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Single Point Insuli...
Single Point Insulin Sensitivity Estimator in Pediatric Non-Alcoholic Fatty Liver Disease
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- Furthner, Dieter (författare)
- Salzkammergutklinikum Voecklabruck, Dept Pediat, Voecklabruck, Austria.;Paracelsus Med Univ, Univ Hosp Salzburg, Obes Res Unit, Salzburg, Austria.
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- Anderwald, Christian-Heinz (författare)
- Paracelsus Med Univ, Univ Hosp Salzburg, Obes Res Unit, Salzburg, Austria.;Med Univ Vienna, Div Endocrinol & Metab, Dept Internal Med 3, Vienna, Austria.;Arnoldstein Healthcare Ctr, Arnoldstein, Austria.
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- Bergsten, Peter (författare)
- Uppsala universitet,Institutionen för medicinsk cellbiologi
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- Forslund, Anders, 1961- (författare)
- Uppsala universitet,Institutionen för kvinnors och barns hälsa
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- Kullberg, Joel, 1979- (författare)
- Uppsala universitet,Geriatrik,Radiologi
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- Ahlström, Håkan, 1953- (författare)
- Uppsala universitet,Radiologi
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- Manell, Hannes (författare)
- Uppsala universitet,Institutionen för medicinsk cellbiologi
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- Ciba, Iris (författare)
- Uppsala universitet,Institutionen för kvinnors och barns hälsa
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- Mangge, Harald (författare)
- Med Univ Graz, Clin Inst Med & Chem Lab Diag, Graz, Austria.
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- Maruszczak, Katharina (författare)
- Paracelsus Med Univ, Univ Hosp Salzburg, Obes Res Unit, Salzburg, Austria.;Paracelsus Med Univ, Univ Hosp Salzburg, Dept Pediat, Salzburg, Austria.
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- Koren, Pia (författare)
- Paracelsus Med Univ, Univ Hosp Salzburg, Obes Res Unit, Salzburg, Austria.;Paracelsus Med Univ, Univ Hosp Salzburg, Dept Pediat, Salzburg, Austria.
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- Schuetz, Sebastian (författare)
- Paracelsus Med Univ, Univ Hosp Salzburg, Obes Res Unit, Salzburg, Austria.;Paracelsus Med Univ, Univ Hosp Salzburg, Dept Pediat, Salzburg, Austria.
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- Brunner, Susanne Maria (författare)
- Paracelsus Med Univ, Dept Pediat, Res Program Receptor Biochem & Tumor Metab, Univ Hosp, Salzburg, Austria.
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- Schneider, Anna Maria (författare)
- Paracelsus Med Univ, Univ Hosp Salzburg, Obes Res Unit, Salzburg, Austria.;Paracelsus Med Univ, Univ Hosp Salzburg, Dept Pediat, Salzburg, Austria.
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- Weghuber, Daniel (författare)
- Paracelsus Med Univ, Univ Hosp Salzburg, Obes Res Unit, Salzburg, Austria.;Paracelsus Med Univ, Univ Hosp Salzburg, Dept Pediat, Salzburg, Austria.
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- Moerwald, Katharina (författare)
- Paracelsus Med Univ, Univ Hosp Salzburg, Obes Res Unit, Salzburg, Austria.;Paracelsus Med Univ, Univ Hosp Salzburg, Dept Pediat, Salzburg, Austria.
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Salzkammergutklinikum Voecklabruck, Dept Pediat, Voecklabruck, Austria;Paracelsus Med Univ, Univ Hosp Salzburg, Obes Res Unit, Salzburg, Austria. Paracelsus Med Univ, Univ Hosp Salzburg, Obes Res Unit, Salzburg, Austria.;Med Univ Vienna, Div Endocrinol & Metab, Dept Internal Med 3, Vienna, Austria.;Arnoldstein Healthcare Ctr, Arnoldstein, Austria. (creator_code:org_t)
- 2022-02-02
- 2022
- Engelska.
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Ingår i: Frontiers in Endocrinology. - : Frontiers Media S.A.. - 1664-2392. ; 13
- Relaterad länk:
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https://doi.org/10.3...
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https://uu.diva-port... (primary) (Raw object)
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https://www.frontier...
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https://urn.kb.se/re...
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https://doi.org/10.3...
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Abstract
Ämnesord
Stäng
- BackgroundAttenuated insulin-sensitivity (IS) is a central feature of pediatric non-alcoholic fatty liver disease (NAFLD). We recently developed a new index, single point insulin sensitivity estimator (SPISE), based on triglycerides, high-density-lipoprotein and body-mass-index (BMI), and validated by euglycemic-hyperinsulinemic clamp-test (EHCT) in adolescents. This study aims to assess the performance of SPISE as an estimation of hepatic insulin (in-)sensitivity. Our results introduce SPISE as a novel and inexpensive index of hepatic insulin resistance, superior to established indices in children and adolescents with obesity. Materials and MethodsNinety-nine pubertal subjects with obesity (13.5 +/- 2.0 years, 59.6% males, overall mean BMI-SDS + 2.8 +/- 0.6) were stratified by MRI (magnetic resonance imaging) into a NAFLD (>5% liver-fat-content; male n=41, female n=16) and non-NAFLD (<= 5%; male n=18, female n=24) group. Obesity was defined according to WHO criteria (> 2 BMI-SDS). EHCT were used to determine IS in a subgroup (n=17). Receiver-operating-characteristic (ROC)-curve was performed for diagnostic ability of SPISE, HOMA-IR (homeostatic model assessment for insulin resistance), and HIRI (hepatic insulin resistance index), assuming null hypothesis of no difference in area-under-the-curve (AUC) at 0.5. ResultsSPISE was lower in NAFLD (male: 4.8 +/- 1.2, female: 4.5 +/- 1.1) than in non-NAFLD group (male 6.0 +/- 1.6, female 5.6 +/- 1.5; P< 0.05 {95% confidence interval [CI]: male NAFLD 4.5, 5.2; male non-NAFLD 5.2, 6.8; female NAFLD 4.0, 5.1, female non-NAFLD 5.0, 6.2}). In males, ROC-AUC was 0.71 for SPISE (P=0.006, 95% CI: 0.54, 0.87), 0.68 for HOMA-IR (P=0.038, 95% CI: 0.48, 0.88), and 0.50 for HIRI (P=0.543, 95% CI: 0.27, 0.74). In females, ROC-AUC was 0.74 for SPISE (P=0.006), 0.59 for HOMA-IR (P=0.214), and 0.68 for HIRI (P=0.072). The optimal cutoff-level for SPISE between NAFLD and non-NAFLD patients was 5.18 overall (Youden-index: 0.35; sensitivity 0.68%, specificity 0.67%). ConclusionSPISE is significantly lower in juvenile patients with obesity-associated NAFLD. Our results suggest that SPISE indicates hepatic IR in pediatric NAFLD patients with sensitivity and specificity superior to established indices of hepatic IR.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)
Nyckelord
- insulin resistance
- pediatric obesity
- hepatic insulin resistance index
- HOMA-IR
- receiver-operating-characteristic curve
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- art (ämneskategori)
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Furthner, Dieter
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Anderwald, Chris ...
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Bergsten, Peter
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Forslund, Anders ...
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Kullberg, Joel, ...
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Ahlström, Håkan, ...
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Manell, Hannes
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Ciba, Iris
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Mangge, Harald
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Maruszczak, Kath ...
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Koren, Pia
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Schuetz, Sebasti ...
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Brunner, Susanne ...
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Schneider, Anna ...
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Weghuber, Daniel
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Moerwald, Kathar ...
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