PMID- 31408243 OWN - NLM STAT- MEDLINE DCOM- 20200826 LR - 20200826 IS - 1399-5448 (Electronic) IS - 1399-543X (Linking) VI - 20 IP - 7 DP - 2019 Nov TI - beta-Cell function in obese children and adolescents with metabolic syndrome compared to isolated obesity. PG - 861-870 LID - 10.1111/pedi.12905 [doi] AB - OBJECTIVE: To evaluate beta-cell function in obese children and adolescents meeting clinical criteria for isolated obesity (iOB), isolated components of dysmetabolism (cMD), or metabolic syndrome (MS), and in obese children and adolescents with normal glucose tolerance (NGT), impaired glucose regulation (IGR), or type 2 diabetes (T2DM). STUDY DESIGN: We undertook a prospective study of Han Chinese children and adolescents aged 8-16 years (median 11 +/- 1.4) seen in an obesity clinic between May 2013 and 2018. Patients were classified as iOB (53), cMD (139), and MS (139) groups based on clinical criteria. The same patients were also classified as NGT (212), IGR (111), or T2DM (8) based on results of an oral glucose tolerance test (OGTT). The MS patients were classified as NGT [MS](59) and IGR [MS](72) for the further study. All participants also completed a mixed-meal tolerance test (MMTT). RESULTS: Compared with the iOB group, the MS group had significantly higher area under the curve of C-peptide up to the 2 hours (AUC CP) (P = .03) and peak C-peptide (P = .03), adjusted for BMI, age and Tanner stage, on MMTT. However, there was no difference in the insulinogenic index (DeltaI30/DeltaG30) or oral disposition index (oDI) derived from the OGTT among the three groups. However, 52% of participants with MS had IGR, compared to 28% in the cMD group. Compared with the NGT group, the individuals with IGR had significantly lower DeltaI30/DeltaG30 (P = .001) and oDI (P < .001). Compared with the iOB group, the NGT[MS] had significantly higher AUC CP (P = .004), peak C-peptide (P = .004) and DeltaI30/DeltaG30 (P = .007) adjusted for age, but no difference in oDI. Compared with the NGT[MS], the IGR[MS] had significantly lower DeltaI30/DeltaG30 (P = .005) and oDI (P < .001), but the AUC CP and peak C-peptide had no difference. CONCLUSION: Although the MS youth have beta-cell hyperfunction as a whole, beta-cell dysfunction is present in the early stages of dysmetabolism in obese youth with cMD or MS and worsened across the spectrum from iOB to cMD and MS, contributing to development of T2DM. CI - (c) 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. FAU - Li, Guo-Hua AU - Li GH AUID- ORCID: 0000-0001-6671-678X AD - Department of Endocrinology, The Children's Hospital of the Zhejiang University School of Medicine, Hangzhou, China. FAU - Chen, Xue-Feng AU - Chen XF AD - Department of Endocrinology, The Children's Hospital of the Zhejiang University School of Medicine, Hangzhou, China. FAU - Liang, Xin-Yi AU - Liang XY AD - Department of Endocrinology, The Children's Hospital of the Zhejiang University School of Medicine, Hangzhou, China. FAU - Lin, Hu AU - Lin H AD - Department of Endocrinology, The Children's Hospital of the Zhejiang University School of Medicine, Hangzhou, China. FAU - Zhang, Li AU - Zhang L AD - Department of Endocrinology, The Children's Hospital of the Zhejiang University School of Medicine, Hangzhou, China. FAU - Xu, Xiao-Qin AU - Xu XQ AD - Department of Endocrinology, The Children's Hospital of the Zhejiang University School of Medicine, Hangzhou, China. FAU - Wu, Wei AU - Wu W AD - Department of Endocrinology, The Children's Hospital of the Zhejiang University School of Medicine, Hangzhou, China. FAU - Huang, Ke AU - Huang K AD - Department of Endocrinology, The Children's Hospital of the Zhejiang University School of Medicine, Hangzhou, China. FAU - Dong, Guan-Ping AU - Dong GP AD - Department of Endocrinology, The Children's Hospital of the Zhejiang University School of Medicine, Hangzhou, China. FAU - Zhang, Jian-Wei AU - Zhang JW AD - Department of Endocrinology, The Children's Hospital of the Zhejiang University School of Medicine, Hangzhou, China. FAU - Rose, Susan R AU - Rose SR AD - Pediatric Endocrinology and Metabolism, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio. FAU - Ullah, Rahim AU - Ullah R AD - Department of Endocrinology, The Children's Hospital of the Zhejiang University School of Medicine, Hangzhou, China. FAU - Zeitler, Phil AU - Zeitler P AUID- ORCID: 0000-0001-5756-7858 AD - Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado. FAU - Fu, Jun-Fen AU - Fu JF AD - Department of Endocrinology, The Children's Hospital of the Zhejiang University School of Medicine, Hangzhou, China. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20190827 PL - Denmark TA - Pediatr Diabetes JT - Pediatric diabetes JID - 100939345 SB - IM MH - Adolescent MH - Case-Control Studies MH - Child MH - Diabetes Mellitus, Type 2/complications/physiopathology MH - Female MH - Glucose Intolerance/complications/physiopathology MH - Glucose Tolerance Test MH - Humans MH - Insulin Resistance/physiology MH - Insulin-Secreting Cells/*physiology MH - Islets of Langerhans/physiopathology MH - Male MH - Metabolic Syndrome/*complications/*physiopathology MH - Pediatric Obesity/*complications/*physiopathology MH - Prospective Studies OTO - NOTNLM OT - MMTT OT - children and adolescents OT - metabolic syndrome OT - obesity OT - type 2 diabetes OT - beta-Cell function EDAT- 2019/08/14 06:00 MHDA- 2020/08/28 06:00 CRDT- 2019/08/14 06:00 PHST- 2019/02/11 00:00 [received] PHST- 2019/05/05 00:00 [revised] PHST- 2019/05/08 00:00 [accepted] PHST- 2019/08/14 06:00 [pubmed] PHST- 2020/08/28 06:00 [medline] PHST- 2019/08/14 06:00 [entrez] AID - 10.1111/pedi.12905 [doi] PST - ppublish SO - Pediatr Diabetes. 2019 Nov;20(7):861-870. doi: 10.1111/pedi.12905. Epub 2019 Aug 27.