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Altered insulin resistance is associated with increased dietary weight loss in obese children
R P Hoffman1, P J Stumbo, K F Janz
1Department of Pediatrics, University of Iowa, Iowa City 52242, USA.
Insights
Weight loss improves insulin sensitivity in obese children. Higher insulin resistance before dieting correlated with greater weight loss, suggesting it may aid calorie restriction effectiveness.
Area of Science:
- Pediatric Endocrinology
- Metabolic Disorders
- Obesity Research
Background:
- Childhood obesity is a growing concern with significant metabolic implications.
- Insulin resistance is a common comorbidity in obese children, affecting glucose metabolism.
- Understanding the interplay between weight management and insulin sensitivity is crucial for effective intervention.
Purpose of the Study:
- To investigate the relationship between insulin resistance and weight loss in prepubertal and early pubertal obese children.
- To assess the impact of a short-term weight reduction diet on insulin sensitivity.
- To explore whether baseline insulin sensitivity predicts the extent of weight loss.
Main Methods:
- Utilized the gold standard euglycemic, hyperinsulinemic clamp technique to measure insulin sensitivity.
- Enrolled 10 obese children (aged 10.1 ± 1.6 years) in a 14-day weight reduction diet.
- Analyzed correlations between insulin sensitivity, weight loss, and height standard deviation score.
Main Results:
- Body weight significantly decreased by an average of 4.6 kg (p < 0.01).
- Insulin sensitivity significantly increased after the diet (p < 0.05).
- Baseline insulin sensitivity showed a strong negative correlation with weight loss (r = -0.8, p < 0.005), and weight loss correlated positively with height SDS (r = 0.9, p < 0.005).
Conclusions:
- Short-term weight reduction effectively decreases insulin resistance in obese children.
- The inverse relationship observed suggests that higher insulin resistance may facilitate greater weight loss during calorie restriction.
- These findings highlight the potential benefits of dietary interventions for improving metabolic health in pediatric obesity.
Abstract:
To determine the relationship between insulin resistance and weight loss in early obesity, we used the euglycemic, hyperinsulinemic clamp to study the effect of a 14-day weight reduction diet in 10 prepubertal and early pubertal obese children (age, 10.1 +/- 1.6 years) on insulin sensitivity. Body weight decreased from 73.7 +/- 6.0 kg to 69.1 +/- 5.8 kg (p < 0.01). Insulin sensitivity before weight reduction negatively correlated with the amount of weight loss during diet (r = -0.8, p < 0.005). Weight loss also positively correlated with height standard deviation score (r = 0.9, p < 0.005). Mean insulin sensitivity increased from 0.068 +/- 0.01 (nmol kg-1 min-1)/(pmol l-1) to 0.096 +/- 0.030 (nmol kg-1 min-1)/(pmol l-1) (p < 0.05, one-tailed test). These results indicate that weight reduction decreases insulin resistance in childhood obesity. The inverse relationship between insulin sensitivity and weight loss during calorie, restriction in these subjects suggests that insulin resistance may enhance weight loss during calorie restriction.