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Urinary C-peptide excretion in obese and anorectic children
M Wallensteen1, B E Ginsburg, B Persson
1Department of Paediatrics, Karolinska Institute, St Göran's Children's Hospital, Stockholm, Sweden.
Insights
Obese children show normal insulin secretion per kilogram, indicating increased total insulin. Anorexic girls exhibit significantly higher insulin secretion relative to body weight.
Area of Science:
- Pediatric Endocrinology
- Metabolic Disorders
- Nutritional Science
Background:
- Insulin secretion is crucial for metabolic regulation.
- Nutritional status significantly impacts endocrine function.
- Assessing insulin secretion in pediatric populations requires nuanced approaches.
Purpose of the Study:
- To evaluate total insulin secretion in children with obesity and anorexia nervosa.
- To compare insulin secretion rates across different nutritional states.
- To utilize 24-hour urinary C-peptide excretion as a marker of insulin production.
Main Methods:
- Analysis of 24-hour urinary C-peptide excretion in 32 obese children (8-15 years).
- Assessment of 7 adolescent girls diagnosed with anorexia nervosa.
- Comparison of excretion rates with age-matched normal-weight control groups.
Main Results:
- Obese children demonstrated similar urinary C-peptide excretion per kilogram compared to normal-weight peers.
- Anorectic girls exhibited significantly higher urinary C-peptide excretion per kilogram (p < 0.05) than normal-weight girls.
- These findings suggest increased total insulin secretion in obesity and elevated relative insulin secretion in anorexia nervosa.
Conclusions:
- Obesity in children is associated with normal insulin secretion per body weight, implying an overall increase in insulin production.
- Anorexia nervosa in adolescent girls is characterized by increased insulin secretion relative to body weight.
- Urinary C-peptide excretion is a valuable tool for assessing insulin secretion dynamics in pediatric metabolic conditions.
Abstract:
To assess the total insulin secretion in children in different nutritional states we have analysed the 24 h urinary C-peptide excretion in 32 obese children (16 boys and 16 girls) 8-15 years of age as well as in 7 girls with anorexia nervosa 11-16 years of age. Obese children had a median urinary C-peptide excretion rate of 0.27 nmol/kg/24 h, which was not different from that of a group of normal-weight children. In the group of anorectic girls, on the other hand, the median value 0.47 nmol/kg/24 h was significantly (p less than 0.05) higher than for normal-weight girls of the same age (median = 0.26 nmol/kg/24 h). These results indicate that in obese children insulin secretion, measured as the 24 h urinary C-peptide excretion per kg body weight, is the same as in normal-weight children. Total insulin secretion is consequently increased. In anorexia nervosa, on the other hand, the higher C-peptide excretion per kg body weight compared with normal-weight children, indicates that insulin secretion is increased in relation to body weight.