Prevalence of impaired glucose tolerance among children and adolescents with marked obesity

Sinha, Ranjana; Fisch, Gene; Teague, Barbara; Tamborlane, William V.; Banyas, Bruna; Allen, Karin; Savoye, Mary; Rieger, Vera; Taksali, Sara; Barbetta, Gina; Sherwin, Robert S.; Caprio, Sonia

doi:10.1056/nejmoa012578

Cited by 1,709Diabetes, Cardiovascular Risks, and LipoproteinsObesity, Physical Activity, DietDiabetes Management and Research

Prevalence of impaired glucose tolerance among children and adolescents with marked obesity

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Sinha, Ranjana, Fisch, Gene, Teague, Barbara, Tamborlane, William V., Banyas, Bruna, Allen, Karin, Savoye, Mary, Rieger, Vera +4 more·2002·New England Journal of Medicine

DOI 10.1056/nejmoa012578

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Abstract

BACKGROUND: Childhood obesity, epidemic in the United States, has been accompanied by an increase in the prevalence of type 2 diabetes among children and adolescents. We determined the prevalence of impaired glucose tolerance in a multiethnic cohort of 167 obese children and adolescents. METHODS: All subjects underwent a two-hour oral glucose-tolerance test (1.75 g [DOSAGE ERROR CORRECTED] of glucose per kilogram of body weight), and glucose, insulin, and C-peptide levels were measured. Fasting levels of proinsulin were obtained, and the ratio of proinsulin to insulin was calculated. Insulin resistance was estimated by homeostatic model assessment, and beta-cell function was estimated by calculating the ratio between the changes in the insulin level and the glucose level during the first 30 minutes after the ingestion of glucose. RESULTS: Impaired glucose tolerance was detected in 25 percent of the 55 obese children (4 to 10 years of age) and 21 percent of the 112 obese adolescents (11 to 18 years of age); silent type 2 diabetes was identified in 4 percent of the obese adolescents. Insulin and C-peptide levels were markedly elevated after the glucose-tolerance test in subjects with impaired glucose tolerance but not in adolescents with diabetes, who had a reduced ratio of the 30-minute change in the insulin level to the 30-minute change in the glucose level. After the body-mass index had been controlled for, insulin resistance was greater in the affected cohort and was the best predictor of impaired glucose tolerance. CONCLUSIONS: Impaired glucose tolerance is highly prevalent among children and adolescents with severe obesity, irrespective of ethnic group. Impaired oral glucose tolerance was associated with insulin resistance while beta-cell function was still relatively preserved. Overt type 2 diabetes was linked to beta-cell failure.

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Authors: Sinha, R., Fisch, G., Teague, B., Tamborlane, W. V., Banyas, B., Allen, K., Savoye, M., Rieger, V., Taksali, S., Barbetta, G., Sherwin, R. S., & Caprio, S.
Affiliations: Yale University (US)
ORCID: Fisch, Gene
Tamborlane, William V.
Caprio, Sonia
Venue: New England Journal of Medicine
Publisher: Massachusetts Medical Society
Published: 2002-03-14
Volume: 346
Issue: 11
Pages: 802-810
ISSN: 0028-4793 (ISSN-L)
1533-4406
DOI: 10.1056/nejmoa012578
OpenAlex: W2067262787
Semantic Scholar: 0e6b33798ee36c635a2c1e99c405ac1fa5d5233c
Cited by: 1,709
References: 28
Citations by year: 2026: 7 · 2025: 11 · 2024: 27 · 2023: 29 · 2022: 46 · 2021: 35 · 2020: 37 · 2019: 35 · 2018: 49 · 2017: 44 · 2016: 60 · 2015: 65 · 2014: 65 · 2013: 87 · 2012: 90
FWCI: 73.16
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: New England Journal of Medicine (publishedVersion)
PubMed (publishedVersion)
Funders: National Center for Research Resources (M01RR000125, M01RR006022, M01 RR-00125, M01 RR-06022)
Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01-HD- 28016, R01HD028016, R01-HD40787, K24HD001464, R01HD040787, K24-HD01464)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords: impaired glucose tolerance, childhood obesity, adolescent obesity, type 2 diabetes, insulin resistance, beta-cell function, proinsulin/insulin ratio, C-peptide, oral glucose tolerance test, prevalence, ethnic differences
MeSH terms: Insulin Secretion, Adolescent, Blood Glucose, C-Peptide, Child, Child, Preschool, Cross-Sectional Studies, Diabetes Mellitus, Female, Glucose, Glucose Tolerance Test, Hispanic or Latino, Humans, Insulin, Male, Obesity, Proinsulin, Risk Factors, Prevalence, Black People, White People

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Prevalence of impaired glucose tolerance among children and adolescents with marked obesity

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