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Research ArticleOriginal Article
Open Access

Indices of insulin resistance and adiposity can detect obesity-related morbidity in pediatrics

Marwa H. Abdelhamed, Shaimaa Salah, Khloud K. ALqudsi, Majd M. Jan, Duaa K. Alahdal, Saher A. Alfaifi, Nuha M. Jafar, Naseem Y. Alyahyawi and Abdulmoein A. Al-Agha
Saudi Medical Journal February 2022, 43 (2) 161-168; DOI: https://doi.org/10.15537/smj.2022.43.2.20210720
Marwa H. Abdelhamed
From the Pediatric Department (Abdelhamed), Faculty of Medicine, Ain Shams University; Pediatric Department (Salah), Faculty of Medicine, Kafrelsheikh University, Kafr Elsheikh; from the Diet & Patient Meal Services (Alqudsi), International Medical Center, Jeddah, Kingdom of Saudi Arabia; From the Medicine Department (Jan), Ibn Sina National College for Medical Studies; from the Clinical Nutrition Department (Alahdal), from the Nutrition and Food Science Department (Alfaifi), from the Clinical Nutrition Department (Jafar), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia; from the Pediatric Department (Alyahyawi), Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
MD
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Shaimaa Salah
From the Pediatric Department (Abdelhamed), Faculty of Medicine, Ain Shams University; Pediatric Department (Salah), Faculty of Medicine, Kafrelsheikh University, Kafr Elsheikh; from the Diet & Patient Meal Services (Alqudsi), International Medical Center, Jeddah, Kingdom of Saudi Arabia; From the Medicine Department (Jan), Ibn Sina National College for Medical Studies; from the Clinical Nutrition Department (Alahdal), from the Nutrition and Food Science Department (Alfaifi), from the Clinical Nutrition Department (Jafar), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia; from the Pediatric Department (Alyahyawi), Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
MD
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Khloud K. ALqudsi
From the Pediatric Department (Abdelhamed), Faculty of Medicine, Ain Shams University; Pediatric Department (Salah), Faculty of Medicine, Kafrelsheikh University, Kafr Elsheikh; from the Diet & Patient Meal Services (Alqudsi), International Medical Center, Jeddah, Kingdom of Saudi Arabia; From the Medicine Department (Jan), Ibn Sina National College for Medical Studies; from the Clinical Nutrition Department (Alahdal), from the Nutrition and Food Science Department (Alfaifi), from the Clinical Nutrition Department (Jafar), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia; from the Pediatric Department (Alyahyawi), Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
MSc
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Majd M. Jan
From the Pediatric Department (Abdelhamed), Faculty of Medicine, Ain Shams University; Pediatric Department (Salah), Faculty of Medicine, Kafrelsheikh University, Kafr Elsheikh; from the Diet & Patient Meal Services (Alqudsi), International Medical Center, Jeddah, Kingdom of Saudi Arabia; From the Medicine Department (Jan), Ibn Sina National College for Medical Studies; from the Clinical Nutrition Department (Alahdal), from the Nutrition and Food Science Department (Alfaifi), from the Clinical Nutrition Department (Jafar), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia; from the Pediatric Department (Alyahyawi), Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
PhD
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Duaa K. Alahdal
