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Journal of Pediatric Endocrinology and Metabolism

Editor-in-Chief: Kiess, Wieland

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Volume 30, Issue 2


Definition of insulin resistance affects prevalence rate in pediatric patients: a systematic review and call for consensus

Marloes P. van der Aa / Catherijne A.J. Knibbe / Anthonius de Boer
  • Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, The Netherlands
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Marja M.J. van der Vorst
  • Corresponding author
  • Department of Pediatrics, St. Antonius Hospital, P.O. Box 2500, 3430 EM Nieuwegein, The Netherlands, Phone: +31 88 320 6325
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2016-12-16 | DOI: https://doi.org/10.1515/jpem-2016-0242



As a result of the rising prevalence of childhood obesity, there is an increasing interest in the type 2 diabetes mellitus precursor insulin resistance (IR). The aim of this study is to review definitions (methods and cutoff values) to define IR in children and to apply these definitions to a previously described obese pediatric population.


A systematic literature review on prevalence and/or incidence rates in children was performed. The extracted definitions were applied to an obese pediatric population.


In the 103 identified articles, 146 IR definitions were reported based on 14 different methods. Fasted definitions were used 137 times, whereas oral/intravenous glucose tolerance test-derived methods were used nine times. The homeostasis model for the assessment of insulin resistance (HOMA-IR) and fasted plasma insulin (FPI) were the most frequently used fasted methods (83 and 37 times, respectively). A wide range in cutoff values to define IR was observed, resulting in prevalence rates in the predefined obese pediatric population between 5.5% (FPI>30 mU/L) and 72.3% (insulin sensitivity indexMatsuda≤7.2).


To compare IR incidence and prevalence rates in pediatric populations, a uniform definition of IR should be defined.

This article offers supplementary material which is provided at the end of the article.

Keywords: diabetes; epidemiology; insulin resistance; obesity


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About the article

Received: 2016-06-16

Accepted: 2016-10-05

Published Online: 2016-12-16

Published in Print: 2017-02-01

Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission. M.A. performed the literature review and data analysis and wrote a first version of the manuscript. All authors discussed study design, data, and interpreted the results. C.K., A.B., and M.V. reviewed and edited the manuscript. All authors take full responsibility for the contents of the manuscript, M.V. is the guarantor of this work.

Research funding: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

Citation Information: Journal of Pediatric Endocrinology and Metabolism, Volume 30, Issue 2, Pages 123–131, ISSN (Online) 2191-0251, ISSN (Print) 0334-018X, DOI: https://doi.org/10.1515/jpem-2016-0242.

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