One-hour glucose–defined metabolic phenotypes in youth with obesity: early β-cell impairment across the spectrum of dysglycemia
Diabetes Research and Clinical Practice, cilt.239, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 239
- Basım Tarihi: 2026
- Doi Numarası: 10.1016/j.diabres.2026.113420
- Dergi Adı: Diabetes Research and Clinical Practice
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CINAHL, EMBASE, Index Islamicus, MEDLINE, Academic Search Ultimate (EBSCO)
- Anahtar Kelimeler: Dysglycemia, Insulin resistance, Obesity, One-hour glucose, β-cell function
- Ankara Yıldırım Beyazıt Üniversitesi Adresli: Evet
Özet
Aims: To characterize oral glucose tolerance test (OGTT)-derived metabolic phenotypes in children and adolescents with obesity, focusing on the clinical significance of elevated 1-hour plasma glucose. Methods: This retrospective study included 726 children and adolescents with obesity who underwent an OGTT at a tertiary center. Participants were classified as NGT-Low (1-hour glucose < 155 mg/dL), NGT-High (≥155 mg/dL), impaired fasting glucose (IFG), impaired glucose tolerance (IGT), or advanced dysglycemia. OGTT-derived indices of insulin sensitivity and β-cell function were compared. ROC and multivariable logistic regression analyses identified determinants of dysglycemia. Results: NGT-High showed lower insulin sensitivity (Matsuda index: 1.59 vs. 2.34, p < 0.001) and greater insulin exposure (insulin AUC: 19,845 vs. 13,048 µIU/mL × min, p < 0.001) than NGT-Low. Lower insulinogenic index at 30 min (IGI30), insulinogenic index at 60 min (IGI60), and Insulin Secretion-Sensitivity Index-2 (ISSI-2) indicated early β-cell dysfunction. Delayed insulin peak timing was observed in IGT and advanced dysglycemia groups. Fasting plasma glucose showed the highest discriminatory performance (AUC = 0.797); glycated hemoglobin (HbA1c) and ISSI-2 were independently associated with dysglycemia. Conclusions: A 1-hour glucose ≥ 155 mg/dL identifies a metabolically distinct phenotype with reduced insulin sensitivity and early β-cell dysfunction despite normal glucose tolerance, supporting 1-hour glucose incorporation into metabolic evaluation of youth with obesity.