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Impact of percent body fat on oral glucose tolerance testing: A cross-sectional study in 1512 obese children

Background: Although an association between insulin resistance (IR) and body adiposity has been reported in obese children, this relationship has not been studied as thoroughly as in adults. Aim: We evaluated the association between oral glucose tolerance testing (OGTT) and percent body fat (PBF) in a sample of 1512 obese children followed at a Pediatric Obesity Clinic. Subjects and methods: Six hundred and twenty-eight male and 884 female obese children aged 6 to 18 yr were consecutively enrolled into the study. OGTT was performed with administration of 1.75 g of glucose per kg of body weight (up to 75 g). PBF was estimated through bioelectrical impedance analysis (BIA) using a population-specific formula recently published by our group. Multivariable median regression was used to evaluate the association between 4 outcomes [glucose area under the curve (AUC), insulin AUC, insulin sensitivity index (ISI), and insulinogenic index (IGI)] and gender, age or pubertal status and PBF. Results: Median PBF was 52% (range 26 to 70%). After correction for age and gender, a 10% increase of PBF was associated with a decrease of −0.50 [95% confidence interval (CI): −0.65 to −0.35] units of ISI and an increase of 0.15 units of IGI (95%CI 0.07 to 0.24). Conclusions: In obese children, PBF is inversely associated with IR and directly associated to γ-cell response as detected by OGTT.