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Threshold for Improvement in Insulin Sensitivity with Adolescent Weight Loss
Journal article   Open access   Peer reviewed

Threshold for Improvement in Insulin Sensitivity with Adolescent Weight Loss

Pamela Abrams, Lorraine E. Levitt Katz, Renee H. Moore, Melissa S. Xanthopoulos, Chanelle T. Bishop-Gilyard, Thomas A. Wadden and Robert I. Berkowitz
The Journal of pediatrics, v 163(3), pp 785-790
01 Sep 2013
DOI: https://doi.org/10.1016/j.jpeds.2013.04.003
PMID: 23706362
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://europepmc.org/articles/pmc3817268?pdf=renderView
Accepted (AM) Open Open Access (License Unspecified)

Abstract

Life Sciences & Biomedicine Pediatrics Science & Technology
Objectives To assess the association of weight loss and insulin sensitivity, glucose tolerance, and metabolic syndrome (MS) in obese adolescents following weight loss treatment, and to determine the threshold amount of weight loss required to observe improvements in these measures. Study design A randomized, controlled behavioral weight loss trial was conducted with 113 obese adolescents. Changes in fasting insulin, homeostasis model assessment of insulin resistance, whole body insulin sensitivity index (WBISI), body mass index (BMI), and MS criteria were assessed at baseline and at month 4. Results There was significant improvement in all measures of insulin sensitivity at month 4. Mean fasting insulin dropped from 22.3 to 16.6 mu U/mL (P < .0001). Homeostasis model assessment of insulin resistance decreased significantly from 4.9 to 3.7 (P = .001) and WBISI increased significantly from 2.87 to 3.98 (P < .0001). An 8% reduction in BMI led to a significant improvement in WBISI (P = .03) and was the optimal threshold. Fewer individuals met criteria for MS after weight loss (P = .0038), although there were no significant changes in the individual features of the syndrome. Conclusions In this trial, weight loss at month 4 was associated with improved insulin sensitivity in obese adolescents. An approximate decrease in BMI of 8% was the threshold level at which insulin sensitivity improved. As more weight loss programs are designed for obese adolescents, it will be important to have reasonable weight loss goals that will yield improvements in metabolic and cardiovascular disease risk factors.

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21 citations in Web of Science
23 citations in Scopus

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Web of Science research areas
Pediatrics
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