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EVALUATION OF INSULIN RESISTANCE IN PATIENTS WITH PREMATURE ADRENARCHE

Year 2023, Volume: 4 Issue: 1, 1 - 6, 31.01.2023
https://doi.org/10.51972/tfsd.1144735

Abstract

Purpose: There is a conflicting result in terms of insulin resistance (IR) in children with Premature Adrenarche (PA). The study aimed to investigate the IR and Trıglycerıde-Glucose (Ty-G) index in patıents wıth PA.

Material and Methods: This cross-sectional study was conducted in a tertiary pediatric endocrinology clinic with 160 children aged 6-8 years old. The study group (n=75) were selected cases diagnosed with PA. Seventy-nine age and sex-matched children were also selected as a control group. Ty-G İndex, Homeostasis Model of Insulin Resistance (HOMA-IR), and atherogenic index of plasma (AIP) were calculated.

Results: Trıglycerıde-Glucose index, AIP, and HOMA-IR were similar (p>0.05). Ty-G İndex was positively correlated with AIP (r=0.61, p<0.001), BMI-SDS (r=0.26, p=0.002), and HOMA-IR (r=0.33, p<0.001) levels. The DHEA-S level was correlated with the AIP (r=0.24, p=0.005), and BMI-SDS (r=0.17, p=0.03) levels. BMI-SDS was correlated wtih HOMA-IR (r=0.28, p=0.02) levels.

Conclusion: Non-obese children with PA have similar IR parameters compared with control groups. Therefore, additional evaluation for IR parameters in lean children with PA is not required.

