title: Inside out the Ragbag of Glucose Intolerance in Obese Adolescents.
abstract: OBJECTIVE
  The prevalence of impaired glucose tolerance (IGT) is rising among obese adolescents in parallel with epidemic obesity. In some cases, IGT reverts to normal glucose tolerance (NGT) by the end of puberty. The aims of the present study were to investigate metabolic factors determining changes over time of glucose at 120 min (Glu120) following an oral glucose tolerance test (OGTT), and to verify whether preserved β-cell glucose sensitivity (βCGS) protects against persistent IGT.
  
  
  METHODS
  We performed a cohort study of 153 severely obese children and adolescents evaluated with a 5-point OGTT at baseline and at follow-up with measurements of glucose, insulin, and C-peptide to estimate several empirical parameters of insulin sensitivity (includ ing oral glucose insulin sensitivity [OGIS] and OGTT-derived glucose effectiveness) and secretion.
  
  
  RESULTS
  At follow-up (range 0.9-4.8 year), 113 (73.9%) patients remained with NGT, 9 (5.9%) had IGT, and 28 (18.3%) had reverted to NGT; 3 NGT patients had developed IGT. In multivariable models, change in loge(βCGS) was inversely associated with time-related change in loge(Glu120), with (model 2) and without (model 1) correction for the change in loge(OGIS). Model 2 was more strongly associated with change in loge(Glu120).
  
  
  CONCLUSIONS
  Changes in βCGS and insulin sensitivity were inversely associated with changes in Glu120 at follow-up, contributing a likely explanation for the reversal of IGT to NGT.
authors.affiliation: Research Area for Multifactorial Diseases and Complex Phenotypes, Obesity and Diabetes, Bambino Gesù Children's Hospital, Rome, Italy.|Unit of Endocrinology and Diabetes, Bambino Gesù Children's Hospital, Rome, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Brufani
authors.affiliation: Institute of Neuroscience, National Research Council, Padua, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Tura
authors.affiliation: Research Area for Multifactorial Diseases and Complex Phenotypes, Obesity and Diabetes, Bambino Gesù Children's Hospital, Rome, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Bedogni
authors.affiliation: Research Area for Multifactorial Diseases and Complex Phenotypes, Obesity and Diabetes, Bambino Gesù Children's Hospital, Rome, Italy.
authors.forename: Rosa
authors.initials: R
authors.lastname: Luciano
authors.affiliation: Institute of Neuroscience, National Research Council, Padua, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Sbrignadello
authors.affiliation: Unit of Endocrinology and Diabetes, Bambino Gesù Children's Hospital, Rome, Italy.
authors.forename: Danilo
authors.initials: D
authors.lastname: Fintini
authors.affiliation: Unit of Endocrinology and Diabetes, Bambino Gesù Children's Hospital, Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Cappa
authors.affiliation: Department of Human Metabolism and Nutrition and Section of Pediatric Endocrinology, Hadassah Hebrew University, Jerusalem, Israel.
authors.forename: Ram
authors.initials: R
authors.lastname: Weiss
authors.affiliation: Research Area for Multifactorial Diseases and Complex Phenotypes, Obesity and Diabetes, Bambino Gesù Children's Hospital, Rome, Italy.
authors.forename: Melania
authors.initials: M
authors.lastname: Manco
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism*; D002096:C-Peptide / Q000097:blood*; D002648:Child; D018149:Glucose Intolerance / Q000097:blood* / Q000473:pathology; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood*; D050417:Insulin-Secreting Cells / Q000378:metabolism* / Q000473:pathology; D009765:Obesity / Q000097:blood* / Q000473:pathology
chemical_list: D001786:Blood Glucose; D002096:C-Peptide; D007328:Insulin
keywords: Glucose tolerance; Insulin secretion; Insulin sensitivity; Obesity