Skip to main content
SpringerLink
Log in

Insulinresistenz und Insulinsensitivität

  • Chapter
  • First Online:
Adipositas bei Kindern und Jugendlichen

  • 4330 Accesses

Zusammenfassung

Der Begriff Insulinresistenz beschreibt den klinischen Zustand einer herabgesetzten Insulinwirkung auf die Glukosehomöostase. Die Insulinresistenz ist ein etablierter Risikofaktor für die Entwicklung von gestörter Glukosetoleranz und Diabetes mellitus Typ 2. Dieses Kapitel stellt die Grundlagen von Physiologie und Pathophysiologie der Insulinwirkung sowie die organsystembezogene Pathogenese der Insulinresistenz dar. Aufgrund des großen klinischen und wissenschaftlichen Interesses an der Insulinresistenz als zentralem Motiv des metabolischen Syndroms, wurden in den zurückliegenden Jahrzehnten eine Vielzahl von Methoden und Indizes zur Messung und Beschreibung des Ausmaßes der Insulinresistenz entwickelt. Im zweiten Teil des Kapitels werden daher häufig eingesetzte Methoden und Surrogatparameter beschrieben und hinsichtlich ihrer in den meisten Fällen nur eingeschränkten Einsetzbarkeit und Aussagekraft bei Patienten im Kindes- und Jugendalter diskutiert.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 44.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 59.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Literatur

  • Bacha F, Lee S, Gungor N, Arslanian SA (2010) From pre-diabetes to type 2 diabetes in obese youth: pathophysiological characteristics along the spectrum of glucose dysregulation. Diabetes Care 33:2225–2231

    Article  Google Scholar 

  • Belfiore F, Iannello S, Volpicelli G (1998) Insulin sensitivity indices calculated from basal and OGTT-induced insulin, glucose, and FFA levels. Mol Genet Metab 63:134–141

    Article  CAS  Google Scholar 

  • Bell GI, Kayano T, Buse JB, Burant CF, Takeda J, Lin D, Fukumoto H, Seino S (1990) Molecular biology of mammalian glucose transporters. Diabetes Care 13:198–208

    Article  CAS  Google Scholar 

  • Boisseau N, Delamarche P (2000) Metabolic and hormonal responses to exercise in children and adolescents. Sports Med 30:405–422

    Article  CAS  Google Scholar 

  • Cali AM, Man CD, Cobelli C, Dziura J, Seyal A, Shaw M, Allen K, Chen S, Caprio S (2009) Primary defects in beta-cell function further exacerbated by worsening of insulin resistance mark the development of impaired glucose tolerance in obese adolescents. Diabetes Care 32:456–461

    Article  Google Scholar 

  • Dam V, Sikder T, Santosa S (2016) From neutrophils to macrophages: differences in regional adipose tissue depots. Obes Rev 17:1–17

    Article  CAS  Google Scholar 

  • Denzer C, Thiere D, Muche R, Koenig W, Mayer H, Kratzer W, Wabitsch M (2009) Gender-specific prevalences of fatty liver in obese children and adolescents: roles of body fat distribution, sex steroids, and insulin resistance. J Clin Endocrinol Metab 94:3872–3881

    Article  CAS  Google Scholar 

  • George L, Bacha F, Lee S, Tfayli H, Andreatta E, Arslanian S (2011) Surrogate estimates of insulin sensitivity in obese youth along the spectrum of glucose tolerance from normal to prediabetes to diabetes. J Clin Endocrinol Metab 96:2136–2145

    Article  CAS  Google Scholar 

  • Golan R, Shelef I, Rudich A, Gepner Y, Shemesh E, Chassidim Y, Harman-Boehm I, Henkin Y, Schwarzfuchs D, Ben Avraham S, Witkow S, Liberty IF, Tangi-Rosental O, Sarusi B, Stampfer MJ, Shai I (2012) Abdominal superficial subcutaneous fat: a putative distinct protective fat subdepot in type 2 diabetes. Diabetes Care 35:640–647

    Article  CAS  Google Scholar 

  • Gungor N, Bacha F, Saad R, Janosky J, Arslanian S (2005) Youth type 2 diabetes: insulin resistance, beta-cell failure, or both. Diabetes Care 28:638–644

    Article  CAS  Google Scholar 

  • Gutt M, Davis CL, Spitzer SB, Llabre MM, Kumar M, Czarnecki EM, Schneiderman N, Skyler JS, Marks JB (2000) Validation of the insulin sensitivity index (ISI(0,120)): comparison with other measures. Diabetes Res Clin Pract 47:177–184

