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Good agreement between hyperinsulinemic‐euglycemic clamp and 2 hours oral minimal model assessed insulin sensitivity in adolescents
Author(s) -
Carreau AnneMarie,
Xie Danielle,
GarciaReyes Yesenia,
Rahat Haseeb,
Bartlette Kai,
Behn Cecilia Diniz,
Pyle Laura,
Nadeau Kristen J.,
CreeGreen Melanie
Publication year - 2020
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/pedi.13072
Subject(s) - medicine , clamp , endocrinology , percentile , population , glucose clamp technique , polycystic ovary , insulin resistance , insulin sensitivity , insulin , cardiology , mechanical engineering , clamping , statistics , mathematics , environmental health , engineering
Abstract Background/objective Rates of dysglycemia are increasing in youth, secondary to obesity and decreased insulin sensitivity (IS) in puberty. The oral minimal model (OMM) has been developed in order to measure IS using an easy oral glucose load, such as an oral glucose tolerance test (OGTT), instead of an hyperinsulinemic‐euglycemic clamp (HE‐clamp), a more invasive and time‐consuming procedure. However, this model, following a standard 2 hour‐ OGTT has never been validated in youth, a population known for a different physiologic response to OGTT than adults. Thus, we compared IS measurements obtained from OMM following a 2‐hour OGTT to HE‐clamp and isotope tracer‐assessed tissue IS in adolescents. We also compared the liver/muscle‐specific IS from HE‐clamp with other liver/muscle‐specific IS surrogates following an OGTT previously validated in adults. Methods Secondary analysis of a cross‐sectional study. Adolescent girls with (n = 26) and without (n = 7) polycystic ovary syndrome (PCOS) (14.6 ± 1.7 years; BMI percentile 23.3%‐98.2%) underwent a 2‐hour 75 g OGTT and a 4‐phase HE‐clamp. OMM IS (Si), dynamic Si (Si d ) and other OGTT‐derived muscle and liver IS indices were correlated with HE‐clamp tissue‐specific IS. Results OMM Si and Si d correlated with HE‐clamp‐measured peripheral IS (r = 0.64, P <.0001 and r = 0.73; P <.0001, respectively) and the correlation coefficient trended higher than the Matsuda index (r = 0.59; P =.003). The other tissue‐specific indices were poorly correlated with their HE‐clamp measurements. Conclusion In adolescent girls, the 2‐hour OMM provided the best estimate of peripheral IS. Additional surrogates for hepatic IS are needed for youth.