Claudia Brufani1,2, Andrea Tura3, Giorgio Bedogni1, Rosa Luciano1, Stefano Sbrignadello3, Danilo Fintini2, Marco Cappa2, Ram Weiss4, Melania Manco1. 1. Research Area for Multifactorial Diseases and Complex Phenotypes, Obesity and Diabetes, Bambino Gesù Children's Hospital, Rome, Italy. 2. Unit of Endocrinology and Diabetes, Bambino Gesù Children's Hospital, Rome, Italy. 3. Institute of Neuroscience, National Research Council, Padua, Italy. 4. Department of Human Metabolism and Nutrition and Section of Pediatric Endocrinology, Hadassah Hebrew University, Jerusalem, Israel.
Abstract
BACKGROUND/AIMS: The prevalence of impaired glucose tolerance (IGT) is rising among obese adolescents in parallel with epidemic obesity. In some cases, IGT reverts to normal glucose tolerance (NGT) by the end of puberty. The aims of the present study were to investigate metabolic factors determining changes over time of glucose at 120 min (Glu120) following an oral glucose tolerance test (OGTT), and to verify whether preserved β-cell glucose sensitivity (βCGS) protects against persistent IGT. METHODS: We performed a cohort study of 153 severely obese children and adolescents evaluated with a 5-point OGTT at baseline and at follow-up with measurements of glucose, insulin, and C-peptide to estimate several empirical parameters of insulin sensitivity (includ ing oral glucose insulin sensitivity [OGIS] and OGTT-derived glucose effectiveness) and secretion. RESULTS: At follow-up (range 0.9-4.8 year), 113 (73.9%) patients remained with NGT, 9 (5.9%) had IGT, and 28 (18.3%) had reverted to NGT; 3 NGT patients had developed IGT. In multivariable models, change in loge(βCGS) was inversely associated with time-related change in loge(Glu120), with (model 2) and without (model 1) correction for the change in loge(OGIS). Model 2 was more strongly associated with change in loge(Glu120). CONCLUSIONS: Changes in βCGS and insulin sensitivity were inversely associated with changes in Glu120 at follow-up, contributing a likely explanation for the reversal of IGT to NGT.
BACKGROUND/AIMS: The prevalence of impaired glucose tolerance (IGT) is rising among obese adolescents in parallel with epidemic obesity. In some cases, IGT reverts to normal glucose tolerance (NGT) by the end of puberty. The aims of the present study were to investigate metabolic factors determining changes over time of glucose at 120 min (Glu120) following an oral glucose tolerance test (OGTT), and to verify whether preserved β-cell glucose sensitivity (βCGS) protects against persistent IGT. METHODS: We performed a cohort study of 153 severely obesechildren and adolescents evaluated with a 5-point OGTT at baseline and at follow-up with measurements of glucose, insulin, and C-peptide to estimate several empirical parameters of insulin sensitivity (includ ing oral glucose insulin sensitivity [OGIS] and OGTT-derived glucose effectiveness) and secretion. RESULTS: At follow-up (range 0.9-4.8 year), 113 (73.9%) patients remained with NGT, 9 (5.9%) had IGT, and 28 (18.3%) had reverted to NGT; 3 NGT patients had developed IGT. In multivariable models, change in loge(βCGS) was inversely associated with time-related change in loge(Glu120), with (model 2) and without (model 1) correction for the change in loge(OGIS). Model 2 was more strongly associated with change in loge(Glu120). CONCLUSIONS: Changes in βCGS and insulin sensitivity were inversely associated with changes in Glu120 at follow-up, contributing a likely explanation for the reversal of IGT to NGT.
Authors: Kannan Kasturi; Anthony U Onuzuruike; Shwetha Kunnam; Lauren B Shomaker; Jack A Yanovski; Stephanie T Chung Journal: Pediatr Diabetes Date: 2018-12-27 Impact factor: 4.866
Authors: Michael Bergman; Muhammad Abdul-Ghani; Ralph A DeFronzo; Melania Manco; Giorgio Sesti; Teresa Vanessa Fiorentino; Antonio Ceriello; Mary Rhee; Lawrence S Phillips; Stephanie Chung; Celeste Cravalho; Ram Jagannathan; Louis Monnier; Claude Colette; David Owens; Cristina Bianchi; Stefano Del Prato; Mariana P Monteiro; João Sérgio Neves; Jose Luiz Medina; Maria Paula Macedo; Rogério Tavares Ribeiro; João Filipe Raposo; Brenda Dorcely; Nouran Ibrahim; Martin Buysschaert Journal: Diabetes Res Clin Pract Date: 2020-06-01 Impact factor: 5.602