Managed by Antonio Secchi.
The online version of this article (https://doi.org/10.1007/s00592-018-01285-3) contains supplementary material, which is available to authorized users.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
In this study, we investigated whether adipose tissue insulin resistance (IR) is affected by the degree of obesity during the fasting and post-prandial state, independent of glucose tolerance among obese children and adolescents. We also tested whether systemic subclinical inflammation is associated with adipose tissue IR.
Subjects were recruited to the Yale Pathophysiology of Type 2 Diabetes in Youth Study (NCT01967849). An oral glucose-tolerance test was performed to establish glucose-tolerance status and blood samples were drawn for measurement of free fatty acids (FFAs), to calculate the area under the curve (AUC) of FFA. Adipose tissue insulin resistance was calculated as the product of insulin and FFA concentrations.
In total, 671 children and adolescents (58.6% females) were included with a mean age of 13.3(2.7) years and BMI Z score of 2.45(0.31). The degree of obesity emerged as an independent predictor of both fasting and post-prandial adipose IR, p < 0.0001. Higher degree of obesity was associated with greater AUC FFA (lower suppression) compared to lower degree of obesity, p = 0.01. Furthermore, higher levels of IL-6 were positively associated with post-prandial adipose tissue IR, p = 0.02.
The degree of obesity in childhood and adolescence is strongly associated with adipose tissue IR independent of glucose tolerance. This is reflected not only in calculated indices of adipose IR but also in lower suppression of FFAs during the OGTT regardless of glucose tolerance or fasting adipose tissue IR. Furthermore, markers of subclinical inflammation such as IL-6 are associated with adipose tissue IR, independent of other factors.
Supplementary material 1 (DOCX 28 KB)592_2018_1285_MOESM1_ESM.docx
Reinehr T, Kiess W, Andler W (2005) Insulin sensitivity indices of glucose and free fatty acid metabolism in obese children and adolescents in relation to serum lipids. Metab Clin Exp 54(3):397–402. https://doi.org/10.1016/j.metabol.2004.10.008 CrossRefPubMed
Toledo-Corral CM, Alderete TL, Richey J, Sequeira P, Goran MI, Weigensberg MJ (2015) Fasting, post-OGTT challenge, and nocturnal free fatty acids in prediabetic versus normal glucose tolerant overweight and obese Latino adolescents. Acta Diabetol 52(2):277–284. https://doi.org/10.1007/s00592-014-0634-7 CrossRefPubMed
Zabarsky G, Beek C, Hagman E, Pierpont B, Caprio S, Weiss R (2018) Impact of severe obesity on cardiovascular risk factors in youth. J Pediatr 192:105–114. https://doi.org/10.1016/j.jpeds.2017.09.066 CrossRefPubMed
Kuczmarski RJ, Ogden CL, Guo SS et al (2002) 2000 CDC growth charts for the United States: methods and development. Vital Health Stat 11(246):1–190
Matsuda M, DeFronzo RA (1999) Insulin sensitivity indices obtained from oral glucose tolerance testing: comparison with the euglycemic insulin clamp. Diabetes Care 22(9):1462–1470 CrossRef
Hughan KS, Bonadonna RC, Lee S, Michaliszyn SF, Arslanian SA (2013) beta-Cell lipotoxicity after an overnight intravenous lipid challenge and free fatty acid elevation in African American versus American white overweight/obese adolescents. J Clin Endocrinol Metab 98(5):2062–2069. https://doi.org/10.1210/jc.2012-3492 CrossRefPubMedPubMedCentral
Michaliszyn SF, Bonadonna RC, Sjaarda LA, Lee S, Farchoukh L, Arslanian SA (2013) beta-Cell lipotoxicity in response to free fatty acid elevation in prepubertal youth: African American versus Caucasian contrast. Diabetes 62(8):2917–2922. https://doi.org/10.2337/db12-1664 CrossRefPubMedPubMedCentral
Perry RJ, Camporez JG, Kursawe R et al (2015) Hepatic acetyl CoA links adipose tissue inflammation to hepatic insulin resistance and type 2 diabetes. Cell 160(4):745–758. https://doi.org/10.1016/j.cell.2015.01.012 CrossRefPubMedPubMedCentral
Kim JY, Nasr A, Tfayli H, Bacha F, Michaliszyn SF, Arslanian S (2017) Increased lipolysis, diminished adipose tissue insulin sensitivity, and impaired beta-cell function relative to adipose tissue insulin sensitivity in obese youth with impaired glucose tolerance. Diabetes 66(12):3085–3090. https://doi.org/10.2337/db17-0551 CrossRefPubMedPubMedCentral
Caprio S, Perry R, Kursawe R (2017) Adolescent obesity and insulin resistance: roles of ectopic fat accumulation and adipose inflammation. Gastroenterology 152(7):1638–1646. https://doi.org/10.1053/j.gastro.2016.12.051 CrossRefPubMed
Gastaldelli A, Harrison SA, Belfort-Aguilar R et al (2009) Importance of changes in adipose tissue insulin resistance to histological response during thiazolidinedione treatment of patients with nonalcoholic steatohepatitis. Hepatology 50(4):1087–1093. https://doi.org/10.1002/hep.23116 CrossRefPubMed
- Relation of the degree of obesity in childhood to adipose tissue insulin resistance
- Springer Milan
Neu im Fachgebiet Innere Medizin
Meistgelesene Bücher aus der Inneren Medizin
Mail Icon II