From the Pediatric Department (Abdelhamed), Faculty of Medicine, Ain Shams University; Pediatric Department (Salah), Faculty of Medicine, Kafrelsheikh University, Kafr Elsheikh; from the Diet & Patient Meal Services (Alqudsi), International Medical Center, Jeddah, Kingdom of Saudi Arabia; From the Medicine Department (Jan), Ibn Sina National College for Medical Studies; from the Clinical Nutrition Department (Alahdal), from the Nutrition and Food Science Department (Alfaifi), from the Clinical Nutrition Department (Jafar), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia; from the Pediatric Department (Alyahyawi), Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
BSc
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Saher A. Alfaifi
From the Pediatric Department (Abdelhamed), Faculty of Medicine, Ain Shams University; Pediatric Department (Salah), Faculty of Medicine, Kafrelsheikh University, Kafr Elsheikh; from the Diet & Patient Meal Services (Alqudsi), International Medical Center, Jeddah, Kingdom of Saudi Arabia; From the Medicine Department (Jan), Ibn Sina National College for Medical Studies; from the Clinical Nutrition Department (Alahdal), from the Nutrition and Food Science Department (Alfaifi), from the Clinical Nutrition Department (Jafar), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia; from the Pediatric Department (Alyahyawi), Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
MSc
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Nuha M. Jafar
From the Pediatric Department (Abdelhamed), Faculty of Medicine, Ain Shams University; Pediatric Department (Salah), Faculty of Medicine, Kafrelsheikh University, Kafr Elsheikh; from the Diet & Patient Meal Services (Alqudsi), International Medical Center, Jeddah, Kingdom of Saudi Arabia; From the Medicine Department (Jan), Ibn Sina National College for Medical Studies; from the Clinical Nutrition Department (Alahdal), from the Nutrition and Food Science Department (Alfaifi), from the Clinical Nutrition Department (Jafar), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia; from the Pediatric Department (Alyahyawi), Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
MSc
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Naseem Y. Alyahyawi
From the Pediatric Department (Abdelhamed), Faculty of Medicine, Ain Shams University; Pediatric Department (Salah), Faculty of Medicine, Kafrelsheikh University, Kafr Elsheikh; from the Diet & Patient Meal Services (Alqudsi), International Medical Center, Jeddah, Kingdom of Saudi Arabia; From the Medicine Department (Jan), Ibn Sina National College for Medical Studies; from the Clinical Nutrition Department (Alahdal), from the Nutrition and Food Science Department (Alfaifi), from the Clinical Nutrition Department (Jafar), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia; from the Pediatric Department (Alyahyawi), Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
MD
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Abdulmoein A. Al-Agha
From the Pediatric Department (Abdelhamed), Faculty of Medicine, Ain Shams University; Pediatric Department (Salah), Faculty of Medicine, Kafrelsheikh University, Kafr Elsheikh; from the Diet & Patient Meal Services (Alqudsi), International Medical Center, Jeddah, Kingdom of Saudi Arabia; From the Medicine Department (Jan), Ibn Sina National College for Medical Studies; from the Clinical Nutrition Department (Alahdal), from the Nutrition and Food Science Department (Alfaifi), from the Clinical Nutrition Department (Jafar), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia; from the Pediatric Department (Alyahyawi), Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
MD, FRCPCH
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  • For correspondence: [email protected]
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    Figure 1

