Display Settings:

Format

Send to:

Choose Destination
See comment in PubMed Commons below
J Clin Endocrinol Metab. 2009 Oct;94(10):3687-95. doi: 10.1210/jc.2008-2844. Epub 2009 Jul 7.

Insulin resistance in adolescents with type 2 diabetes is associated with impaired exercise capacity.

Author information

  • 1Division of Pediatric Endocrinology, The Children's Hospital, University of Colorado Denver School of Medicine, Aurora, Colorado 80045, USA. kristen.nadeau@ucdenver.edu

Abstract

CONTEXT:

The incidence of pediatric type 2 diabetes (T2D) is rising, with unclear effects on the cardiovascular system. Cardiopulmonary fitness, a marker of morbidity and mortality, is abnormal in adults with T2D, yet the mechanisms are incompletely understood.

OBJECTIVE:

We hypothesized that cardiopulmonary fitness would be reduced in youth with T2D in association with insulin resistance (IR) and cardiovascular dysfunction.

DESIGN, SETTING, AND PARTICIPANTS:

We conducted a cross-sectional study at an academic hospital that included 14 adolescents (age range, 12-19 yr) with T2D, 13 equally obese adolescents and 12 lean adolescents similar in age, pubertal stage, and activity level.

MAIN OUTCOME MEASURES:

Cardiopulmonary fitness was measured by peak oxygen consumption (VO(2)peak) and oxygen uptake kinetics (VO(2)kinetics), IR by hyperinsulinemic clamp, cardiac function by echocardiography, vascular function by venous occlusion plethysmography, body composition by dual-energy x-ray absorptiometry, intramyocellular lipid by magnetic resonance spectroscopy, and inflammation by serum markers.

RESULTS:

Adolescents with T2D had significantly decreased VO(2)peak and insulin sensitivity, and increased soleus intramyocellular lipid, C-reactive protein, and IL-6 compared to obese or lean adolescents. Adolescents with T2D also had significantly prolonged VO(2)kinetics, decreased work rate, vascular reactivity, and adiponectin, and increased left ventricular mass and fatty acids compared to lean adolescents. In multivariate linear regression analysis, IR primarily, and fasting free fatty acids and forearm blood flow secondarily, were significant independent predictors of VO(2)peak.

CONCLUSIONS:

Given the strong relationship between decreased cardiopulmonary fitness and increased mortality, these findings in children are especially concerning and represent early signs of impaired cardiac function.

PMID:
19584191
[PubMed - indexed for MEDLINE]
PMCID:
PMC2758737
Free PMC Article

Images from this publication.See all images (3)Free text

Figure 1
Figure 2
Figure 3
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Icon for Atypon Icon for PubMed Central
    Loading ...
    Write to the Help Desk