INSULIN RESISTANCE IN CHILDHOOD

Summary

Principal Investigator: Silva A Arslanian
Affiliation: Children's Hospital of Pittsburgh
Country: USA
Abstract: [unreadable] DESCRIPTION (provided by applicant): This is a competing renewal application for a K24 in patient-oriented research (POR) for Silva Arslanian, M.D. of the Children's Hospital University of Pittsburgh, School of Medicine. The applicant's original award provided support for POR for investigating insulin resistance during childhood growth and development, mentoring of junior faculty and fellows, advancing the research in new directions, and leadership in POR locally, nationally, and internationally. All of these aims have been executed with outstanding rigor, and the candidate has been successful in accomplishing the following: 1) Competitively renewed her R01 (2R01 HD027503); 2) Obtained new independent NIH funding as PI (1U01 DK063704), and funding for several pharmaceutical trials; 3) Advanced her mentoring commitment by obtaining new funding as PI for a fellow training grant (T32 DK63686) and junior faculty development grant (K12 DK63704), both in pediatric diabetes; 4) Established new collaborations in POR at her own institution (1R01- HD38425, and 5U01 DK061230; PI, Marsha Marcus, Ph.D.) and with other academic institutions (1R01 DK071485; PI, Shumei Sun, Ph.D., Wright State University); 5) Competitively renewed the GCRC grant (5M01RR00084), with an outstanding score, at Children's Hospital of Pittsburgh, where she is director; 6) Became a board member of the Endocrine Fellows Foundation, a national organization whose primary and sole mission is the education and research support of endocrine fellows nationally; 7) Increased the pool of pediatrician investigators in POR by attracting and mentoring new fellows/faculty from within and outside the institution; 9) Assumed a leadership role in directing the newly founded Weight Management & Wellness Center (WMWC) at Children's Hospital of Pittsburgh; and, last but not least, received the inaugural University of Pittsburgh Medical Center Richard L. Day Endowed Chair in Pediatrics. This renewal application proposes to: 1) Continue the leadership of the PI in POR in the area of childhood obesity, insulin resistance, type 2 diabetes, and cardiovascular disease, major public health problems of this millennium; 2) Provide ongoing mentoring to junior faculty, fellows, and medical students; and 3) To conduct innovative research in childhood insulin resistance, its causes, complications and control strategies. Support for these activities will enable Dr. Arslanian to further strengthen and expand the research scope of childhood obesity and insulin resistance but, more importantly, contribute to the academic development of young and upcoming clinician-investigators who will contribute to the global childhood obesity control by developing new paradigms of intervention, prevention and treatment. [unreadable] [unreadable] [unreadable]
Funding Period: 2000-05-01 - 2011-11-30
more information: NIH RePORT

Top Publications

  1. pmc Surrogate lipid markers for small dense low-density lipoprotein particles in overweight youth
    Stephen F Burns
    Division of Weight Management and Wellness, Children s Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA 15224, USA
    J Pediatr 161:991-6. 2012
  2. pmc Aerobic exercise but not resistance exercise reduces intrahepatic lipid content and visceral fat and improves insulin sensitivity in obese adolescent girls: a randomized controlled trial
    SoJung Lee
    Division of Weight Management and Wellness and
    Am J Physiol Endocrinol Metab 305:E1222-9. 2013
  3. pmc Effects of aerobic versus resistance exercise without caloric restriction on abdominal fat, intrahepatic lipid, and insulin sensitivity in obese adolescent boys: a randomized, controlled trial
    SoJung Lee
    Division of Weight Management and Wellness, Children s Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
    Diabetes 61:2787-95. 2012
  4. pmc HbA(1c) diagnostic categories and β-cell function relative to insulin sensitivity in overweight/obese adolescents
    Lindsey A Sjaarda
    Division of Weight Management and Wellness, Children s Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
    Diabetes Care 35:2559-63. 2012
  5. pmc Progressive deterioration of β-cell function in obese youth with type 2 diabetes
    Fida Bacha
    Division of Weight Management and Wellness, Children s Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA
    Pediatr Diabetes 14:106-11. 2013
  6. pmc Metabolomic profiling of amino acids and β-cell function relative to insulin sensitivity in youth
    Sara F Michaliszyn
    Children s Hospital of Pittsburgh, 4401 Penn Avenue, Pittsburgh, Pennsylvania 15224, USA
    J Clin Endocrinol Metab 97:E2119-24. 2012
  7. pmc Relationships between insulin sensitivity, skeletal muscle mass and muscle quality in obese adolescent boys
    S Lee
    Division of Weight Management and Wellness, University of Pittsburgh School of Medicine, Children s Hospital of Pittsburgh of UPMC, Pittsburgh, PA 15224, USA
    Eur J Clin Nutr 66:1366-8. 2012
  8. pmc Effects of an overnight intravenous lipid infusion on intramyocellular lipid content and insulin sensitivity in African-American versus Caucasian adolescents
    SoJung Lee
    Division of Weight Management and Wellness, Children s Hospital of Pittsburgh of UPMC, University of Pittsburgh, School of Medicine, Pittsburgh, PA 15224, USA
    Metabolism 62:417-23. 2013
  9. pmc Measuring β-cell function relative to insulin sensitivity in youth: does the hyperglycemic clamp suffice?
