Insulin resistance, hyperinsulinemia, and energy intake in overweight children.
OBJECTIVE
To examine the relationship between energy intake during a buffet meal and indexes of insulin dynamics in overweight children.


METHODS
Ninety-five nondiabetic, overweight (body mass index > or = 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 (beta = 0.24, P = .042), fasting insulin/glucose ratio (beta = 0.24, P = .044), first-phase insulin (beta = 0.23, P = .032), and first-phase C-peptide (beta = 0.21, P = .046); energy intake was negatively associated with clamp-derived insulin sensitivity (beta = -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.
Han
Joan C
JC
Unit on Growth and Obesity, Program in Developmental Endocrinology and Genetics, National Institute of Child Health and Human Development, Bethesda, MD 20892-1103, USA.
Rutledge
Margaret S
MS
Kozlosky
Merel
M
Salaita
Christine G
CG
Gustafson
Jennifer K
JK
Keil
Margaret F
MF
Fleisch
Abby F
AF
Roberts
Mary D
MD
Ning
Cong
C
Yanovski
Jack A
JA
D015992:Body Mass Index; D002648:Child; D015331:Cohort Studies; D002149:Energy Intake / Q000502:physiology*; D005260:Female; D005518:Food Preferences; D015309:Glucose Clamp Technique; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D050177:Overweight / Q000209:etiology / Q000378:metabolism* / Q000523:psychology