INSULIN-SECRETION AND INSULIN-RESISTANCE DETERMINED BY EUGLYCEMIC CLAMP

Obesity among children is increasingly recognized and linked to severa l metabolic problems, In this study, 47 children, aged 5-14 yr, with e xogenous obesity were compared to 20 normal (non-obese) children to sh ow alterations in glucose metabolism, All the obese children had body mass index >95(th) percentile and weight for age >120%, nasal and stim ulated insulin and C-peptide levels were obtained during oral glucose tolerance test (OGTT), Seven children from the obese group had impaire d OGTT according to WHO criteria, Mean fasting insulin levels were 26. 7+/-14.6 mu IU/ml in obese and 10.99+/-4.36 mu IU/ml in controls; post prandial insulin levels were 70.4+/-56.4 mu IU/ml and 22.23+/-6.55 mu IU/ml, respectively (p<0.001). The euglycemic glucose clamp technique was applied to 8 normal and 22 obese children, The amount of metaboliz ed glucose (M) during clamp test is measured to identify glucose sensi tivity, Mean M values were 3.24+/-1.35 mg/kg/min in obese and 6.525+/- 0.770 mg/kg/min in control children (p<0.001). As a result of this stu dy, it seems reasonable to consider all obese children and adults as b eing at risk for hyperinsulinism and insulin resistance.