Metabolic inflexibility and insulin resistance in obese adolescents with non‐alcoholic fatty liver disease. Issue 3 (23rd April 2014)

• Record Type: Journal Article
• Authors: Lee, SoJung; Rivera‐Vega, Michelle; Alsayed, Hany Mohamed Abdel Aal; Boesch, Chris; Libman, Ingrid
• Is Part Of: Pediatric diabetes. Volume 16:Issue 3(2015:May)
• Page Start: 211
• Page End: 218
• Publication Date: 2014-04-23
• Subjects: Diabetes in children -- Periodicals; 616.462
• DOI: 10.1111/pedi.12141
• Languages: English
• ISSNs: 1399-543X

Abstract

<abstract abstract-type="main" id="pedi12141-abs-0001"> <title>Abstract</title> <sec id="pedi12141-sec-0001" sec-type="section"> <title>Background</title> <p id="pedi12141-para-0001">Non‐alcoholic fatty liver disease (NAFLD) is a comorbidity of childhood obesity.</p> </sec> <sec id="pedi12141-sec-0002" sec-type="section"> <title>Objective</title> <p id="pedi12141-para-0002">We examined whole‐body substrate metabolism and metabolic characteristics in obese adolescents with vs. without NAFLD.</p> </sec> <sec id="pedi12141-sec-0003" sec-type="section"> <title>Subjects</title> <p id="pedi12141-para-0003">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.</p> </sec> <sec id="pedi12141-sec-0004" sec-type="section"> <title>Methods</title> <p id="pedi12141-para-0004">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.</p> </sec> <sec id="pedi12141-sec-0005" sec-type="section"> <title>Results</title> <p id="pedi12141-para-0005">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).</p> </sec> <sec id="pedi12141-sec-0006" sec-type="section"> <title>Conclusion</title> <p id="pedi12141-para-0006">NAFLD in obese adolescents is associated with adverse cardiometabolic profile, peripheral insulin resistance and metabolic inflexibility.</p> </sec> </abstract>