ALTERED INSULIN-RESISTANCE IS ASSOCIATED WITH INCREASED DIETARY WEIGHT-LOSS IN OBESE CHILDREN

To determine the relationship between insulin resistance and weight lo ss in early obesity, we used the euglycemic, hyperinsulinemic clamp to study the effect of a 14-day weight reduction diet in 10 prepubertal and early pubertal obese children (age, 10.1 +/- 1.6 years) on insulin sensitivity. Body weight decreased from 73.7 +/- 6.0 kg to 69.1 +/- 5 .8 kg (p < 0.01). Insulin sensitivity before weight reduction negative ly correlated with the amount of weight loss during diet (r = -0.8, p < 0.005). Weight loss also positively correlated with height standard deviation score (r = 0.9, p < 0.005). Mean insulin sensitivity increas ed from 0.068 +/- 0.01 (nmol kg(-1) min(-1))/(pmol l(-1)) to 0.096 +/- 0.030 (nmol kg(-1) min(-1))/(pmol l(-1)) (p < 0.05, one-tailed test). These results indicate that weight reduction decreases insulin resist ance in childhood obesity. The inverse relationship between insulin se nsitivity and weight loss during calorie restriction in these subjects suggests that insulin resistance may enhance weight loss during calor ie restriction.