Back to Search
Start Over
Insulin resistance and exercise capacity in male children and adolescents with non-alcholic fatty liver disease.
- Source :
-
Acta diabetologica [Acta Diabetol] 2009 Jun; Vol. 46 (2), pp. 97-104. Date of Electronic Publication: 2008 Oct 07. - Publication Year :
- 2009
-
Abstract
- Insulin resistance (IR) and obesity may be associated with impaired response to physical exercise. We aimed at assessing physical capacity in obese children with biopsy proven non-alcoholic fatty liver disease (NAFLD) as compared to normal weight and obese children without fatty liver disease. All male subjects, 20 NAFLD and 31 control individuals (20 obese, without NAFLD and 11 normal weight children) took part in the study. We evaluated changes in cardiovascular parameters during a bicycle-ergometer exercise test (James' test). Duration, power of exercise, heart rate (HR), blood pressure (BP), pulse pressure, cardiac output ((I)CO) and total peripheral vascular resistance indexed for height ((I)TPVR) were recorded at rest ((r)) and peak ((p)) exercise. The homeostatic model assessment was used to determine insulin resistance (HOMA-IR) and beta-cell action (HOMA-beta cell). In NAFLD and obese subjects, fasting leptin, insulin secretion, insulinogenic index (IGI), muscle insulin sensitivity (MISI) and hepatic insulin resistance index (HIRI) were assayed. Children with NAFLD were the most insulin-resistant (P = 0.001), and showed higher HIRI than obese controls (P = 0.05). At rest, they had the lowest values of SBP(r) (P = 0.001 vs. controls and P < or = 0.05 vs. obese controls); during the test, the highest values of (I)CO(p) (P = 0.005), Delta(I)CO (P = 0.003) and DeltaTRVP(p) (P < or = 0.0001). NAFLD and obese controls both had impaired DeltaHR(p) (P < or = 0.0001). However, obese controls were not able to reduce peripheral resistance during the test. HOMA-IR explained 28% of variance in Delta(I)CO of the whole sample, (P < or = 0.0001). In obese children with or without NAFLD, increased IR and body weight may induce cardiovascular compensatory changes in response to physical exercise with fairly different pathogenetic mechanisms, which are likely to be dependent on the different degree of IR.
- Subjects :
- Adolescent
Alanine Transaminase blood
Aspartate Aminotransferases blood
Blood Glucose analysis
Body Mass Index
Cardiac Output
Child
Cholesterol blood
Cholesterol, HDL blood
Fatty Liver diagnostic imaging
Heart Rate
Humans
Insulin Secretion
Liver diagnostic imaging
Male
Obesity prevention & control
Obesity rehabilitation
Reference Values
Rest physiology
Ultrasonography
Exercise
Fatty Liver physiopathology
Insulin metabolism
Insulin Resistance physiology
Obesity physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1432-5233
- Volume :
- 46
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Acta diabetologica
- Publication Type :
- Academic Journal
- Accession number :
- 18839055
- Full Text :
- https://doi.org/10.1007/s00592-008-0063-6