Comparison of the Clinical Utility of Two Insulin Resistance Indices: IRI-HOMA and IRI-Belfiore in Diagnosing Insulin Resistance and Metabolic Complications in Children Based on the Results Obtained for the Polish Population
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Comparison of Two IR Indices Depending on Gender in the Analyzed Group of Children
3.2. Comparison of Two IR Indices Depending on Pubertal Stage in the Analyzed Group of Children
3.3. Comparison of IRI Indices Based on Body Mass Index (BMI) in the Analyzed Group of Children
3.4. Correlations between IR Indices and Calendar Age, as Well as Individual Auxological Parameters and Laboratory Test Results in the Entire Analyzed Group of Children
3.5. Frequency of IR Based on IRI-Belfiore
3.6. Frequency of IR Based on IRI-HOMA According to Different Diagnostic Criteria
4. Discussion
5. Conclusions
- IRI-HOMA and IRI-Belfiore values positively correlated with age, BMI, and pubertal stage, but not with the child’s gender.
- IR was more frequently diagnosed based on the abnormal value of IRI-Belfiore than based on IRI-HOMA.
- While the majority of children with abnormal IRI-HOMA also had an abnormal result regarding IRI-Belfiore, nearly half of the children with normal fasting insulin levels and normal IRI-HOMA exhibited increased insulin secretion during OGTT, resulting in elevated IRI-Belfiore scores.
- In this study, children diagnosed with IR through OGTT exhibited markedly poorer lipid profiles compared to those without IR (with normal values in both IRI-Belfiore and IRI-HOMA). This finding strongly suggests that IR indices derived from OGTT facilitate the identification of individuals harboring risk factors for obesity and IR-related complications before the onset of metabolic syndrome (MS) symptoms.
- IRI-Belfiore allows for the detection of patients with peripheral IR and increased risk factors for cardiovascular diseases even before IRI-HOMA detects liver IR.
- (1)
- The authors of this study seek to underscore the often overlooked potential of the OGTT and the derived IRI-Belfiore in diagnosing IR. IRI-Belfiore holds promise for diagnosing IR in children at heightened risk of future cardiovascular ailments (such as those with familial predispositions to obesity, type 2 diabetes, arterial hypertension, or those born small for gestational age), especially when the widely employed IRI-HOMA yields normal results. This approach enables the early identification of peripheral IR before the onset of metabolic syndrome, facilitating the timely implementation of targeted preventive interventions.
- (2)
- In instances where IRI-HOMA levels are elevated, assessing peripheral IR via the IRI-Belfiore index may seem superfluous, given the prevailing association of hepatic IR with peripheral IR in the majority of cases. Nevertheless, patients falling into this category should undergo OGTT to preemptively rule out disturbances in glucose tolerance or the manifestation of type 2 diabetes.
