Fasting and 2-Hour Plasma Glucose and Insulin Relationship with risk factors for cardiovascular disease in overweight nondiabetic children

OBJECTIVE - To determine whether elevated fasting or 2-h plasma glucose and/or insulin better reflects the presence of cardiovascular disease (CVD) risk markers in an overweight pediatric population with normal glucose tolerance RESEARCH DESIGN AND METHODS - A total of 151 overweight youths (8-17 years old) were evaluated with oral glucose tolerance tests and measurement of CVD risk factors The study population was categorized according to quartiles of fasting and 2-h glucose and insulin levels ANCOVA adjusted for age sex race Tanner stage and percent body fat (measured by dual energy X-ray absorptiometry) was used to compare metabolic variables between the quartiles of glucose and insulin groups RESULTS - Increasing quartiles of fasting and 2-h insulin were associated with increasing CVD risk factors Glucose quartiles on the other hand either fasting or at 2 h were not CONCLUSIONS - These data suggest that hyperinsulinemia may be the earliest and/or primary metabolic alteration in childhood associated with risk markers for CVD Prospective studies are needed