期刊
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
卷 104, 期 8, 页码 3481-3490出版社
ENDOCRINE SOC
DOI: 10.1210/jc.2019-00161
关键词
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资金
- National Institutes of Health/National Institute of Child Health and Human Development [R01-HD-40787, R01-HD-28016, K24-HD-01464]
- National Institute of Diabetes and Digestive and Kidney Diseases Clinical and Translational Science Award from the National Center for Research Resources, a component of the National Institutes of Health [UL1-RR-0249139]
- American Diabetes Association
- National Institute of Diabetes and Digestive and Kidney Diseases [R01-DK-111038]
- Robert E. Leet and Clara Guthrie Patterson Trust Mentored Research Award
- Pediatric Endocrine Society
- European Society for Pediatric Endocrinology Long-term Research Fellowship
Context: The consumption of high-fructose beverages is associated with a higher risk for obesity and diabetes. Fructose can stimulate glucagon-like peptide 1 (GLP-1) secretion in lean adults, in the absence of any anorexic effect. Objective: We hypothesized that the ingestion of glucose and fructose may differentially stimulate GLP-1 and insulin response in lean adolescents and adolescents with obesity. Design: We studied 14 lean adolescents [four females; 15.9 +/- 1.6 years of age; body mass index (BMI), 21.8 +/- 2.2 kg/m(2)] and 23 adolescents with obesity (five females; 15.1 +/- 1.6 years of age; BMI, 34.5 +/- 4.6 kg/m(2)). Participants underwent a baseline oral glucose tolerance test to determine their glucose tolerance and estimate insulin sensitivity and beta-cell function [oral disposition index (oDI(cpep))]. Eligible subjects received, in a double-blind, crossover design, 75 g of glucose or fructose. Plasma was obtained every 10 minutes for 60 minutes for the measures of glucose, insulin, and GLP-1 (radioimmunoassay) and glucose-dependent insulinotropic polypeptide (GIP; ELISA). Incremental glucose and hormone levels were compared between lean individuals and those with obesity by a linear mixed model. The relationship between GLP-1 increment and oDI(cpep) was evaluated by regression analysis. Results: Following the fructose challenge, plasma glucose excursions were similar in both groups, yet the adolescents with obesity exhibited a greater insulin (P < 0.001) and GLP-1 (P < 0.001) increase than did their lean peers. Changes in GIP were similar in both groups. After glucose ingestion, the GLP-1 response (P < 0.001) was higher in the lean group. The GLP-1 increment during 60 minutes from fructose drink was correlated with a lower oDI(cpep) (r(2) = 0.22, P = 0.009). Conclusion: Fructose, but not glucose, ingestion elicits a higher GLP-1 and insulin response in adolescents with obesity than in lean adolescents. Fructose consumption may contribute to the hyperinsulinemic phenotype of adolescent obesity through a GLP-1-mediated mechanism.
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