    Lindsey Sjaarda
    Division of Weight Management and Wellness, Children s Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
    Diabetes Care 36:1607-12. 2013
  10. pmc Polycystic ovary syndrome and nonalcoholic fatty liver in obese adolescents: association with metabolic risk profile
    Sara F Michaliszyn
    Division of Weight Management, Children s Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
    Fertil Steril 100:1745-51. 2013

Scientific Experts

  • Silva A Arslanian
  • Tamara Hannon
  • I M Libman
  • Fida Bacha
  • SoJung Lee
  • J L Andreacci
  • Julia Warren-Ulanch
  • Hala Tfayli
  • Sara F Michaliszyn
  • Stephen F Burns
  • Neslihan Gungor
  • Javier de las Heras
  • Kumaravel Rajakumar
  • Lindsey A Sjaarda
  • Michael F Holick
  • Stephanie J Mihalik
  • Riccardo C Bonadonna
  • Lindsey Sjaarda
  • Kara S Hughan
  • Lama Farchoukh
  • Rola Saad
  • Jerry Vockley
  • Donald H Chace
  • Lindsey George Sjaarda
  • Elisa Andreatta
  • Lindsey George
  • Kim Sutton-Tyrrell
  • Janine Janosky
  • Marnie Bertolet
  • Victor R De Jesus
  • Victor R Dejesus
  • Tai C Chen
  • Julia Warren Ulnach
  • Sheryl F Kelsey
  • Trina Thompson

Detail Information

Publications70

  1. pmc Surrogate lipid markers for small dense low-density lipoprotein particles in overweight youth
    Stephen F Burns
    Division of Weight Management and Wellness, Children s Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA 15224, USA
    J Pediatr 161:991-6. 2012
    ..To determine if the ratio of triglycerides to high-density lipoprotein cholesterol (TG/HDL) and non-HDL cholesterol concentration could identify youth with small dense low-density lipoprotein (LDL)...
  2. pmc Aerobic exercise but not resistance exercise reduces intrahepatic lipid content and visceral fat and improves insulin sensitivity in obese adolescent girls: a randomized controlled trial
    SoJung Lee
    Division of Weight Management and Wellness and
    Am J Physiol Endocrinol Metab 305:E1222-9. 2013
    ..65, P = 0.02). In obese adolescent girls, AE but not RE is effective in reducing liver fat and visceral adiposity and improving insulin sensitivity independent of weight loss or calorie restriction...
  3. pmc Effects of aerobic versus resistance exercise without caloric restriction on abdominal fat, intrahepatic lipid, and insulin sensitivity in obese adolescent boys: a randomized, controlled trial
    SoJung Lee
    Division of Weight Management and Wellness, Children s Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
    Diabetes 61:2787-95. 2012
    ..72) and insulin sensitivity (r = -0.47). Both AE and RE alone are effective for reducing abdominal fat and intrahepatic lipid in obese adolescent boys. RE but not AE is also associated with significant improvements in insulin sensitivity...
  4. pmc HbA(1c) diagnostic categories and β-cell function relative to insulin sensitivity in overweight/obese adolescents
    Lindsey A Sjaarda
    Division of Weight Management and Wellness, Children s Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
    Diabetes Care 35:2559-63. 2012
    ..We hypothesized that alterations in the pathophysiologic mechanisms of type 2 diabetes may be evident in the American Diabetes Association recommended at-risk/prediabetes category (HbA(1c) 5.7 to <6.5%)...