References

  • Aslan Çin, N. N., Yardlmcl, H., Koç, N., Uçaktürk, S. A., & Akçil Ok, M. (2020). Triglycerides/high-density lipoprotein cholesterol is a predictor similar to the triglyceride-glucose index for the diagnosis of metabolic syndrome using International Diabetes Federation criteria of insulin resistance in obese adolescents: A cross-sectional study. Journal of Pediatric Endocrinology and Metabolism, 33(6), 777–784. https://doi.org/10.1515/jpem-2019-0310
  • Bezen, D., Tutunculer Kokenli, F., Dilek, E., Ag Seleci, D., & Erbas, H. (2022). Evaluation of Glucose Metabolism and Cardiovascular Risk Factors in Prepubertal Girls with Premature Pubarche. Journal of Clinical Research in Pediatric Endocrinology. https://doi.org/10.4274/JCRPE.GALENOS.2022.2022-1-1
  • Çelik, N., Alp, H., Çamtosun, E., Alp, E., Çelik, S., & Berk, E. (2017). The Association between Premature Adrenarche and Cardiovascular Risk May Be Greater than Expected. Hormone Research in Paediatrics, 87(1), 7–14. https://doi.org/10.1159/000452445
  • Cersosimo, E., Solis-Herrera, C., Trautmann, M. E., Malloy, J., & Triplitt, C. L. (2014). Assessment of Pancreatic β-Cell Function: Review of Methods and ClinicalApplications. Current Diabetes Reviews, 10(1), 2. https://doi.org/10.2174/1573399810666140214093600
  • Corvalán, C., Uauy, R., & Mericq, V. (2013). Obesity is positively associated with dehydroepiandrosterone sulfate concentrations at 7 y in Chilean children of normal birth weight. The American Journal of Clinical Nutrition, 97(2), 318–325. https://doi.org/10.3945/AJCN.112.037325
  • de Jesus Teixeira, R., Ginzbarg, D., Rodrigues Freitas, J., Fucks, G., Silva, C. M., & Bordallo, M. A. N. (2004). Serum leptin levels in premature pubarche and prepubertal girls with and without obesity. Journal of Pediatric Endocrinology & Metabolism : JPEM, 17(10), 1393–1398. https://doi.org/10.1515/JPEM.2004.17.10.1393
  • Guerrero-Romero, F., Simental-Mendía, L. E., González-Ortiz, M., Martínez-Abundis, E., Ramos-Zavala, M. G., Hernández-González, S. O., Jacques-Camarena, O., & Rodríguez-Morán, M. (2010). The product of triglycerides and glucose, a simple measure of insulin sensitivity. Comparison with the euglycemic-hyperinsulinemic clamp. The Journal of Clinical Endocrinology and Metabolism, 95(7), 3347–3351. https://doi.org/10.1210/JC.2010-0288
  • Ibáñez, L., DiMartino-Nardi, J., Potau, N., & Saenger, P. (2000). Premature adrenarche--normal variant or forerunner of adult disease? Endocrine Reviews, 21(6), 671–696. https://doi.org/10.1210/EDRV.21.6.0416
  • Ibáñez, L., Oberfield, S. E., Witchel, S., Auchus, R. J., Chang, R. J., Codner, E., Dabadghao, P., Darendeliler, F., Elbarbary, N. S., Gambineri, A., Garcia Rudaz, C., Hoeger, K. M., López-Bermejo, A., Ong, K., Peña, A. S., Reinehr, T., Santoro, N., Tena-Sempere, M., Tao, R., … Lee, P. A. (2017). An International Consortium Update: Pathophysiology, Diagnosis, and Treatment of Polycystic Ovarian Syndrome in Adolescence. Hormone Research in Paediatrics, 88(6), 371–395. https://doi.org/10.1159/000479371
  • Ibáñez, L., Ong, K., De Zegher, F., Victoria Marcos, M., Del Rio, L., & Dunger, D. B. (2003). Fat distribution in non-obese girls with and without precocious pubarche: central adiposity related to insulinaemia and androgenaemia from prepuberty to postmenarche. Clinical Endocrinology, 58(3), 372–379. https://doi.org/10.1046/J.1365-2265.2003.01728.X
  • Ibáñez, L., Potau, N., Chacon, P., Pascual, C., & Carrascosa, A. (1998). Hyperinsulinaemia, dyslipaemia and cardiovascular risk in girls with a history of premature pubarche. Diabetologia, 41(9), 1057–1063. https://doi.org/10.1007/S001250051030
