Predictors of insulin resistance in pediatric injury survivors 24 to 36 months post burn

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 780-806-Determinants of Insulin Resistance & Associated Metabolic Disturbances
Basic/Translational
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-792
Maria Chondronikola*1, Walter John Meyer III2, Labros S Sidossis3, Sylvia Ojeda4, Joanna Huddleston4, Pamela Stevens4, Elisabet Borsheim4, Oscar E Suman4, Celeste C Finnerty4 and David N Herndon2
1University of Texas Medical Branch at Galveston, Galveston, TX, 2Shriners Hospital for Children, Galveston, TX, 3Shriners Hospital for Children, 4Shriners Hospital for Children-Galveston
Background: Burn injury is a dramatic event with acute and chronic metabolic consequences including insulin resistance. In some, but not all patients insulin resistance persists up at least 36 months post-injury.

Purpose: To identify factors associated with insulin resistance in long-term pediatric burn injury survivors.

Methods: The study sample consisted of 61 pediatric burn injury survivors (burn size ≥ 40% total body surface area, 3 to 21 years old) who underwent an oral glucose tolerance test (OGTT) 24 to 36 months after burn injury. Insulin resistance was calculated as the ratio of the area under the curve for glucose (AUCglu) and the area under the curve for insulin (AUCins). The diagnostic criteria of the American Diabetes Association (ADA) were used to define individuals with impaired glucose metabolism. Additional data collected include body composition and anthropometric measurements, burn related characteristics and demographic information. The data were analyzed using multivariate linear regression analysis.

Results: Twelve percent of the patients met the ADA criteria for impaired glucose metabolism. Burn size, percent body fat and age were associated with AUCglu (p<0.05 for all). Lean mass and time post-burn were inversely associated with AUCglu (p<0.05 for both).  Similarly, age was associated with higher AUCins  (p<0.001) and decreased AUCglu/AUCins ratio after adjusting for sex, burn size, weight status and percent body fat.

Conclusion: A significant proportion of pediatric injury survivors suffer from impaired glucose metabolism 24-36 months post burn. Burn size, time post burn, lean body mass, adiposity and age are significant predictors of insulin resistance in pediatric burn injury survivors. Clinical evaluation and screening for abnormal glucose metabolism should be emphasized in patients with large burns, older age and survivors with high body fat for many years post injury.

Nothing to Disclose: MC, WJM III, LSS, SO, JH, PS, EB, OES, CCF, DNH

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm

Sources of Research Support: NIDDR:H133A070026NIH: P50 GM 060338; RO1 049471; RO1-GM56687Shriners 84080; 84090; 843309; 71008; 8660; 9145; 79135; 71009; 8760; KL2RR209875; UL1RR029876Maria Chondronikola is supported from the Onassis Foundation Scholarship.