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

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

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Abstrakt

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.

OriginalsprogEngelsk
Sider (fra-til)538-548
Antal sider11
TidsskriftPediatric Diabetes
Vol/bind20
Udgave nummer5
DOI
StatusUdgivet - aug. 2019

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� 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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