  • Kaya, G., Yavas Abali, Z., Bas, F., Poyrazoglu, S., & Darendeliler, F. (2018). Body mass index at the presentation of premature adrenarche is associated with components of metabolic syndrome at puberty. European Journal of Pediatrics, 177(11), 1593–1601. https://doi.org/10.1007/S00431-018-3211-1
  • Keskin, M., Kurtoglu, S., Kendirci, M., Atabek, M. E., & Yazici, C. (2005). Homeostasis model assessment is more reliable than the fasting glucose/insulin ratio and quantitative insulin sensitivity check index for assessing insulin resistance among obese children and adolescents. Pediatrics. https://doi.org/10.1542/peds.2004-1921
  • Mosca, S., Araújo, G., Costa, V., Correia, J., Bandeira, A., Martins, E., Mansilha, H., Tavares, M., & Coelho, M. P. (2022). Dyslipidemia Diagnosis and Treatment: Risk Stratification in Children and Adolescents. Journal of Nutrition and Metabolism, 2022. https://doi.org/10.1155/2022/4782344
  • Neyzi, O., Bundak, R., Gökçay, G., Günöz, H., Furman, A., Darendeliler, F., & Baş, F. (2015). Reference values for weight, height, head circumference, and body mass index in Turkish children. JCRPE Journal of Clinical Research in Pediatric Endocrinology, 7(4), 280–293. https://doi.org/10.4274/jcrpe.2183
  • Oberfield, S. E., Sopher, A. B., & Gerken, A. T. (2011). Approach to the girl with early onset of pubic hair. The Journal of Clinical Endocrinology and Metabolism, 96(6), 1610–1622. https://doi.org/10.1210/JC.2011-0225
  • Rosenfield, R. L. (2021). Normal and Premature Adrenarche. Endocrine Reviews, 42(6), 783–814. https://doi.org/10.1210/ENDREV/BNAB009 Sapunar, J., Aguilar-Farías, N., Navarro, J., Araneda, G., Chandía-Poblete, D., Manríquez, V., Brito, R., & Cerda, Á. (2018). [High prevalence of dyslipidemia and high atherogenic index of plasma in children and adolescents]. Revista Medica de Chile, 146(10), 1112–1122. https://doi.org/10.4067/S0034-98872018001001112
  • Simental-Mendía, L. E., Rodríguez-Morán, M., & Guerrero-Romero, F. (2008). The product of fasting glucose and triglycerides as surrogate for identifying insulin resistance in apparently healthy subjects. Metabolic Syndrome and Related Disorders, 6(4), 299–304. https://doi.org/10.1089/MET.2008.0034
  • Taştanoğlu, H., Çelik, N. (2021). Triglyceride-Glucose Index As a Surrogate Marker for Insulin Resistance ın Obese Adolescents. Cumhuriyet Medical Journal, December, 355–363. https://doi.org/10.7197/cmj.1022934
  • Utriainen, P., Jääskeläinen, J., Romppanen, J., & Voutilainen, R. (2007). Childhood metabolic syndrome and its components in premature adrenarche. The Journal of Clinical Endocrinology and Metabolism, 92(11), 4282–4285. https://doi.org/10.1210/JC.2006-2412
  • Vasques, A. C. J., Novaes, F. S., de Oliveira, M. da S., Matos Souza, J. R., Yamanaka, A., Pareja, J. C., Tambascia, M. A., Saad, M. J. A., & Geloneze, B. (2011). TyG index performs better than HOMA in a Brazilian population: a hyperglycemic clamp validated study. Diabetes Research and Clinical Practice, 93(3). https://doi.org/10.1016/J.DIABRES.2011.05.030
  • Wan, K., Zhao, J., Huang, H., Zhang, Q., Chen, X., Zeng, Z., Zhang, L., & Chen, Y. (2015). The association between triglyceride/high-density lipoprotein cholesterol ratio and all-cause mortality in acute coronary syndrome after coronary revascularization. PloS One, 10(4). https://doi.org/10.1371/JOURNAL.PONE.0123521
  • Yoon, J. S., Lee, H. J., Jeong, H. R., Shim, Y. S., Kang, M. J., & Hwang, I. T. (2022). Triglyceride glucose index is superior biomarker for predicting type 2 diabetes mellitus in children and adolescents. Endocrine Journal, 69(5), 559–565. https://doi.org/10.1507/ENDOCRJ.EJ21-0560
Year 2023, Volume: 4 Issue: 1, 1 - 6, 31.01.2023
https://doi.org/10.51972/tfsd.1144735

