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Ann Pediatr Endocrinol Metab > Volume 27(3); 2022 > Article
Kim: Commentary on "Single point insulin sensitivity estimator for predicting type 2 diabetes mellitus in obese adolescents"
Recent studies implied that an increase in calorie consumption and a decrease in physical activity among Korean teenagers have contributed to an increase in central obesity, dyslipidemia, metabolic syndrome, and type 2 diabetes over the last decade [1-7]. Obesity-related insulin resistance is a key pathophysiology of diabetes development [8]. Various insulin resistance indices, such as Homeostasis Model Assessment for Insulin Resistance, insulin sensitivity index, triglyceride to high-density lipoprotein-cholesterol ratio, and triglyceride and glucose index have been proposed to identify and stratify insulin resistance in obese populations and to aid in the early detection and prevention of type 2 diabetes mellitus [9-12].
"Single point insulin sensitivity estimator for predicting type 2 diabetes mellitus in obese adolescents" by Ha et al. [13] investigated the usefulness of this recently proposed insulin sensitivity marker, the single point insulin sensitivity estimator (SPISE) index, for detecting blood glucose abnormalities or diabetes mellitus in Korean children with obesity. The SPISE index is a lipid- and body mass index-based index of insulin sensitivity that can predict metabolic syndrome in adolescents and adults with more accuracy than other lipid and fasting insulin-based indicators [14]. Furthermore, a recent large-scale longitudinal study from Italy confirmed the superiority of the SPISE index for predicting the development of blood glucose abnormalities among overweight/obese children compared with other insulin resistance indices [14].
This research is meaningful since it is the first to examine the clinical utility of the SPISE index in Korean children and adolescents with type 2 diabetes. In this work, the authors suggested that a low SPISE index (<4.49) was an independent factor of type 2 diabetes mellitus in overweight/obese children, after adjusting for well-known risk factors including family history, fatty liver, and/or obesity [13]. The main limitation of this study was that it was cross-sectional with a small number of cases. Large-scale longitudinal studies are needed to confirm that the SPISE index could be useful for predicting future diabetes development in Korean children.


Conflicts of interest

No potential conflict of interest relevant to this article was reported.


1. Chae J, Seo MY, Kim SH, Park MJ. Trends and risk factors of metabolic syndrome among Korean adolescents, 2007 to 2018. Diabetes Metab J 2021;45:880–9.
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2. Jeong DY, Kim SH, Seo MY, Kang SY, Park MJ. Trends in serum lipid profiles among Korean adolescents, 2007-2018. Diabetes Metab Syndr Obes 2021;14:4189–97.
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3. Gudi SK. Dairy consumption and risk of type-2 diabetes: the untold story. Ann Pediatr Endocrinol Metab 2021;26:14–8.
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4. Kim J, Lee J. Role of obesity-induced inflammation in the development of insulin resistance and type 2 diabetes: history of the research and remaining questions. Ann Pediatr Endocrinol Metab 2021;26:1–13.
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5. Kim M, Kim JH. Cardiometabolic risk factors and metabolic syndrome based on severity of obesity in Korean children and adolescents: data from the Korea National Health and Nutrition Examination Survey 2007-2018. Ann Pediatr Endocrinol Metab 2022;Jun 20 [Epub].
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7. Kim JY, Jeon JY. Role of exercise on insulin sensitivity and beta-cell function: is exercise sufficient for the prevention of youth-onset type 2 diabetes? Ann Pediatr Endocrinol Metab 2020;25:208–16.
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8. Nogueira-de-Almeida CA. Metabolic syndrome definition in adolescents should incorporate insulin resistance. Ann Pediatr Endocrinol Metab 2020;25:287–8.
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9. Kim JW, Park SH, Kim Y, Im M, Han HS. The cutoff values of indirect indices for measuring insulin resistance for metabolic syndrome in Korean children and adolescents. Ann Pediatr Endocrinol Metab 2016;21:143–8.
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10. Chu SY, Jung JH, Park MJ, Kim SH. Risk assessment of metabolic syndrome in adolescents using the triglyceride/ high-density lipoprotein cholesterol ratio and the total cholesterol/high-density lipoprotein cholesterol ratio. Ann Pediatr Endocrinol Metab 2019;24:41–8.
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11. Lee SH, Ahn MB, Choi YJ, Kim SK, Kim SH, Cho WK, et al. Comparison of different criteria for the definition of insulin resistance and its relationship to metabolic risk in children and adolescents. Ann Pediatr Endocrinol Metab 2020;25:227–33.
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12. Seo JY, Kim JH. Validation of surrogate markers for metabolic syndrome and cardiometabolic risk factor clustering in children and adolescents: a nationwide population-based study. PLoS One 2017;12:e0186050.
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13. Ha J, Oh YR, Kang E, Nam HK, Rhie YJ, Lee KH. Single point insulin sensitivity estimator for predicting type 2 diabetes mellitus in obese adolescents. Ann Pediatr Endocrinol Metab 2022;27:201–6.
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14. Barchetta I, Dule S, Bertoccini L, Cimini FA, Sentinelli F, Bailetti D, et al. The single-point insulin sensitivity estimator (SPISE) index is a strong predictor of abnormal glucose metabolism in overweight/obese children: a longterm follow-up study. J Endocrinol Invest 2022;45:43–51.
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