Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Apr;38(4):689-95.
doi: 10.2337/dc14-2183. Epub 2015 Jan 29.

Glucose effectiveness in obese children: relation to degree of obesity and dysglycemia

Ram Weiss  1 , Sheela N Magge  2 , Nicola Santoro  3 , Cosimo Giannini  3 , Raymond Boston  4 , Tara Holder  3 , Melissa Shaw  3 , Elvira Duran  3 , Karen J Hershkop  5 , Sonia Caprio  3
Affiliations

Glucose effectiveness in obese children: relation to degree of obesity and dysglycemia

Ram Weiss et al. Diabetes Care. 2015 Apr.

Abstract

Objective: Impaired glucose effectiveness (GE) plays a role in the deterioration of glucose metabolism. Our aim was to validate a surrogate of GE derived from an oral glucose tolerance test (OGTT) and to assess the impact of degrees of obesity and of glucose tolerance on it.

Research design and methods: The OGTT-derived surrogate of GE (oGE) was validated in obese adolescents who underwent an OGTT and an intravenous glucose tolerance test (IVGTT). We then evaluated anthropometric determinants of the oGE and its impact on the dynamics of glucose tolerance in a cohort of children with varying degrees of obesity.

Results: The correlation of oGE and IVGTT-derived GE in 98 obese adolescents was r = 0.35 (P < 0.001) as a whole and r = 0.51 (P < 0.001) in subjects with normal glucose tolerance. In a cohort of 1,418 children, the adjusted GE was associated with increasing obesity (P < 0.001 for each category of obesity). Quartiles of oGE and the oral disposition index were associated with 2-h glucose levels (P < 0.001 for both). Among 421 nondiabetic obese subjects (276 subjects with normal glucose tolerance/145 subjects with impaired glucose tolerance who repeated their OGTT after a mean time of 28 ± 16 months), oGE changes were tightly associated with weight (r = 0.83, P < 0.001) and waist circumference changes (r = 0.67, P < 0.001). Baseline oGE and changes in oGE over time emerged as significant predictors of the change in 2-h glucose levels (standardized B = -0.76 and B = -0.98 respectively, P < 0.001 for both).

Conclusions: The oGE is associated with the degree of and changes in weight and waist circumference and is an independent predictor of glucose tolerance dynamics.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Relation of the oDI, GE, and 2-h glucose levels on the OGTT results. Quartiles of the oDI and of GE are significantly associated with 2-h glucose levels (P < 0.001 for both), as is the interaction between them (P < 0.001).
Figure 2
Figure 2
Unadjusted and adjusted GE in relation to glucose tolerance and ethnicity. A: Unadjusted GE is significantly and negatively associated with altered glucose tolerance and is lower in African Americans with NGT. B: Adjusted GE is significantly and negatively associated with altered glucose tolerance and is significantly lower in obese African American children in comparison with their Caucasian and Hispanic counterparts. AA, African American; Cau, Caucasian; His, Hispanic.
Figure 3
Figure 3
Relation of anthropometric changes with GE dynamics. Both weight gain (A) and increase in waist circumference (B) are negatively associated with the change in GE over time.
See this image and copyright information in PMC

References

    1. Bergman RN, Finegood DT, Ader M. Assessment of insulin sensitivity in vivo. Endocr Rev 1985;6:45–86 - PubMed
    1. Best JD, Kahn SE, Ader M, Watanabe RM, Ni TC, Bergman RN. Role of glucose effectiveness in the determination of glucose tolerance. Diabetes Care 1996;19:1018–1030 - PubMed
    1. Nagasaka S, Tokuyama K, Kusaka I, et al. Endogenous glucose production and glucose effectiveness in type 2 diabetic subjects derived from stable-labeled minimal model approach. Diabetes 1999;48:1054–1060 - PubMed
    1. Basu A, Caumo A, Bettini F, et al. Impaired basal glucose effectiveness in NIDDM: contribution of defects in glucose disappearance and production, measured using an optimized minimal model independent protocol. Diabetes 1997;46:421–432 - PubMed
    1. Doi K, Taniguchi A, Nakai Y, et al. Decreased glucose effectiveness but not insulin resistance in glucose-tolerant offspring of Japanese non-insulin-dependent diabetic patients: a minimal-model analysis. Metabolism 1997;46:880–883 - PubMed

Publication types

MeSH terms