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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IRI-HOMA | Puberty I, n = 209 | Puberty II and III, n = 111 | Puberty IV and V, n = 233 | p= |
---|---|---|---|---|
Normal weight, n = 239 | 0.82 ± 0.67 *, # n = 138 | 1.90 ± 1.68 * n = 31 | 2.34 ± 1.21 # n = 70 | p = 0.00002 *, # |
Obesity, n = 314 | 2.72 ± 2.11 * n = 71 | 3.66 ± 2.89 n = 80 | 3.79 ± 2.52 * n = 163 | p = 0.008 * |
p= | p = 0.000009 | p = 0.002 | p = 0.00001 |
IRI-Belfiore | Puberty I, n = 209 | Puberty II and III, n = 111 | Puberty IV and V, n = 233 | p= |
---|---|---|---|---|
Normal weight, n = 239 | 0.96 ± 0.36 *, # n = 138 | 1.29 ± 0.36 * n = 31 | 1.41 ± 0.31 # n = 70 | p = 0.00002 *, # |
Obesity, n = 314 | 1.38 ± 0.35 *, # n = 71 | 1.57 ± 0.28 * n = 80 | 1.62 ± 0.24 # n = 163 | p = 0.008 *, # |
p= | p = 0.000009 | p = 0.0001 | p = 0.000009 |
IRI-HOMA | p= | IRI-Belfiore | p= | |
---|---|---|---|---|
Age (years) | 0.35 | 0.000 | 0.342 | 0.000 |
HSDS | 0.11 | 0.128 | 0.221 | 0.000 |
BMISDS for HA | 0.537 | 0.000 | 0.532 | 0.000 |
ALT | 0.307 | 0.000 | 0.197 | 0.000 |
AST | 0.169 | 0.005 | −0.153 | 0.799 |
Triglicerides | 0.387 | 0.000 | 0.310 | 0.000 |
Total cholesterol | −0.009 | 0.837 | 0.453 | 0.323 |
LDL cholesterol | 0.071 | 0.134 | 0.143 | 0.002 |
HDL cholesterol | −0.286 | 0.000 | −0.273 | 0.000 |
HDL/total cholesterol | −0.284 | 0.000 | −0.329 | 0.000 |
Glucose 0′ | 0.345 | 0.000 | 0.608 | 0.153 |
Glucose 60′ | 0.17 | 0.000 | 0.408 | 0.000 |
Glucose 120′ | 0.21 | 0.000 | 0.406 | 0.000 |
Insulin 0′ | 0.98 | 0.000 | 0.581 | 0.000 |
Insulin 60′ | 0.589 | 0.000 | 0.733 | 0.000 |
Insulin 120′ | 0.38 | 0.000 | 0.627 | 0.000 |
IRI-HOMA | - | - | 0.542 | 0.000 |
IRI-Belfiore | 0.542 | 0.000 | - | - |
Normal IRI-HOMA According to Criterion A | IRI-Belfiore | ||
---|---|---|---|
Normal, n = 209 (63.1%) | Increased, n = 122 (36.9%) | p | |
Age (years) | 10.12 ± 4.24 | 12.31 ± 4.35 | 0.00001 |
BMI SDS for HA | 0.98 ± 2.63 | 2.92 ± 3.32 | 0.000000 |
Triglicerides (mg/dL) | 72.84 ± 32.53 | 85.26 ± 37.81 | 0.0004 |
Total cholesterol (mg/dL) | 160.30 ± 29.57 | 63.01 ± 33.43 | 0.480 |
LDL cholesterol (mg/dL) | 92.67 ± 25.62 | 97.53 ± 30.35 | 0.175 |
HDL cholesterol (mg/dL) | 53.87 ± 15.19 | 51.44 ± 17.14 | 0.239 |
HDL/cholesterol ratio | 0.35 ± 0.10 | 0.32 ± 0.09 | 0.005 |
ALT (U/L) | 20.31 ± 11.15 | 20.95 ± 8.63 | 0.6864 |
AST (U/L) | 25.67 ± 8.63 | 23.35 ± 7.03 | 0.0792 |
Normal IRI-HOMA according to criterion B | IRI-Belfiore | ||
normal, n = 231 (53.1%) | increased, n = 204 (46.9%) | p | |
Age (years) | 10.51 ± 4.36 | 13.25 ± 3.88 | 0.000000 |
BMI SDS for HA | 1.25 ± 2.79 | 3.63 ± 3.28 | 0.000000 |
Triglicerides (mg/dL) | 74.98 ± 34.93 | 90.46 ± 41.93 | 0.002 |
Total cholesterol (mg/dL) | 158.90 ± 30.78 | 160.45 ± 32.78 | 0.637 |
LDL cholesterol (mg/dL) | 91.73 ± 26.22 | 97.62 ± 29.54 | 0.051 |
HDL cholesterol (mg/dL) | 53.14 ± 15.08 | 48.22 ± 14.89 | 0.003 |
