Children’s Nutrition Research Center Staff Publications
Language
English
Publication Date
7-1-2025
Journal
Obesity
DOI
10.1002/oby.24317
PMID
40470991
PMCID
PMC12210107
PubMedCentral® Posted Date
6-5-2025
PubMedCentral® Full Text Version
Post-print
Abstract
Objective: Despite β-cell failure in youth with dysglycemia (i.e., impaired glucose tolerance [IGT] and type 2 diabetes), fasting insulin (FI) concentrations are elevated. Herein, we examined the following: 1) metabolic clearance rate of insulin (MCRI) in youth with obesity and normal glucose tolerance (NGT) versus those with IGT versus those with type 2 diabetes; 2) racial and ethnic differences in insulin dynamics; and 3) metabolic/adiposity correlates of MCRI.
Methods: A total of 206 youth underwent assessment of fasting glucose, FI, MCRI and peripheral insulin sensitivity (PIS), first-phase insulin secretion, disposition index, body composition, and abdominal adiposity.
Results: In type 2 diabetes versus NGT, MCRI was lower (p < 0.001), and FI was higher (p < 0.001). In Black versus White youth, MCRI was lower (p < 0.001), driven by lower MCRI in youth with dysglycemia (p < 0.001) and not with NGT. MCRI correlated inversely with FI, as well as adiposity measures, and correlated directly with PIS and disposition index. Lower PIS, lower MCRI, and higher first-phase insulin secretion were characteristics of Black versus White youth with dysglycemia.
Conclusions: Higher FI concentrations in the presence of dysglycemia despite β-cell failure could be explained by decreased MCRI. Racial and ethnic contrast in insulin dynamics differs by glycemic status and is more pronounced in dysglycemia manifested by lower MCRI and heightened first-phase insulin secretion in Black versus White youth.
Keywords
Humans, Female, Male, Insulin, Adolescent, Blood Glucose, Insulin Resistance, Glucose Intolerance, White People, Diabetes Mellitus, Type 2, Child, Glucose Tolerance Test, Metabolic Clearance Rate, Black or African American, Insulin Secretion, Obesity, Adiposity, Fasting, Body Composition, Pediatric Obesity, Ethnicity
Published Open-Access
yes
Recommended Citation
Cho, Wonhee; Bacha, Fida; Tfayli, Hala; et al., "Metabolic Clearance Rate of Insulin Across the Glucose Tolerance Spectrum by Race and Ethnicity in Youth With Obesity" (2025). Children’s Nutrition Research Center Staff Publications. 240.
https://digitalcommons.library.tmc.edu/staff_pub/240
Included in
Biochemical Phenomena, Metabolism, and Nutrition Commons, Dietetics and Clinical Nutrition Commons, Endocrinology, Diabetes, and Metabolism Commons, Nutrition Commons