Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2014 Oct;9(5):373-80.
doi: 10.1111/j.2047-6310.2013.00189.x. Epub 2013 Jul 17.

Adipose tissue insulin resistance in adolescents with and without type 2 diabetes

M M Kelsey  1 , J E Forster, R E Van Pelt, J E B Reusch, K J Nadeau
Affiliations
Comparative Study

Adipose tissue insulin resistance in adolescents with and without type 2 diabetes

M M Kelsey et al. Pediatr Obes. 2014 Oct.

Abstract

Background: The incidence of type 2 diabetes mellitus (T2D) is increasing in youth, yet little is known about the underlying pathophysiology. Decreased insulin suppression of lipolysis and elevated non-esterified free fatty acid (NEFA) concentrations are known to be associated with insulin resistance and T2D in adults, but less is known about the relationship in adolescents.

Objectives: This study aimed to assess adipose tissue insulin resistance (IR; insulin suppression of lipolysis) and its metabolic correlates in lean, obese and T2D adolescents.

Methods: Forty-seven lean, obese and T2D youth underwent hyperinsulinaemic (80 mU*m(-2) *min(-1)) euglycaemic clamps. NEFAs were measured at baseline and during steady state. Insulin-mediated suppression of lipolysis (%NEFA suppression from baseline) was calculated, and metabolic risk factors were assessed by %NEFA suppression tertile.

Results: There was expected variability in %NEFA suppression within obese and T2D youth, but a subset had significantly reduced suppression of lipolysis. NEFA suppression tertile was significantly inversely associated with fasting triglycerides (P = 0.0001), log alanine aminotransferase (ALT; P = 0.02) and low-density lipoprotein cholesterol (P = 0.0002).

Conclusions: Marked adipose tissue IR occurs in some obese and T2D adolescents, which may result in release of triglycerides into the circulation and liver deposition of fatty acids, as evidenced by higher ALT in poor NEFA suppressors.

Keywords: Adipose tissue insulin resistance; adolescents; free fatty acids; type 2 diabetes.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Participant groups (Lean, Obese, T2D) broken down by NEFA suppression tertiles. The distribution of obese and T2D subjects across the suppressor tertiles indicates the high variability in adipose tissue insulin resistance in the obese and T2D groups.
See this image and copyright information in PMC

References

    1. Pinhas-Hamiel O, Zeitler P. Acute and chronic complications of type 2 diabetes mellitus in children and adolescents. Lancet. 2007;369:1823–31. - PubMed
    1. Schwimmer JB, Deutsch R, Kahen T, et al. Prevalence of fatty liver in children and adolescents. Pediatrics. 2006;118:1388–93. - PubMed
    1. Nadeau KJ, Ehlers L, Draznin B, et al. Exercise Capacity is Abnormal in Youth with Type 2 Diabetes. Diabetes. 2007;56(Suppl 1):A278.
    1. Rossetti L, Smith D, Shulman GI, et al. Correction of hyperglycemia with phlorizin normalizes tissue sensitivity to insulin in diabetic rats. The Journal of clinical investigation. 1987;79:1510–5. - PMC - PubMed
    1. Tessari P, Nosadini R, Trevisan R, et al. Defective suppression by insulin of leucine-carbon appearance and oxidation in type 1, insulin-dependent diabetes mellitus. Evidence for insulin resistance involving glucose and amino acid metabolism. The Journal of clinical investigation. 1986;77:1797–804. - PMC - PubMed

Publication types