Original Article
Pubertal Changes of Insulin Sensitivity, Acute Insulin Response, and β-Cell Function in Overweight Latino Youth

https://doi.org/10.1016/j.jpeds.2010.08.046Get rights and content

Objective

To examine changes in insulin sensitivity (SI), compensatory acute insulin response (AIR), and β-cell function/disposition index (DI) across puberty in overweight Latino boys and girls.

Study design

Latino children (n = 253) were followed annually for up to 5 years. Longitudinal modeling was used to examine changes in SI, AIR, DI, and fasting and 2-hour glucose and insulin across Tanner stage.

Results

In boys, SI decreased in early puberty with a recovery by late puberty. The compensatory increase in AIR was appropriate in early maturation, but after Tanner stage 3, AIR declined by more than that predicted from the recovery in SI. For girls, SI decreased in early puberty and across all stages of maturation. In early maturation, there was an appropriate compensatory increase in AIR, but after Tanner stage 3, AIR decreased. Thus, DI deteriorated across puberty in boys and girls.

Conclusions

In overweight Hispanic youth, compensatory changes in insulin secretion fails after Tanner stage 3 in both sexes, indicating β-cell deterioration during this critical period of development, thus increasing risk for type 2 diabetes.

Section snippets

Methods

Participants were enrolled in the SOLAR (Study of Latino Adolescents at Risk) Diabetes Project at the University of Southern California. This study is an ongoing, longitudinal investigation exploring risk factors in a group of boys and girls at high risk for developing type 2 diabetes early in life. Data are collected for each participant annually. We have previously reported several findings from this cohort including a baseline cross-sectional analysis of puberty and a 1-year follow-up

Results

The baseline (visit 1) characteristics of the 253 participants in the SOLAR cohort are presented in the Table. At baseline, participants included 110 girls and 143 boys. The mean age at baseline was 11.1 ± 1.7 years, and analysis included an average of 3.2 ± 1.6 visits per participants for a total of 818 visits. The Table shows the number of observations per Tanner stage. For SI, there was a decrease from Tanner stages 1 through 3, after which boys increased in SI, and girls continued to

Discussion

The findings from this analysis indicate that the compensation to pubertal insulin resistance in obese Hispanic children was different by sex in the early stages of maturation, though the end result of a declining DI across all stages of puberty was consistent in boys and girls. For boys in early maturation, there was only a marginal improvement in AIR, despite progressive insulin resistance. After Tanner stage 3, SI improved, but AIR declined by more than would be predicted from the

References (23)

  • S. Caprio et al.

    Increased insulin secretion in puberty: a compensatory response to reductions in insulin sensitivity

    J Pediatr

    (1989)
  • G.D.C. Ball et al.

    Longitudinal changes in insulin sensitivity, insulin secretion and beta-cell function during puberty

    J Pediatr

    (2006)
  • H. King et al.

    Global burden of diabetes, 1995-2025: prevalence, numerical estimates, and projections

    Diabetes Care

    (1998)
  • Type 2 diabetes in children and adolescents

    Pediatrics

    (2000)
  • E.J. Boyke et al.

    Visceral adiposity and risk of type 2 diabetes

    Diabetes Care

    (2000)
  • S.E. Khan

    The importance of β-cell failure in the development and progression of type 2 diabetes

    J Clin Endocrinol Metab

    (2001)
  • S. Caprio et al.

    Co-existence of severe insulin resistance and hyperinsulinemia in pre-adolescent obese children

    Diabetologica

    (1996)
  • M.I. Goran et al.

    Longitudinal study on pubertal insulin resistance

    Diabetes

    (2001)
  • S.A. Amiel et al.

    Impaired insulin action in puberty: a contributing factor to poor glycemic control in adolescents with diabetes

    N Engl J Med

    (1986)
  • G.D.C. Ball et al.

    Insulin sensitivity, insulin secretion and β-cell function during puberty in overweight Hispanic children with a family history of type 2 diabetes

    IJO

    (2005)
  • M.I. Goran et al.

    Deterioration of insulin sensitivity and beta-cell function in overweight, insulin resistant Hispanic children: a longitudinal assessment

    Int J Pediatr Obes

    (2006)
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    Supported by grants (R01 DK 59211 and M01 RR 00043), the American Diabetes Association, Mentor-Based Postdoctoral Fellowship (F31-DK081276 to C.T.-C. under the sponsorship of M.G.), and the USC Center for Transdisciplinary Research on Energetics and Cancer (U54 CA 116848). The authors declare no conflicts of interest.

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