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Related Concept Videos

Type II Diabetes I: Introduction01:26

Type II Diabetes I: Introduction

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by insulin resistance, in which target tissues such as the liver, muscle, and adipose tissue respond poorly to insulin. It is also associated with inadequate compensatory insulin secretion, where pancreatic β-cells fail to produce sufficient insulin. Together, these abnormalities lead to persistent hyperglycemia.EtiologyT2DM develops through a complex interaction of genetic predisposition and environmental or...
Type II Diabetes II: Pathophysiology01:24

Type II Diabetes II: Pathophysiology

PathophysiologyType 2 diabetes mellitus (T2DM ) is a chronic metabolic disorder characterized by insulin resistance and progressive pancreatic β-cell dysfunction, leading to impaired glucose homeostasis. It results from interactions among genetic predisposition, environmental factors, and metabolic stressors, such as overnutrition and a sedentary lifestyle.Insulin Resistance and Glucose DysregulationEarly T2DM involves insulin resistance in skeletal muscle, adipose tissue, and the liver.
Hyperglycemia01:29

Hyperglycemia

Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose levels exceed 180 mg/dL two...
Insulin: The Receptor and Signaling Pathways01:28

Insulin: The Receptor and Signaling Pathways

Insulin action is mediated through a receptor tyrosine kinase, akin to the IGF-1 receptor. The number of receptors per cell varies significantly, from 40 on erythrocytes to 300,000 on adipocytes and hepatocytes. The insulin receptor consists of linked α/β subunit dimers, forming a heterotetramer glycoprotein with two extracellular α subunits and two β subunits spanning the membrane. The α subunits inhibit the inherent tyrosine kinase activity of the β subunits, but this inhibition is released...
Diabetes Mellitus: Introduction01:26

Diabetes Mellitus: Introduction

Diabetes mellitus consists of chronic metabolic disorders characterized by persistent hyperglycemia. This elevated blood glucose results from defects in insulin secretion, impaired insulin action, or both. Insulin, produced by pancreatic β-cells, is essential for maintaining glucose homeostasis by facilitating cellular glucose uptake for energy or storage. Disruptions in insulin production or function lead to glucose accumulation in the bloodstream, causing the clinical features and long-term...
Type I Diabetes II: Pathophysiology01:26

Type I Diabetes II: Pathophysiology

Type 1 diabetes mellitus arises from an immune-mediated destruction of pancreatic β-cells, resulting in an absolute deficiency of insulin. This process develops in genetically susceptible individuals when autoimmunity, environmental exposures, and immunologic dysregulation converge to trigger a targeted attack on the insulin-producing cells of the pancreas. The β-cells are located within the islets of Langerhans and are essential for regulating blood glucose by facilitating cellular uptake of...

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Differentiated Mouse Adipocytes in Primary Culture: A Model of Insulin Resistance
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Ethnic differences in the link between insulin resistance and elevated ALT.

Mark D Deboer1, R Constance Wiener, Barrett H Barnes

  • 1Department of Pediatrics, University of Virginia, Charlottesville, VA, USA.

Pediatrics
|August 14, 2013
PubMed
Summary

Insulin resistance (IR) is linked to nonalcoholic fatty liver disease (NAFLD), but this association differs by race. Among Black adolescents, triglyceride elevations are better predictors of elevated ALT than metabolic syndrome (MetS).

Keywords:
inflammationmetabolic syndromeracial/ethnic differencevisceral obesity

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Area of Science:

  • Pediatric endocrinology
  • Hepatology
  • Cardiovascular risk assessment

Background:

  • Nonalcoholic fatty liver disease (NAFLD) is closely associated with insulin resistance (IR) and metabolic syndrome (MetS).
  • Non-Hispanic Black adolescents have higher IR but lower NAFLD/MetS prevalence than non-Hispanic whites.
  • This study investigated predictors of elevated alanine aminotransferase (ALT) in diverse adolescent populations.

Purpose of the Study:

  • To test the hypothesis that IR is a better predictor of elevated ALT than MetS in non-Hispanic Black adolescents.
  • To explore racial/ethnic differences in the relationship between IR, MetS, and NAFLD indicators.
  • To inform screening strategies for NAFLD in at-risk adolescent populations.

Main Methods:

  • Analysis of data from 4124 adolescents (aged 12-19) from NHANES (1999-2010).
  • Elevated ALT (>30 U/L) used as a proxy for presumed NAFLD.
  • Pediatric adaptation of the Adult Treatment Panel III definition for MetS.

Main Results:

  • ALT elevation prevalence varied by race: Hispanics (13.7%), non-Hispanic whites (8.6%), non-Hispanic blacks (5.4%).
  • MetS effectively identified elevated ALT in non-Hispanic whites and Hispanics.
  • In non-Hispanic Blacks, MetS association with ALT was weaker (OR=3.24, P=.051); IR and waist circumference were poorer predictors.
  • Triglyceride elevations were a significant predictor of ALT elevation in non-Hispanic Blacks (OR=4.44).

Conclusions:

  • A weaker relationship exists between IR and elevated ALT in non-Hispanic Black adolescents compared to other groups.
  • Racial/ethnic differences influence the link between MetS and NAFLD.
  • Screening for NAFLD in non-Hispanic Black adolescents should consider triglyceride levels as a key indicator.