A Novel, Non-Invasive C-13-Glucose Breath Test to Estimate Insulin Resistance in Obese Prepubertal Children

作者：Jetha Mary M; Nzekwu Ugo; Lewanczuk Richard Z; Ball Geoff D C^*

来源：Journal of Pediatric Endocrinology & Metabolism, 2009, 22(11): 1051-1059.

• pediatrics
• prepubertal
• obesity
• insulin resistance
• type 2 diabetes mellitus
• HOMA

Insulin resistance (IR) is an important risk factor for the development of type 2 diabetes mellitus in obese boys and girls. Because needle-associated fear and anxiety are common in children, non-invasive methods to determine IR are desirable. Our objective in this cross-sectional study of obese prepubertal children (n = 39) was to compare estimates of IR using a novel, non-invasive technique (C-13-glucose breath test) with common indices of IR derived from an oral glucose tolerance test (OGTT). For the C-13-glucose breath test, samples were collected before and 90 minutes after ingestion of 25 ling C-13-labelled glucose. For the OGTT, glucose and insulin samples were collected at 0, 15, 30, 45, 60, 90 and 120 minutes. The homeostatic model assessment of insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), insulin area-under-the-curve (AUC), and sum-of-insulin were calculated as indices of IR. Pearson correlations revealed significant, but moderate, associations between the C-13-glucose breath test and fasting insulin (r = -0.50; p <0.01), 2-hour insulin (r = -0.40; p <0.05), HOMA-IR (r = -0.51; p <0.01), QUICKI (r = 0.53; p <0.01), insulin AUC (r = -0.22; NS), and sum-of-insulin (r = -0.48; p <0.05). Paired t-tests between estimates of IR from C-13-glucose breath test and other indices showed no significant differences. Bland-Altman plots showed acceptable levels of agreement between indices of IR. In obese prepubertal children, the C-13-glucose breath test can provide a proxy estimate of IR when gold-standard techniques are either unavailable or impractical.

• 出版日期2009-11