Insulin Clearance at the Pubertal Transition in Youth with Obesity and Steatosis Liver Disease

No data are available on insulin clearance (Cl<sub>I</sub>) trends during the pubertal transition. The aim of this study was to investigate in 973 youths with obesity whether Cl<sub>I</sub> in fasting and post-oral glucose challenge (OGTT) conditions varies at the pubertal tr...

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Main Authors: Roberto Franceschi, Danilo Fintini, Lucilla Ravà, Michela Mariani, Alessia Aureli, Elena Inzaghi, Stefania Pedicelli, Annalisa Deodati, Carla Bizzarri, Marco Cappa, Stefano Cianfarani, Melania Manco
Format: Article
Language:English
Published: MDPI AG 2023-10-01
Series:International Journal of Molecular Sciences
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Online Access:https://www.mdpi.com/1422-0067/24/19/14963
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author Roberto Franceschi
Danilo Fintini
Lucilla Ravà
Michela Mariani
Alessia Aureli
Elena Inzaghi
Stefania Pedicelli
Annalisa Deodati
Carla Bizzarri
Marco Cappa
Stefano Cianfarani
Melania Manco
author_facet Roberto Franceschi
Danilo Fintini
Lucilla Ravà
Michela Mariani
Alessia Aureli
Elena Inzaghi
Stefania Pedicelli
Annalisa Deodati
Carla Bizzarri
Marco Cappa
Stefano Cianfarani
Melania Manco
author_sort Roberto Franceschi
collection DOAJ
description No data are available on insulin clearance (Cl<sub>I</sub>) trends during the pubertal transition. The aim of this study was to investigate in 973 youths with obesity whether Cl<sub>I</sub> in fasting and post-oral glucose challenge (OGTT) conditions varies at the pubertal transition in relation to the severity of obesity and the presence of steatosis liver disease (SLD). The severity of obesity was graded according to the Centers for Disease Control. SLD was graded as absent, mild and severe based on alanine amino transferase levels. Cl<sub>I</sub> was defined as the molar ratio of fasting C-peptide to insulin and of the areas under the insulin to glucose curves during an OGTT. In total, 35% of participants were prepubertal, 72.6% had obesity class II, and 52.6% had mild SLD. Fasting Cl<sub>I</sub> (nmol/pmol × 10<sup>−2</sup>) was significantly lower in pubertal [0.11 (0.08–0.14)] than in prepubertal individuals [0.12 (0.09–0.16)] and higher in class III [0.15 (0.11–0.16)] than in class I obesity [0.11 (0.09–0.14)]. OGTT Cl<sub>I</sub> was higher in boys [0.08 (0.06–0.10)] than in girls [0.07 (0.06–0.09)]; in prepubertal [0.08 (0.06–0.11)] than in pubertal individuals [0.07 (0.05–0.09)]; in class III [0.14 (0.08–0.17)] than in class I obesity [0.07 (0.05–0.10)]; and in severe SLD [0.09 (0.04–0.14)] than in no steatosis [0.06 (0.04–0.17)]. It was lower in participants with prediabetes [0.06 (0.04–0.07)]. OGTT Cl<sub>I</sub> was lower in youths with obesity at puberty along with insulin sensitivity and greater secretion. The findings suggest that the initial increase in Cl<sub>I</sub> in youth with severe obesity and SLD is likely to compensate for hyperinsulinemia and its subsequent decrease at the onset of prediabetes and other metabolic abnormalities.