  5. pmc Progressive deterioration of β-cell function in obese youth with type 2 diabetes
    Fida Bacha
    Division of Weight Management and Wellness, Children s Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA
    Pediatr Diabetes 14:106-11. 2013
    ..In adults, type 2 diabetes (T2DM) is characterized with progressive deterioration in insulin secretion. Data are scanty in youth. We investigated prospectively the change in β-cell function and in insulin sensitivity in youth with T2DM...
  6. pmc Metabolomic profiling of amino acids and β-cell function relative to insulin sensitivity in youth
    Sara F Michaliszyn
    Children s Hospital of Pittsburgh, 4401 Penn Avenue, Pittsburgh, Pennsylvania 15224, USA
    J Clin Endocrinol Metab 97:E2119-24. 2012
    ..In longitudinal studies of adults, elevated amino acid (AA) concentrations predicted future type 2 diabetes mellitus (T2DM)...
  7. pmc Relationships between insulin sensitivity, skeletal muscle mass and muscle quality in obese adolescent boys
    S Lee
    Division of Weight Management and Wellness, University of Pittsburgh School of Medicine, Children s Hospital of Pittsburgh of UPMC, Pittsburgh, PA 15224, USA
    Eur J Clin Nutr 66:1366-8. 2012
    ..Our findings suggest that SM quality, but not SM mass, is associated with IS in obese adolescent boys...
  8. pmc Effects of an overnight intravenous lipid infusion on intramyocellular lipid content and insulin sensitivity in African-American versus Caucasian adolescents
    SoJung Lee
    Division of Weight Management and Wellness, Children s Hospital of Pittsburgh of UPMC, University of Pittsburgh, School of Medicine, Pittsburgh, PA 15224, USA
    Metabolism 62:417-23. 2013
    ....
  9. pmc Measuring β-cell function relative to insulin sensitivity in youth: does the hyperglycemic clamp suffice?
    Lindsey Sjaarda
    Division of Weight Management and Wellness, Children s Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
    Diabetes Care 36:1607-12. 2013
    ....
  10. pmc Polycystic ovary syndrome and nonalcoholic fatty liver in obese adolescents: association with metabolic risk profile
    Sara F Michaliszyn
    Division of Weight Management, Children s Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
    Fertil Steril 100:1745-51. 2013
    ..To investigate the relationship between liver fat and in vivo insulin sensitivity, body composition, abdominal adiposity, and lipid metabolism in obese adolescent girls with polycystic ovary syndrome (PCOS)...
  11. pmc β-Cell lipotoxicity in response to free fatty acid elevation in prepubertal youth: African American versus Caucasian contrast
    Sara F Michaliszyn
    Division of Weight Management, Children s Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
    Diabetes 62:2917-22. 2013
    ....
  12. pmc β-Cell lipotoxicity after an overnight intravenous lipid challenge and free fatty acid elevation in African American versus American white overweight/obese adolescents
    Kara S Hughan
    Division of Weight Management and Wellness, Children s Hospital of Pittsburgh of the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15224, USA
    J Clin Endocrinol Metab 98:2062-9. 2013
    ..The present study investigated β-cell lipotoxicity to test whether increased free fatty acid (FFA) levels result in greater β-cell dysfunction in AA vs AW OW/OB adolescents...
  13. pmc 25-Hydroxyvitamin D in obese youth across the spectrum of glucose tolerance from normal to prediabetes to type 2 diabetes
    Javier de las Heras
    Division of Pediatric Metabolism, Hospital Universitario de Cruces, Barakaldo, Vizcaya, Spain
    Diabetes Care 36:2048-53. 2013
    ....
  14. pmc Indices of insulin secretion during a liquid mixed-meal test in obese youth with diabetes
    Fida Bacha
    Division of Weight Management and Wellness, Children s Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
    J Pediatr 162:924-9. 2013
    ....
  15. pmc Surrogate estimates of insulin sensitivity in obese youth along the spectrum of glucose tolerance from normal to prediabetes to diabetes
    Lindsey George
    Division of Weight Management and Wellness, Children s Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15224, USA
    J Clin Endocrinol Metab 96:2136-45. 2011
    ..In epidemiological studies of childhood obesity, simple and reliable surrogate estimates of insulin sensitivity are needed because the gold standard, the hyperinsulinemic-euglycemic clamp, is not feasible on a large scale...
