Skip to main content
SpringerLink
Log in

The effect of puberty on insulin resistance in obese children

  • Original Articles
  • Published:
Journal of Endocrinological Investigation Aims and scope Submit manuscript

Abstract

Objective: Insulin resistance (IR) increases during puberty in normal children. IR is the first adverse metabolic event of obesity, and the marker of the metabolic syndrome. We aimed to study the effect of puberty on IR in obese and normal-weight children. Design: Cross-sectional evaluation of fasting glucose, insulin concentrations, and homeostasis model assessment of IR (HOMA-IR) in obese and control children throughout puberty. Patients and methods: We recruited 424 obese children (207 pre-pubertal and 217 pubertal divided in Tanner stages 2–3, 4, and 5) and estimated IR using the HOMA-IR index. Data were compared to those obtained in 123 healthy normal-weight children (40 pre-pubertal and 83 pubertal divided in Tanner stages 2–3, 4, and 5). Results: In the obese children mean HOMA-IR increased progressively across Tanner stages, and was significantly higher in all groups (pre-pubertal and Tanner stages 2–3, 4, and 5) of obese than in control children. HOMA-IR was significantly correlated with BMI. Conclusions: HOMA-IR in obese children increases at puberty more than in normal-weight children and does not return to pre-pubertal values at the end of puberty.

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

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Lobstein T, Baur L, Uauy R; IASO International Obesity TaskForce. Obesity in children and young people: a crisis in public health. Obes Rev 2004, 5 (Suppl): 4–85.

    Article  PubMed  Google Scholar 

  2. Miller J, Rosenbloom A, Silverstein J. Childhood obesity. J Clin Endocrinol Metab 2004, 89: 4211–8.

    Article  PubMed  CAS  Google Scholar 

  3. Troiano RP, Flegal KM. Overweight children and adolescents: description, epidemiology, and demographics. Pediatrics 1998, 10: 497–504.

    Google Scholar 

  4. Marras V, Macchis R, Foschini ML, et al. Prevalence of overweight and obesity in primary school children in Southern Sardinia, Italy. Ital J Pediatr 2006,32: 251–5.

    Google Scholar 

  5. American Diabetes Association. Type II Diabetes in children and adolescents. Pediatrics 2000, 105: 671–80.

    Article  Google Scholar 

  6. Sinha R, Fisch G, Teague B, et al. Prevalence of impaired glucose tolerance among children and adolescents with marked obesity. N Engl J Med 2002, 346: 802–10.

    Article  PubMed  CAS  Google Scholar 

  7. Beard JC, Ward WK, Halter JB, Wallum BJ, Porte D Jr. Relationship of islet function to insulin action in human obesity. J Clin Endocrinol Metab 1987, 65: 59–64.

    Article  PubMed  CAS  Google Scholar 

  8. Caprio S, Bronson M, Sherwin RS, Rife F, Tamborlane WV. Co-existence of severe insulin resistance and hyperinsulinaemia in preadolescent obese children. Diabetologia 1996, 39: 1489–97.

    Article  PubMed  CAS  Google Scholar 

  9. Krotkiewski M, Björntorp P, Sjöström L, Smith U. Impact of obesity on metabolism in men and women. Importance of regional adipose tissue distribution. J Clin Invest 1983, 72: 1150–62.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  10. Larsson B, Svärdsudd K, Welin L, Wilhelmsen L, Björntorp P, Tibblin G. Abdominal adipose tissue distribution, obesity and risk of cardiovascular disease and death: a 13 years follow-up of partecipants in the study of men born in 1913. Brit Med J 1984, 288: 1401–4.

    Article  CAS  Google Scholar 

  11. Lapidus L, Bengtsson C, Larsson B, Pennert K, Rybo E, Sjöström L. Distribution of adipose tissue and risk of cardiovascular disease and death: a 12 year follow-up of partecipants in the population study of women in Gothenburg, Sweden. Brit Med J (Clin Res Ed) 1984, 289: 1257–61.

    Article  CAS  Google Scholar 

  12. Dietz WH. Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics 1998, 101: 518–25.

    PubMed  CAS  Google Scholar 

  13. Kissebah AH, Vydelingum N, Murray R, et al. Relation of body fat distribution to metabolic complications of obesity. J Clin Endocrinol Metab 1982, 54: 254–60.

