gms | German Medical Science

MAINZ//2011: 56. GMDS-Jahrestagung und 6. DGEpi-Jahrestagung

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e. V.
Deutsche Gesellschaft für Epidemiologie e. V.

26. - 29.09.2011 in Mainz

Surrogate markers of insulin resistance in pre-pubertal children: findings of the European multicenter study IDEFICS

Meeting Abstract

  • Jenny Peplies - Bremer Institut für Präventionsforschung und Sozialmedizin (BIPS), Bremen
  • Claudia Boernhorst - Bremer Institut für Präventionsforschung und Sozialmedizin (BIPS), Bremen
  • Arno Fraterman - MVZ Dortmund Dr. Eberhard und Partner, Dortmund
  • Paola Russo - Epidemiology & Population Genetics, Institute of Food Sciences, CNR, Avellino, Italy
  • Toomas Veidebaum - National Institute for Health Development, Tallinn, Estonia
  • Michael Tornaritis - Research & Education Institute of Child Health, Strovolos, Cyprus
  • Stefaan De Henauw - Department of Public Health, Ghent University, Ghent, Belgium
  • Staffan Marild - Department of Public Health and Community Medicine, The Queen Silvia Children's Hospital, Göteborg, Sweden
  • Dénes Molnar - National Institute of Health Promotion, University of Pécs, Pécs, Hungary
  • Luis A Moreno - GENUD (Growth, Exercise, Nutrition and Development) research group, School of Health Sciences, University of Zaragoza, Zaragoza, Spain
  • Wolfgang Ahrens - Bremer Institut für Präventionsforschung und Sozialmedizin (BIPS), Bremen

Mainz//2011. 56. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 6. Jahrestagung der Deutschen Gesellschaft für Epidemiologie (DGEpi). Mainz, 26.-29.09.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11gmds157

doi: 10.3205/11gmds157, urn:nbn:de:0183-11gmds1571

Published: September 20, 2011

© 2011 Peplies et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objectives: Insulin resistance (IR) is frequently observed in childhood obesity. It represents a link between obesity and type 2 diabetes or cardiovascular disease and can track into adult life. Several markers, e.g. fasting insulin, glucose/insulin ratio, HOMA, HbA1c and CRP, have been suggested as surrogate markers for screening purposes in adults (Singh, 2010), as the gold standard method to measure insulin sensitivity (the hyperinsulinemic euglycemic clamp) is very labor- and time-intensive and thus not feasible in epidemiological research. In children, however, screening data on insulin resistance is rare, especially from large-scale epidemiological studies. Moreover, there is lack of adequate reference values for the respective markers of insulin resistance in children. The aim of this study is to describe levels of surrogate markers for insulin resistance in a population-based cross-sectional study of European children, aged 2-9 years. The influence of age on the distributions is evaluated, as well as the effect of BMI, waist circumference and sex.

Material and methods: During the baseline survey of the IDEFICS study in 2007/2008 fasting venous blood was collected from 9,185 2 to 9 year old children from eight European countries. 7,246 children could be included into the statistical analyses, because all parameters of interest were available for them. Potentially confounding factors were taken into account.

Results: Insulin and glucose levels and the derived HOMA index of children in the IDEFICS baseline survey increased with age and weight group (BMI classes according to Cole) of the children. CRP as a marker of inflammation also increased with the weight group of the children but remained stable with growing age. Data analysis showed lower and age-dependent biomarker concentrations for children in the IDEFICS cohort compared to normal ranges for adults. Concentrations of most markers differed slightly between the sexes. Insulin, glucose, HOMA index and CRP, but not HbA1c were significantly correlated with BMI and waist circumference in an age-adjusted Spearman correlation analysis.

Conclusion: This study shows that most surrogate markers for IR are elevated in overweight/ obese children already before puberty. The increase of insulin and glucose concentrations with age underlines that age-dependent reference values are needed for children.


Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. British Medical Journal. 2000;320(7244):1240-3.
Singh B, Saxena A. Surrogate markers of insulin resistance: A review. World J Diabetes. 2010;1(2):36-47.