    - Receiver Operating characteristic curves of the adiposity indices. ROC: receiver operating characteristic, BMI SD: body mass index standard deviation, WC: waist circumference, HOMA-IR: homeostatic model assessment for insulin resistance

  • Figure 2
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    Figure 2

    - Association between the indices of insulin resistance and adiposity indices. WC: waist circumference, BMI SD: body mass index standard deviation, WC: waist circumference, HOMA-IR: homeostatic model assessment for insulin resistance

Tables

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    Table 1

    - Clinical and biochemical characteristics.

    CharacteristicMean
    Age (years)12.57 ± 3.1
    Weight SDS*1.87 (0.03 - 3.93)
    BMI SDS2.08 ± 0.45
    WC (cm)96.3 ± 12.92
    WHR0.92 ± 0.07
    SBP (mmHg)112.73 ± 11.38
    DBP (mmHg)68.97 ± 9.26
    BIA TBF %45.52 ± 5.84
    BIA VF*16 (4 - 99.3)
    HbA1C (%)5.71 ± 1.09
    FI (mlU/L)*17.9 (2.5 - 300)
    TG (mg/dL)*84 (17 -1530)
    TC (mg/dL)165.5 ± 42.7
    LDL-C (mg/dL)*96.1 (43 - 482.6)
    HDL-C (mg/dL)*46.33 (24.12-181)
    FBS (mmol/L)5.4 ± 1.32
    HOMA-IR*4.13 (0.5 - 78.66)
    25(OH)vitamin D (ng/ml)*27.2 (6.8 - 104.8)
    • Data are represented as mean ± SD or *median and interquartile range (IQR). Statistical significance was set at p<0.05. BMI SDS: body mass index standard deviation score, WC: waist circumference, WHR: waist-to-hip ratio, SBP: systolic blood pressure, DBP: diastolic blood pressure, BIA TBF%: bioimpedance-derived total body fat percentage, BIA VF: bioimpedance-derived visceral fat level, FI: fasting insulin; TG: triglycerides, TC: total cholesterol, LDL-C: low-density lipoprotein cholesterol, HDL-C: high-density lipoprotein cholesterol, FBS: fasting blood sugar, HOMA-IR: homeostatic model assessment for insulin resistance, HbA1C: haemoglobin A1C, OH: hydroxy

    • View popup
    Table 2

    - Area under curve and cut-off points of the indices of insulin resistance and adiposity to predict obesity-related morbidity in the studied population.

    CharacteristicsAUC (95% CI)Cut point (sensitivity; specificity)P-value
    BMI SDS0.639 (0.573-0.705)2.025 (71; 55)<0.001
    WC (cm)0.638 (0.562-0.713)97.25 (53.9; 70.1)<0.001
    HOMA-IR0.677 (0.597-0.757)4.527 (56.5; 74.6)<0.001
    FI (mlU/L)0.639 (0.561-0.718)19.2 (54.9; 69)<0.001
    BIA TBF%0.657 (0.558-0.756)46.15 (62.8; 62.8)0.002
    BIA VF0.638 (0.534-0.742)15.2 (65.4; 56.8)0.009
    • AUC: area under curve, CI: confidence interval, BMI SDS: body mass index standard deviation score, WC: waist circumference, HOMA-IR: homeostatic model assessment for insulin resistance, FI: fasting insulin, BIA TBF%: bioimpedance analysis derived total body fat percentage, BIA VF: bioimpedance-derived visceral fat level. Statistical significance was set at p<0.05.

    • View popup
    Table 3

    - Comparing of study population based on their glycemic control.

    CharacteristicsNormal glycemiaPrediabetesDiabetesP-value
    Age12.5 ± 3.2113.5 ± 2.7214.2 ± 3.580.048
    WHR0.91 ± 0.060.94 ± 0.060.99 ± 0.070.013
    HOMA-IR*3.6 (0.5-35.6)5 (1.28-78.6)25 (1.9-55)<0.001
    • Data are represented as mean ± SD or *median and interquartile range (IQR). Statistical significance was set at p<0.05. FBS: fasting blood sugar, WHR: waist-hip ratio, HOMA-IR: homeostatic model assessment for insulin resistance

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Saudi Medical Journal: 43 (2)
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Indices of insulin resistance and adiposity can detect obesity-related morbidity in pediatrics
Marwa H. Abdelhamed, Shaimaa Salah, Khloud K. ALqudsi, Majd M. Jan, Duaa K. Alahdal, Saher A. Alfaifi, Nuha M. Jafar, Naseem Y. Alyahyawi, Abdulmoein A. Al-Agha
Saudi Medical Journal Feb 2022, 43 (2) 161-168; DOI: 10.15537/smj.2022.43.2.20210720

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Indices of insulin resistance and adiposity can detect obesity-related morbidity in pediatrics
Marwa H. Abdelhamed, Shaimaa Salah, Khloud K. ALqudsi, Majd M. Jan, Duaa K. Alahdal, Saher A. Alfaifi, Nuha M. Jafar, Naseem Y. Alyahyawi, Abdulmoein A. Al-Agha
Saudi Medical Journal Feb 2022, 43 (2) 161-168; DOI: 10.15537/smj.2022.43.2.20210720
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Keywords

  • insulin resistance
  • obesity
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  • pediatrics

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