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Evidence for two types of juvenile obesity on the basis of body composition and insulin release following small doses of glucose

Anhaltspunkte für zwei Arten juveniler Adipositas auf Grund der Körperzusammensetzung und der Insulinausschüttung nach kleinen Glucosedosen

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Summary

In twelve obese children (relative weight 161–222%) threshold studies of insulin secretion were performed after administration of increasing doses of glucose I.V. (0.02, 0.04, 0.08 and 0.33 g/kg body weight) given at 0, 60, 120, and 180 minutes. Glucose and immunoreactive insulin (IRI) levels were determined at short intervals after each dose. The contrast group consisted of twelve subjects of normal body weight selected in such a way that the total weight of the two groups was comparable. The IRI, IRI/Glucose quotient and the increment of IRI over the baseline values (Δ IRI) were significantly increased in the obese group. The response to the smallest glucose dose allowed to divide the obese into two subgroups: group A with a normal Δ IRI and group B with a considerably increased Δ IRI.

Determination of the body composition by means of a whole body counter showed that patients of group B have more fat tissue than patients of group A. These results clearly indicate that the pathological insulin secretion is related to body composition.

Zusammenfassung

Bei 12 adipösen Kindern (relatives Gewicht 161–222%) wurden Schwellenuntersuchungen der Insulinsekretion durchgeführt. Glucose wurde in steigenden Dosen (0,02, 0,04, 0,08 und 0,33 g/kg) und stündlichen Abständen innert einer Minute intravenös verabreicht. Glucose und immunoreaktives Insulin (IRI) wurden in kurzen Intervallen nach jeder Dosis bestimmt. Als Kontrollgruppe dienten 12 Normalgewichtige, die so gewählt wurden, daß das totale Gewicht der beiden Vergleichsgruppen ähnlich war. Die Glucosetoleranz war in beiden Gruppen identisch. Das IRI, der IRI/Glucosequotient und der IRI-Anstieg (Δ IRI) waren bei den Adipösen bei allen Dosen signifikant höher. Die kleinste Glucosedosis erlaubte die Unterteilung der Adipösen in zwei Gruppen: Gruppe A mit normalem Δ IRI und Gruppe B mit stark erhöhtem Δ IRI. Die mittels Ganzkörperkaliumbestimmung geschätzte Körperzusammensetzung zeigte, daß die Adipösen der Gruppe B mehr Fettgewebe aufweisen als diejenigen der Gruppe A. Die Resultate zeigen, daß die pathologisch vermehrte Insulinsekretion mit der Körperzusammensetzung zusammenhängt.

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Authors and Affiliations

  1. Department of Pediatrics and Radiology University of Berne, Switzerland

    J. P. Jacot, K. A. Zuppinger, E. E. Joss & A. Donath

  2. Universitäts-Kinderklinik Inselspital Bern, Freiburgstr. 23, CH-3008, Bern/Schweiz

    K. A. Zuppinger

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  1. J. P. Jacot
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  2. K. A. Zuppinger
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  3. E. E. Joss
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  4. A. Donath
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Supported by the Swiss National Science foundation Grant number 3.473.68.

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Jacot, J.P., Zuppinger, K.A., Joss, E.E. et al. Evidence for two types of juvenile obesity on the basis of body composition and insulin release following small doses of glucose. Klin Wochenschr 51, 1109–1114 (1973). https://doi.org/10.1007/BF01468305

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