Akademik Veri Yönetim Sistemi
62nd Annual ESPE (ESPE 2024), Liverpool, İngiltere, 16 - 18 Kasım 2024, ss.521-522, (Özet Bildiri)
Background: Insulin resistance is predominantly associated
with obesity. The euglycemic hyperinsulinemic clamp test, the
gold standard for diagnosis of insulin resistance, has limited practical
application. Although oral glucose tolerance test (OGTT) is
generally used instead, there remains a need for more practical
methods in outpatient clinics.
Aim: The objective of this study is to assess the outcomes of the
OGTT in non-obese adolescent girls and their relationship with
clinical and biochemical characteristics.
Subjects and Methods: We retrospectively analyzed the clinical
and 2-hour standard OGTT data of non-obese adolescent
female patients with irregular menstruation and/or clinical hyperandrogenism,
in whom other endocrine causes were excluded.
Insulin resistance was considered when total insulin levels were
>300 mIU/L and/or peak insulin level>100 mIU/L. Subjects were
further divided to subgroups according to presence of insulin
resistance, total insulin level >300 mIU/L, peak insulin level
>100mIU/L and clinical features.
Results: Among the 30 participants, 25 (83%) had irregular
menstruation and 16 (53.3%) had clinical hyperandrogenism.
Median (IQR) age was 15.15 years (2.3), age at first menstruation
12.5 years (1.13), median weight SD -0.08 (1.77), median height SD
0.55 (2.25) and BMI percentile was 39.93 (51.44). Insulin resistance
was identified in 18 subjects (60%). Patients with total insulin levels
>300 mIU/L (n=16) had higher BMI percentile values compared
with the subjects with lower total insulin levels [65.38 (54.01)
vs 24.3 (34.44), p=0.013]. BMI percentiles were similar among
other subgroups. Among all patients, strong positive correlations
were found between total insulin levels and insulin values at the
30th minute (rs=0.757, p<0.01), 60th minute (rs=0.941, p<0.01),
90th minute (rs=0.793, p<0.01), and 120th minute (rs=0.823,
p<0.01). ROC curve analysis indicated that the best cut-off insulin
value for predicting insulin resistance was 66.05 mIU/L at 60th
minute with 88% sensitivity and 91% specificity. On the other
hand, the best cut-off insulin value for predicting total insulin levels
>300 mIU/L was 74.47 mIU/L at 60th minute (93% sensitivity
and 100% specificity), while it predicted peak insulin levels >100
mU/L with 82% sensitivity and 92% specificity.
Conclusion: Insulin resistance should be investigated in nonobese
adolescent girls with irregular menstruation and/or clinical
hyperandrogenism. Obtaining only 60th minute insulin level after
oral glucose