Hepatic Insulin Clearance Increases after Weight Loss in Obese Children and Adolescents
作者:
Oscar Escobar,
Haruo Mizuma,
Melinda Sothern,
Uwe Blecker,
John Udall,
Robert Suskind,
Charles Hilton,
Alfonso Vargas,
期刊:
The American Journal of the Medical Sciences
(OVID Available online 1999)
卷期:
Volume 317,
issue 5
页码: 282-282
ISSN:0002-9629
年代: 1999
出版商: OVID
关键词: Hyperinsulinemia;Diabetes;Obesity;Childhood;Weight loss
数据来源: OVID
摘要:
BackgroundObesity is a rapidly increasing health problem among US youth. Hyperinsulinemia is associated with obesity and has been found to be a contributory factor for the development of cardiovascular disease in the obese. It has been suggested that hyperinsulinemia of obesity is a result of increased insulin secretion caused by insulin resistance. However, it has been shown in adults that decreased hepatic insulin clearance (HIC) is the primary cause of hyperinsulinemia in this population.MethodsWe studied 15 obese children and adolescents (11 F, 4 M; 8.6 to 18.1 years) before and 10 weeks after their enrollment in a multidisciplinary weight reduction program, which included a protein-sparing modified fast, a moderate intensity progressive exercise program, and a behavior-modification intervention.ResultsAll patients lost weight (P< 0.05). Measurements of immunoreactive insulin (IRI) and C-peptide reactivity (CPR) were performed before the program and at 10 weeks. IRI levels dropped significantly, whereas CPR levels did not change. CPR/IRI molar ratios, considered an indirect estimation of HIC, rose significantly after weight loss.ConclusionsOur data suggest that hyperinsulinemia seen in obese children and adolescents is caused by decreased HIC. The cause for this decrease remains unknown, but it is reversible upon weight loss.
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