Journal
ACTA DIABETOLOGICA
Volume 56, Issue 2, Pages 219-226Publisher
SPRINGER-VERLAG ITALIA SRL
DOI: 10.1007/s00592-018-01285-3
Keywords
Pediatric obesity; Insulin resistance; Fatty acid; Adipose tissue
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Funding
- National Institutes of Health (NIH) [R01-HD-40787, R01-HD-28016]
- ADA Distinguished Clinical Scientist Awards from the American Diabetes Association [DK-49230]
- National Center for Advancing Translational Science [UL1 RR024139]
- NIH [DK045735]
- NIH roadmap for Medical Research
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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.
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