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      Prediction Models for Insulin Resistance in Girls with Premature Adrenarche

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          Abstract

          Aim: The purpose of this study was to develop an accurate regression model to predict insulin resistance in girls with premature adrenarche. Methods: The insulin sensitivity index was calculated from the frequently sampled intravenous glucose tolerance test with tolbutamide. Thirty-five prepubertal girls (23 Caribbean-Hispanic and 12 African-American; mean age 6.8 years) were studied. The insulin sensitivity index was compared to birth weight, body mass index (BMI), the presence of acanthosis nigricans (AN), insulin-like growth factor 1, insulin-like growth factor binding protein 1, sex hormone binding globulin, lipid profile, and adrenocorticotropic hormone stimulated androgens. Results: The best prediction models included birth weight, BMI, and AN (model 1: R<sup>2</sup> = 0.78) and BMI, AN, and serum 17-OH pregnenolone (model 2: R<sup>2</sup> = 0.76). When viewed as screening tests, a cutoff value <5.5 (premature adrenarche insulin resistance score) in both equations showed a sensitivity of 100% and a specificity of 85%. Conclusion: Born small for gestational age, premature adrenarche, obesity, AN, and higher serum 17-OH pregnenolone levels may confer negative, but independent, health risks.

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          Most cited references23

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          Long-term morbidity and mortality of overweight adolescents. A follow-up of the Harvard Growth Study of 1922 to 1935.

          A Must, P Jacques, G Dallal … (1992)
          Overweight in adults is associated with increased morbidity and mortality. In contrast, the long-term effect of overweight in adolescence on morbidity and mortality is not known. We studied the relation between overweight and morbidity and mortality in 508 lean or overweight adolescents 13 to 18 years old who participated in the Harvard Growth Study of 1922 to 1935. Overweight adolescents were defined as those with a body-mass index that on two occasions was greater than the 75th percentile in subjects of the same age and sex in a large national survey. Lean adolescents were defined as those with a body-mass index between the 25th and 50th percentiles. Subjects who were still alive were interviewed in 1988 to obtain information about their medical history, weight, functional capacity, and other risk factors. For those who had died, information on the cause of death was obtained from death certificates. Overweight in adolescent subjects was associated with an increased risk of mortality from all causes and disease-specific mortality among men, but not among women. The relative risks among men were 1.8 (95 percent confidence interval, 1.2 to 2.7; P = 0.004) for mortality from all causes and 2.3 (95 percent confidence interval, 1.4 to 4.1; P = 0.002) for mortality from coronary heart disease. The risk of morbidity from coronary heart disease and atherosclerosis was increased among men and women who had been overweight in adolescence. The risk of colorectal cancer and gout was increased among men and the risk of arthritis was increased among women who had been overweight in adolescence. Overweight in adolescence was a more powerful predictor of these risks than overweight in adulthood. Overweight in adolescence predicted a broad range of adverse health effects that were independent of adult weight after 55 years of follow-up.
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            Body mass index as a measure of adiposity among children and adolescents: a validation study.

            Angelo Pietrobelli, Myles Faith, David B. Allison … (1998)
            To test the hypothesis that in a healthy pediatric population body mass index (BMI) (kilograms per meter square) is a valid measure of fatness that is independent of age for both sexes. Total body fat (TBF) (in kilograms) and percent of body weight as fat (PBF) were estimated by dual energy x-ray absorptiometry (DXA) in 198 healthy Italian children and adolescents between 5 and 19 years of age. We developed multiple regression analysis models with TBF and percent body fat as dependent variables and BMI, age, and interaction terms as independent variables. Separate analyses were conducted for boys and girls. BMI was strongly associated with TBF (R2 = 0.85 and 0.89 for boys and girls, respectively) and PBF (R2 =0.63 and 0.69 for boys and girls, respectively). Confidence limits on BMI-fatness association were wide, with individuals of similar BMI showing large differences in TBF and in PBF. Age was a significant covariate in all regression models. Addition of nonlinear terms for BMI did not substantially increase the R2 for TBF and PBF models in boys and girls. Our results support the use of BMI as a fatness measure in groups of children and adolescents, although interpretation should be cautious when comparing BMI across groups that differ in age or when predicting a specific individual's TBF or PBF.
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              Type 2 diabetes among North adolescents: An epidemiologic health perspective

              Anne Fagot-Campagna, David Pettitt, Michael Engelgau … (2000)
              Article 0 comments Cited 64 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (publisher-id): HRE
                Journal ID (nlm-ta): Horm Res Paediatr
                Journal ID (doi): 10.1159/issn.1663-2818
                Title: Hormone Research in Paediatrics
                Publisher: S. Karger AG
                ISSN (Print): 1663-2818
                ISSN (Electronic): 1663-2826
                Publication date Subscription-year: 2006
                Publication date (Print): April 2006
                Publication date (Electronic): 09 May 2006
                Volume: 65
                Issue: 4
                Pages: 185-191
                Affiliations
                aDivision of Pediatric Endocrinology, Children’s Hospital at Montefiore Medical Center, Bronx, and b Division of Endocrinology and Metabolism, Department of Pediatrics, Long Island College Hospital, Brooklyn, N.Y., USA
                Article
                Publisher ID: 92103 Other ID: Horm Res 2006;65:185–191
                DOI: 10.1159/000092103
                PubMed ID: 16549934
                SO-VID: 95f066bb-b57c-46a6-93e5-d5133daef056
                Copyright © © 2006 S. Karger AG, Basel
                License:

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                Date received : 18 August 2005
                Date accepted : 15 December 2005
                Page count
                Figures: 2, Tables: 5, References: 36, Pages: 7
                Categories
                Subject: Original Paper

                ScienceOpen disciplines: Endocrinology & Diabetes,Neurology,Nutrition & Dietetics,Sexual medicine,Internal medicine,Pharmacology & Pharmaceutical medicine
                Keywords: PAIR score,Insulin resistance, prediction models,Premature adrenarche, insulin resistance
                Data availability:
                ScienceOpen disciplines: Endocrinology & Diabetes, Neurology, Nutrition & Dietetics, Sexual medicine, Internal medicine, Pharmacology & Pharmaceutical medicine
                Keywords: PAIR score, Insulin resistance, prediction models, Premature adrenarche, insulin resistance

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