Insulin sensitivity, VO2max and body composition in severely obese Swedish children and adolescents

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Abstract

Aim

The aim of this study was to identify relationships between insulin sensitivity (SI), cardiorespiratory fitness and body composition in severely obese Swedish children and adolescents.

Methods

Two hundred and twenty-eight obese children (119 girls, 8–16 years, body mass index (BMI) 23.2–57.0 kg/m2) performed a frequently sampled intravenous glucose tolerance test (FSIVGTT), a submaximal bicycle ergometry test and a dual-energy X-ray absorptiometry (DEXA).

Results

Mean SI (SD) was 0.38 (0.32) (×10−5/min/pM). SI correlated positively with relative body mass (BM) VO2max (r = 0.42) (p < 0.001), relative fat-free mass (FFM) VO2max (r = 0.36) (p < 0.001) and negatively with body mass index standard deviation score (BMI SDS) (r = −0.22) (p = 0.001). SI did not correlate with percent body fat (r = −0.01) and absolute VO2max (r = 0.01). In multiple regression analyses with SI as dependent variable, VO2max and body composition, together with gender, age and Tanner stage, explained 20–26% of the variance.

Conclusion

Relative (BM) VO2max and relative (FFM) VO2max were stronger predictors of SI than percent body fat in severely obese children and adolescents. The study confirms that cardiorespiratory fitness is of importance for the metabolic syndrome in the studied population. Efforts to improve SI should include physical activity targeting cardiorespiratory fitness also in severely obese children and adolescents.

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