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Insulin resistance and hyperinsulinemia in prepubertal obese children
Assimina Galli-Tsinopoulou1, Michael Karamouzis, Sanda Nousia-Arvanitakis
114th Department of Pediatrics, Aristotle University of Thessaloniki, Greece. galtsin@otenet.gr
Insights
Obese children, even before puberty, show signs of hyperinsulinemia and insulin resistance. Early intervention to manage weight is crucial to prevent long-term complications associated with insulin insensitivity.
Area of Science:
- Pediatric Endocrinology
- Metabolic Health
- Obesity Research
Background:
- Obesity is linked to insulin resistance, where tissues respond poorly to insulin.
- Pancreatic beta-cells compensate by increasing insulin secretion to maintain glucose balance.
Purpose of the Study:
- To prospectively evaluate hyperinsulinemia and insulin resistance in obese children and adolescents.
- To compare metabolic markers between obese and non-obese pediatric groups.
Main Methods:
- Measured fasting glucose (FG) and insulin (FI) levels, and calculated fasting glucose to insulin ratio (FGIR).
- Included obese and non-obese prepubertal children and adolescents.
- Administered oral glucose tolerance tests to assess glucose and insulin responses.
Main Results:
- Elevated FI (>24 microU/ml) observed in 54% of obese prepubertal children and 80% of obese adolescents.
- Low FGIR (<6) indicative of insulin resistance found in 88% of obese prepubertal children and 100% of obese adolescents.
- Insulin resistance markers were also present in a significant portion of non-obese adolescents.
Conclusions:
- Hyperinsulinemia and insulin resistance are present in obese children, including prepubertal individuals.
- Early detection and weight management before puberty are recommended to prevent complications.
- Addressing insulin insensitivity in childhood obesity can mitigate long-term health risks.
Background:
Tissue resistance to insulin has been demonstrated in obese individuals. Pancreatic beta-cells respond to the reduced tissue sensitivity with increased insulin secretion so that glucose homeostasis is maintained.
Objective:
The purpose of this prospective study was to investigate the presence of hyperinsulinemia and insulin resistance in obese children and adolescents.
Subjects And Methods:
Fasting glucose (FG) and insulin (FI) levels and fasting glucose to insulin ratio (FGIR) were measured in 26 obese prepubertal children and 20 obese adolescents, as compared to 20 non-obese prepupertal children and 20 adolescents with normal body weight. Furthermore, obese children and adolescents underwent an oral glucose tolerance test with measurements of glucose and insulin 2 hours post glucose load.
Results:
In 14/26 (54%) obese prepubertal children and in 16/20 (80%) obese adolescents FI was >24 microU/ml. FGIR was <6 in 23/26 (88%) prepubertal obese children and in all obese adolescents. All non-obese prepubertal children and adolescents had normal FI. However, FGIR was <6 in 6/20 (30%) non-obese prepubertal children and in 15/20 (75%) non-obese adolescents.
Conclusion:
Hyperinsulinemia and insulin resistance are already present in prepubertal obese children. As hyperinsulinemia is a potentially reversible condition and the complications related to it may be prevented, early measurements should be undertaken so that obese children lose body weight before the onset of puberty which may enhance the problem of insulin insensitivity.