High FPG predicts impaired glucose metabolism in obese youth
MedWire News: Study results show that a higher than average fasting plasma glucose (FPG) level, within the normal range, predicts insulin resistance (IR) and beta cell dysfunction in obese children and adolescents.
FPG levels at the upper end of the normal range have been associated with increased risk for Type 2 diabetes and cardiovascular disease in adults, but whether this is the case in children and adolescents has been unclear to date.
Sonia Caprio (Yale University School of Medicine, New Haven, Connecticut, USA) and colleagues carried out a cross-sectional study of a multi-ethnic group of 1020 obese girls (n=614) and boys (n=406) to assess links between FPG levels and measures of glucose metabolism and cardiovascular risk.
The participants were aged 12.9 years on average and had a mean body mass index (BMI) z score of 2.34. All had FPG values within the normal range (3.42–5.60 mmol/l).
The children were stratified into quartiles of FPG: 3.42–4.81; 4.82–5.04; 5.05–5.26; and 5.27–5.54 mmol/l for quartiles 1–4, respectively.
Prepubertal and pubertal children in quartiles 3 and 4 versus those in quartiles 1 and 2 were 7% and 64% more likely, respectively, to present with impaired fasting glucose (IFG) or Type 2 diabetes. Overall, the likelihood of having IFG increased by 4.5% for each 0.06 mmol/l increase in FPG.
In addition, the team reports that fasting insulin and the area under the receiver operator curve (AUC) score for the 2-hour oral glucose tolerance test increased significantly across increasing quartiles of FPG.
Of note, no significant differences in cardiovascular indices, such as lipids and blood pressure, were seen across the quartiles of FPG.
“Thus, FPG may be a useful measure for identifying children with higher odds of presenting with metabolic impairment and might be useful to identify those for whom subsequent targeted therapeutic lifestyle management would be most beneficial,” conclude the authors in the journal Diabetologia.
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By Helen Albert