Gender differences in prediabetes and insulin resistance among 1356 obese children in Northern California

Abstract

Aims: While it has been shown that there are gender differences in prediabetes and insulin resistance among adults, less is known about whether these differences exist in children. Obese children have elevated risk for developing metabolic dysfunction, and this analysis was conducted to compare obese boys and girls.

Methods: Biomarkers of prediabetes (IFG and HbA1c) and insulin resistance (HOMA-IR), were examined for 1356 obese children (2-19 years) who presented to a pediatric weight management clinic between 2008 and 2012. Gender differences were analyzed with multivariate logistic regression.

Results: Boys were more likely than girls to have IFG (adjusted OR: 1.68; CI: 1.06-2.65), but less likely to have elevated HOMA-IR (adjusted OR 0.71; CI: 0.52 -0.97). The female predominance of insulin resistance was present at younger ages than the male predominance of IFG. There were no gender differences with respect to HbA1c. Elevated HbA1c identified 20.7% of the sample as prediabetic whereas IFG identified 7.8%.

Conclusions: Similar to findings in adults, obese children appear to exhibit more impaired fasting glucose among boys and a higher predominance of insulin resistance among girls. However, HbA1c identified a larger proportion of these high-risk, obese youth as prediabetic than IFG.

Keywords: BMI; Body Mass Index; CI; Children; Confidence Interval; Gender; HOMA-IR; HbA1c; Hemoglobin HbA1c; Homeostasis Model Insulin Resistance; Hyperglycemia; IFG; Impaired Fasting Glucose; Insulin resistance; OGTT; OR; Odds Ratio; Oral Glucose Tolerance Test; Prediabetic state.