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Longitudinal multicenter analysis on the course of glucose metabolism in obese children

International Journal of Obesity volume 37, pages 931–936 (2013)Cite this article

Abstract

Objective:

Although there is evidence of increasing prevalence of impaired glucose metabolism in obese children from smaller single cohorts, data are lacking on the progression of glucose metabolism in this patient group.

We aimed to assess the prevalence and the longitudinal course of impaired glucose metabolism assessed by oral glucose tolerance test (oGTT) in a large multi-center pediatric obesity registry.

Subjects:

We performed an observational multicenter (n=84) cross-sectional (n=11 156) and longitudinal analysis (n=1008) on the course of glucose metabolism evaluated by oGTT in obese children documented in the Adiposity Patients Verlaufsbeobachtung (APV) registry. Patients were stratified with impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and Type 2 diabetes (T2D), according to American Diabetes Association criteria.

Results:

A total of 12.6% of the children presented with abnormal glucose metabolism (5.99% IFG, 5.51% IGT, 1.07% T2D). Body mass index (BMI) correlated modestly with 2-h blood glucose (r=0.04, P<0.001).

In the 1008 patients with follow-up oGTT, metabolic parameters improved and the percentage of abnormal glucose metabolism decreased from 18.7 to 14.2%. Of the children with initial IGT, 70.6% converted to normal glucose tolerance. The improvement in oGTT results was associated with, but not dependent on, a reduction of BMI s.d. score.

Conclusion:

In summary, we provide evidence for significant improvement of oGTT parameters in obese children treated in specialized treatment centers, even though reduction in BMI was modest.

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Acknowledgements

We very gratefully acknowledge the work of the study nurses and physicians, for caring for the patients and for data management. This study was supported by the German Ministry of Education and Research (BMBF) within the scope of the competence network ‘Obesity’ LARGE consortium (to AK, SW, WK, RH) FKZ 01610824, by the competence net diabetes of the BMBF (FKZ 01GI0859), by the German Research Council (DFG) KO3512/1, by the LIFE (Leipzig Research Center for Civilization Diseases, Universität Leipzig to AK), funded by the European Union, by the European Regional Development Fund (ERFD) by means of the Free State of Saxony within the framework of the excellence initiative (to AK, WK) and by the Beta-JUDO consortium funded by the European Community's 7th Framework Programme (FP7/2007-2013) under grant agreement n° 279153 (to AK, WK, KW).

Author contributions

AK: conception and design of the study, acquisition of data, analysis plan, interpretation of data, drafting and revising article; SW: acquisition of data, discussion of article; AH: statistical analyses; ST: acquisition of data; KPO: acquisition of data; DA-J: acquisition of data, discussion of article; KW: acquisition of data; WK: acquisition of data, discussion of article; and RWH: conception and design of registry, data analysis, interpretation of data, critical revision of article.

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Authors and Affiliations

  1. Department of Women and Child Health, Center for Pediatric Research, University Hospital for Children & Adolescents, University of Leipzig, Leipzig, Germany

    A Körner & W Kiess

  2. Leipzig University Medical Center, IFB AdiposityDiseases, Leipzig, Germany

    A Körner

  3. Obesity Center BABELUGA, Interdisciplinary SPZ, Charité University Children’s Hospital, Berlin, Germany

    S Wiegand

  4. Department of Epidemiology, University of Ulm, Ulm, Germany

    A Hungele & R W Holl

  5. Department of Pediatric Medicine, SANA Klinikum Lichtenberg, SPZ - Adiposity Diseases, Berlin, Germany

    S Tuschy

  6. Kath Kinderkrankenhaus Wilhelmstift, Hamburg, Germany

    K P Otto

  7. Department of Pediatric Endocrinology/Diabetology, Eastern Swiss Children’s Hospital, St. Gallen, Switzerland

    D l'Allemand-Jander

  8. Medical University Vienna, Vienna, Austria

    K Widhalm

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  1. A Körner
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  2. S Wiegand
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  4. S Tuschy
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for the APV initiative and the German Competence Net Obesity

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Correspondence to A Körner.

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Supplementary Information accompanies the paper on International Journal of Obesity website

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Körner, A., Wiegand, S., Hungele, A. et al. Longitudinal multicenter analysis on the course of glucose metabolism in obese children. Int J Obes 37, 931–936 (2013). https://doi.org/10.1038/ijo.2012.163

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