  16. pmc Vitamin D status, adiposity, and lipids in black American and Caucasian children
    Kumaravel Rajakumar
    Department of Pediatrics, Division of General Academic Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15224, USA
    J Clin Endocrinol Metab 96:1560-7. 2011
    ..The aim of the study was to examine the relationship between vitamin D status, total and abdominal adiposity, and lipids in black and white children...
  17. pmc Drospirenone/ethinyl estradiol versus rosiglitazone treatment in overweight adolescents with polycystic ovary syndrome: comparison of metabolic, hormonal, and cardiovascular risk factors
    Hala Tfayli
    Division of Weight Management and Wellness, Children s Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15224, USA
    J Clin Endocrinol Metab 96:1311-9. 2011
    ..Adolescents with polycystic ovary syndrome (PCOS) have insulin resistance and higher rates of the metabolic syndrome...
  18. pmc Measurement site of visceral adipose tissue and prediction of metabolic syndrome in youth
    SoJung Lee
    Division of Weight Management and Wellness, Children s Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine, Pittsburgh, PA 15224, USA
    Pediatr Diabetes 12:250-7. 2011
    ..We examined the influence of the measurement site of VAT on the relationships between VAT and metabolic syndrome (MetS) in African-American (AA) and American-White (AW) youth...
  19. pmc Fasting and 2-hour plasma glucose and insulin: relationship with risk factors for cardiovascular disease in overweight nondiabetic children
    Ingrid M Libman
    Division of Pediatric Endocrinology, Metabolism and Diabetes Mellitus, Children s Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
    Diabetes Care 33:2674-6. 2010
    ..To determine whether elevated fasting or 2-h plasma glucose and/or insulin better reflects the presence of cardiovascular disease (CVD) risk markers in an overweight pediatric population with normal glucose tolerance...
  20. pmc Declining beta-cell function relative to insulin sensitivity with increasing fasting glucose levels in the nondiabetic range in children
    Hala Tfayli
    Division of Weight Management and Wellness, Children s Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
    Diabetes Care 33:2024-30. 2010
    ..This investigation tested the hypothesis that beta-cell function relative to insulin sensitivity decreases with increasing FPG in youth...
  21. pmc From pre-diabetes to type 2 diabetes in obese youth: pathophysiological characteristics along the spectrum of glucose dysregulation
    Fida Bacha
    Division of Weight Management and Wellness, Children s Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
    Diabetes Care 33:2225-31. 2010
    ..We investigated differences in insulin sensitivity and secretion among youth with IFG, IGT, and coexistent IFG/IGT compared with those with normal glucose tolerance (NGT) and type 2 diabetes...
  22. pmc Sleep-disordered breathing in obese adolescents is associated with visceral adiposity and markers of insulin resistance
    Tamara S Hannon
    Division of Weight Management and Wellness, Department of Pediatrics, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA
    Int J Pediatr Obes 6:157-60. 2011
    ..Further study to allow for critical assessment of the relationships between sleep-disordered breathing and cardiometabolic risk factors in obese youth remains necessary...
  23. pmc β-cell autoimmunity in overweight non-diabetic youth: any implications?
    Ingrid M Libman
    Division of Pediatric Endocrinology, Children s Hospital of Pittsburgh, Pittsburgh, PA 15201, USA
    Pediatr Diabetes 12:207-11. 2011
    ..without ß-cell AA...
  24. pmc Oral disposition index in obese youth from normal to prediabetes to diabetes: relationship to clamp disposition index
    Lindsey George Sjaarda
    Division of Weight Management and Wellness, Children s Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA 15224, USA
    J Pediatr 161:51-7. 2012
    ....
  25. pmc Metabolomic profiling of fatty acid and amino acid metabolism in youth with obesity and type 2 diabetes: evidence for enhanced mitochondrial oxidation
    Stephanie J Mihalik
    Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
    Diabetes Care 35:605-11. 2012
    ..We compared acylcarnitine (AcylCN) species, common amino acid and fat oxidation (FOX) byproducts, and plasma amino acids in normal weight (NW; n = 39), obese (OB; n = 64), and type 2 diabetic (n = 17) adolescents...
  26. pmc 25-hydroxyvitamin D concentrations and in vivo insulin sensitivity and β-cell function relative to insulin sensitivity in black and white youth
    Kumaravel Rajakumar
    Department of Pediatrics, Division of General Academic Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
    Diabetes Care 35:627-33. 2012
    ..To examine the relationships between plasma 25-hydroxyvitamin D [25(OH)D] and in vivo insulin sensitivity and β-cell function relative to insulin sensitivity, disposition index (DI), in black and white youth...
