP. Insulin action and resistance in obesity and type 2 diabetes. Nat Med. 2017;23(7):804-814. doi: 10.1038/nm.4350.

Pankiv VI, Yuzvenko TYu, Pashkovska NV, Pankiv IV. Effect of vitamin D on insulin resistance and anthropometric parameters in patients with type 2 diabetes mellitus. Clinical Endocrinology and Endocrine Surgery. 2019;(65):53-58. doi: 10.30978/CEES-2019-1-53.

Soriguer F, Gutiérrez-Repiso C, Rubio-Martín E, et al. Metabolically healthy but obese, a matter of time? Findings from the prospective Pizarra study. J Clin Endocrinol Metab. 2013 Jun;98(6):2318-25. doi: 10.1210/jc.2012-4253.

Gepstein V, Weiss R. Obesity as the Main Risk Factor for Metabolic Syndrome in Children. Front Endocrinol (Lausanne). 2019;10:568. doi: 10.3389/fendo.2019.00568.

Pankiv IV. Intercommunication between serum vitamin D concentration and the body mass index. Obesity Reviews. 2020;21(Suppl.1):EP 411.

da Silva CC, Zambon MP, Vasques ACJ, et al; Brazilian Metabolic Syndrome Study (BRAMS) Investigators. Homeostatic model assessment of adiponectin (HOMA-Adiponectin) as a surrogate measure of insulin resistance in adolescents: Comparison with the hyperglycaemic clamp and homeostatic model assessment of insulin resistance. PLoS One. 2019 Mar 25;14(3):e0214081. doi: 10.1371/journal.pone.0214081.

Zabarsky G, Beek C, Hagman E, Pierpont B, Caprio S, Weiss R. Impact of Severe Obesity on Cardiovascular Risk Factors in Youth. J Pediatr. 2018 Jan;192:105-114. doi: 10.1016/j.jpeds.2017.09.066.

Hershkop K, Besor O, Santoro N, Pierpont B, Caprio S, Weiss R. Adipose Insulin Resistance in Obese Adolescents Across the Spectrum of Glucose Tolerance. J Clin Endocrinol Metab. 2016 Jun;101(6):2423-31. doi: 10.1210/jc.2016-1376.

Ahila A, Vimalraj V, Raghupathy P. Insulin resistance and adverse lipid profile in obese pre-pubertal South Indian children. Int J Pediatr Endocrinol. 2015;2015(Suppl 1):P78. doi: 10.1186/1687-9856-2015-S1-P78.

van der Aa MP, Fazeli Farsani S, Knibbe CA, de Boer A, van der Vorst MM. Population-Based Studies on the Epidemiology of Insulin Resistance in Children. J Diabetes Res. 2015;2015:362375. doi: 10.1155/2015/362375.

Takahashi T, Okamoto T, Sato Y, Hayashi A, Ueda Y, Ariga T. Glucose metabolism disorders in children with refractory nephrotic syndrome. Pediatr Nephrol. 2020 Apr;35(4):649-657. doi: 10.1007/s00467-019-04360-1.

Mastrangelo A, Martos-Moreno GÁ, García A, et al. Insulin resistance in prepubertal obese children correlates with sex-dependent early onset metabolomic alterations. Int J Obes (Lond). 2016 Oct;40(10):1494-1502. doi: 10.1038/ijo.2016.92.

Armstrong MJ, Hazlehurst JM, Hull D, et al. Abdominal subcutaneous adipose tissue insulin resistance and lipolysis in patients with non-alcoholic steatohepatitis. Diabetes Obes Metab. 2014;16(7):651-60. doi: 10.1111/dom.12272.

Abbasi F, Kohli P, Reaven GM, Knowles JW. Hypertriglyceridemia: A simple approach to identify insulin resistance and enhanced cardio-metabolic risk in patients with prediabetes. Diabetes Res Clin Pract. 2016 Oct;120:156-61. doi: 10.1016/j.diabres.2016.07.024.

Chmyr NV, Dutka RJ. Pathogenetic And Clinical Peculiarities Of Metabolic Syndrome, Due To Obesity And Their Prognostic Value. Bukovinian Med Bullet. 2017;21(2 Pt 1):127-130. doi: 10.24061/2413-0737/XXI. (in Ukrainian).

Mitsuhashi T, Hibi K, Kosuge M, et al. Relation between hyperinsulinemia and nonculprit plaque characteristics in nondiabetic patients with acute coronary syndromes. JACC Cardiovasc Imaging. 2011 Apr;4(4):392-401. doi: 10.1016/j.jcmg.2011.02.004.

Gao F, Lucke-Wold BP, Li X, et al. Reduction of Endothelial Nitric Oxide Increases the Adhesiveness of Constitutive Endothelial Membrane ICAM-1 through Src-Mediated Phosphorylation. Front Physiol. 2018 Jan 10;8:1124. doi: 10.3389/fphys.2017.01124.

Boucher J, Kleinridders A, Kahn CR. Insulin receptor signaling in normal and insulin-resistant states. Cold Spring Harb Perspect Biol. 2014 Jan 1;6(1):a009191. doi: 10.1101/cshperspect.a009191.

Janus A, Szahidewicz-Krupska E, Mazur G, Doroszko A. Insulin Resistance and Endothelial Dysfunction Constitute a Common Therapeutic Target in Cardiometabolic Disorders. Mediators Inflamm. 2016;2016:3634948. doi: 10.1155/2016/3634948.

Ibarra-Reynoso Ldel R, Pisarchyk L, Pérez-Luque EL, Garay-Sevilla ME, Malacara JM. Whole-body and hepatic insulin resistance in obese children. PLoS One. 2014 Nov 20;9(11):e113576. doi: 10.1371/journal.pone.0113576.

Moonishaa TM, Nanda SK, Shamraj M, Sivaa R, Sivakumar P, Ravichandran K. Evaluation of Leptin as a Marker of Insulin Resistance in Type 2 Diabetes Mellitus. Int J Appl Basic Med Res. 2017 Jul-Sep;7(3):176-180. doi: 10.4103/ijabmr.IJABMR_278_16.

Das P, Bhattacharjee D, Bandyopadhyay SK, Bhattacharya G, Singh R. Association of obesity and leptin with insulin resistance in type 2 diabetes mellitus in Indian population. Indian J Physiol Pharmacol. 2013 Jan-Mar;57(1):45-50.

Tibaldi J. Preserving insulin secretion in Type 2 diabetes mellitus. Expert Rev Endocrinol Metab. 2008 Mar;3(2):147-159. doi: 10.1586/17446651.3.2.147.

Niswender KD, Magnuson MA. Obesity and the beta cell: lessons from leptin. J Clin Invest. 2007 Oct;117(10):2753-6. doi: 10.1172/JCI33528.

Mohiti J, Afkhami M, Babaei A. Relation between leptin and insulin in patients with type II diabetes mellitus. Int J Endocrinol Metab. 2005;3(3):121-125.




How to Cite

Gromnatska, N., Sklyarova, O., & Kulya, O. (2022). Insulin resistance: metabolic and somatic changes in children. INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine), 18(4), 219–225.



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