[Insulin resistance and hyperinsulinemia--risk factors of the metabolic syndrome in the pubertal population].

Pubertal insulin resistance has been well documented, the fall in insulin sensitivity (Sl) during puberty is associated with a compensatory increase in insulin secretion. Observation of pubertal insulin resistance showed that insulin-stimulated glucose metabolism was approximately 30% lower in a sample of children at Tanner stages II-IV compared with children at Tanner stage I or adults. Although the phenomenon of pubertal insulin resistance is well documented, the mechanism has not been clearly determined. Pubertal insulin resistance occurs during a time of profound changes in body composition and hormone levels. Resistance of the body to the actions of insulin results in increased production of this hormone by the pancreas and ensuing hyperinsulinemia. Obesity beginning in childhood often precedes the hyperinsulinemic state. Other components of the insulin resistance syndrome are also present in children and adolescents. Conditions of insulin resistance, hyperinsulinemia, dyslipidemia, hypertension and obesity, especially in constellation, are potent risk factors of coronary atherosclerosis among adolescents and young adults. Early conservative intervention with diet, exercise, and behavioral therapy may prevent the complications of insulin resistance.