Insulin Resistance and Associated Compensatory Responses in African-American and Hispanic Children

Goran, Michael I.; Bergman, Richard N.; Cruz, Martha L.; Watanabe, Richard M.

doi:10.2337/diacare.25.12.2184

Cited by 219 publications

(199 citation statements)

References 31 publications

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“…Brazil has a highly miscegenated population and this feature cannot be ruled out as a possible source of variances found in the study. Regardless of the ethnic composition, studies elsewhere show similar association between insulin resistance and MS whenever diverse human groups are compared 11,17,[27][28][29] .…”

Section: Discussionmentioning

confidence: 85%

Associação do índice de massa corporal e da resistência à insulina com síndrome metabólica em crianças brasileiras

Ferreira¹,

Nóbrega²,

França³

2009

Arq. Bras. Cardiol.

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Section: Discussionmentioning

confidence: 85%

Associação do índice de massa corporal e da resistência à insulina com síndrome metabólica em crianças brasileiras

Ferreira¹,

Nóbrega²,

França³

2009

Arq. Bras. Cardiol.

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“…Insulin clearance is decreased in obesity resulting in higher circulating levels (35). Furthermore, insulin clearance is lower in African American and Hispanic children compared with whites (36)(37)(38)(39). These factors do not affect C-peptide levels.…”

Section: Discussionmentioning

confidence: 99%

Measures of β-Cell Function during the Oral Glucose Tolerance Test, Liquid Mixed-Meal Test, and Hyperglycemic Clamp Test

Bacha

Güngör

Arslanian

2008

The Journal of Pediatrics

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Objective-To evaluate clinically useful measures of Beta-cell function derived from the oral glucose tolerance test (OGTT) or mixed meal (Boost) tolerance test to assess insulin secretion, in comparison with the gold standard method of the hyperglycemic clamp (Hyper-C).Study design-We hypothesized that OGTT/Boost derived measures are useful estimates of β-cell function and correlate well with insulin secretion measured during the Hyper-C. We assessed the correlation between the ratio of the early incremental insulin/glucose responses at 15 and 30 min (ΔI 15 /ΔG 15 , ΔI 30 /ΔG 30 ) of the OGTT and Boost, with insulin secretion during the Hyper-C (225 mg/ dl). The same indices were evaluated using C-peptide (C). 26 (14M/12F) children (9.9±0.2yrs, BMI: 22.1±1.2kg/m 2 ) underwent a 2 hour Hyper-C (225 mg/dl) and a 3 hour OGTT and Boost with measurements of glucose (G), insulin (I) and C.Results-Correlations between clamp-and OGTT-derived measures of insulin secretion were stronger for the 15 minute than the 30 minute indices of insulin secretion and stronger with the use of C-peptide than insulin levels (r = 0.7, p < 0.001 for 1 st phase C-peptide vs both OGTT and Boost ΔC 15 /ΔG 15 ).Conclusion-In youth with normal glucose tolerance, C-peptide rather than insulin at 15 minutes of the OGTT and/or Boost provides a reliable estimate of β-cell function that correlates well with clamp derived insulin secretion. KeywordsOGTT; Boost test; Insulinogenic index; C-peptide; insulin clearance Obesity, impaired glucose tolerance (IGT), and type 2 diabetes are characterized with insulin resistance, in addition to impaired insulin secretion in the latter two (1). With the increasing rates of obesity (2,3), IGT, and type 2 diabetes in youth (4), simple, clinically obtainable measures of insulin secretion are desirable for the follow-up of progression from one stage to the other and for evaluation of therapeutic interventions. The oral glucose tolerance test (OGTT) is recommended by the WHO and the ADA for the diagnosis of IGT and diabetes and is a frequently utilized clinical tool. The objective of our study was to evaluate if measures of Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. We hypothesized that OGTT or mixed meal (Boost) derived measures of insulin release are useful estimates of β-cell function, and correlate well with insulin secretion measured during the hyperglycemic clamp (Hyper-C). NIH Public Access METHODSThe study population consisted of 26 (14M/12F) children, 7 to 12 years of age (mean 9.9±1.1 years). They included 15 African American and 11 Caucasian normoglyce...

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“…2), but produced 50% less insulin and eliminated it more slowlythus compensating for reduced secretion and maintaining insulin at premenopausal levels. There is other evidence of compensation for insulin resistance and control of glucose tolerance via effects on insulin elimination [16], but whether [17] did report a striking relationship between the onset of diabetes and the menopause but such an effect should be reflected in a discontinuity between men and women in diabetes incidence with age. There has been some evidence for this [18] and change in prevalence was seen in the second US National Health and Nutrition Examination Survey (NHANES-II) 1976-1980 [19] (Fig.…”

Section: Effects Of Oestrogens On Insulin Secretion In Humansmentioning

confidence: 99%

Oestrogens and insulin secretion

2005

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There is a persistent perception that oestrogens have an adverse effect on carbohydrate metabolism. It might therefore be expected that their use would result in a corresponding increase in the incidence of diabetes. Recent evidence from clinical trials suggesting that women on postmenopausal oestrogen hormone replacement therapy (HRT) have a reduced incidence of type 2 diabetes therefore appears paradoxical. Short-term supraphysiological oestrogen administration has an adverse effect on glucose tolerance, resulting from suppression of first-phase insulin secretion and increased insulin resistance. Oestrogen-induced increases in glucocorticoid activity could account for these effects. Oestrogen-induced deterioration in glucose tolerance is, however, accompanied by a reduction in fasting glucose, an effect that could be accounted for by glucagon antagonism. These short-term effects contrast with long-term preservation of insulin secretion and glucose homeostasis by oestrogens. In animal studies, ovariectomy is associated with decreased insulin secretion and increased risk of diabetes, whereas oestrogen administration protects against diabetes and increases the insulin response to glucose. The mechanism is uncertain, but direct effects on the pancreas via steroid receptors or indirect effects via oestrogen-induced glucagon antagonism and subclinical increases in glucocorticoids and growth hormone could all contribute. Recent evidence that HRT increases the risk of cardiovascular disease suggests that it should not be used for the prevention of diabetes, but the mechanism responsible for this benefit merits further investigation and might lead to new therapies.

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Insulin Resistance and Associated Compensatory Responses in African-American and Hispanic Children

Cited by 219 publications

References 31 publications

Associação do índice de massa corporal e da resistência à insulina com síndrome metabólica em crianças brasileiras

Associação do índice de massa corporal e da resistência à insulina com síndrome metabólica em crianças brasileiras

Measures of β-Cell Function during the Oral Glucose Tolerance Test, Liquid Mixed-Meal Test, and Hyperglycemic Clamp Test

Oestrogens and insulin secretion

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