Etiology of insulin resistance in youth with type 2 diabetes.

Etiology of insulin resistance in youth with type 2 diabetes.
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DOI:
10.1007/s11892-012-0341-0
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发表时间:
2013-02
影响因子:
4.2
通讯作者:
Nadeau, Kristen J.
Nadeau, Kristen J.
中科院分区:
医学2区
文献类型:
--
作者:
Cree-Green, Melanie;Triolo, Taylor M.;Nadeau, Kristen J.

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2 型糖尿病 (T2DM) 历来是一种成人疾病,现在在肥胖青少年中越来越流行。不良饮食和久坐行为增加导致青少年肥胖率上升,但并非所有肥胖儿童都会患上 T2DM。一般来说,T2DM 的特点是胰岛素抵抗 (IR) 和胰腺 β 细胞不足。在儿童中,IR 与体重指数 (BMI) 升高和青春期激素升高以及脂肪分配异常、游离脂肪酸升高、炎症和/或线粒体功能障碍有关。当胰腺无法满足 IR 导致的胰岛素需求增加时,就会出现高血糖和 T2DM。 IR 是青少年特有的,它会随着青春期发育阶段的不同而变化,一旦青春期 IR 消失,一些儿童可能会在青春期后高血糖得到缓解。进一步了解 IR、青少年向 T2DM 的进展以及成年后的结局将有助于指导未来针对高危青少年的治疗和干预。
Type 2 diabetes (T2DM), historically an adult disease, is now increasingly prevalent in obese youth. Poor diet and increased sedentary behavior contribute to the increasing rates of obesity in youth, yet not all obese children develop T2DM. In general, T2DM is characterized by both insulin resistance (IR) and pancreatic beta-cell insufficiency. In children, IR is related to elevated body mass index (BMI) and pubertal hormones, along with abnormal fat partitioning, elevated free fatty acids, inflammation, and/or mitochondrial dysfunction. Hyperglycemia and T2DM develop when the pancreas cannot match the increased insulin demands resulting from IR. Unique to youth, IR varies with stage of pubertal development, and some children may have resolution of hyperglycemia post-puberty once the IR of puberty resolves. Further understanding of IR, the progression to T2DM in youth, and later outcomes as adults will help direct future therapies and interventions for youth at risk.
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