    Article  CAS  Google Scholar 

  • Hershkop K, Besor O, Santoro N, Pierpont B, Caprio S, Weiss R (2016) Adipose insulin resistance in obese adolescents across the spectrum of glucose tolerance. J Clin Endocrinol Metab 101:2423–2431

    Article  CAS  Google Scholar 

  • Kahn SE, Prigeon RL, McCulloch DK, Boyko EJ, Bergman RN, Schwartz MW, Neifing JL, Ward WK, Beard JC, Palmer JP (1993) Quantification of the relationship between insulin sensitivity and beta-cell function in human subjects. Evidence for a hyperbolic function. Diabetes 42:1663–1672

    Article  CAS  Google Scholar 

  • Kelsey MM, Zeitler PS (2016) Insulin resistance of puberty. Curr Diab Rep 16:64

    Article  Google Scholar 

  • Körner A, Wiegand S, Hungele A, Tuschy S, Otto KP, l’Allemand-Jander D, Widhalm K, Kiess W, Holl RW, I APV, CNO German (2013) Longitudinal multicenter analysis on the course of glucose metabolism in obese children. Int J Obes 37:931–936

    Article  Google Scholar 

  • Levy-Marchal C, Arslanian S, Cutfield W, Sinaiko A, Druet C, Marcovecchio ML, Chiarelli F (2010) Insulin resistance in children: consensus, perspective, and future directions. J Clin Endocrinol Metab 95:5189–5198

    Article  CAS  Google Scholar 

  • Matsuda M, DeFronzo RA (1999) Insulin sensitivity indices obtained from oral glucose tolerance testing: comparison with the euglycemic insulin clamp. Diabetes Care 22:1462–1470

    Article  CAS  Google Scholar 

  • Oh YS, Bae GD, Baek DJ, Park EY, Jun HS (2018) Fatty acid-induced lipotoxicity in pancreatic beta-cells during development of type 2 diabetes. Front Endocrinol (Lausanne) 9:384

    Article  Google Scholar 

  • Panarotto D, Rémillard P, Bouffard L, Maheux P (2002) Insulin resistance affects the regulation of lipoprotein lipase in the postprandial period and in an adipose tissue-specific manner. Eur J Clin Investig 32:84–92

    Article  CAS  Google Scholar 

  • Perry RJ, Samuel VT, Petersen KF, Shulman GI (2014) The role of hepatic lipids in hepatic insulin resistance and type 2 diabetes. Nature 510:84–91

    Article  CAS  Google Scholar 

  • Petersen KF, Dufour S, Befroy D, Garcia R, Shulman GI (2004) Impaired mitochondrial activity in the insulin-resistant offspring of patients with type 2 diabetes. N Engl J Med 350:664–671

    Article  CAS  Google Scholar 

  • Raygor V, Abbasi F, Lazzeroni LC, Kim S, Ingelsson E, Reaven GM, Knowles JW (2019) Impact of race/ethnicity on insulin resistance and hypertriglyceridaemia. Diab Vasc Dis Res 16:153–159

    Article  CAS  Google Scholar 

  • Rosenfield RL, Ehrmann DA (2016) The pathogenesis of polycystic ovary syndrome (PCOS): the hypothesis of PCOS as functional ovarian hyperandrogenism revisited. Endocr Rev 37:467–520

    Article  CAS  Google Scholar 

  • Samuel VT, Shulman GI (2016) The pathogenesis of insulin resistance: integrating signaling pathways and substrate flux. J Clin Invest 126:12–22

    Article  Google Scholar 

  • Savage DB, Petersen KF, Shulman GI (2007) Disordered lipid metabolism and the pathogenesis of insulin resistance. Physiol Rev 87:507–520

    Article  CAS  Google Scholar 

  • Schwartz B, Jacobs DR, Moran A, Steinberger J, Hong CP, Sinaiko AR (2008) Measurement of insulin sensitivity in children: comparison between the euglycemic-hyperinsulinemic clamp and surrogate measures. Diabetes Care 31:783–788

    Article  CAS  Google Scholar 

  • Shulman GI (2000) Cellular mechanisms of insulin resistance. J Clin Invest 106:171–176

    Article  CAS  Google Scholar 

  • Soonthornpun S, Setasuban W, Thamprasit A, Chayanunnukul W, Rattarasarn C, Geater A (2003) Novel insulin sensitivity index derived from oral glucose tolerance test. J Clin Endocrinol Metab 88:1019–1023

