Longitudinal study of physiologic insulin resistance and metabolic changes of puberty
Longitudinal study of physiologic insulin resistance and metabolic changes of puberty
复制标题
DOI：
10.1203/01.pdr.0000246097.73031.27
复制
发表时间：
2006-12-01
影响因子：
3.6
通讯作者：
Arslanian, Silva A.
中科院分区：
文献类型：
--
作者：
Hannon, Tamara S.;Janosky, Janine;Arslanian, Silva A.
横断面研究表明：1）与青春期前儿童和成人相比，青少年存在胰岛素抵抗; 2）青春期胰岛素抵抗可能由生长激素（GH）介导; 3）青春期胰岛素抵抗与脂肪氧化增加和葡萄糖氧化减少相关。本研究的目的是通过对青春期前和青春期的正常儿童进行纵向研究来评估这些横断面观察的有效性。9名健康、体重正常的青春期前儿童进行了高胰岛素-正常血糖和高血糖钳夹研究，以评价胰岛素敏感性和胰岛素分泌。儿童在青春期重复评估。与横断面观察结果一致，该纵向研究表明，在青春期：1）胰岛素敏感性降低了约50%，2）胰岛素敏感性的降低通过胰岛素分泌加倍得到补偿，3）胰岛素敏感性的降低与体脂百分比的变化无关。青春期与全身脂肪分解增加和葡萄糖氧化减少有关。一个新的观察结果是在青春期时间点脂联素水平下降了50%。这些代谢变化被认为部分由GH分泌增加介导，并且与葡萄糖和脂肪氧化之间竞争的Randle循环一致。
Cross-sectional studies have shown that 1) adolescents are insulin resistant compared with prepubertal children and adults, 2) pubertal insulin resistance is likely mediated by growth hormone (GH), and 3) pubertal insulin resistance is associated with increased fat oxidation and decreased glucose oxidation. The aim of this study was to assess the validity of these cross-sectional observations by performing a longitudinal study in normal children during the prepubertal and pubertal periods. Nine healthy, normal weight, prepubertal children underwent hyperinsulinemic-euglycemic and hyperglycemic clamp studies for evaluation of insulin sensitivity and insulin secretion. Children had repeat evaluations during puberty. Consistent with cross-sectional observations, this longitudinal study demonstrated that during puberty: 1) insulin sensitivity decreased by similar to 50%, 2) the decrease in insulin sensitivity was compensated by a doubling in insulin secretion, and 3) the decrease in insulin sensitivity was independent of changes in percentage of body fat. Puberty was associated with increased total body lipolysis and decreased glucose oxidation. A novel observation is the demonstration of similar to 50% decrease in adiponectin levels at the pubertal time point. These metabolic changes are proposed to be partially mediated by increased GH secretion and are consistent with the Randle cycle of competition between glucose and fat oxidation.