Utility of estimated glucose disposal rate for predicting metabolic syndrome in children and adolescents with type-1 diabetes

Özlem Yayıcı Köken; Cengiz Kara; Gülay Can Yılmaz; Hasan Murat Aydın

doi:10.1515/jpem-2020-0012

Article

Utility of estimated glucose disposal rate for predicting metabolic syndrome in children and adolescents with type-1 diabetes

Özlem Yayıcı Köken , Cengiz Kara , Gülay Can Yılmaz and Hasan Murat Aydın

Published/Copyright: July 6, 2020

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From the journal Journal of Pediatric Endocrinology and Metabolism Volume 33 Issue 7

Abstract

Objectives

To determine the clinical utility of the estimated glucose disposal rate (eGDR) for predicting metabolic syndrome (MetS) in children and adolescents with type-1 diabetes (T1D).

Methods

Modified criteria of the International Diabetes Federation were used to determine MetS in children and adolescents between 10 and 18 years of age with T1D. The eGDR, a validated marker of insulin sensitivity, was calculated in two different ways using either the waist-to-hip ratio (WHR) or waist circumference (WC). Receiver operating characteristic (ROC) curve analysis was performed to ascertain cut-off levels of the eGDR to predict MetS.

Results

A total of 200 patients (52% male) with T1D were enrolled in the study. The prevalence of MetS was 10.5% (n: 21). Lower eGDR levels, indicating greater insulin resistance, were found in T1D patients with MetS when compared to those without (6.41 ± 1.86 vs. 9.50 ± 1.34 mg/kg/min) (p < 0.001). An eGDR_WHR cut-off of 8.44 mg/kg/min showed 85.7% sensitivity and 82.6% specificity, while an eGDR_WC cut-off of 8.16 mg/kg/min showed 76.1% sensitivity and 92.1% specificity for MetS diagnosis. The diagnostic odds ratio was 28.6 (7.3–131.0) for the eGDR_WHR cut-off and 37.7 (10.8–140.8) for the eGDR_WC cut-off.

Conclusions

The eGDR is a mathematical formula that can be used in clinical practice to detect the existence of MetS in children and adolescents with T1D using only the WC, existence of hypertension, and hemoglobin A1c levels. An eGDR calculated using the WC could be a preferred choice due to its higher diagnostic performance.

Keywords: double diabetes; metabolic syndrome; type-1 diabetes

Corresponding author: Özlem Yayıcı Köken, MD, Department of Pediatrics, Division of Pediatric Neurology, Ankara City Hospital, Ankara, Turkey; Üniversiteler Mahallesi Bilkent Cad, No: 1, Ankara Şehir Hastanesi, Çocuk Hastanesi, B1 katı, Çocuk Nörolojisi Departmanı, Çankaya, Ankara, Turkey, Phone: +90 312 305 6171, GSM: +90 530 762 4200, Fax: +90 242 325 5527, E-mail: drozlemkoken@gmail.com

Acknowledgments

The authors thank the patients and family members for their participation in this study. Preliminary data from this study were presented in poster form at the European Society of Pediatric Endocrinology Congress, Barcelona/Spain, 01–03 October, 2014. The same patient population was also evaluated for the comparison of MetS criteria in the same study and the results were published in Journal of Clinical Research in Pediatric Endocrinology, 22 August 2019 (doi : 10.4274/jcrpe.galenos.2019.2019.0048).

Research funding: This study has received no financial support.
Author contributions: Concept, design, supervision, analysis, and/or interpretation – Ö.Y.K. and C.K. Materials, data collection and/or processing, literature review, and critical review – Ö.Y.K., C.K., G.C.Y., and H.M.A. Writing – Ö.Y.K., C.K., and G.C.Y.
Competing interests: No conflict of interest was declared by the authors.
Informed consent: Informed consent was obtained from all individuals included in this study.
Ethical approval: The study was approved by the Independent Ethics Committee “Faculty of Medicine, Samsun Ondokuz Mayıs University” (reference number: 2014-354).
Peer-review: Externally peer-reviewed.

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Received: 2020-01-08

Revised: 2020-03-04

Accepted: 2020-03-21

Published Online: 2020-07-06

Published in Print: 2020-07-28

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Articles in the same Issue

https://doi.org/10.1515/jpem-2020-0012

Keywords for this article

double diabetes; metabolic syndrome; type-1 diabetes