Surrogate Estimates of Insulin Sensitivity in Obese Youth along the Spectrum of Glucose Tolerance from Normal to Prediabetes to Diabetes

George, Lindsey A.; Bacha, Fida; Lee, So Jung; Tfayli, Hala; Andreatta, Elisa; Arslanian, Silva

doi:10.1210/jc.2010-2813

Cited by 109 publications

(116 citation statements)

References 38 publications

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“…Previous investigations suggested a lower degree of insulin resistance in PWS when compared to nonsyndromic obesity [24, 25]. However, in our study, either GH therapy [26] or obesity [27] could account for comparable insulin concentrations in those with PWS and obese controls. Considering the lack of hypoglycemia experienced by the children in the present study and the increase in glucose IP (see below), the lack of an increase in glucagon is normal [28].…”

Section: Discussioncontrasting

confidence: 58%

Hormonal and Metabolic Responses to a Single Bout of Resistance Exercise in Prader-Willi Syndrome

Rubin¹,

Clark²,

Haqq³

et al. 2017

Horm Res Paediatr

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Background: Prader-Willi syndrome (PWS) is characterized by excessive adiposity. Excess adiposity negatively affects hormonal and metabolic responses to aerobic exercise. This study determined whether PWS and/or adiposity affected hormonal and metabolic responses to resistance exercise. Methods: Eleven children with PWS (11.4 ± 3.1 years, 43.9 ± 7.5% body fat), 12 lean children (9.3 ± 1.4 years, 18.3 ± 4.9% body fat), and 13 obese children (9.6 ± 1.3 years, 40.3 ± 5.2% body fat) participated. The children stepped onto an elevated platform while wearing a weighted vest for 6 sets of 10 repetitions per leg (sets separated by 1 min of rest). For the children with PWS, the platform height was 23.0 cm and vest load was computed as (20% of stature × 50% of lean body mass)/23.0 cm. For the controls, the platform height was 20% of the stature and vest load 50% of the lean body mass. Blood samples were obtained before, immediately after, and during recovery from exercise (+15, +30, and +60 min). Results: All groups had similar catecholamine, insulin, and glucagon responses. The groups showed no major differences in glucose and lactate levels. The PWS children demonstrated earlier increases in fatty acids during recovery and higher glycerol and ketone levels than the controls. Conclusion: The PWS children demonstrated largely intact hormonal, glycolytic, and lipolytic responses to lower-body resistance exercise. In PWS, elevated ketone levels suggest an incomplete fat oxidation.

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Section: Discussioncontrasting

confidence: 58%

Hormonal and Metabolic Responses to a Single Bout of Resistance Exercise in Prader-Willi Syndrome

Rubin¹,

Clark²,

Haqq³

et al. 2017

Horm Res Paediatr

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“…Finally, the use of fasting insulin, or its inverse or HOMA, as surrogate estimates of insulin sensitivity, may perhaps be viewed as a limitation. However, our group has shown that these surrogate estimates correlate strongly with in vivo insulin sensitivity measured with the hyperinsulinemic-euglycemic clamp in youth with NGT, PD and diabetes [46], particularly when applied to large numbers.…”

Section: Discussionmentioning

confidence: 99%

Pre-diabetes in overweight youth and early atherogenic risk

Burns¹,

Lee²,

Bacha³

et al. 2014

Metabolism

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Purpose To compare atherogenic lipoprotein particles and vascular smooth muscle biomarkers in overweight youth with pre-diabetes (PD) vs. normal glucose tolerance (NGT). Methods 144 adolescents (60 black, 84 white; 102 female; PD=45, NGT=99) aged 10-19 years underwent a fasting blood draw and 2-hr OGTT. Lipoprotein particle size and subclass concentration and vascular smooth muscle biomarkers (ICAM-1, VCAM-1 and E-selectin) were compared between youth with PD and NGT. Results Compared with NGT, PD adolescents had smaller LDL (mean ± SE: 20.5 ± 0.1 vs. 21.0 ± 0.1 nm; P=0.002) and HDL (8.62 ± 0.05 vs. 8.85 ± 0.04 nm; P=0.013) size and elevated medium small (159.2 ± 10.3 vs. 123.8 ± 6.4 nmol/L; P=0.037) and very small (626.3 ± 45.4 vs. 458.5 ± 26.4 nmol/L; P=0.032) LDL particle concentrations, after adjustment for race and BMI. Further adjusting for fasting insulin or visceral adiposity obviated these differences between the groups except for LDL size. ICAM-1 and E-selectin did not differ in youth with PD but correlated with LDL and HDL size, and small LDL particle concentrations. Conclusions Overweight adolescents with PD have an atherogenic lipoprotein profile of small LDL and HDL size and increased concentrations of small LDL, moderated by insulin resistance and visceral adiposity, but independently driven by dysglycemia for LDL size. Associations between smooth muscle biomarkers and lipoproteins could be an early signal heralding the atherogenic process. It remains to be determined if correction of dysglycemia and associated lipoprotein abnormalities in obese youth could prove effective in halting this process.

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“…We used the Homeostatic Model Assessment V.2 (HOMA2), which is derived from fasting values, as an assessment of insulin sensitivity 21. Fasting insulin concentrations correlate well with insulin sensitivity as measured by the hyperinsulinemic clamp in adults22 and fasting-derived surrogates have been found to be robust in some paediatric studies as well 23. On the other hand, fasting values have also been deemed to be a poor measure of insulin sensitivity 20.…”

Section: Methodsmentioning

confidence: 99%

Catch-up growth and metabolic outcomes in adolescents born preterm

et al. 2016

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The association of rapid weight gain on health is time critical in those born preterm; in early infancy, this does not impact on metabolic status in adolescence, in contrast to rapid weight gain in childhood, which should be discouraged. However, given the critical importance of brain growth in the neonatal period and infancy, further research is needed before strategies that discourage infant weight gain or catch-up can be recommended for infants born preterm.

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Surrogate Estimates of Insulin Sensitivity in Obese Youth along the Spectrum of Glucose Tolerance from Normal to Prediabetes to Diabetes

Cited by 109 publications

References 38 publications

Hormonal and Metabolic Responses to a Single Bout of Resistance Exercise in Prader-Willi Syndrome

Hormonal and Metabolic Responses to a Single Bout of Resistance Exercise in Prader-Willi Syndrome

Pre-diabetes in overweight youth and early atherogenic risk

Catch-up growth and metabolic outcomes in adolescents born preterm

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