Introduction: The obesity epidemic has become one of the most important public health issues of modern times. Impaired insulin sensitivity seems to be the cornerstone of multiple obesity related comorbidities. However, there is no accepted definition of impaired insulin sensitivity. Objective: We hypothesize that assessment of insulin resistance differs between centers. Methods: The ESPE Obesity Working Group (ESPE ObWG) Scientific Committee developed a questionnaire with a focus on the routine practices of assessment of hyperinsulinemia and insulin resistance, which was distributed through Google Docs platform to the clinicians and researchers from the current ESPE ObWG database (n = 73). Sixty-one complete responses (84% response rate) from clinicians and researchers were analyzed: 32 from European Union (EU) centers (representatives of 14 countries) and 29 from Non-EU centers (representatives from 10 countries). Standard statistics were used for the data analysis. Results: The majority of respondents considered insulin resistance (IR) as a clinical tool (85.2%) rather than a research instrument. For the purpose of IR assessment EU specialists prefer analysis of the oral glucose tolerance test (OGTT) results, whereas non-EU ones mainly use Homeostatic Model Assessment of Insulin Resistance (HOMA-IR; p = 0.032). There was no exact cutoff for the HOMA-IR in either EU or non-EU centers. A variety of OGTT time points and substances measured per local protocol were reported. Clinicians normally analyzed blood glucose (88.52% of centers) and insulin (67.21%, mainly in EU centers, p = 0.0051). Furthermore, most participants (70.5%) considered OGTT insulin levels as a more sensitive parameter of IR than glucose. Meanwhile, approximately two-thirds (63.9%) of the centers did not use any cutoffs for the insulin response to the glucose load. Conclusions: Since there is no standard for the IR evaluation and uniform accepted indication of performing, an OGTT the assessment of insulin sensitivity varies between EU and non-EU centers. A widely accepted standardized protocol is needed to allow comparison between centers.
Horm Res Paediatr

中文翻译：

---

欧盟与非欧盟肥胖治疗中心胰岛素抵抗评估的差异（ESPE肥胖工作组胰岛素抵抗项目）

简介：肥胖流行已成为现代最重要的公共卫生问题之一。胰岛素敏感性受损似乎是多种肥胖相关合并症的基石。然而，没有公认的胰岛素敏感性受损的定义。目标：我们假设不同中心对胰岛素抵抗的评估不同。方法： ESPE 肥胖工作组 (ESPE ObWG) 科学委员会制定了一份问卷，重点关注高胰岛素血症和胰岛素抵抗评估的常规做法，该问卷通过 Google Docs 平台分发给当前 ESPE ObWG 数据库中的临床医生和研究人员。 n= 73）。分析了来自临床医生和研究人员的 61 份完整答复（84% 的答复率）：32 份来自欧盟 (EU) 中心（来自 14 个国家的代表）和 29 份来自非欧盟中心（来自 10 个国家的代表）。标准统计用于数据分析。结果：大多数受访者认为胰岛素抵抗 (IR) 是一种临床工具 (85.2%) 而不是研究工具。出于 IR 评估的目的，欧盟专家更喜欢分析口服葡萄糖耐量试验 (OGTT) 结果，而非欧盟专家则主要使用胰岛素抵抗的稳态模型评估 (HOMA-IR; p= 0.032）。欧盟或非欧盟中心的 HOMA-IR 没有确切的截止值。报告了根据当地协议测量的各种 OGTT 时间点和物质。临床医生通常分析血糖（88.52% 的中心）和胰岛素（67.21%，主要在欧盟中心，p = 0.0051）。此外，大多数参与者 (70.5%) 认为 OGTT 胰岛素水平是比葡萄糖更敏感的 IR 参数。同时，大约三分之二 (63.9%) 的中心没有对胰岛素对葡萄糖负荷的反应使用任何临界值。结论：由于没有 IR 评估标准和统一接受的执行指示，OGTT 对胰岛素敏感性的评估在欧盟和非欧盟中心之间有所不同。需要一个广泛接受的标准化协议来允许中心之间的比较。
儿科研究