INSULIN SENSITIVITY IN ADOLESCENTS WITH DIABETES

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 胰岛素抵抗与代谢综合征和2型糖尿病（T2 D）患者的心血管疾病相关。 然而，人们越来越关注胰岛素抵抗在1型糖尿病（T1 D）患者中的作用，特别是当这些儿童变得更加肥胖时。 然而，这一领域的研究受到技术挑战的限制。 虽然可以使用高胰岛素钳夹技术严格测量T1 D患者的胰岛素敏感性，但这需要大量的劳动力和时间，并且在大型流行病学试验中没有用处。 然而，代谢综合征和T2 D成人患者中常用的胰岛素敏感性替代估计值假设胰岛素和c肽分泌完整。 因此，开发不依赖于完整胰岛素和C肽分泌的胰岛素敏感性估计值是T1 D胰岛素敏感性和心血管风险研究进展的基础。开发胰岛素敏感性的替代估计值对于T2 D青年患者的护理也很重要，因为成人中使用的指标可能不适用于年轻患者，这些患者还存在青春期胰岛素抵抗以及与成人的其他差异。 来自历史数据、人体测量学和胰岛素/C肽以外的生物标志物的指数已用于估计正常和糖尿病成人T1 D和T2 D的胰岛素敏感性。 因此，有可能为青少年制定类似的指数。 在这项提案中，我们将利用先前的特征人群的青少年糖尿病，以确定和验证这样一个指数对严格的测量胰岛素敏感性通过高胰岛素正葡萄糖钳夹。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Insulin resistance is associated with cardiovascular disease among patients with metabolic syndrome and type 2 diabetes (T2D). However, there has been increasing interest in the role of insulin resistance in patients with type 1 diabetes (T1D), particularly as these children become more obese. However, research in this area has been limited by technical challenges. While it is possible to measure insulin sensitivity rigorously in T1D utilizing the hyperinsulinemic clamp, this is labor and time-intensive and not useful in large epidemiologic trials. Yet, surrogate estimates of insulin sensitivity used commonly in adults with metabolic syndrome and T2D assume intact insulin and c-peptide secretion. Therefore, the development of estimates of insulin sensitivity that do not rely on intact insulin and c-peptide secretion are fundamental to progress in the study of insulin sensitivity and cardiovascular risk in T1D. Development of surrogate estimates of insulin sensitivity is also important to the care of youth with T2D, as the indicies used in adults may not apply to younger patients, who also have superimposed insulin resistance of puberty, and other differences from adults. Indices derived from historical data, anthropometrics, and biomarkers other than insulin/c-peptide have been used to estimate insulin sensitivity in normal and diabetic adults with T1D and T2D. Therefore, it may be possible to develop similar indices for adolescents. In this proposal, we will utilize a previously characterized population of adolescents with diabetes to identify and validate such an index against rigorous measurements of insulin sensitivity obtained through hyperinsulinemic euglycemic clamp.