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Ann Pediatr Endocrinol Metab > Accepted Articles
DOI: https://doi.org/10.6065/apem.2142178.089    [Accepted] Published online January 25, 2022.
Single Point Insulin Sensitivity Estimator for predicting type 2 diabetes mellitus in obese adolescents
Jaewook Ha1, Ye-Rim Oh2, Engu Kang2, Hyo-Kyoung Nam2, Young-Jun Rhie2, Kee-Hyoung Lee2 
1Department of Pediatrics, Veterans Health Service, Seoul, Korea
2Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
Address for correspondence:  Kee-Hyoung Lee
Email: doclee@korea.ac.kr
Received: August 26, 2021   Revised: November 1, 2021   Accepted: November 15, 2021
Abstract
Purpose
The prevalence of adolescents with type 2 diabetes mellitus (T2DM) has rapidly increased in Korea over the last decades as obese adolescents increased. The single point insulin sensitivity estimator (SPISE) was recently introduced as a surrogate marker for insulin sensitivity to predict T2DM in adults. We aimed to investigate the risk factors for T2DM in obese adolescents, including SPISE.
Methods
This retrospective study included 104 adolescents diagnosed with T2DM at Korea University Hospital between January 2010 and December 2020. We compared clinical and biochemical parameters, SPISE of T2DM with normal overweight and prediabetes to investigate the risk factors for T2DM. Receiver operating characteristic analysis was performed with the Youden index to determine the cutoff point of SPISE.
Results
The frequency of fatty liver and family history of T2DM were significantly higher and SPISE level was significantly decreased in patients with T2DM than in normoglycemic overweight/obesity and prediabetic adolescents (P<0.01). A family history of T2DM, fatty liver, and SPISE below the cutoff point (4.49) were identified as significant risk factors for T2DM in the multiple logistic regression analysis after controlling for age, sex, body mass index standard deviation score (BMI SDS) (P<0.01).
Conclusion
Family history of T2DM, fatty liver and low SPISE (<4.49) are the risk factors that can independently affect the occurrence of T2DM in obese adolescents. Among the risk factors, SPISE may be a promising marker for predicting adolescent T2DM and careful monitoring is needed to prevent the progression to T2DM.
Keywords: Obese adolescent, Type 2 diabetes mellitus, SPISE, Fatty liver


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