Relation of the degree of obesity in childhood to adipose tissue insulin resistance.

Content Provider	Europe PMC
Author	Hagman, Emilia Besor, Omri Hershkop, Karen Santoro, Nicola Pierpont, Bridget Mata, Mariana Caprio, Sonia Weiss, Ram
Abstract	AimsIn 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.MethodsSubjects 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.ResultsIn 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.ConclusionsThe 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.Electronic supplementary materialThe online version of this article (10.1007/s00592-018-01285-3) contains supplementary material, which is available to authorized users.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC6373259&blobtype=pdf
ISSN	09405429
Journal	Acta Diabetologica [Acta Diabetol]
Volume Number	56
DOI	10.1007/s00592-018-01285-3
PubMed Central reference number	PMC6373259
Issue Number	2
PubMed reference number	30637483
e-ISSN	14325233
Language	English
Publisher	Springer Milan
Publisher Date	2019-01-12
Publisher Place	Milan
Access Restriction	Open
Rights License	OpenAccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. © The Author(s) 2019
Subject Keyword	Pediatric obesity Insulin resistance Fatty acid Adipose tissue
Content Type	Text
Resource Type	Article
Subject	Endocrinology, Diabetes and Metabolism Internal Medicine Endocrinology