A personalized approach to classify the degree of liver insulin resistance in children with obesity

AimsThis study aimed to develop a novel approach for quantifying liver insulin resistance (LIR) in children with obesity using personalized glucose and insulin responses from oral glucose tolerance tests (OGTTs).Materials and MethodsA total of 242 OGTTs were performed on paediatric patients with obesity. Blood glucose and insulin levels were determined at six timepoints. Measurements of liver enzymes, plasma lipids, blood pressure and height and weight were obtained concurrently. Associations of LIR with other clinical parameters of obesity and type 2 diabetes were compared between the conventional and novel LIR quantification.ResultsThe study revealed heterogeneous OGTT response dynamics among the population, with substantial variability in peak levels of glucose and insulin. The novel approach to quantify LIR showed stronger associations between glucose and insulin responses and clinical markers of obesity and type 2 diabetes, compared to the conventional method.ConclusionsThe novel LIR quantification method provides a more precise assessment of insulin resistance in paediatric obesity management compared to traditional methods. By considering individual glucose and insulin dynamics, this approach enhances risk stratification and treatment planning tailored to each patient's OGTT response curve.