Relation of the degree of obesity in childhood to adipose tissue insulin resistance

Abstract

Aims In this study, we investigated whether adipose tissue insulin resistance (IR) is affected by the degree of obesity during the fasting and post-prandial state, independent of glucose tolerance among obese children and adolescents. We also tested whether systemic subclinical inflammation is associated with adipose tissue IR. Methods Subjects were recruited to the Yale Pathophysiology of Type 2 Diabetes in Youth Study (NCT01967849). An oral glucose-tolerance test was performed to establish glucose-tolerance status and blood samples were drawn for measurement of free fatty acids (FFAs), to calculate the area under the curve (AUC) of FFA. Adipose tissue insulin resistance was calculated as the product of insulin and FFA concentrations. Results In total, 671 children and adolescents (58.6% females) were included with a mean age of 13.3(2.7) years and BMI Z score of 2.45(0.31). The degree of obesity emerged as an independent predictor of both fasting and post-prandial adipose IR, p < 0.0001. Higher degree of obesity was associated with greater AUC FFA (lower suppression) compared to lower degree of obesity, p = 0.01. Furthermore, higher levels of IL-6 were positively associated with post-prandial adipose tissue IR, p = 0.02. Conclusions The degree of obesity in childhood and adolescence is strongly associated with adipose tissue IR independent of glucose tolerance. This is reflected not only in calculated indices of adipose IR but also in lower suppression of FFAs during the OGTT regardless of glucose tolerance or fasting adipose tissue IR. Furthermore, markers of subclinical inflammation such as IL-6 are associated with adipose tissue IR, independent of other factors. Electronic supplementary material The online version of this article (10.1007/s00592-018-01285-3) contains supplementary material, which is available to authorized users.

Determinants and correlates of adipose tissue insulin resistance index in Japanese women without diabetes and obesity

“…28 Indeed, HDL cholesterol averaged 77 mg/dL in middle-aged Japanese women while it was 49 mg/dL in normal weight youth. 15 However, it is noted that HDL cholesterol emerged as an independent determinant of AT-IR in young women in the present study.…”

“…In contrast, there was no association of AT-IR with HDL cholesterol and apoA1, major apolipoprotein of HDL particles, in two age groups of women whereas inverse correlation between AT-IR and HDL cholesterol was evident in youth with obesity. 15 This discrepancy may be due in part to high HDL cholesterol, which is accounted for by genetic deficiency of cholesteryl ester transfer protein, in Japanese people. 28 Indeed, HDL cholesterol averaged 77 mg/dL in middle-aged Japanese women while it was 49 mg/dL in normal weight youth.…”

“…[10][11][12][13][14][15][16] However, most studies which employed AT-IR investigated people with obesity and/or type 2 diabetes and were conducted in Western countries. [10][11][12][13][14][15][16] We, therefore, investigated determinants, correlates and usefulness of AT-IR in Japanese women without diabetes and obesity, populations in which confounding factors are so scarce. 17 Because we have shown that endurance training lowered AT-IR in young women, 18 we excluded female collegiate athletes in the present study.…”

Influenza and obesity: its odd relationship and the lessons for COVID-19 pandemic

“…In summary, regular physical exercise emerges as a cornerstone as a preventive measure to improve host defense against influenza viral infection and other metabolic diseases in obese subjects (but not only). Furthermore, the increase in overweight and metabolic syndrome among adolescents in US [33,34] and other industrialized countries [35,36] constitutes an additional problem. In fact, being social distancing the only preventive measure that can be taken waiting for a vaccine against COVID-19, children and adolescents constitute a population where the actuation of social distancing is more difficult than in adults and where, apparently, there is a less symptomatic disease with a higher chance of having asymptomatic virus carriers.…”

Trilobatin ameliorates insulin resistance through IRS-AKT-GLUT4 signaling pathway in C2C12 myotubes and ob/ob mice

“…Increasing evidence indicates that obesity and type 2 diabetes has elevated over years in both developing and developed country, which are closely associated with insulin resistance, a pathophysiological condition characterized by an impaired insulin action in insulin-sensitizing tissues including liver, adipose tissue and skeletal muscle [1,2]. Skeletal muscle accounts for 40% of body weight in humans, and is responsible for up to 80% insulin-mediated glucose disposal under normal physiological conditions [3,4].…”