Utility of estimated glucose disposal rate for predicting metabolic syndrome in children and adolescents with type-1 diabetes

  • 1 Department of Pediatrics, Division of Pediatric Neurology, Ankara City Hospital, Ankara, Turkey
  • 2 Üniversiteler Mahallesi Bilkent Cad, Çocuk Nörolojisi Departmanı, No: 1, Ankara Şehir Hastanesi, Çocuk Hastanesi, B1 katı, Ankara, Turkey
  • 3 Department of Pediatrics, Division of Pediatric Neurology, İstinye University, Istanbul, Turkey
  • 4 Department of Pediatrics, Division of Pediatric Neurology, Muğla Sıtkı Koçman Research and Training Hospital, Mugla, Turkey
  • 5 Department of Pediatrics, Division of Pediatric Neurology, Ondokuz Mayıs University, Samsun, Turkey
Özlem Yayıcı KökenORCID iD: https://orcid.org/0000-0003-2112-8284
  • Corresponding author
  • Department of Pediatrics, Division of Pediatric Neurology, Ankara City Hospital, Ankara, Turkey
  • Üniversiteler Mahallesi Bilkent Cad, No: 1, Ankara Şehir Hastanesi, Çocuk Hastanesi, B1 katı, Çocuk Nörolojisi Departmanı, Çankaya, Ankara, Turkey
  • orcid.org/0000-0003-2112-8284
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, Cengiz KaraORCID iD: https://orcid.org/0000-0002-8989-560X, Gülay Can YılmazORCID iD: https://orcid.org/0000-0003-0525-1231 and Hasan Murat AydınORCID iD: https://orcid.org/0000-0001-7374-229X

Abstract

Objectives

To determine the clinical utility of the estimated glucose disposal rate (eGDR) for predicting metabolic syndrome (MetS) in children and adolescents with type-1 diabetes (T1D).

Methods

Modified criteria of the International Diabetes Federation were used to determine MetS in children and adolescents between 10 and 18 years of age with T1D. The eGDR, a validated marker of insulin sensitivity, was calculated in two different ways using either the waist-to-hip ratio (WHR) or waist circumference (WC). Receiver operating characteristic (ROC) curve analysis was performed to ascertain cut-off levels of the eGDR to predict MetS.

Results

A total of 200 patients (52% male) with T1D were enrolled in the study. The prevalence of MetS was 10.5% (n: 21). Lower eGDR levels, indicating greater insulin resistance, were found in T1D patients with MetS when compared to those without (6.41 ± 1.86 vs. 9.50 ± 1.34 mg/kg/min) (p < 0.001). An eGDRWHR cut-off of 8.44 mg/kg/min showed 85.7% sensitivity and 82.6% specificity, while an eGDRWC cut-off of 8.16 mg/kg/min showed 76.1% sensitivity and 92.1% specificity for MetS diagnosis. The diagnostic odds ratio was 28.6 (7.3–131.0) for the eGDRWHR cut-off and 37.7 (10.8–140.8) for the eGDRWC cut-off.

Conclusions

The eGDR is a mathematical formula that can be used in clinical practice to detect the existence of MetS in children and adolescents with T1D using only the WC, existence of hypertension, and hemoglobin A1c levels. An eGDR calculated using the WC could be a preferred choice due to its higher diagnostic performance.

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The Journal of Pediatric Endocrinology and Metabolism (JPEM) is the only international journal dedicated exclusively to endocrinology in the neonatal, pediatric and adolescent age groups, and publishes the results of clinical investigations in pediatric endocrinology and basic research. JPEM publishes Review Articles, Original Research, Case Reports, Short Communications and Letters to the Editor.

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