  27. pmc Relationships among obstructive sleep apnea, anthropometric measures, and neurocognitive functioning in adolescents with severe obesity
    Tamara S Hannon
    Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
    J Pediatr 160:732-5. 2012
    ..To explore associations between measures of obstructive sleep apnea (OSA) and sleep quality, anthropometrics, and neurocognitive functioning in severely obese adolescents...
  28. pmc Differences in stimulated androgen levels in black and white obese adolescent females
    Tamara S Hannon
    University of Pittsburgh School of Medicine, Department of Pediatrics, Divisions of Weight Management and Wellness and Pediatric Endocrinology, Diabetes and Metabolism, USA
    J Pediatr Adolesc Gynecol 25:82-5. 2012
    ..8-13.9 y) who underwent adrenocorticotropic hormone stimulation testing at an academic medical center as part of a protocol for the study of obesity-related conditions...
  29. pmc Cross-sectional association between blood pressure, in vivo insulin sensitivity and adiponectin in overweight adolescents
    Javier de las Heras
    Division of Pediatric Metabolism, Hospital de Cruces, Barakaldo, Spain
    Horm Res Paediatr 76:379-85. 2011
    ....
  30. pmc Type 2 diabetes in youth: are there racial differences in β-cell responsiveness relative to insulin sensitivity?
    Fida Bacha
    Division of Weight Management and Wellness, Children s Hospital of Pittsburgh, Pittsburgh, PA, USA
    Pediatr Diabetes 13:259-65. 2012
    ..Non-diabetic African American (AA) youth have an upregulated insulin secretion relative to insulin sensitivity (IS) compared with their American White (AW) peers. We investigated if similar racial differences exist in youth with T2DM...
  31. pmc Declining β-cell function relative to insulin sensitivity with escalating OGTT 2-h glucose concentrations in the nondiabetic through the diabetic range in overweight youth
    Stephen F Burns
    University of Pittsburgh Medical Center, Pittsburgh, PA, USA
    Diabetes Care 34:2033-40. 2011
    ..Cell function relative to insulin sensitivity, assessed by clamp disposition index (DI) and oral disposition index (DI(O)), were compared among groups...
  32. pmc Skeletal muscle lipid content and insulin sensitivity in black versus white obese adolescents: is there a race differential?
    SoJung Lee
    Division of Weight Management and Wellness, Department of Pediatrics, Children s Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15201, USA
    J Clin Endocrinol Metab 95:2426-32. 2010
    ..We tested the hypothesis that skeletal muscle lipid content (SMLC) is higher in obese black adolescents compared with their white peers and assessed the relationship between SMLC and insulin sensitivity (IS)...
  33. pmc Islet cell antibody-positive versus -negative phenotypic type 2 diabetes in youth: does the oral glucose tolerance test distinguish between the two?
    Hala Tfayli
    Division of Weight Management and Wellness, Children s Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
    Diabetes Care 33:632-8. 2010
    ..This underscores the importance of using more sensitive methods and the importance of determining antibody status in obese youths with CDx-type 2 diabetes...
  34. pmc One-hour plasma glucose concentration during the OGTT: what does it tell about β-cell function relative to insulin sensitivity in overweight/obese children?
    Hala Tfayli
    Division of Weight Management and Wellness, Children s Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA 15224, USA
    Pediatr Diabetes 12:572-9. 2011
    ..In adults 1-h plasma glucose concentration cut-point of 155 mg/dL (8.6 mmol/L) during the oral glucose tolerance test (OGTT) is a strong predictor of future diabetes risk...
  35. pmc Waist circumference, atherogenic lipoproteins, and vascular smooth muscle biomarkers in children
    Stephen F Burns
    Division of Weight Management and Wellness, Children s Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, USA
    J Clin Endocrinol Metab 94:4914-22. 2009
    ..The present study determined differences in lipoprotein particle size and subclass concentration and markers of vascular smooth muscle function in children using WC percentile cutoffs...
  36. ncbi Use of markers of dyslipidemia to identify overweight youth with insulin resistance
    Tamara S Hannon
    Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
    Pediatr Diabetes 7:260-6. 2006
    ..Markers to identify overweight youth with insulin resistance are of clinical importance...
