Improving insulin resistance in obese youth: Choose your measures wisely

Gabriel Shaibi, Jaimie N. Davis, Marc J. Weigensberg, Michael I. Goran

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Objective. The purpose of this investigation was to compare the homeostasis model assessment of insulin resistance (HOMA-IR) to more direct measures of insulin action before and after lifestyle interventions in obese Latino youth. Study design. Eleven obese Latino boys (age 15.1 ± 1.6 years, body mass index (BMI) percentile 97.3 ± 3.5%) and twenty obese Latina girls (age 14.7 ± 1.8 years, BMI percentile 96.6 ± 3.6%) participated in two distinct lifestyle interventions. Boys participated in a 16-week exercise intervention and girls participated in a 12-week nutrition education program. Insulin sensitivity was determined by the frequently sampled intravenous glucose tolerance test (FSIVGTT) in boys and by a 3-hour oral glucose tolerance test with multiple sampling calculations for the whole-body insulin sensitivity index (WBISI) in girls. HOMA-IR was measured for both groups. Results. HOMA-IR was correlated at baseline to the FSIVGTT (r = -0.57, p = 0.07) and the WBISI (r = -0.78, p<0.01) and at follow-up (FSIVGTT: r = -0.81, p<0.003; WBISI: r = -0.71, p = 0.001). Post-intervention, insulin sensitivity increased 45% in the boys and 34% in the girls; however, these improvements were not reflected by significant changes in HOMA-IR. Conclusions. Improvements in insulin sensitivity following an intervention measured either by the FSIVGTT or an OGTT were not detected by HOMA-IR. Researchers and clinicians should exercise caution in relying on fasting indices, such as HOMA-IR, to determine the impact of lifestyle interventions on insulin sensitivity in overweight youth.

Original languageEnglish (US)
JournalInternational Journal of Pediatric Obesity
Volume6
Issue number2 -2
DOIs
StatePublished - Jun 2011

Fingerprint

Insulin Resistance
Glucose Tolerance Test
Homeostasis
Hispanic Americans
Life Style
Body Mass Index
Exercise
Fasting
Research Personnel
Insulin
Education

Keywords

  • Exercise
  • Latino
  • Nutrition
  • Obesity
  • Pediatrics
  • Type 2 diabetes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Public Health, Environmental and Occupational Health
  • Health Policy
  • Nutrition and Dietetics

Cite this

Improving insulin resistance in obese youth : Choose your measures wisely. / Shaibi, Gabriel; Davis, Jaimie N.; Weigensberg, Marc J.; Goran, Michael I.

In: International Journal of Pediatric Obesity, Vol. 6, No. 2 -2, 06.2011.

Research output: Contribution to journalArticle

Shaibi, Gabriel ; Davis, Jaimie N. ; Weigensberg, Marc J. ; Goran, Michael I. / Improving insulin resistance in obese youth : Choose your measures wisely. In: International Journal of Pediatric Obesity. 2011 ; Vol. 6, No. 2 -2.
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abstract = "Objective. The purpose of this investigation was to compare the homeostasis model assessment of insulin resistance (HOMA-IR) to more direct measures of insulin action before and after lifestyle interventions in obese Latino youth. Study design. Eleven obese Latino boys (age 15.1 ± 1.6 years, body mass index (BMI) percentile 97.3 ± 3.5{\%}) and twenty obese Latina girls (age 14.7 ± 1.8 years, BMI percentile 96.6 ± 3.6{\%}) participated in two distinct lifestyle interventions. Boys participated in a 16-week exercise intervention and girls participated in a 12-week nutrition education program. Insulin sensitivity was determined by the frequently sampled intravenous glucose tolerance test (FSIVGTT) in boys and by a 3-hour oral glucose tolerance test with multiple sampling calculations for the whole-body insulin sensitivity index (WBISI) in girls. HOMA-IR was measured for both groups. Results. HOMA-IR was correlated at baseline to the FSIVGTT (r = -0.57, p = 0.07) and the WBISI (r = -0.78, p<0.01) and at follow-up (FSIVGTT: r = -0.81, p<0.003; WBISI: r = -0.71, p = 0.001). Post-intervention, insulin sensitivity increased 45{\%} in the boys and 34{\%} in the girls; however, these improvements were not reflected by significant changes in HOMA-IR. Conclusions. Improvements in insulin sensitivity following an intervention measured either by the FSIVGTT or an OGTT were not detected by HOMA-IR. Researchers and clinicians should exercise caution in relying on fasting indices, such as HOMA-IR, to determine the impact of lifestyle interventions on insulin sensitivity in overweight youth.",
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