{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T12:51:38Z","timestamp":1777639898319,"version":"3.51.4"},"reference-count":61,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2008,6,1]],"date-time":"2008-06-01T00:00:00Z","timestamp":1212278400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Food Nutr Bull"],"published-print":{"date-parts":[[2008,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Worldwide obesity has become an unprecedented public health challenge. In addition, a notable increase in the risk of insulin resistance and type 2 diabetes mellitus has emerged. In Costa Rica, there are no epidemiological data to establish the prevalence of type 2 diabetes in the pediatric population. However, information from the Endocrinology Department of the Children's National Hospital indicates an increased number of cases in the last 2 to 3 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine the prevalence of insulin resistance and impaired glucose tolerance in overweight and obese schoolchildren.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study was conducted among 214 healthy 8- to 10-year-old children from urban schools of San Jos\u00e9, Costa Rica. Anthropometric measurements and blood determinations of glucose, insulin, proinsulin, glycosylated hemoglobin, C-peptide, and leptin were performed. Indexes were calculated to assess insulin resistance. Information on social and lifestyle variables was obtained from questionnaires, and acanthosis nigricans was certified by a physician. Statistical analysis was performed with SPSS software for Windows, version 10.0.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The prevalence of type 2 diabetes mellitus was very low (0.5%) in the studied population. However, hyperinsulinemia and impaired glucose tolerance were present in 20.6% and 6.5% of the subjects, respectively. On the basis of the Fasting Glucose-to-Insulin Resistance Ratio (FGIR), 46.7% of the children showed insulin resistance. Girls and obese children (body mass index \u2265 95th percentile) were more likely to have higher serum insulin levels and insulin resistance than boys and over-weight children (BMI \u2265 85th percentile). Compared with the lowest quintile, children in the highest quintile of body-fat tissue had higher insulin resistance but had similar serum concentrations of glucose, C-peptide, and proinsulin. Positive family histories of type 2 diabetes mellitus and sedentarism (73.7% and 40.7%, respectively) were highly prevalent among overweight and obese children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The prevalence of impaired glucose tolerance and insulin resistance in obese children indicates a worrisome trend in the incidence of type 2 diabetes in Costa Rica. Strategies for weight reduction, obesity prevention, and promotion of healthy lifestyles are necessary to prevent the onset of type 2 diabetes during childhood and adolescence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/156482650802900206","type":"journal-article","created":{"date-parts":[[2015,11,25]],"date-time":"2015-11-25T16:02:41Z","timestamp":1448467361000},"page":"123-131","source":"Crossref","is-referenced-by-count":13,"title":["Insulin Resistance and Impaired Glucose Tolerance in Overweight and Obese Costa Rican Schoolchildren"],"prefix":"10.1177","volume":"29","author":[{"given":"Ileana","family":"Holst-Schumacher","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hilda","family":"Nu\u00f1ez-Rivas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafael","family":"Monge-Rojas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mauro","family":"Barrantes-Santamar\u00eda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2008,6,10]]},"reference":[{"key":"bibr1-156482650802900206","volume-title":"The challenge of obesity in WHO European Region and the strategies for response. Summary","author":"Brama F","year":"2007"},{"key":"bibr2-156482650802900206","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/131.3.893S"},{"key":"bibr3-156482650802900206","doi-asserted-by":"publisher","DOI":"10.1017\/S000711450000088X"},{"key":"bibr4-156482650802900206","doi-asserted-by":"publisher","DOI":"10.1097\/00008480-200308000-00010"},{"key":"bibr5-156482650802900206","doi-asserted-by":"crossref","first-page":"1395S","DOI":"10.1515\/jpem-2000-s613","volume":"13","author":"Fogot-Campagna A","year":"2000","journal-title":"J Pediatr Endocrinol Metab"},{"key":"bibr6-156482650802900206","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69703-1"},{"key":"bibr7-156482650802900206","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcl.2005.07.009"},{"key":"bibr8-156482650802900206","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2006-0690"},{"key":"bibr9-156482650802900206","doi-asserted-by":"publisher","DOI":"10.2337\/diaspect.18.4.213"},{"key":"bibr10-156482650802900206","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2003.09.045"},{"key":"bibr11-156482650802900206","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.27.2.314"},{"key":"bibr12-156482650802900206","doi-asserted-by":"publisher","DOI":"10.1590\/S1020-49892003000100004"},{"key":"bibr13-156482650802900206","volume-title":"Obesity: Preventing and managing the global epidemic. World Health Organ Tech Rep Ser 894","author":"World Health Organization","year":"2000"},{"key":"bibr14-156482650802900206","volume-title":"Physical status: The use and interpretation of anthropometry. World Health Organ Tech Rep Ser No. 854","author":"World Health Organization","year":"1995"},{"key":"bibr15-156482650802900206","volume-title":"Anthropometric standardization reference manual","author":"Lohman TG","year":"1998"},{"key":"bibr16-156482650802900206","volume-title":"Procedures for the collection of diagnostic blood specimens by venipunture, approved standard","author":"Clinical and Laboratory Standards