Índices de sensibilidad insulínica (homa y quicki): en escolares y adolescentes sanos en Valera: estado Trujillo-Venezuela / Insuline sensibility index among healthy children and adolescents in Valera: Trujillo state-Venezuela

RESUMEN

La resistencia a la insulina contribuye a la fisiopatología de la diabetes tipo 2 y es la antesala de la obesidad, el síndrome metabólico y muchas enfermedades cardiovasculares, de allí la importancia de su detección temprana. Evaluar el grado de sensibilidad insulinica mediante los índices HOMA y QUICKI y la asociación de la insulinosensibilidad basal con algunas variables biológicas (edad, sexo, estado nutricional). Se realizó un estudio descriptivo de corte transversal en escolares y adolescentes entre 6 y 18 años, entre marzo y julio de 2005. Se calculó el IMC y se emplearon las curvas percentiles de FUNDACREDESA para su categorización. Se extranjeron 5mL de sangre para detectar los valores de glucosa e insulina. La sensibilidad insulínica basal se calculó mediante los índices HOMA [glicemia en ayunas (mmol/l) x insulina en ayunas (mU/l)]/22,5 y QUICKI (1/(Log glicemia ayuno (mg/dl)+Log insulina ayuno (µU/ml). Se calcularon los estadísticos descriptivos y las diferencias fueron estudiadas mediante la prueba Chi², considerando significativo a todo valor de p<0,05. 269 niños tenían peso normal (84,5 por ciento), 29 presentaron sobrepeso (9,11 por ciento) y 20 eran obesos (6,28 por ciento). No se encontró asociación significativa entre la sensibilidad insulínica y el estado nutricional. Hubo diferencia significativa en las glicemias en ayunas entre escolares y adolescentes eutróficos y con sobrepeso (p<0.001). No hubo insulino resistencia en escolares ni adolescentes. El índice HOMA alcanzó un valor cercano a 1, y el índice de QUICKI se mantuvo alrededor de 0,40 independientemente del estado nutricional.

ABSTRACT

Insulin resistance contributes to the physiopathology of diabetes and is the previous step to obesity, metabolic syndrome and many cardiovascular disease, therefore the importance of its early detection. To evaluate the degree of insulin sensitivity by means of the indexes HOMA and QUICKI and the association with some biological variables (age, gender, nutritional state). The study is descriptive of transverse cut type and included children and adolescents between 6 and 18 years. Body Mass Index was calculated and the categorization was performed by Fundacredesa's charts. Glucose and insulin were measured in blood. Basal insulin sensitivity was calculated by means of the indexes HOMA, [blood fasting sugar (mmol/1) x fasting insulin (mU/1)]/22,5 and QUICKI (1/(Log fasting blood sugar (mg/dl) + Log fasting blood insulin (µU/ml). Descriptive statistic were calculated and differences were studied by means of the test X², considering as significant, values under 0.05. There were 269 children with normal weight (84,5%), 29 were overweight (9,11%) and obese (6,28%). There was no significant association between insulin sensitivity and nutritional state. There were significant differences in fasting blood sugar between normal and overweight children and adolescents (p<0,001). There were neither children nor adolescents with insulin resistance the HOMA index reached a value of 1 and the QUICKI index was near 0,40 independently of the nutritional state.