HDL/total cholesterol ratio | 0.35 ± 0.10 | 0.31 ± 0.09 | 0.00005 |
ALT (U/L) | 20.69 ± 11.59 | 24.71 ± 19.13 | 0.027 |
AST (U/L) | 25.02 ± 8.62 | 23.48 ± 7.16 | 0.1604 |
Increased IRI-HOMA According to Criterion A | IRI-Belfiore | ||
---|---|---|---|
Normal, n = 28 (12.6%) | Increased, n = 194 (87.4%) | p | |
Age (years) | 14.47 ± 3.75 | 13.59 ± 3.23 | 0.184 |
BMI SDS for HA | 3.57 ± 2.88 | 5.56 ± 3.20 | 0.002 |
Triglicerides (mg/dL) | 92.5 ± 43.87 | 113.01 ± 61.42 | 0.103 |
Total cholesterol (mg/dL) | 150.00 ± 35.40 | 160.82 ± 32.89 | 0.117 |
LDL cholesterol (mg/dL) | 85.56 ± 28.40 | 99.42 ± 29.02 | 0.027 |
HDL cholesterol (mg/dL) | 47.35 ± 12.50 | 44.22 ± 13.09 | 0.282 |
HDL/total cholesterol ratio | 0.33 ± 0.09 | 0.28 ± 0.08 | 0.029 |
ALT (U/L) | 21.88 ± 12.63 | 30.72 ± 25.78 | 0.0762 |
AST (U/L) | 22.17 ± 7.87 | 26.95 ± 14.41 | 0.2208 |
Increased IRI-HOMA according to criterion B | IRI-Belfiore | ||
normal, n = 6 (5.1%) | increased, n = 112 (94.9%) | p | |
Age (years) | 15.42 ± 4.11 | 12.80 ± 3.48 | 0.077 |
BMI SDS for HA | 2.84 ± 2.02 | 6.20 ± 3.26 | 0.014 |
Triglicerides (mg/dL) | 89.83 ± 26.91 | 123.55 ± 68.33 | 0.233 |
Cholesterol (mg/dL) | 159.67 ± 22.62 | 163.77 ± 33.59 | 0.769 |
LDL cholesterol (mg/dL) | 90.80 ± 21.11 | 100.59 ± 29.41 | 0.465 |
HDL cholesterol (mg/dL) | 49.50 ± 12.37 | 44.54 ± 15.22 | 0.523 |
HDL/total cholesterol ratio | 0.30 ± 0.06 | 0.28 ± 0.08 | 0.545 |
ALT (U/L) | 18.6 ± 2.5 | 31.26 ± 7.2 | 0.2685 |
AST (U/L) | 23.0 ± 0.0 | 28.25 ± 17.59 | 0.6762 |
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Łupińska, A.; Aszkiełowicz, S.; Kowalik, D.; Jeziorny, K.; Kolasa-Kicińska, M.; Smalczewska, P.; Zygmunt, A.; Lewiński, A.; Stawerska, R. Comparison of the Clinical Utility of Two Insulin Resistance Indices: IRI-HOMA and IRI-Belfiore in Diagnosing Insulin Resistance and Metabolic Complications in Children Based on the Results Obtained for the Polish Population. J. Clin. Med. 2024, 13, 2865. https://doi.org/10.3390/jcm13102865
Łupińska A, Aszkiełowicz S, Kowalik D, Jeziorny K, Kolasa-Kicińska M, Smalczewska P, Zygmunt A, Lewiński A, Stawerska R. Comparison of the Clinical Utility of Two Insulin Resistance Indices: IRI-HOMA and IRI-Belfiore in Diagnosing Insulin Resistance and Metabolic Complications in Children Based on the Results Obtained for the Polish Population. Journal of Clinical Medicine. 2024; 13(10):2865. https://doi.org/10.3390/jcm13102865
Chicago/Turabian StyleŁupińska, Anna, Sara Aszkiełowicz, Dorota Kowalik, Krzysztof Jeziorny, Marzena Kolasa-Kicińska, Paula Smalczewska, Arkadiusz Zygmunt, Andrzej Lewiński, and Renata Stawerska. 2024. "Comparison of the Clinical Utility of Two Insulin Resistance Indices: IRI-HOMA and IRI-Belfiore in Diagnosing Insulin Resistance and Metabolic Complications in Children Based on the Results Obtained for the Polish Population" Journal of Clinical Medicine 13, no. 10: 2865. https://doi.org/10.3390/jcm13102865