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Metabolic inflexibility and insulin resistance in obese adolescents with non‐alcoholic fatty liver disease
Author(s) -
Lee SoJung,
RiveraVega Michelle,
Alsayed Hany Mohamed Abdel Aal,
Boesch Chris,
Libman Ingrid
Publication year - 2015
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/pedi.12141
Subject(s) - medicine , insulin resistance , endocrinology , fatty liver , insulin , respiratory quotient , metabolic syndrome , obesity , triglyceride , diabetes mellitus , disease , cholesterol
Background Non‐alcoholic fatty liver disease ( NAFLD ) is a comorbidity of childhood obesity. Objective We examined whole‐body substrate metabolism and metabolic characteristics in obese adolescents with vs. without NAFLD . Subjects Twelve obese ( BMI ≥ 95th percentile) adolescents with and without NAFLD [intrahepatic triglyceride ( IHTG ) ≥5.0% vs. <5.0%] were pair‐matched for race, gender, age and % body fat. Methods Insulin sensitivity ( IS ) was assessed by a 3‐h hyperinsulinemic–euglycemic clamp and whole‐body substrate oxidation by indirect calorimetry during fasting and insulin‐stimulated conditions. Results Adolescents with NAFLD had increased (p < 0.05) abdominal fat, lipids, and liver enzymes compared with those without NAFLD . Fasting glucose concentration was not different between groups, but fasting insulin concentration was higher (p < 0.05) in the NAFLD group compared with those without. Fasting hepatic glucose production and hepatic IS did not differ (p > 0.1) between groups. Adolescents with NAFLD had higher (p < 0.05) fasting glucose oxidation and a tendency for lower fat oxidation. Adolescents with NAFLD had lower (p < 0.05) insulin‐stimulated glucose disposal and lower peripheral IS compared with those without NAFLD . Although respiratory quotient ( RQ ) increased significantly from fasting to insulin‐stimulated conditions in both groups (main effect, p < 0.001), the increase in RQ was lower in adolescents with NAFLD vs. those without (interaction, p = 0.037). Conclusion NAFLD in obese adolescents is associated with adverse cardiometabolic profile, peripheral insulin resistance and metabolic inflexibility.