title: Altered Plasma Levels of Glucagon, GLP-1 and Glicentin During OGTT in Adolescents With Obesity and Type 2 Diabetes.
abstract: BACKGROUND
  Proglucagon-derived hormones are important for glucose metabolism, but little is known about them in pediatric obesity and type 2 diabetes mellitus (T2DM).
  
  
  OBJECTIVE
  Fasting and postprandial levels of proglucagon-derived peptides glucagon, GLP-1, and glicentin in adolescents with obesity across the glucose tolerance spectrum were investigated.
  
  
  METHODS
  This was a cross-sectional study with plasma hormone levels quantified at fasting and during an oral glucose tolerance test (OGTT).
  
  
  METHODS
  This study took place in a pediatric obesity clinic at Uppsala University Hospital, Sweden.
  
  
  METHODS
  Adolescents with obesity, age 10-18 years, with normal glucose tolerance (NGT, n = 23), impaired glucose tolerance (IGT, n = 19), or T2DM (n = 4) and age-matched lean adolescents (n = 19) were included.
  
  
  METHODS
  Outcome measures were fasting and OGTT plasma levels of insulin, glucagon, active GLP-1, and glicentin.
  
  
  RESULTS
  Adolescents with obesity and IGT had lower fasting GLP-1 and glicentin levels than those with NGT (0.25 vs 0.53 pM, P < .05; 18.2 vs 23.6 pM, P < .01) and adolescents with obesity and T2DM had higher fasting glucagon levels (18.1 vs 10.1 pM, P < .01) than those with NGT. During OGTT, glicentin/glucagon ratios were lower in adolescents with obesity and NGT than in lean adolescents (P < .01) and even lower in IGT (P < .05) and T2DM (P < .001).
  
  
  CONCLUSIONS
  Obese adolescents with IGT have lowered fasting GLP-1 and glicentin levels. In T2DM, fasting glucagon levels are elevated, whereas GLP-1 and glicentin levels are maintained low. During OGTT, adolescents with obesity have more products of pancreatically than intestinally cleaved proglucagon (ie, more glucagon and less GLP-1) in the plasma. This shift becomes more pronounced when glucose tolerance deteriorates.
authors.affiliation: Department of Medical Cell Biology (H.M., J.S., L.M., H.K., J.C., R.S., P.B.), Uppsala University, 75123 Uppsala, Sweden; Department of Women's and Children's Health (H.M., J.S., J.C., R.S., I.C., A.F.), Uppsala University Hospital, Uppsala, Sweden.
authors.forename: Hannes
authors.initials: H
authors.lastname: Manell
authors.affiliation: Department of Medical Cell Biology (H.M., J.S., L.M., H.K., J.C., R.S., P.B.), Uppsala University, 75123 Uppsala, Sweden; Department of Women's and Children's Health (H.M., J.S., J.C., R.S., I.C., A.F.), Uppsala University Hospital, Uppsala, Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Staaf
authors.affiliation: Department of Medical Cell Biology (H.M., J.S., L.M., H.K., J.C., R.S., P.B.), Uppsala University, 75123 Uppsala, Sweden; Department of Women's and Children's Health (H.M., J.S., J.C., R.S., I.C., A.F.), Uppsala University Hospital, Uppsala, Sweden.
authors.forename: Levon
authors.initials: L
authors.lastname: Manukyan
authors.affiliation: Department of Medical Cell Biology (H.M., J.S., L.M., H.K., J.C., R.S., P.B.), Uppsala University, 75123 Uppsala, Sweden; Department of Women's and Children's Health (H.M., J.S., J.C., R.S., I.C., A.F.), Uppsala University Hospital, Uppsala, Sweden.
authors.forename: Hjalti
authors.initials: H
authors.lastname: Kristinsson
authors.affiliation: Department of Medical Cell Biology (H.M., J.S., L.M., H.K., J.C., R.S., P.B.), Uppsala University, 75123 Uppsala, Sweden; Department of Women's and Children's Health (H.M., J.S., J.C., R.S., I.C., A.F.), Uppsala University Hospital, Uppsala, Sweden.
authors.forename: Jing
authors.initials: J
authors.lastname: Cen
authors.affiliation: Department of Medical Cell Biology (H.M., J.S., L.M., H.K., J.C., R.S., P.B.), Uppsala University, 75123 Uppsala, Sweden; Department of Women's and Children's Health (H.M., J.S., J.C., R.S., I.C., A.F.), Uppsala University Hospital, Uppsala, Sweden.
authors.forename: Rasmus
authors.initials: R
authors.lastname: Stenlid
authors.affiliation: Department of Medical Cell Biology (H.M., J.S., L.M., H.K., J.C., R.S., P.B.), Uppsala University, 75123 Uppsala, Sweden; Department of Women's and Children's Health (H.M., J.S., J.C., R.S., I.C., A.F.), Uppsala University Hospital, Uppsala, Sweden.
authors.forename: Iris
authors.initials: I
authors.lastname: Ciba
authors.affiliation: Department of Medical Cell Biology (H.M., J.S., L.M., H.K., J.C., R.S., P.B.), Uppsala University, 75123 Uppsala, Sweden; Department of Women's and Children's Health (H.M., J.S., J.C., R.S., I.C., A.F.), Uppsala University Hospital, Uppsala, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Forslund
authors.affiliation: Department of Medical Cell Biology (H.M., J.S., L.M., H.K., J.C., R.S., P.B.), Uppsala University, 75123 Uppsala, Sweden; Department of Women's and Children's Health (H.M., J.S., J.C., R.S., I.C., A.F.), Uppsala University Hospital, Uppsala, Sweden.
authors.forename: Peter
authors.initials: P
authors.lastname: Bergsten
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism; D016022:Case-Control Studies; D002648:Child; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000453:epidemiology; D005260:Female; D053771:Glicentin / Q000097:blood*; D005934:Glucagon / Q000097:blood*; D052216:Glucagon-Like Peptide 1 / Q000097:blood*; D018149:Glucose Intolerance / Q000097:blood / Q000150:complications / Q000453:epidemiology; D005951:Glucose Tolerance Test; D006801:Humans; D008297:Male; D063766:Pediatric Obesity / Q000097:blood* / Q000150:complications / Q000453:epidemiology; D013548:Sweden / Q000453:epidemiology
chemical_list: D001786:Blood Glucose; D053771:Glicentin; D052216:Glucagon-Like Peptide 1; D005934:Glucagon