EARLY ALTERATIONS OF GLUCOSE METABOLISM IN PREPUBERTAL OBESITY (pPOb)

Abstract

The liver, muscles and adipose mass of adults with long-lasting obesity are insulin resistant. This explains why, despite chronic hyperinsulinism, they produce and utilize glucose at a similar rate than normal adults. We studied (d₂-glucose tracing, iv somatostatin, euglycemic clamp) 7 children (13 ± 0.5 yrs), obese (176 ± 9% ideal BW) for 5 ± 0.5 yrs, gaining 13.5 ± 1.4 kg kg/yr. Normoglycemic (82 ± 4 mg/dl) and hyperinsulinemic (22 ± 4 μU/ml) in the fasting state, they produce 2.5 times more glucose (295 ± 18 mg/min) than age-matched controls (C) and than obese adults. The similar increase of glucose utilization suggests a large glucose uptake by the adipose tissue of pPOb. Normalized to BW, the glucose uptake of pPOb (3.6 ± 0.2 mg/kg.min) equalled that of C (3.7 ± 0.2). This indicates that the main component of BW in pPOb, adipose tissue, takes up a similar relative amount of glucose than the main component of BW in C, lean body mass(as opposed to obese adults). Suppression of insulin by somatostatin reduced glucose utilization by 110 ± 19 mg/min in pPOb (C: 41 ± 14), as expected from an insulin-sensitive enlarged adipose mass. But hyperinsulinic clamp increased glucose uptake in pPOb (250 ± 20 mg/ M².min, insulin 402 uU/ml) much less than in C (366 ± 31, insulin 366 μU/ml), as expected from insulin-resistant muscles. Glucose overproduction by the liver, overutilization by adipose tissue contrasting with muscle insulin resistance characterize recent obesity in prepubertal children.

Log in or create a free account to read this content

Gain free access to this article, as well as selected content from this journal and more on nature.com

Access through your institution

or

Sign in or create an account

Continue with Google

Continue with ORCiD