    Article  CAS  Google Scholar 

  • Stumvoll M, Mitrakou A, Pimenta W, Jenssen T, Yki-Järvinen H, Van Haeften T, Renn W, Gerich J (2000) Use of the oral glucose tolerance test to assess insulin release and insulin sensitivity. Diabetes Care 23:295–301

    Article  CAS  Google Scholar 

  • Styne DM, Arslanian SA, Connor EL, Farooqi IS, Murad MH, Silverstein JH, Yanovski JA (2017) Pediatric obesity-assessment, treatment, and prevention: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 102:709–757

    Article  Google Scholar 

  • Unger RH (2003) Lipid overload and overflow: metabolic trauma and the metabolic syndrome. Trends Endocrinol Metab 14:398–403

    Article  CAS  Google Scholar 

  • Weiss R (2007) Fat distribution and storage: how much, where, and how. Eur J Endocrinol 157(Suppl 1):S39–S45

    Article  CAS  Google Scholar 

  • Weiss R, Dufour S, Taksali SE, Tamborlane WV, Petersen KF, Bonadonna RC, Boselli L, Barbetta G, Allen K, Rife F, Savoye M, Dziura J, Sherwin R, Shulman GI, Caprio S (2003) Prediabetes in obese youth: a syndrome of impaired glucose tolerance, severe insulin resistance, and altered myocellular and abdominal fat partitioning. Lancet 362:951–957

    Article  CAS  Google Scholar 

  • Weiss R, Dziura J, Burgert TS, Tamborlane WV, Taksali SE, Yeckel CW, Allen K, Lopes M, Savoye M, Morrison J, Sherwin RS, Caprio S (2004) Obesity and the metabolic syndrome in children and adolescents. N Engl J Med 350:2362–2374

    Article  CAS  Google Scholar 

  • Weiss R, Taksali SE, Dufour S, Yeckel CW, Papademetris X, Cline G, Tamborlane WV, Dziura J, Shulman GI, Caprio S (2005) The „obese insulin-sensitive“ adolescent: importance of adiponectin and lipid partitioning. J Clin Endocrinol Metab 90:3731–3737

    Article  CAS  Google Scholar 

  • Yeckel CW, Weiss R, Dziura J, Taksali SE, Dufour S, Burgert TS, Tamborlane WV, Caprio S (2004) Validation of insulin sensitivity indices from oral glucose tolerance test parameters in obese children and adolescents. J Clin Endocrinol Metab 89:1096–1101

    Article  CAS  Google Scholar 

  • Yu C, Chen Y, Cline GW, Zhang D, Zong H, Wang Y, Bergeron R, Kim JK, Cushman SW, Cooney GJ, Atcheson B, White MF, Kraegen EW, Shulman GI (2002) Mechanism by which fatty acids inhibit insulin activation of insulin receptor substrate-1 (IRS-1)-associated phosphatidylinositol 3-kinase activity in muscle. J Biol Chem 277:50230–50236

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Sektion Pädiatrische Endokrinologie und Diabetologie, Universitätsklinik für Kinder- und Jugendmedizin Ulm, Ulm, Deutschland

    Christian Denzer

  2. Sektion Pädiatrische Endokrinologie u. Diabetologie, Universitätsklinik für Kinder- und Jugendmedizin, Ulm, Deutschland

    Eberhard Heinze

Authors
  1. Christian Denzer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Eberhard Heinze
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Christian Denzer .

Editor information

Editors and Affiliations

  1. Sektion Pädiatrische Endokrinologie u. Diabetologie, Universitätsklinik für Kinder- und Jugendmedizin, Ulm, Deutschland

    Martin Wabitsch

  2. Kinder- und Jugendpsychiatrie, Rheinische Kliniken der Universität Duisburg-Essen, Essen, Deutschland

    Johannes Hebebrand

  3. Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Leipzig, Leipzig, Deutschland

    Wieland Kiess

  4. Endokrinologie und Diabetologie, Vestische Kinderklinik, Datteln, Deutschland

    Thomas Reinehr

  5. Sozialpädiatrisches Zentrum, Charité – Universitätsmedizin Berlin, Berlin, Deutschland

    Susanna Wiegand

Rights and permissions

Reprints and permissions

Copyright information

© 2022 Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Denzer, C., Heinze, E. (2022). Insulinresistenz und Insulinsensitivität. In: Wabitsch, M., Hebebrand, J., Kiess, W., Reinehr, T., Wiegand, S. (eds) Adipositas bei Kindern und Jugendlichen. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-59216-8_22

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-59216-8_22

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-59215-1

  • Online ISBN: 978-3-662-59216-8

  • eBook Packages: Medicine (German Language)

Publish with us

Policies and ethics

Search

Navigation