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United States Department of Agriculture

Agricultural Research Service

Title: Glucose Production, Gluconeogenesis and Insulin Sensitivity in Children and Adolescents: An Evaluation of Their Reproducibility

Authors
item Sunehag, Agneta - BAYLOR COLLEGE MEDICINE
item Treuth, Margarita
item Toffolo, Gianna - PADUA, ITALY
item Butte, Nancy - BAYLOR COLLEGE MEDICINE
item Cobelli, Claudio - PADUA, ITALY
item Bier, Dennis - BAYLOR COLLEGE MEDICINE
item Haymond, Morey

Submitted to: Pediatric Research
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: January 20, 2000
Publication Date: August 1, 2001

Interpretive Summary: The prevalence of overweight and obese children has doubled and the incidence of type II diabetes in children (0-19 years) has increased fourfold over the past several decades. As a result we can anticipate an increased number of metabolic studies in children. There are few data on parameters of glucose metabolism in normal children, and virtually none relating to their reproducibility. The aim of this study was 1) to provide new data on energy expenditure, glucose, lipid and protein metabolism in non-obese, healthy children and adolescents; 2) evaluate how reproducible these data are; and 3) use these data to calculate the number of subjects needed for various metabolic studies. Eight non-obese subjects (8-16 years) were studied on two occasions, preceded by 7 d of a diet with identical calorie content and distribution of carbohydrate, fat and protein. Production of new glucose from substrates like lactate and amino acids was measured by deuterium oxide, and was shown to account for 50% of the total glucose production. Glucose production rates were significantly higher (p<0.01) in the children than in the adolescents. Otherwise none of the measured parameters differenced between the children and adolescents. Further, we demonstrate that for energy intake and expenditure, plasma concentrations of glucose and C-peptide, and rates of appearance of glucose and leucine, a 10% difference can be detected in less than 5 subjects with a power of 80% and a type II error of 5%. Insulin concentration, gluconeogenesis, insulin secretory indices, insulin sensitivity and glucose effectiveness were more variable, but with the above power a difference of 25% could be detected in 7-11 subjects using a paired study design.

Technical Abstract: The prevalence of overweight and obese children has doubled and the incidence of type II diabetes in children (0-19 years) has increased fourfold over the past several decades. As a result we can anticipate an increased number of metabolic studies in children. There are few data on parameters of glucose metabolism in normal children, and virtually none relating to their reproducibility. The aim of this study was 1) to provide new data on energy expenditure, glucose, lipid and protein metabolism in non-obese, healthy children and adolescents; 2) evaluate their reproducibility; and 3) based on these data to perform power calculations for metabolic studies. Eight non-obese subjects (8-16 years) were studied on two occasions, preceded by 7 d of a diet with identical energy content and macronutrient distribution. Gluconeogenesis, measured by deuterium oxide, accounted for 50% of glucose production. Insulin sensitivity, measured by the labeled minimal model, averaged 4.9 x 10**-4 min-1 /uU mL- Glucose appearance rate was significantly higher (p<0.01) in the children than in the adolescents. Further, we demonstrate that for energy intake and expenditure, plasma concentrations of glucose and C-peptide, and rates of appearance of glucose and leucine, a 10% difference can be detected in less than 5 subjects with a power of 80% and a type II error of 5%. Insulin concentration, gluconeogenesis, insulin secretory indices, insulin sensitivity and glucose effectiveness were more variable, but with the above power a difference of 25% could be detected in 7-11 subjects using a paired study design.

Last Modified: 7/31/2014
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