BIOHW 15 |
| In adults, type 2 diabetes develops over a long period. Most, if not all, patients initially have IGT, which is an intermediate stage in the natural history of type 2 diabetes and is highly predictive of diabetes and cardiovascular disease. With appropriate changes in lifestyle and or pharmacologic interventions, progression from IGT to frank diabetes can be delayed or prevented. Thus, great emphasis has recently been placed on the early detection of IGT in adults. Although severe obesity has a prominent role in the pathogenesis of type 2 diabetes in children and adolescents, it was unknown whether it is a risk factor for IGT. We determined the prevalence of IGT in a multiethnic cohort of 55 obese children and 112 obese adolescents. Irrespective of ethnicity, IGT was detected in 25% of the obese children and 21% of the obese adolescents, and silent type 2 diabetes was identified in 4% of the obese adolescents. Insulin resistance is an important risk factor for the development of T2DM, but the decline in the acute insulin response to intravenous glucose determines disease progression in adults. To address these issues, we studied differences in insulin sensitivity and secretion in obese adolescents with NGT and IGT. These studies revealed profound insulin resistance in the obese adolescents with IGT compared with those with NGT. Insulin resistance was mainly accounted for by a reduction in non-oxidative glucose disposal (storage). These studies demonstrated excessive accumulation of IMCL in the soleus muscle of obese adolescents with IGT compared to age and adiposity matched obese adolescents with NGT. Abdominal MRI showed that subcutaneous fat in IGT subjects was significantly lower compared with NGT subjects while visceral fat tended to be higher in the IGT group than in the NGT group.
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Genomics of Obesity
1:30 PM-4:45 PM, Tuesday, August 21, 2007 BCEC -- 203, Oral
Biotechnology of Health and Wellness |