  37. ncbi Cardiorespiratory fitness in youth: relationship to insulin sensitivity and beta-cell function
    SoJung Lee
    Children s Hospital of Pittsburgh, Division of Pediatric Endocrinology, Metabolism, and Diabetes Mellitus, Weight Management and Wellness Center, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
    Obesity (Silver Spring) 14:1579-85. 2006
    ..We examined whether the relationship between cardiorespiratory fitness (CRF) and insulin sensitivity (IS)/secretion is independent of adiposity in healthy African-American (n = 65) and white (n = 57) youth...
  38. ncbi Cardiorespiratory fitness and abdominal adiposity in youth
    S J Lee
    Division of Pediatric Endocrinology, Metabolism and Diabetes Mellitus, Weight Management and Wellness Center, Children s Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
    Eur J Clin Nutr 61:561-5. 2007
    ....
  39. ncbi Are obesity-related metabolic risk factors modulated by the degree of insulin resistance in adolescents?
    Fida Bacha
    Division of Pediatric Endocrinology, Metabolism and Diabetes Mellitus and the Weight Management and Wellness Center, Children s Hospital of Pittsburgh, Pennsylvania 15213, USA
    Diabetes Care 29:1599-604. 2006
    ..However, wide variations in insulin sensitivity are noted in obese youth. It is not clear if greater insulin resistance confers a higher risk of cardiovascular comorbidities and risk for type 2 diabetes...
  40. ncbi Treatment of PCOS in adolescence
    Julia Warren-Ulanch
    Division of Endocrinology, University of Pittsburgh Medical Center, Children s Hospital of Pittsburgh, 3705 Fifth Avenue, Pittsburgh, PA 15213 2583, USA
    Best Pract Res Clin Endocrinol Metab 20:311-30. 2006
    ..Long-term follow-up is needed to determine the effectiveness of these approaches in changing the natural history of the reproductive and metabolic outcomes without causing undue harm...
  41. ncbi Waist circumference is an independent predictor of insulin resistance in black and white youths
    SoJung Lee
    Children s Hospital of Pittsburgh, Division of Pediatric Endocrinology, Metabolism, and Diabetes Mellitus, Weight Management and Wellness Center, 3705 Fifth Avenue at DeSoto Street, Pittsburgh, PA 15213, USA
    J Pediatr 148:188-94. 2006
    ..We examined how well waist circumference (WC) reflects total and abdominal fat and whether WC predicts insulin resistance independent of body mass index (BMI) percentile in youths...
  42. ncbi Clamp techniques in paediatrics: what have we learned?
    Silva A Arslanian
    Children s Hospital of Pittsburgh, Weight Management and Wellness Center, and Division of Pediatric Endocrinology, Metabolism and Diabetes Mellitus, Pittsburgh, PA 15213, USA
    Horm Res 64:16-24. 2005
    ..This article will delineate our paediatric experience with the clamp technique, the hyperinsulinaemic-euglycaemic clamp in assessing in vivo insulin sensitivity, and the hyperglycaemic clamp in assessing insulin secretion...
  43. ncbi Racial differences in adiponectin in youth: relationship to visceral fat and insulin sensitivity
    SoJung Lee
    Division of Pediatric Endocrinology, Metabolism and Diabetes Mellitus, Weight Management and Wellness Center, Children s Hospital of Pittsburgh, 3705 Fifth Avenue at DeSoto St, Pittsburgh, Pennsylvania 15213, USA
    Diabetes Care 29:51-6. 2006
    ....
  44. ncbi Type 2 diabetes mellitus in youth: the complete picture to date
    Neslihan Gungor
    Division of Pediatric Endocrinology, Metabolism, and Diabetes Mellitus, Children s Hospital of Pittsburgh, 3705 Fifth Avenue, Pittsburgh, PA 15213, USA
    Pediatr Clin North Am 52:1579-609. 2005
    ..This article discusses the amassed information in type 2 diabetes mellitus of youth to date with respect to the epidemiology, pathophysiology, risk factors, clinical presentation, screening, and management strategies...
  45. ncbi Comparison of maximal oxygen consumption between obese black and white adolescents
    Joseph L Andreacci
    Department of Exercise, Bloomsburg University, Bloomsburg, PA 17815, USA
    Pediatr Res 58:478-82. 2005
    ..Further investigations should study Hb flow rate (a function of [Hb] . maximal cardiac output) and physical activity/inactivity patterns in obese black and white children as it relates to VO2max...