Institute","year":"1991","edition":"5"},{"key":"bibr17-156482650802900206","doi-asserted-by":"publisher","DOI":"10.1007\/BF00280883"},{"key":"bibr18-156482650802900206","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.85.7.6661"},{"key":"bibr19-156482650802900206","first-page":"2863","volume":"86","author":"Silfen ME","year":"2001","journal-title":"J Clin Endocrinol Metab"},{"key":"bibr20-156482650802900206","doi-asserted-by":"publisher","DOI":"10.1515\/JPEM.2004.17.2.183"},{"key":"bibr21-156482650802900206","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.26.11.3160"},{"key":"bibr22-156482650802900206","volume-title":"La construcci\u00f3n de \u00edndices. Editorial de la Universidad de Costa Rica","author":"Madrigal J","year":"1997"},{"key":"bibr23-156482650802900206","first-page":"2","volume":"15","author":"Nu\u00f1ez-Rivas H","year":"2003","journal-title":"Bolet\u00edn INCIENSA"},{"key":"bibr24-156482650802900206","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2003.027821"},{"key":"bibr25-156482650802900206","first-page":"1","volume":"17","author":"Herder C","year":"2007","journal-title":"Int J Obes"},{"key":"bibr26-156482650802900206","first-page":"1443","volume":"188","author":"Czernichow P","year":"2004","journal-title":"Bull Acad Natl Med"},{"key":"bibr27-156482650802900206","doi-asserted-by":"publisher","DOI":"10.2337\/dc06-0709"},{"key":"bibr28-156482650802900206","doi-asserted-by":"publisher","DOI":"10.1001\/jama.286.10.1195"},{"key":"bibr29-156482650802900206","doi-asserted-by":"publisher","DOI":"10.3928\/0090-4481-20070201-10"},{"key":"bibr30-156482650802900206","doi-asserted-by":"publisher","DOI":"10.1542\/peds.105.3.671"},{"key":"bibr31-156482650802900206","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2005.08.059"},{"key":"bibr32-156482650802900206","doi-asserted-by":"publisher","DOI":"10.2337\/diabetes.50.11.2444"},{"key":"bibr33-156482650802900206","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa012578"},{"key":"bibr34-156482650802900206","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.20.1.45"},{"key":"bibr35-156482650802900206","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1997.03550210047037"},{"key":"bibr36-156482650802900206","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1520-6300(1999)11:2<259::AID-AJHB13>3.0.CO;2-W"},{"key":"bibr37-156482650802900206","first-page":"263","volume":"97","author":"Weiss R","year":"2006","journal-title":"Minerva Med"},{"key":"bibr38-156482650802900206","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)14364-4"},{"key":"bibr39-156482650802900206","doi-asserted-by":"publisher","DOI":"10.2337\/diabetes.48.8.1515"},{"key":"bibr40-156482650802900206","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2004-2001"},{"key":"bibr41-156482650802900206","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2004-0339"},{"key":"bibr42-156482650802900206","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.86.10.7956"},{"key":"bibr43-156482650802900206","doi-asserted-by":"publisher","DOI":"10.1053\/meta.2002.34029"},{"key":"bibr44-156482650802900206","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2004-1921"},{"key":"bibr45-156482650802900206","first-page":"187","volume":"20","author":"Atabeck ME","year":"2007","journal-title":"J Pediatr Endocrinol Metab"},{"key":"bibr46-156482650802900206","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.87.1.8292"},{"key":"bibr47-156482650802900206","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2004-0329"},{"key":"bibr48-156482650802900206","doi-asserted-by":"crossref","unstructured":"Slinger JD, van Breda E, Keizer H, Rump P, Hornstra G, Kuipers H. Insulin resistance, physical fitness, body composition and leptin concentration in 7\u20138 year old children. J Sci Med Sport 2007;8 [Epub ahead of print] (Abstract).","DOI":"10.1016\/j.jsams.2006.10.004"},{"key":"bibr49-156482650802900206","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.25.12.2353"},{"key":"bibr50-156482650802900206","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.27.6.1412"},{"key":"bibr51-156482650802900206","doi-asserted-by":"publisher","DOI":"10.1067\/mpd.2001.112657"},{"key":"bibr52-156482650802900206","first-page":"7","volume":"103","author":"Hirschler V","year":"2005","journal-title":"Arch Argent Pediatr"},{"key":"bibr53-156482650802900206","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.92.11.3249"},{"key":"bibr54-156482650802900206","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/46.3.403"},{"key":"bibr55-156482650802900206","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2006.09.039"},{"key":"bibr56-156482650802900206","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2006.09.014"},{"key":"bibr57-156482650802900206","doi-asserted-by":"publisher","DOI":"10.1139\/H07-033"},{"key":"bibr58-156482650802900206","doi-asserted-by":"publisher","DOI":"10.1139\/H07-030"},{"key":"bibr59-156482650802900206","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2006.12.051"},{"key":"bibr60-156482650802900206","first-page":"685S","volume":"19","author":"Lee M","year":"2007","journal-title":"Am J Cardiol"},{"key":"bibr61-156482650802900206","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ijo.0803195"}],"container-title":["Food and Nutrition Bulletin"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/156482650802900206","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/156482650802900206","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T06:15:09Z","timestamp":1777443309000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/156482650802900206"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,6]]},"references-count":61,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2008,6]]}},"alternative-id":["10.1177\/156482650802900206"],"URL":"https:\/\/doi.org\/10.1177\/156482650802900206","relation":{},"ISSN":["0379-5721","1564-8265"],"issn-type":[{"value":"0379-5721","type":"print"},{"value":"1564-8265","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,6]]}}}