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Received on January 15, 2008
Accepted on April 28, 2008
Pediatric Clinical Chemistry |
1 Division of Pathology and Neuroscience, University of Dundee, Dundee, UK
2 Department of Endocrinology and Metabolism, Peninsula Medical School, Plymouth Campus, Plymouth, UK
3 Department of Vascular Biochemistry, University of Glasgow, Glasgow, UK
4 Department of Clinical Chemistry, Derriford Hospital, Plymouth, UK
* To whom correspondence should be addressed. E-mail: m.j.murphy{at}dundee.ac.uk.
BACKGROUND: The emergence of type 2 diabetes in young populations has mirrored a rising prevalence of obesity and insulin resistance during childhood and adolescence. At the same time, the role of adipokines as links between obesity and insulin resistance is becoming more appreciated. We sought to establish age- and sex-specific distributions of metabolic correlates of insulin resistance in healthy prepubertal children.
METHODS: We collected fasting blood samples from a contemporary cohort of 307 British children at ages 5, 6, 7, and 8 years and measured insulin, glucose, triglycerides, total and HDL cholesterol, urate, glycohemoglobin, sex hormone–binding globulin (SHBG), leptin, and adiponectin. We used homeostasis model assessment (HOMA 2) to estimate insulin sensitivity (HOMA-%S) and
-cell function (HOMA-%B). Anthropometric measures included body mass index.
RESULTS: Body mass index increased from age 5 to 8 years (P < 0.001). HOMA-%B decreased (P < 0.001) and HOMA-%S increased (P < 0.05), but glucose also increased (P < 0.001) whereas glycohemoglobin decreased (P < 0.001). Consistent with the rise in insulin sensitivity, HDL cholesterol increased (P < 0.001) and triglycerides decreased (NS), whereas adiponectin decreased (P = 0.02). The patterns were similar in boys and girls, although girls were less insulin sensitive throughout. Accordingly, triglycerides tended to be higher in the girls, and HDL cholesterol and SHBG lower.
CONCLUSIONS: The metabolic disturbances associated with insulin resistance appear to be more advanced in girls. Markers of metabolic health improve in both sexes from 5 to 8 years, despite rising adiposity.
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