2.2.2. Metabolic Assessment

Blood samples were collected from fasting participants scheduled early in the morning. Glucose and insulin measurements and a lipid panel were requested for every patient. The homeostatic model assessment (HOMA) index of IR was measured as the product of insulin (μU/mL) and glucose (mmol/L) divided by 22.5. Hyperinsulinism was defined according to pubertal stage normative data [57].

Adipokine laboratory measurements were obtained from the Cardiovascular Risk Unit Laboratory at Hospital General of Valencia (Valencia, Spain). Ghrelin, leptin, and adiponectin were measured using commercially available BMS 2192, BMS 2039, and BMS 2032/2 eBioscience ELISA kits. The leptin assay detection limit was set at 894 ng/L. Adiponectin assay range was set from 764 μg/L to 16,893 μg/L. The ghrelin assay was set from a mean value of 915 pg/mL.
