Caprio Sonia
Department of Pediatrics, the Yale Children's General Clinical Research Center, Yale University School of Medicine, New Haven, Connecticut 06511.
Am J Hum Biol. 1999;11(2):259-266. doi: 10.1002/(SICI)1520-6300(1999)11:2<259::AID-AJHB13>3.0.CO;2-W.
The distribution of body fat may play an important role in determining the risk of obesity-related morbidity in obese adults. In view of the alarming increase in adolescent obesity, this article addresses whether defects in insulin action and secretion and increased intra-abdominal fat that typify central obesity in adults are expressed early in the course of developing obesity. The euglycemic hyperinsulinemic clamp technique with stable isotopes was used to determine insulin effects on glucose and glycerol turnover in obese and lean adolescents. The hyperglycemic clamp was used to quantitate insulin secretion, while magnetic resonance imaging was used to directly assess abdominal subcutaneous and visceral fat. The results indicate that obese adolescent girls have the following characteristics: 1) insulin resistance with major defects in oxidative and nonoxidative glucose metabolism; 2) hyperinsulinemia in the fasting state and in response to intravenous glucose; and 3) impaired suppression of total body lipid oxidation and plasma FFA concentrations in response to insulin. Am. J. Hum. Biol. 11:259-266, 1999. Copyright 1999 Wiley-Liss, Inc.
体脂分布在决定肥胖成年人肥胖相关发病风险方面可能起着重要作用。鉴于青少年肥胖现象惊人地增加，本文探讨了胰岛素作用和分泌缺陷以及典型的成年中心性肥胖的腹内脂肪增加是否在肥胖发展过程早期就已出现。采用稳定同位素的正常血糖高胰岛素钳夹技术来测定肥胖和瘦青少年中胰岛素对葡萄糖和甘油代谢率的影响。采用高血糖钳夹来定量胰岛素分泌，同时用磁共振成像直接评估腹部皮下和内脏脂肪。结果表明，肥胖青少年女孩具有以下特征：1）胰岛素抵抗，伴有氧化和非氧化葡萄糖代谢的主要缺陷；2）空腹状态下以及对静脉注射葡萄糖反应时出现高胰岛素血症；3）胰岛素作用下全身脂质氧化和血浆游离脂肪酸浓度的抑制受损。《美国人类生物学杂志》11:259 - 266，1999年。版权所有1999威利 - 利斯公司。
