Adolescent Obesity and Insulin Resistance: Roles of Ectopic Fat Accumulation and Adipose Inflammation. 2017

Sonia Caprio, and Rachel Perry, and Romy Kursawe
Department of Pediatric Endocrinology, Yale University School of Medicine, New Haven, Connecticut. Electronic address: sonia.caprio@yale.edu.

As a consequence of the global rise in the prevalence of adolescent obesity, an unprecedented phenomenon of type 2 diabetes has emerged in pediatrics. At the heart of the development of type 2 diabetes lies a key metabolic derangement: insulin resistance (IR). Despite the widespread occurrence of IR affecting an unmeasurable number of youths worldwide, its pathogenesis remains elusive. IR in obese youth is a complex phenomenon that defies explanation by a single pathway. In this review we first describe recent data on the prevalence, severity, and racial/ethnic differences in pediatric obesity. We follow by elucidating the initiating events associated with the onset of IR, and describe a distinct "endophenotype" in obese adolescents characterized by a thin superficial layer of abdominal subcutaneous adipose tissue, increased visceral adipose tissue, marked IR, dyslipidemia, and fatty liver. Further, we provide evidence for the cellular and molecular mechanisms associated with this peculiar endophenotype and its relations to IR in the obese adolescent.

UI MeSH Term Description Entries
D007249 Inflammation A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. Innate Inflammatory Response,Inflammations,Inflammatory Response, Innate,Innate Inflammatory Responses
D007333 Insulin Resistance Diminished effectiveness of INSULIN in lowering blood sugar levels: requiring the use of 200 units or more of insulin per day to prevent HYPERGLYCEMIA or KETOSIS. Insulin Sensitivity,Resistance, Insulin,Sensitivity, Insulin
D008099 Liver A large lobed glandular organ in the abdomen of vertebrates that is responsible for detoxification, metabolism, synthesis and storage of various substances. Livers
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D015992 Body Mass Index An indicator of body density as determined by the relationship of BODY WEIGHT to BODY HEIGHT. BMI Quetelet Index,Quetelet's Index,Index, Body Mass,Index, Quetelet,Quetelets Index
D015995 Prevalence The total number of cases of a given disease in a specified population at a designated time. It is differentiated from INCIDENCE, which refers to the number of new cases in the population at a given time. Period Prevalence,Point Prevalence,Period Prevalences,Point Prevalences,Prevalence, Period,Prevalence, Point,Prevalences
D050152 Intra-Abdominal Fat Fatty tissue inside the ABDOMINAL CAVITY, including visceral fat and retroperitoneal fat. It is the most metabolically active fat in the body and easily accessible for LIPOLYSIS. Increased visceral fat is associated with metabolic complications of OBESITY. Abdominal Visceral Fat,Fat, Intra-Abdominal,Intra-Abdominal Adipose Tissue,Retroperitoneal Adipose Tissue,Retroperitoneal Fat,Visceral Adipose Tissue,Visceral Fat,Abdominal Visceral Fats,Adipose Tissue, Intra-Abdominal,Adipose Tissue, Retroperitoneal,Adipose Tissue, Visceral,Fat, Abdominal Visceral,Fat, Intra Abdominal,Fat, Retroperitoneal,Fat, Visceral,Fats, Abdominal Visceral,Fats, Intra-Abdominal,Fats, Retroperitoneal,Fats, Visceral,Intra Abdominal Adipose Tissue,Intra Abdominal Fat,Intra-Abdominal Fats,Retroperitoneal Fats,Visceral Fats
D050507 Subcutaneous Fat, Abdominal Fatty tissue under the SKIN in the region of the ABDOMEN. Abdominal Subcutaneous Adipose Tissue,Abdominal Subcutaneous Fat,Adipose Tissue, Abdominal Subcutaneous,Fat, Abdominal Subcutaneous,Abdominal Subcutaneous Fats,Fats, Abdominal Subcutaneous,Subcutaneous Fats, Abdominal
D058068 Endophenotypes Measurable biological (physiological, biochemical, and anatomical features), behavioral (psychometric pattern) or cognitive markers that are found more often in individuals with a disease than in the general population. Because many endophenotypes are present before the disease onset and in individuals with heritable risk for disease such as unaffected family members, they can be used to help diagnose and search for causative genes. Endophenotype

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