Ann Pediatr Endocrinol Metab.  2022 Sep;27(3):201-206. 10.6065/apem.2142178.089.

Single Point Insulin Sensitivity Estimator for predicting type 2 diabetes mellitus in obese adolescents

• Ha J
• Oh YR
• Kang E
• Nam HK
• Rhie YJ
• Lee KH

• KMID: 2533339
• DOI: http://doi.org/10.6065/apem.2142178.089

Abstract

Purpose
The prevalence of adolescents with type 2 diabetes mellitus (T2DM) has rapidly increased in Korea over the past few decades with the increase in the number of obese adolescents. The single point insulin sensitivity estimator (SPISE) was recently introduced as a surrogate marker for insulin sensitivity to predict T2DM in adults. We aimed to determine risk factors for T2DM in obese adolescents, including SPISE.
Methods
This retrospective study included 104 adolescents diagnosed with T2DM at Korea University Hospital between January 2010 and December 2020. We compared clinical and biochemical parameters and the SPISE of normoglycemic overweight and obese individuals with those of prediabetic and diabetic adolescents to determine risk factors for T2DM. Receiver operating characteristic analysis was performed with the Youden index to determine the cutoff point of SPISE.
Results
Frequency of fatty liver and family history of T2DM were significantly higher and SPISE level was significantly lower in patients with T2DM than in normoglycemic overweight/obese and prediabetic adolescents (p<0.01). A family history of T2DM, fatty liver, and SPISE value below the cutoff point (4.49) were identified as significant risk factors for T2DM in multiple logistic regression analysis after controlling for age, sex, and body mass index standard deviation score (p<0.01).
Conclusion
Family history of T2DM, fatty liver, and low SPISE (<4.49) are risk factors that can independently affect the occurrence of T2DM in obese adolescents. Among these risk factors, SPISE is a promising marker for predicting adolescent T2DM; careful monitoring of these individuals is needed to prevent progression to T2DM.

Keyword

Obese adolescents; Type 2 diabetes mellitus; Single point insulin sensitivity estimator; Fatty liver

Figure

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  Fig. 1. The receiver operating characteristic curve for single point insulin sensitivity estimator in the diagnosis of type 2 diabetes mellitus, which corresponds to the area under the curve (95% confidence interval) of 0.665 (0.589–0.741).

Reference

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