Adolescent Gastric By-Pass and Diabetic Precursors

青少年胃绕道手术和糖尿病前兆

• 批准号: 6926331
• 负责人: THOMAS HARRIS INGE
• 金额: $ 14.9万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-07-01 至 2007-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6926331
• 关键词: adolescence (12-20); age difference; blood glucose; blood tests; body composition; body physical activity; carbohydrate metabolism; clinical research; disease /disorder prevention /control; glucose tolerance test; human middle age (35-64); human subject; insulin; insulin sensitivity /resistance; noninsulin dependent diabetes mellitus; nutrient intake activity; obesity; pancreatic islet function; personal log /diary; stomach /intestine bypass; weight loss; young adult human (21-34)

DESCRIPTION (provided by applicant): Abstract: Overweight and obesity are the most common metabolic disorders affecting the U.S. with 31% of adults and 16% of adolescents now meeting Centers for Disease Control criteria for these conditions. As the obesity epidemic has unfolded, so too has the increase in prevalence of type 2 diabetes in children and adults. The single most effective treatment for type 2 diabetes in severely obese adults may be bariatric surgery, a procedure that is most commonly performed in the 5th and 6th decades of life. While it is clear that rapid and profound weight loss can significantly improve carbohydrate metabolism in adults, it is not clear to what degree diabetes is reversible in these patients. The pathophysiology of type 2 diabetes in adolescents and children is not well understood and no studies have yet examined the effect of surgical weight loss on insulin resistance, insulin production, or glucose tolerance in severely obese young people. However, it seems likely that bariatric surgery could improve these conditions in youth. Understanding the relative benefits of surgically induced weight reduction on carbohydrate metabolism in adolescents compared to middle-aged subjects is important for determining optimal timing of this intervention. This knowledge may also lead to key insights into obesity-induced diabetes. In this project we will test the hypothesis that bariatric surgical intervention will more effectively improve defects in insulin sensitivity, pancreatic beta cell function, and glucose tolerance in adolescents compared to adults. Two specific aims are proposed 1) to compare the derangements of carbohydrate metabolism among very severely obese (body mass index >40 kg/m2) adolescents and adults referred for bariatric surgery; and 2) To assess improvement in carbohydrate metabolism longitudinally (during and after surgical weight loss) in adolescents and adults and compare differences in the mechanisms of improvement between the two groups. These data will provide critical information about age-related metabolic outcomes of bariatric surgery and could inform the design of larger studies to examine the role of early bariatric surgery for treatment or even prevention of diabetes or the metabolic syndrome in patients at high risk for these dangerous conditions.

描述（由申请人提供）： 摘要：超重和肥胖是影响美国最常见的代谢紊乱，31%的成年人和16%的青少年现在符合疾病控制中心的标准。随着肥胖症的流行，儿童和成人2型糖尿病的患病率也在增加。对于严重肥胖的成年人来说，2型糖尿病最有效的单一治疗方法可能是减肥手术，这是一种最常见的手术，在生命的第五和第六个十年进行。虽然很明显，快速和深刻的减肥可以显着改善成人的碳水化合物代谢，但尚不清楚糖尿病在这些患者中的可逆程度。青少年和儿童2型糖尿病的病理生理学尚未得到很好的理解，也没有研究检查手术减肥对严重肥胖的年轻人胰岛素抵抗、胰岛素产生或葡萄糖耐量的影响。然而，减肥手术似乎可以改善年轻人的这些情况。了解手术减肥对青少年碳水化合物代谢的相对益处与中年受试者相比，对于确定这种干预的最佳时机非常重要。这些知识也可能导致对肥胖引起的糖尿病的关键见解。在这个项目中，我们将测试的假设，减肥手术干预将更有效地改善胰岛素敏感性，胰腺β细胞功能和葡萄糖耐量的缺陷，在青少年相比，成年人。提出了两个具体目标：1）比较接受减肥手术的非常严重肥胖（体重指数>40 kg/m2）青少年和成人的碳水化合物代谢紊乱; 2）评估青少年和成人纵向（手术减肥期间和手术减肥后）碳水化合物代谢的改善，并比较两组之间改善机制的差异。这些数据将提供有关减肥手术的年龄相关代谢结果的关键信息，并可以为更大规模的研究设计提供信息，以检查早期减肥手术在治疗甚至预防糖尿病或代谢综合征中的作用。