Pubertal Changes of Insulin Sensitivity, Acute Insulin Response, and β-Cell Function in Overweight Latino Youth

Objective To examine changes in insulin sensitivity (SI), compensatory acute insulin response (AIR), and beta-cell function/disposition index (DI) across puberty in overweight Latino boys and girls. Study design Latino children (n = 253) were followed annually for up to 5 years. Longitudinal modeling was used to examine changes in SI, AIR, DI, and fasting and 2-hour glucose and insulin across Tanner stage. Results In boys, SI decreased in early puberty with a recovery by late puberty. The compensatory increase in AIR was appropriate in early maturation, but after Tanner stage 3, AIR declined by more than that predicted from the recovery in SI. For girls, SI decreased in early puberty and across all stages of maturation. In early maturation, there was an appropriate compensatory increase in AIR, but after Tanner stage 3, AIR decreased. Thus, DI deteriorated across puberty in boys and girls. Conclusions In overweight Hispanic youth, compensatory changes in insulin secretion fails after Tanner stage 3 in both sexes, indicating b-cell deterioration during this critical period of development, thus increasing risk for type 2 diabetes. (J Pediatr 2011;158:442-6).