Sato Hidetoshi, Kikuchi Toru, Harada Waka, Yoshida Hiroshi, Ito Sueshi, Uchiyama Makoto
Department of Pediatrics, Shonai Hospital, Tsuruoka, Japan ; Division of Pediatrics, Department of Homeostatic Regulation and Development, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Clin Pediatr Endocrinol. 2011 Apr;20(2):25-32. doi: 10.1297/cpe.20.25. Epub 2011 Oct 7.
The aim of this study was to clarify the relation between postprandial hyperinsulinemia and metabolic disorders in obese children. Twenty-eight obese Japanese children (8.8-16.2 yr) were divided into four groups: without impaired liver function and dyslipidemia (Group A), with impaired liver function (Group B), with dyslipidemia (Group C), and with impaired liver function and dyslipidemia (Group D). The levels of PG, serum immunoreactive insulin (IRI) and serum C-peptide (CPR) were measured during an oral glucose tolerance test (OGTT). The subjects had delayed superfluous insulin and CPR secretion during the OGTT compared with healthy references. In regard to the insulin secretion pattern, Group A's response peaked at 60 min and then decreased gradually until 120 min, Group B's response peaked at 60 min, remained at the peak until 120 min and then decreased gradually until 180 min, Group C's response peaked at 120 min and then decreased gradually until 180 min, and Group D's response peaked at 120 min and remained at the peak until 180 min. These results suggest that delayed superfluous insulin secretion during an OGTT is related to metabolic disorders in obese Japanese children and that these patients will experience a vicious cycle of postprandial hyperinsulinemia and metabolic disorders. It is important to prevent healthy children from becoming obese and to improve management of childhood obesity.
本研究旨在阐明肥胖儿童餐后高胰岛素血症与代谢紊乱之间的关系。28名肥胖日本儿童（8.8 - 16.2岁）被分为四组：肝功能和血脂均未受损组（A组）、肝功能受损组（B组）、血脂异常组（C组）以及肝功能和血脂均受损组（D组）。在口服葡萄糖耐量试验（OGTT）期间测量PG、血清免疫反应性胰岛素（IRI）和血清C肽（CPR）水平。与健康对照相比，受试者在OGTT期间胰岛素和CPR分泌延迟且过多。关于胰岛素分泌模式，A组的反应在60分钟时达到峰值，然后逐渐下降直至120分钟；B组的反应在60分钟时达到峰值，在峰值水平持续到120分钟，然后逐渐下降直至180分钟；C组的反应在120分钟时达到峰值，然后逐渐下降直至180分钟；D组的反应在120分钟时达到峰值，并在峰值水平持续到180分钟。这些结果表明，OGTT期间胰岛素分泌延迟且过多与肥胖日本儿童的代谢紊乱有关，并且这些患者将经历餐后高胰岛素血症和代谢紊乱的恶性循环。预防健康儿童肥胖并改善儿童肥胖管理很重要。