  46. ncbi Childhood obesity and type 2 diabetes mellitus
    Tamara S Hannon
    Division of Weight Management and Wellness, University of Pittsburgh School of Medicine, Children s Hospital of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA
    Pediatrics 116:473-80. 2005
    ..Health care professionals are advised to perform the appropriate screening in children at risk for T2DM, diagnose the condition as early as possible, and provide rigorous management of the disease...
  47. ncbi Does adiponectin explain the lower insulin sensitivity and hyperinsulinemia of African-American children?
    Fida Bacha
    Division of Endocrinology, Metabolism and Diabetes Mellitus, Children s Hospital of Pittsburgh, PA 15213, USA
    Pediatr Diabetes 6:100-2. 2005
    ..Lower adiponectin does not seem to explain the racial differences in insulin sensitivity. The relationship of hyperinsulinemia and hypoadiponectinemia needs to be further explored...
  48. ncbi Progression from normal glucose tolerance to type 2 diabetes in a young girl: longitudinal changes in insulin sensitivity and secretion assessed by the clamp technique and surrogate estimates
    Rola Saad
    Division of Pediatric Endocrinology, Metabolism and Diabetes Mellitus, Children s Hospital of Pittsburgh, PA 15213, USA
    Pediatr Diabetes 6:95-9. 2005
    ....
  49. pmc Early signs of cardiovascular disease in youth with obesity and type 2 diabetes
    Neslihan Gungor
    Division of Endocrinology, Children s Hospital of Pittsburgh, 3705 Fifth Avenue at DeSoto Street, Pittsburgh, PA 15213, USA
    Diabetes Care 28:1219-21. 2005
  50. pmc Youth type 2 diabetes: insulin resistance, beta-cell failure, or both?
    Neslihan Gungor
    Division of Pediatric Endocrinology, Children s Hospital of Pittsburgh, 3705 Fifth Ave at DeSoto St, Pittsburgh, PA 15213, USA
    Diabetes Care 28:638-44. 2005
    ..This study evaluates insulin sensitivity, pancreatic beta-cell function (BCF), and the balance between the two in youth with type 2 diabetes and assesses the relationship of diabetes duration and HbA(1c) to insulin sensitivity and BCF...
  51. ncbi Longitudinal study of physiologic insulin resistance and metabolic changes of puberty
    Tamara S Hannon
    Division of Pediatric Endocrinology, Metabolism, and Diabetes Mellitus and Division of Weight Management and Wellness, Children s Hospital of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA
    Pediatr Res 60:759-63. 2006
    ..These metabolic changes are proposed to be partially mediated by increased GH secretion and are consistent with the Randle cycle of competition between glucose and fat oxidation...
  52. ncbi Waist circumference, blood pressure, and lipid components of the metabolic syndrome
    SoJung Lee
    Weight Management and Wellness Center and Division of Pediatric Endocrinology, Metabolism and Diabetes Mellitus, Children s Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
    J Pediatr 149:809-16. 2006
    ..To examine whether waist circumference (WC) predicts blood pressure (BP) and lipid components of the metabolic syndrome independent of body mass index (BMI) percentile in youths...
  53. pmc In vivo insulin sensitivity and lipoprotein particle size and concentration in black and white children
    Stephen F Burns
    Division of Weight Management and Wellness, Children s Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
    Diabetes Care 32:2087-93. 2009
    ..To examine sex-specific black/white differences in lipoprotein profile and the role of visceral adiposity and to assess the relationship between insulin sensitivity and lipoprotein profiles in each group...
  54. pmc Pathophysiology of type 2 diabetes mellitus in youth: the evolving chameleon
    Hala Tfayli
    Division of Weight Management and Wellness from Center, Children s Hospital of Pittsburgh, University of Pittsburgh Medical Center, 3705 Fifth Avenue, Pittsburgh, PA 15213, USA
    Arq Bras Endocrinol Metabol 53:165-74. 2009
    ..These challenges combined with the evolving picture of youth T2DM and its future complications provide unending opportunities for acquisition of new knowledge in the field of childhood diabetes...
  55. pmc Phenotypic type 2 diabetes in obese youth: insulin sensitivity and secretion in islet cell antibody-negative versus -positive patients
    Hala Tfayli
    Division of Weight Management and Wellness, Children s Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
    Diabetes 58:738-44. 2009
    ..In this study, we investigated the differences in insulin sensitivity and secretion between autoantibody-negative (Ab-) and -positive (Ab+) youth with clinically diagnosed type 2 diabetes in comparison with control subjects...
