Adipose tissue insulin resistance in adolescents with and without type 2 diabetes.

Abstract:

BACKGROUND:The incidence of type 2 diabetes mellitus (T2D) is increasing in youth, yet little is known about the underlying pathophysiology. Decreased insulin suppression of lipolysis and elevated non-esterified free fatty acid (NEFA) concentrations are known to be associated with insulin resistance and T2D in adults, but less is known about the relationship in adolescents. OBJECTIVES:This study aimed to assess adipose tissue insulin resistance (IR; insulin suppression of lipolysis) and its metabolic correlates in lean, obese and T2D adolescents. METHODS:Forty-seven lean, obese and T2D youth underwent hyperinsulinaemic (80 mU*m(-2) *min(-1)) euglycaemic clamps. NEFAs were measured at baseline and during steady state. Insulin-mediated suppression of lipolysis (%NEFA suppression from baseline) was calculated, and metabolic risk factors were assessed by %NEFA suppression tertile. RESULTS:There was expected variability in %NEFA suppression within obese and T2D youth, but a subset had significantly reduced suppression of lipolysis. NEFA suppression tertile was significantly inversely associated with fasting triglycerides (P = 0.0001), log alanine aminotransferase (ALT; P = 0.02) and low-density lipoprotein cholesterol (P = 0.0002). CONCLUSIONS:Marked adipose tissue IR occurs in some obese and T2D adolescents, which may result in release of triglycerides into the circulation and liver deposition of fatty acids, as evidenced by higher ALT in poor NEFA suppressors.

journal_name

Pediatr Obes

journal_title

Pediatric obesity

authors

Kelsey MM,Forster JE,Van Pelt RE,Reusch JE,Nadeau KJ

doi

10.1111/j.2047-6310.2013.00189.x

subject

Has Abstract

pub_date

2014-10-01 00:00:00

pages

373-80

issue

5

eissn

2047-6302

issn

2047-6310

journal_volume

9

pub_type

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