Insulinemia e índice HOMA en niños y adolescentes chilenos.

Salesa Barja, Pilar Arnaiz, Angélica Domínguez, Luis Villarroel, Berta Cassis, Oscar Castillo, Gianina Salomó, Marcelo Farías, Manuela Goycoolea, Teresa Quiroga, Francisco Mardones

Resumen


NORMAL PLASMA INSULIN AND HOMA VALUES AMONG CHILEAN CHILDREN AND ADOLESCENTS

Background: Plasma insulin and HOMA (homeostasis model assessment) index, used to determine insulin resistance, do not have local standard values for children and adolescents in Chile. Aim: To establish the normal reference intervals for insulin and HOMA in children and adolescents aged 10-15 years old, according to sex and puberal maturation. Material and methods: A cross-sectional study of 2,153 children and adolescents from Puente Alto County was performed, during 2009 and 2010. Anthropometry and self-report of puberal maturation were assessed. Fasting glucose (hexoquinase) and insulin blood levels (chemiluminiscence), were determined and HOMA index was calculated. Percentile distributions of these variables were calculated. Results: The reference group included only subjects with normal body mass index and fasting blood glucose (n=1,192). Women had higher insulin and HOMA values than men (12.5±6.0 and  9.1±4.9 ?U/mL (p< 0.01) and 2.7±1.4 and 2.1±1,1 (p< 0.01), respectively). Subjects with Tanner I and II puberal stages had lower insulin and HOMA mean values than subjects with Tanner III and IV:  9.0±4.3 and 12.5±6.2 µU/ml (p<0.01) and 2.0±1 and 2.8±1.4 (p<0.01), respectively. Conclusions: The 90th percentile of insulin and HOMA distributions according to sex and maturation, was selected as the upper cut-off point to identify individuals with insulin resistance.  HOMA cutoff point for Tanner I and II males was 3.2, for Tanner I and II women was 4.1, for Tanner III and IV men was  4.2 and for Tanner III and IV women was 5.0. 

 


Palabras clave


Adolescent; Child; Insulin resistance