Glucose metabolism in children and adolescents: Population-based reference values and comparisons to children and adolescents enrolled in obesity treatment.

Abstract

BACKGROUND:

Alterations in glucose metabolism that lead to the development of metabolic and cardiovascular disease may begin already in childhood.

OBJECTIVE:

This study aims to generate pediatric age and sex-specific reference values for fasting concentrations of glucose, hemoglobin A1c (HbA1c), insulin, C-peptide, and homeostasis model assessment: insulin resistance (HOMA-IR) in Danish/North-European white children and adolescents from a population-based cohort and to compare values from children and adolescents with overweight/obesity with this reference.

METHODS:

The population- and obesity clinic-based cohorts consisted of 2451 and 1935 children and adolescents between 6 and 18 years of age. Anthropometric measurements and blood samples were obtained and percentile curves were calculated.

RESULTS:

In the population-based cohort, glucose, insulin, and HOMA-IR values increased before the expected onset of puberty (P < .05). Thereafter, all variables decreased in girls (P < .05) and HbA1c decreased in boys (P < .05). Concentrations of all measured markers of glucose metabolism were higher in the obesity clinic-based cohort than the population-based cohort (both sexes P < .001). Specifically, insulin and HOMA-IR continued to increase to 18 years in the clinic-based cohort, particularly among boys.

CONCLUSIONS:

Fasting glucose, insulin, and HOMA-IR change during childhood, making pediatric reference values essential for timely identification of derangements in glucose metabolism. Children and adolescents with obesity exhibit increased concentrations of these biomarkers.

• Authors: Christine Frithioff-Bøjsøe, Morten A V Lund, Julie T Kloppenborg, Tenna T H Nielsen, Cilius E Fonvig, Ulrik Lausten-Thomsen, Paula L Hedley, Tina Hansen, Oluf B Pedersen, Michael Christiansen, Jennifer L Baker, Torben Hansen, Jens-Christian Holm
• Journal: Pediatric diabetes (Pediatr Diabetes) Vol. 20 Issue 5 Pg. 538-548 (08 2019) ISSN: 1399-5448 [Electronic] Denmark
• PMID: 31074070 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Chemical References

• Blood Glucose
• C-Peptide
• Insulin

Topics

• Adolescent
• Blood Glucose
• C-Peptide (blood)
• Child
• Cohort Studies
• Female
• Humans
• Insulin (blood)
• Male
• Obesity (blood, therapy)
• Reference Values