Abstract

References

  • Aslan Çin, N. N., Yardlmcl, H., Koç, N., Uçaktürk, S. A., & Akçil Ok, M. (2020). Triglycerides/high-density lipoprotein cholesterol is a predictor similar to the triglyceride-glucose index for the diagnosis of metabolic syndrome using International Diabetes Federation criteria of insulin resistance in obese adolescents: A cross-sectional study. Journal of Pediatric Endocrinology and Metabolism, 33(6), 777–784. https://doi.org/10.1515/jpem-2019-0310
  • Bezen, D., Tutunculer Kokenli, F., Dilek, E., Ag Seleci, D., & Erbas, H. (2022). Evaluation of Glucose Metabolism and Cardiovascular Risk Factors in Prepubertal Girls with Premature Pubarche. Journal of Clinical Research in Pediatric Endocrinology. https://doi.org/10.4274/JCRPE.GALENOS.2022.2022-1-1
  • Çelik, N., Alp, H., Çamtosun, E., Alp, E., Çelik, S., & Berk, E. (2017). The Association between Premature Adrenarche and Cardiovascular Risk May Be Greater than Expected. Hormone Research in Paediatrics, 87(1), 7–14. https://doi.org/10.1159/000452445
  • Cersosimo, E., Solis-Herrera, C., Trautmann, M. E., Malloy, J., & Triplitt, C. L. (2014). Assessment of Pancreatic β-Cell Function: Review of Methods and ClinicalApplications. Current Diabetes Reviews, 10(1), 2. https://doi.org/10.2174/1573399810666140214093600
  • Corvalán, C., Uauy, R., & Mericq, V. (2013). Obesity is positively associated with dehydroepiandrosterone sulfate concentrations at 7 y in Chilean children of normal birth weight. The American Journal of Clinical Nutrition, 97(2), 318–325. https://doi.org/10.3945/AJCN.112.037325
  • de Jesus Teixeira, R., Ginzbarg, D., Rodrigues Freitas, J., Fucks, G., Silva, C. M., & Bordallo, M. A. N. (2004). Serum leptin levels in premature pubarche and prepubertal girls with and without obesity. Journal of Pediatric Endocrinology & Metabolism : JPEM, 17(10), 1393–1398. https://doi.org/10.1515/JPEM.2004.17.10.1393
  • Guerrero-Romero, F., Simental-Mendía, L. E., González-Ortiz, M., Martínez-Abundis, E., Ramos-Zavala, M. G., Hernández-González, S. O., Jacques-Camarena, O., & Rodríguez-Morán, M. (2010). The product of triglycerides and glucose, a simple measure of insulin sensitivity. Comparison with the euglycemic-hyperinsulinemic clamp. The Journal of Clinical Endocrinology and Metabolism, 95(7), 3347–3351. https://doi.org/10.1210/JC.2010-0288
  • Ibáñez, L., DiMartino-Nardi, J., Potau, N., & Saenger, P. (2000). Premature adrenarche--normal variant or forerunner of adult disease? Endocrine Reviews, 21(6), 671–696. https://doi.org/10.1210/EDRV.21.6.0416
  • Ibáñez, L., Oberfield, S. E., Witchel, S., Auchus, R. J., Chang, R. J., Codner, E., Dabadghao, P., Darendeliler, F., Elbarbary, N. S., Gambineri, A., Garcia Rudaz, C., Hoeger, K. M., López-Bermejo, A., Ong, K., Peña, A. S., Reinehr, T., Santoro, N., Tena-Sempere, M., Tao, R., … Lee, P. A. (2017). An International Consortium Update: Pathophysiology, Diagnosis, and Treatment of Polycystic Ovarian Syndrome in Adolescence. Hormone Research in Paediatrics, 88(6), 371–395. https://doi.org/10.1159/000479371
  • Ibáñez, L., Ong, K., De Zegher, F., Victoria Marcos, M., Del Rio, L., & Dunger, D. B. (2003). Fat distribution in non-obese girls with and without precocious pubarche: central adiposity related to insulinaemia and androgenaemia from prepuberty to postmenarche. Clinical Endocrinology, 58(3), 372–379. https://doi.org/10.1046/J.1365-2265.2003.01728.X
  • Ibáñez, L., Potau, N., Chacon, P., Pascual, C., & Carrascosa, A. (1998). Hyperinsulinaemia, dyslipaemia and cardiovascular risk in girls with a history of premature pubarche. Diabetologia, 41(9), 1057–1063. https://doi.org/10.1007/S001250051030
  • Kaya, G., Yavas Abali, Z., Bas, F., Poyrazoglu, S., & Darendeliler, F. (2018). Body mass index at the presentation of premature adrenarche is associated with components of metabolic syndrome at puberty. European Journal of Pediatrics, 177(11), 1593–1601. https://doi.org/10.1007/S00431-018-3211-1
