β‐cell function, incretin response, and insulin sensitivity of glucose and fat metabolism in obese youth: Relationship to OGTT‐time‐to‐glucose‐peak.

Autor:	Kim, Joon Young, Tfayli, Hala, Bacha, Fida, Lee, SoJung, Michaliszyn, Sara F., Yousuf, Shahwar, Gebara, Nour, Arslanian, Silva
Předmět:	TYPE 2 diabetes risk factors BODY composition FATTY acids GASTROINTESTINAL hormones GLUCOSE tolerance tests HYPERGLYCEMIA HYPERINSULINISM INSULIN resistance ISLANDS of Langerhans INCRETINS CHILDHOOD obesity PEPTIDE hormones RISK assessment DISEASE prevalence ABDOMINAL adipose tissue GLUCOSE clamp technique ADOLESCENCE
Zdroj:	Pediatric Diabetes; Feb2020, Vol. 21 Issue 1, p18-27, 10p, 1 Chart, 3 Graphs
Abstrakt:	Background: In adults, the time‐to‐glucose‐peak at or after 30 minutes during an oral glucose tolerance test (OGTT) identifies physiologically distinct groups with differences in insulin sensitivity, β‐cell function and risk for type 2 diabetes. In obese non‐diabetic adolescents, we investigated if the OGTT‐time‐to‐glucose‐peak also reflects incretin and free fatty acid (FFA) responses besides insulin sensitivity and β‐cell function, measured by the clamp. Methods: Obese adolescents (n = 278) were categorized according to their OGTT‐time‐to‐glucose‐peak by Early‐peak (at 30 minutes) vs Late‐peak (>30 minutes) groups. Body composition, visceral adipose tissue, oral disposition index and OGTT‐area under the curve (AUC) were examined. A subset of 102 participants had both hyperinsulinemic‐euglycemic and hyperglycemic clamps to measure in vivo insulin sensitivity, insulin secretion, and β‐cell function relative to insulin sensitivity. Results: Compared with the Early‐peak group, the Late‐peak group had impaired β‐cell function relative to insulin sensitivity, lower glucose‐dependent insulinotropic polypeptide‐AUC, and higher FFA‐AUC despite higher insulin‐ and C‐peptide‐AUC. They also had lower hepatic and peripheral insulin sensitivity despite similar percent body fat and visceral adipose tissue, and had higher prevalence of impaired glucose tolerance (all P <.05). Conclusions: In obese non‐diabetic youth, those with a Late‐peak vs an Early‐peak glucose during an OGTT showed diminished β‐cell function, blunted incretin secretion, and lower insulin sensitivity of glucose and FFA metabolism. It remains to be determined if Late‐peak glucose predicts the future development of type 2 diabetes in these high‐risk youth. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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