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spelling doaj.art-c3eff34a3f1248f88e8f0c7b80392d9e2023-11-19T14:33:13ZengMDPI AGInternational Journal of Molecular Sciences1661-65961422-00672023-10-0124191496310.3390/ijms241914963Insulin Clearance at the Pubertal Transition in Youth with Obesity and Steatosis Liver DiseaseRoberto Franceschi0Danilo Fintini1Lucilla Ravà2Michela Mariani3Alessia Aureli4Elena Inzaghi5Stefania Pedicelli6Annalisa Deodati7Carla Bizzarri8Marco Cappa9Stefano Cianfarani10Melania Manco11Pediatric Department, S. Chiara Hospital of Trento, APSS, 38121 Trento, ItalyDiabetes and Growth Disorders Unit, Bambino Gesù Children’s Hospital, IRCCS, 00168 Rome, ItalyClinical Epidemiology, Bambino Gesù Children’s Hospital, IRCCS, 00168 Rome, ItalyDiabetes and Growth Disorders Unit, Bambino Gesù Children’s Hospital, IRCCS, 00168 Rome, ItalyDiabetes and Growth Disorders Unit, Bambino Gesù Children’s Hospital, IRCCS, 00168 Rome, ItalyDiabetes and Growth Disorders Unit, Bambino Gesù Children’s Hospital, IRCCS, 00168 Rome, ItalyDiabetes and Growth Disorders Unit, Bambino Gesù Children’s Hospital, IRCCS, 00168 Rome, ItalyDiabetes and Growth Disorders Unit, Bambino Gesù Children’s Hospital, IRCCS, 00168 Rome, ItalyDiabetes and Growth Disorders Unit, Bambino Gesù Children’s Hospital, IRCCS, 00168 Rome, ItalyResearch Unit, Innovative Therapies for Endocrinopathies, Scientific Directorate, Bambino Gesù Children’s Hospital, IRCCS, 00168 Rome, ItalyDiabetes and Growth Disorders Unit, Bambino Gesù Children’s Hospital, IRCCS, 00168 Rome, ItalyResearch Unit of Predictive and Preventive Medicine, Bambino Gesù Children’s Hospital, 00146 Rome, ItalyNo data are available on insulin clearance (Cl<sub>I</sub>) trends during the pubertal transition. The aim of this study was to investigate in 973 youths with obesity whether Cl<sub>I</sub> in fasting and post-oral glucose challenge (OGTT) conditions varies at the pubertal transition in relation to the severity of obesity and the presence of steatosis liver disease (SLD). The severity of obesity was graded according to the Centers for Disease Control. SLD was graded as absent, mild and severe based on alanine amino transferase levels. Cl<sub>I</sub> was defined as the molar ratio of fasting C-peptide to insulin and of the areas under the insulin to glucose curves during an OGTT. In total, 35% of participants were prepubertal, 72.6% had obesity class II, and 52.6% had mild SLD. Fasting Cl<sub>I</sub> (nmol/pmol × 10<sup>−2</sup>) was significantly lower in pubertal [0.11 (0.08–0.14)] than in prepubertal individuals [0.12 (0.09–0.16)] and higher in class III [0.15 (0.11–0.16)] than in class I obesity [0.11 (0.09–0.14)]. OGTT Cl<sub>I</sub> was higher in boys [0.08 (0.06–0.10)] than in girls [0.07 (0.06–0.09)]; in prepubertal [0.08 (0.06–0.11)] than in pubertal individuals [0.07 (0.05–0.09)]; in class III [0.14 (0.08–0.17)] than in class I obesity [0.07 (0.05–0.10)]; and in severe SLD [0.09 (0.04–0.14)] than in no steatosis [0.06 (0.04–0.17)]. It was lower in participants with prediabetes [0.06 (0.04–0.07)]. OGTT Cl<sub>I</sub> was lower in youths with obesity at puberty along with insulin sensitivity and greater secretion. The findings suggest that the initial increase in Cl<sub>I</sub> in youth with severe obesity and SLD is likely to compensate for hyperinsulinemia and its subsequent decrease at the onset of prediabetes and other metabolic abnormalities.https://www.mdpi.com/1422-0067/24/19/14963insulin clearancefatty liver diseaseobesitypuberty
spellingShingle Roberto Franceschi
Danilo Fintini
Lucilla Ravà
Michela Mariani
Alessia Aureli
Elena Inzaghi
Stefania Pedicelli
Annalisa Deodati
Carla Bizzarri
Marco Cappa
Stefano Cianfarani
Melania Manco
Insulin Clearance at the Pubertal Transition in Youth with Obesity and Steatosis Liver Disease
International Journal of Molecular Sciences
insulin clearance
fatty liver disease
obesity
puberty
title Insulin Clearance at the Pubertal Transition in Youth with Obesity and Steatosis Liver Disease
title_full Insulin Clearance at the Pubertal Transition in Youth with Obesity and Steatosis Liver Disease
title_fullStr Insulin Clearance at the Pubertal Transition in Youth with Obesity and Steatosis Liver Disease
title_full_unstemmed Insulin Clearance at the Pubertal Transition in Youth with Obesity and Steatosis Liver Disease
title_short Insulin Clearance at the Pubertal Transition in Youth with Obesity and Steatosis Liver Disease
title_sort insulin clearance at the pubertal transition in youth with obesity and steatosis liver disease
topic insulin clearance
fatty liver disease
obesity
puberty
url https://www.mdpi.com/1422-0067/24/19/14963
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