    Article  PubMed  CAS  Google Scholar 

  14. Freedman DS, Khan LK, Dietz WH, Srinivasan SR, Berenson GS. Relationship of childhood obesity to coronary heart disease risk factors in adulthood: The Bogalusa heart study. Pediatrics 2001, 108: 712–8.

    Article  PubMed  CAS  Google Scholar 

  15. Bloch CA, Clemons P, Sperling MA. Puberty decreases insulin sensitivity. J Pediatr 1987, 110: 481–7.

    Article  PubMed  CAS  Google Scholar 

  16. Caprio S, Plewe G, Diamond MP, et al. Increased insulin secretion in puberty: a compensatory response to reductions in insulin sensitivity. J Pediatr 1989, 114: 963–7.

    Article  PubMed  CAS  Google Scholar 

  17. Cook JS, Hoffman RP, Stene MA, Hansen JR. Effects of maturational stage on insulin sensitivity during puberty. J Clin Endocrinol Metab 1993, 77: 725–30.

    PubMed  CAS  Google Scholar 

  18. Moran A, Jacobs DR Jr, Steinberger J, et al. Insulin resistance during puberty: results from clamp studies in 357 children. Diabetes 1999, 48: 2039–44.

    Article  PubMed  CAS  Google Scholar 

  19. Hoffman RP, Vicini P, Sivitz WI, Cobelli C. Pubertal adolescent male-female differences in insulin sensitivity and glucose effectiveness determined by the one compartment minimal model. Pediatr Res 2000, 48: 384–8.

    Article  PubMed  CAS  Google Scholar 

  20. Klein DJ, Aronson Friedman L, Harlan WR, et al. Obesity and the development of insulin resistance and impaired fasting glucose in black and white adolescent girls: a longitudinal study. Diabetes Care 2004, 27: 378–83.

    Article  PubMed  Google Scholar 

  21. Cacciari E, Milani S, Balsamo A, et al. Italian cross-sectional growth charts for height, weight and BMI (2 to 20 yr). J Endocrinol Invest 2006, 29: 581–93.

    Article  PubMed  CAS  Google Scholar 

  22. Marshall WA, Tanner JM. Variations in the pattern of pubertal changes in girls. Arch Dis Child 1969, 44: 291–303.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  23. Marshall WA, Tanner JM. Variations in the pattern of pubertal changes in boys. Arch Dis Child 1970, 45: 13–23.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  24. Luciano A, Bressan F, Zoppi G. Body mass index reference curves for children aged 3–19 years from Verona, Italy. Eur J Clin Nutr 1997, 51: 6–10.

    Article  PubMed  CAS  Google Scholar 

  25. Arslanian S, Suprasongsin C, Janosky JE. Insulin secretion and sensitivity in black versus white prepubertal healthy children. J Clin Endocrinol Metab 1997, 82: 1923–7.

    PubMed  CAS  Google Scholar 

  26. Travers SH, Jeffers BW, Bloch CA, Hill JO, Eckel RH. Gender and Tanner stage differences in body composition and insulin sensitivity in early pubertal children. J Clin Endocrinol Metab 1995, 80: 172–8.

    PubMed  CAS  Google Scholar 

  27. McCartney CR, Blank SK, Prendergast KA, et al. Obesity and sex steroid changes across puberty: evidence for marked hyperandrogenemia in pre- and early pubertal obese girls. J Clin Endocrinol Metab 2007, 92: 430–6.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  28. Ferrannini E, Mari A. How to measure insulin sensitivity. J Hypertens 1998, 16: 895–906.

    Article  PubMed  CAS  Google Scholar 

  29. DeFronzo RA, Tobin JD, Andres R. Glucose clamp technique: a method for quantifying insulin secretion and resistance. Am J Physiol Endocrinol Metab 1979, 237: E214–23.

    CAS  Google Scholar 

  30. Bergman RN. Lilly Lecture 1989. Toward physiological understanding of glucose tolerance: minimal-model approach. Diabetes 1989, 38: 1512–27.

    Article  PubMed  CAS  Google Scholar 

  31. Bergman RN, Prager R, Volund A, Olefsky JM. Equivalence of the insulin sensitivity index in man derived by the minimal model method and the euglycemic glucose clamp. J Clin Invest 1987, 79: 790–800.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  32. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985, 28: 412–9.

