Co-existence of severe insulin resistance and hyperinsulinaemia in pre-adolescent obese children

被引:108
作者
Caprio, S
Bronson, M
Sherwin, RS
Rife, F
Tamborlane, WV
机构
[1] YALE UNIV, SCH MED, DEPT INTERNAL MED, NEW HAVEN, CT 06520 USA
[2] YALE UNIV, SCH MED, YALE CHILDRENS GEN CLIN RES CTR, NEW HAVEN, CT 06520 USA
关键词
obesity; preadolescents; hyperinsulinaemia; insulin resistance;
D O I
10.1007/s001250050603
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
To determine the time course of changes in insulin action and secretion that occur early during the development of obesity, we studied children before the onset of puberty. The reason for choosing the prepubertal stage of development is that it is metabolically characterized by both a high sensitivity to insulin and low glucose stimulated insulin responses. Fifteen obese preadolescents (8 male/7 female, age 10 +/- 0.4 years, body mass index (BMI) 31 +/- 1.2 kg/m(2) Tamer Stage I) with a duration of obesity of less than 5 years and 10 non-obese preadolescents (6 male/4 female, age 10+/-0.4 years, BMI 18 +/- 0.9 kg/m(2)) matched for gender were studied. In a cross-sectional analysis, we compared responses in obese preadolescents, with those in obese adolescents and obese adults with a longer duration of obesity. The euglycaemic hyperinsulinaemic clamp with 1-C-13-glucose (Hot Ginf) and indirect calorimetry were used to quantitate insulin action and the hyperglycaemic clamp used to assess beta-cell function. Insulin-stimulated glucose uptake measured at two physiological levels of hyperinsulinaemia (similar to 180 and 480 pmol) was reduced by 20 and 45 % in all three groups of obese compared to non-obese subjects (p < 0.01). Defects in oxidative and non-oxidative glucose metabolism were observed in all three groups of obese subjects at the higher insulin infusion rate. The ability of insulin to inhibit lipid oxidation was impaired in all three obese groups at both levels of hyperinsulinaemia: Increases in basal and glucose-stimulated insulin levels during the hyperglycaemic damp mirrored the reductions in glucose uptake during the insulin clamp in all obese groups. These results indicate that insulin resistance and hyperinsulinaemia co-exist in preadolescent children with moderate to severe obesity.
引用
收藏
页码:1489 / 1497
页数:9
相关论文
共 37 条
  • [1] ABBOTT N, 1987, METAB CLIN EXP, V36, P568
  • [2] AMIEL S, 1995, J CLIN ENDOCR METAB, V72, P277
  • [3] IMPAIRED INSULIN ACTION IN PUBERTY - A CONTRIBUTING FACTOR TO POOR GLYCEMIC CONTROL IN ADOLESCENTS WITH DIABETES
    AMIEL, SA
    SHERWIN, RS
    SIMONSON, DC
    LAURITANO, AA
    TAMBORLANE, WV
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1986, 315 (04) : 215 - 219
  • [4] BAGDADE JD, 1974, J LAB CLIN MED, V83, P563
  • [5] RELATIONSHIP OF ISLET FUNCTION TO INSULIN ACTION IN HUMAN OBESITY
    BEARD, JC
    WARD, WK
    HALTER, JB
    WALLUM, BJ
    PORTE, D
    [J]. JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1987, 65 (01) : 59 - 64
  • [6] MECHANISMS OF FATTY ACID-INDUCED INHIBITION OF GLUCOSE-UPTAKE
    BODEN, G
    CHEN, XH
    RUIZ, J
    WHITE, JV
    ROSSETTI, L
    [J]. JOURNAL OF CLINICAL INVESTIGATION, 1994, 93 (06) : 2438 - 2446
  • [7] TOTAL-BODY FAT-CONTENT AND FAT TOPOGRAPHY ARE ASSOCIATED DIFFERENTLY WITH INVIVO GLUCOSE-METABOLISM IN NONOBESE AND OBESE NONDIABETIC WOMEN
    BONORA, E
    DELPRATO, S
    BONADONNA, RC
    GULLI, G
    SOLINI, A
    SHANK, ML
    GHIATAS, AA
    LANCASTER, JL
    KILCOYNE, RF
    ALYASSIN, AM
    DEFRONZO, RA
    [J]. DIABETES, 1992, 41 (09) : 1151 - 1159
  • [8] INCREASED INSULIN-SECRETION IN PUBERTY - A COMPENSATORY RESPONSE TO REDUCTIONS IN INSULIN SENSITIVITY
    CAPRIO, S
    PLEWE, G
    DIAMOND, MP
    SIMONSON, DC
    BOULWARE, SD
    SHERWIN, RS
    TAMBORLANE, WV
    [J]. JOURNAL OF PEDIATRICS, 1989, 114 (06) : 963 - 967
  • [9] CENTRAL ADIPOSITY AND ITS METABOLIC CORRELATES IN OBESE ADOLESCENT GIRLS
    CAPRIO, S
    HYMAN, LD
    LIMB, C
    MCCARTHY, S
    LANGE, R
    SHERWIN, RS
    SHULMAN, G
    TAMBORLANE, WV
    [J]. AMERICAN JOURNAL OF PHYSIOLOGY-ENDOCRINOLOGY AND METABOLISM, 1995, 269 (01): : E118 - E126
  • [10] OXIDATIVE FUEL METABOLISM DURING MILD HYPOGLYCEMIA - CRITICAL ROLE OF FREE FATTY-ACIDS
    CAPRIO, S
    GELFAND, RA
    TAMBORLANE, WV
    SHERWIN, RS
    [J]. AMERICAN JOURNAL OF PHYSIOLOGY, 1989, 256 (03): : E413 - E419