  • Keskin, M., Kurtoglu, S., Kendirci, M., Atabek, M. E., & Yazici, C. (2005). Homeostasis model assessment is more reliable than the fasting glucose/insulin ratio and quantitative insulin sensitivity check index for assessing insulin resistance among obese children and adolescents. Pediatrics. https://doi.org/10.1542/peds.2004-1921
  • Mosca, S., Araújo, G., Costa, V., Correia, J., Bandeira, A., Martins, E., Mansilha, H., Tavares, M., & Coelho, M. P. (2022). Dyslipidemia Diagnosis and Treatment: Risk Stratification in Children and Adolescents. Journal of Nutrition and Metabolism, 2022. https://doi.org/10.1155/2022/4782344
  • Neyzi, O., Bundak, R., Gökçay, G., Günöz, H., Furman, A., Darendeliler, F., & Baş, F. (2015). Reference values for weight, height, head circumference, and body mass index in Turkish children. JCRPE Journal of Clinical Research in Pediatric Endocrinology, 7(4), 280–293. https://doi.org/10.4274/jcrpe.2183
  • Oberfield, S. E., Sopher, A. B., & Gerken, A. T. (2011). Approach to the girl with early onset of pubic hair. The Journal of Clinical Endocrinology and Metabolism, 96(6), 1610–1622. https://doi.org/10.1210/JC.2011-0225
  • Rosenfield, R. L. (2021). Normal and Premature Adrenarche. Endocrine Reviews, 42(6), 783–814. https://doi.org/10.1210/ENDREV/BNAB009 Sapunar, J., Aguilar-Farías, N., Navarro, J., Araneda, G., Chandía-Poblete, D., Manríquez, V., Brito, R., & Cerda, Á. (2018). [High prevalence of dyslipidemia and high atherogenic index of plasma in children and adolescents]. Revista Medica de Chile, 146(10), 1112–1122. https://doi.org/10.4067/S0034-98872018001001112
  • Simental-Mendía, L. E., Rodríguez-Morán, M., & Guerrero-Romero, F. (2008). The product of fasting glucose and triglycerides as surrogate for identifying insulin resistance in apparently healthy subjects. Metabolic Syndrome and Related Disorders, 6(4), 299–304. https://doi.org/10.1089/MET.2008.0034
  • Taştanoğlu, H., Çelik, N. (2021). Triglyceride-Glucose Index As a Surrogate Marker for Insulin Resistance ın Obese Adolescents. Cumhuriyet Medical Journal, December, 355–363. https://doi.org/10.7197/cmj.1022934
  • Utriainen, P., Jääskeläinen, J., Romppanen, J., & Voutilainen, R. (2007). Childhood metabolic syndrome and its components in premature adrenarche. The Journal of Clinical Endocrinology and Metabolism, 92(11), 4282–4285. https://doi.org/10.1210/JC.2006-2412
  • Vasques, A. C. J., Novaes, F. S., de Oliveira, M. da S., Matos Souza, J. R., Yamanaka, A., Pareja, J. C., Tambascia, M. A., Saad, M. J. A., & Geloneze, B. (2011). TyG index performs better than HOMA in a Brazilian population: a hyperglycemic clamp validated study. Diabetes Research and Clinical Practice, 93(3). https://doi.org/10.1016/J.DIABRES.2011.05.030
  • Wan, K., Zhao, J., Huang, H., Zhang, Q., Chen, X., Zeng, Z., Zhang, L., & Chen, Y. (2015). The association between triglyceride/high-density lipoprotein cholesterol ratio and all-cause mortality in acute coronary syndrome after coronary revascularization. PloS One, 10(4). https://doi.org/10.1371/JOURNAL.PONE.0123521
  • Yoon, J. S., Lee, H. J., Jeong, H. R., Shim, Y. S., Kang, M. J., & Hwang, I. T. (2022). Triglyceride glucose index is superior biomarker for predicting type 2 diabetes mellitus in children and adolescents. Endocrine Journal, 69(5), 559–565. https://doi.org/10.1507/ENDOCRJ.EJ21-0560
There are 23 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases
Journal Section Articles
Authors

Nurullah Çelik 0000-0003-1583-6807

Gülşah Ünsal

Publication Date January 31, 2023
Submission Date July 17, 2022
Acceptance Date October 11, 2022
Published in Issue Year 2023 Volume: 4 Issue: 1

Cite

APA Çelik, N., & Ünsal, G. (2023). EVALUATION OF INSULIN RESISTANCE IN PATIENTS WITH PREMATURE ADRENARCHE. Turkish Journal of Science and Health, 4(1), 1-6. https://doi.org/10.51972/tfsd.1144735








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