Metabolic clearance rate of insulin across the glucose tolerance spectrum by race and ethnicity in youth with obesity

IF 4.7 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Obesity Pub Date : 2025-06-05 DOI:10.1002/oby.24317

Wonhee Cho, Fida Bacha, Hala Tfayli, SoJung Lee, Sara F. Michaliszyn, Joon Young Kim, Silva Arslanian

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Abstract

Objective

Despite β-cell failure in youth with dysglycemia (i.e., impaired glucose tolerance [IGT] and type 2 diabetes), fasting insulin (FI) concentrations are elevated. Herein, we examined the following: 1) metabolic clearance rate of insulin (MCRI) in youth with obesity and normal glucose tolerance (NGT) versus those with IGT versus those with type 2 diabetes; 2) racial and ethnic differences in insulin dynamics; and 3) metabolic/adiposity correlates of MCRI.

Methods

A total of 206 youth underwent assessment of fasting glucose, FI, MCRI and peripheral insulin sensitivity (PIS), first-phase insulin secretion, disposition index, body composition, and abdominal adiposity.

Results

In type 2 diabetes versus NGT, MCRI was lower (p < 0.001), and FI was higher (p < 0.001). In Black versus White youth, MCRI was lower (p < 0.001), driven by lower MCRI in youth with dysglycemia (p < 0.001) and not with NGT. MCRI correlated inversely with FI, as well as adiposity measures, and correlated directly with PIS and disposition index. Lower PIS, lower MCRI, and higher first-phase insulin secretion were characteristics of Black versus White youth with dysglycemia.

Conclusions

Higher FI concentrations in the presence of dysglycemia despite β-cell failure could be explained by decreased MCRI. Racial and ethnic contrast in insulin dynamics differs by glycemic status and is more pronounced in dysglycemia manifested by lower MCRI and heightened first-phase insulin secretion in Black versus White youth.

Abstract Image

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不同种族和民族的青少年肥胖患者葡萄糖耐量谱胰岛素代谢清除率

目的：尽管β细胞衰竭的青年血糖异常（即糖耐量受损[IGT]和2型糖尿病），空腹胰岛素（FI）浓度升高。在此，我们检查了以下内容：1)肥胖和正常葡萄糖耐量（NGT）的青少年与IGT患者和2型糖尿病患者的胰岛素代谢清除率（MCRI）；2)胰岛素动态的种族差异；3)代谢/肥胖与MCRI的相关性。方法：对206名青少年进行空腹血糖、FI、MCRI和外周血胰岛素敏感性（PIS）、一期胰岛素分泌、性格指数、体成分和腹部脂肪的评估。结果：与NGT相比，2型糖尿病患者的MCRI更低(p)。结论：尽管β细胞衰竭，但血糖异常患者的FI浓度较高，可以通过降低的MCRI来解释。胰岛素动态的种族和民族差异因血糖状态而异，在黑人和白人青年中表现为较低的MCRI和较高的第一阶段胰岛素分泌的血糖异常中更为明显。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Obesity 医学-内分泌学与代谢

CiteScore

11.70

自引率

1.40%

发文量

261

审稿时长

2-4 weeks

期刊介绍： Obesity is the official journal of The Obesity Society and is the premier source of information for increasing knowledge, fostering translational research from basic to population science, and promoting better treatment for people with obesity. Obesity publishes important peer-reviewed research and cutting-edge reviews, commentaries, and public health and medical developments.