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β ‐ Cell function in obese children and adolescents with metabolic syndrome compared to isolated obesity
Author(s) -
Li GuoHua,
Chen XueFeng,
Liang XinYi,
Lin Hu,
Zhang Li,
Xu XiaoQin,
Wu Wei,
Huang Ke,
Dong GuanPing,
Zhang JianWei,
Rose Susan R.,
Ullah Rahim,
Zeitler Phil,
Fu JunFen
Publication year - 2019
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.12905
Subject(s) - medicine , obesity , body mass index , diabetes mellitus , metabolic syndrome , gastroenterology , endocrinology
Objective To evaluate β‐cell function in obese children and adolescents meeting clinical criteria for isolated obesity (iOB), isolated components of dysmetabolism (cMD), or metabolic syndrome (MS), and in obese children and adolescents with normal glucose tolerance (NGT), impaired glucose regulation (IGR), or type 2 diabetes (T2DM). Study Design We undertook a prospective study of Han Chinese children and adolescents aged 8‐16 years (median 11 ± 1.4) seen in an obesity clinic between May 2013 and 2018. Patients were classified as iOB (53), cMD (139), and MS (139) groups based on clinical criteria. The same patients were also classified as NGT (212), IGR (111), or T2DM (8) based on results of an oral glucose tolerance test (OGTT). The MS patients were classified as NGT [MS](59) and IGR [MS](72) for the further study. All participants also completed a mixed‐meal tolerance test (MMTT). Results Compared with the iOB group, the MS group had significantly higher area under the curve of C‐peptide up to the 2 hours (AUC CP) ( P = .03) and peak C‐peptide ( P = .03), adjusted for BMI, age and Tanner stage, on MMTT. However, there was no difference in the insulinogenic index (ΔI30/ΔG30) or oral disposition index (oDI) derived from the OGTT among the three groups. However, 52% of participants with MS had IGR, compared to 28% in the cMD group. Compared with the NGT group, the individuals with IGR had significantly lower ΔI30/ΔG30 ( P = .001) and oDI ( P < .001). Compared with the iOB group, the NGT[MS] had significantly higher AUC CP ( P = .004), peak C‐peptide ( P = .004) and ΔI30/ΔG30 ( P = .007) adjusted for age, but no difference in oDI. Compared with the NGT[MS], the IGR[MS] had significantly lower ΔI30/ΔG30 ( P = .005) and oDI ( P < .001), but the AUC CP and peak C‐peptide had no difference. Conclusion Although the MS youth have β ‐ cell hyperfunction as a whole, β ‐ cell dysfunction is present in the early stages of dysmetabolism in obese youth with cMD or MS and worsened across the spectrum from iOB to cMD and MS, contributing to development of T2DM.