    Article  PubMed  CAS  Google Scholar 

  33. Keskin M, Kurtoglu S, Kendirci M, Atabek ME, Yazici C. Homeostasis model assessment is more reliable than the fasting glucose/insulin ratio and quantitative insulin sensitivity check index for assessing insulin resistance among obese children and adolescents. Pediatrics 2005, 115: e500–3.

    Article  PubMed  Google Scholar 

  34. Conwell LS, Brown WJ, Trost SG, Batch JA. Indexes of insulin resistance and secretion in obese children and adolescent: a validation study. Diabetes Care 2004, 27: 314–9.

    Article  PubMed  Google Scholar 

  35. Gungor N, Saad R, Janosky J, Arslanian S. Validation of surrogate estimates of insulin sensitivity and insulin secretion in children and adolescents. J Pediatr 2004, 144: 47–55.

    Article  PubMed  CAS  Google Scholar 

  36. Guzzaloni G, Grugni G, Mazzilli G, Moro D, Morabito F. Comparison between beta-cell function and insulin resistance indexes in prepubertal and pubertal obese children. Metabolism 2002, 51: 1011–6.

    Article  PubMed  CAS  Google Scholar 

  37. Rössner SM, Neovius M, Montgomery SM, Marcus C, Norgren S. Alternative methods of insulin sensitivity assessment in obese children and adolescents. Diabetes Care 2008, 31: 802–4.

    Article  PubMed  Google Scholar 

  38. Schwartz B, Steinberger J, Jacobs DR, Hong C, Moran A, Sinaiko AR. Measurement of insulin sensitivity in children: comparison between the euglycemic-hyperinsulinemic clamp and surrogate measures. Diabetes Care 2008, 31: 783–8.

    Article  PubMed  CAS  Google Scholar 

  39. Brandou F, Brun JF, Mercier J. Limited accuracy of surrogates of insulin resistance during puberty in obese and lean children at risk for altered glucoregulation. J Clin Endocrinol Metab 2005, 90: 761–7.

    Article  PubMed  CAS  Google Scholar 

  40. Siervogel RM, Demerath EW, Schubert C, et al. Puberty and body composition. Horm Res 2003, 60 (Suppl): 36–45.

    Article  PubMed  CAS  Google Scholar 

  41. Scacchi M, Pincelli AI, Cavagnini F. Growth hormone in obesity. Int J Obes Relat Metab Disord 1999, 23: 260–71.

    Article  PubMed  CAS  Google Scholar 

  42. Ronti T, Lupattelli G, Mannarino E. The endocrine function of adipose tissue: an update. Clin Endocrinol (Oxf) 2006, 64: 355–65.

    CAS  Google Scholar 

  43. Martos-Moreno GA, Barrios V, Argente J. Normative data for adiponectin, resistin, interleukin 6, and leptin/receptor ratio in a healthy Spanish pediatric population: relationship with sex steroids. Eur J Endocrinol 2006, 155: 429–34.

    Article  PubMed  CAS  Google Scholar 

  44. Mann DR, Johnson AO, Gimpel T, Castracane VD. Changes in circulating leptin, leptin receptor, and gonadal hormones from infancy until advanced age in humans. J Clin Endocrinol Metab 2003, 88: 3339–45.

    Article  PubMed  CAS  Google Scholar 

  45. Böttner A, Kratzsch J, Müller G, et al. Gender differences of adiponectin levels develop during the progression of puberty and are related to serum androgen levels. J Clin Endocrinol Metab 2004, 89: 4053–61.

    Article  PubMed  CAS  Google Scholar 

  46. Mayes JS, Watson GH. Direct effects of sex steroid hormones on adipose tissues and obesity. Obes Rev 2004, 5: 197–216.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Pediatric Endocrinology Unit, Microcitemico Hospital, ASL Cagliari

    S. Pilia, M. R. Casini, M. L. Foschini, M. C. Musiu, V. Marras, P. Civolani & S. Loche MD

  2. Department of Public Health, University of Cagliari, Cagliari, Italy

    L. Minerba

Authors
  1. S. Pilia
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. R. Casini
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. L. Foschini
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. L. Minerba
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M. C. Musiu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. V. Marras
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. P. Civolani
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. S. Loche MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S. Loche MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pilia, S., Casini, M.R., Foschini, M.L. et al. The effect of puberty on insulin resistance in obese children. J Endocrinol Invest 32, 401–405 (2009). https://doi.org/10.1007/BF03346475

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03346475

Key-words

Search

Navigation