Insulin Resistance, Hyperinsulinemia, and Energy Intake in Overweight Children

Joan C. Han, Margaret S. Rutledge, Merel Kozlosky, Christine G. Salaita, Jennifer K. Gustafson, Margaret F. Keil, Abby F. Fleisch, Mary D. Roberts, Cong Ning, Jack A. Yanovski

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Objective: To examine the relationship between energy intake during a buffet meal and indexes of insulin dynamics in overweight children. Study design: Ninety-five nondiabetic, overweight (body mass index ≥95th percentile) children (age 10.3 ± 1.4 years) selected lunch from a 9835-kcal buffet eaten ad libitum after an overnight fast. The associations between energy intake and measures of insulin dynamics, in the postabsorptive state and during a 2-hour hyperglycemic clamp, were determined. Covariates in the statistical model included race, sex, skeletal age, fat-free mass, fat mass, socioeconomic status, and number of foods in the buffet rated as acceptable. Results: Energy intake was positively associated with the fasting homeostasis model assessment for insulin resistance index (β = 0.24, P = .042), fasting insulin/glucose ratio (β = 0.24, P = .044), first-phase insulin (β = 0.23, P = .032), and first-phase C-peptide (β = 0.21, P = .046); energy intake was negatively associated with clamp-derived insulin sensitivity (β = -0.29, P = .042). Each 10% decrease in clamp-derived insulin sensitivity predicted a 27-kcal greater energy intake. Conclusions: Insulin resistance and hyperinsulinemia are associated with greater energy intake after an overnight fast in overweight children. These associations suggest mechanisms whereby insulin resistance may contribute to excessive weight gain in children.

Original languageEnglish
Pages (from-to)612-617.e1
JournalJournal of Pediatrics
Volume152
Issue number5
DOIs
StatePublished - May 2008
Externally publishedYes

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