  56. pmc Effects of an intravenous lipid challenge and free fatty acid elevation on in vivo insulin sensitivity in African American versus Caucasian adolescents
    Stephen F Burns
    Division of Weight Management and Wellness, Children s Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
    Diabetes Care 32:355-60. 2009
    ..The present investigation determined whether elevating FFA is more deleterious to insulin sensitivity in African American than in Caucasian adolescents...
  57. pmc In vivo insulin sensitivity and secretion in obese youth: what are the differences between normal glucose tolerance, impaired glucose tolerance, and type 2 diabetes?
    Fida Bacha
    Division of Pediatric Endocrinology, Metabolism and Diabetes Mellitus, Children s Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
    Diabetes Care 32:100-5. 2009
    ..The aim of this study was to investigate the differences in insulin sensitivity (IS) and secretion in obese adolescents with IGT compared with those with normal glucose tolerance (NGT) and type 2 diabetes...
  58. pmc Reproducibility of the oral glucose tolerance test in overweight children
    I M Libman
    Children s Hospital of Pittsburgh, and Department of Epidemiology, Graduate School of Public Health, Center for Exercise and Health Fitness Research, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA
    J Clin Endocrinol Metab 93:4231-7. 2008
    ..We examined the reproducibility of the oral glucose tolerance test (OGTT) in overweight children and evaluated distinguishing characteristics between those with concordant vs. discordant results...
  59. pmc Fat oxidation in black and white youth: a metabolic phenotype potentially predisposing black girls to obesity
    SoJung Lee
    University of Pittsburgh, School of Medicine, Weight Management and Wellness Center, Pediatric Clinical and Translational Research Center, Children s Hospital of Pittsburgh, 3705 Fifth Avenue, Pittsburgh, Pennsylvania 15213, USA
    J Clin Endocrinol Metab 93:4547-51. 2008
    ..Thus, we examined the relationships between race, pubertal development, and postabsorptive fat oxidation in youth...
  60. pmc Menstrual health and the metabolic syndrome in adolescents
    Hala Tfayli
    Division of Pediatric Endocrinology, Metabolism and Diabetes Mellitus, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
    Ann N Y Acad Sci 1135:85-94. 2008
    ..Careful assessment of menstrual history and appropriate laboratory work-up could reveal the presence of PCOS in obese at-risk adolescent girls with a family history of the metabolic syndrome...
  61. pmc Hyperinsulinemia in African-American adolescents compared with their American white peers despite similar insulin sensitivity: a reflection of upregulated beta-cell function?
    Tamara S Hannon
    Division of Pediatric Endocrinology, Metabolism, and Diabetes, Children s Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
    Diabetes Care 31:1445-7. 2008
    ..The aim of the present investigation was to assess whether glucose-stimulated insulin response is higher in AA versus AW adolescents who have comparable in vivo insulin sensitivity...
  62. pmc Measures of beta-cell function during the oral glucose tolerance test, liquid mixed-meal test, and hyperglycemic clamp test
    Fida Bacha
    Division of Pediatric Endocrinology, Metabolism and Diabetes Mellitus, Children s Hospital of Pittsburgh, Pittsburgh, PA 15213, USA
    J Pediatr 152:618-21. 2008
    ....
  63. ncbi Race and gender differences in the relationships between anthropometrics and abdominal fat in youth
    SoJung Lee
    Children s Hospital of Pittsburgh, Division of Weight Management and Wellness, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
    Obesity (Silver Spring) 16:1066-71. 2008
    ..We examined the influence of race and gender on abdominal adipose tissue (AT) distribution for a given anthropometric measure including waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height (W/Ht) in youth...
  64. doi Comparison of different definitions of pediatric metabolic syndrome: relation to abdominal adiposity, insulin resistance, adiponectin, and inflammatory biomarkers
    SoJung Lee
    Division of Weight Management and Wellness, Children s Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
    J Pediatr 152:177-84. 2008
    ....
  65. ncbi Growth hormone treatment in adolescent males with idiopathic short stature: changes in body composition, protein, fat, and glucose metabolism
    Tamara S Hannon
    Division of Pediatric Endocrinology, Children s Hospital of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA
    J Clin Endocrinol Metab 92:3033-9. 2007
    ..Cross-sectional observations show an inverse relationship between pubertal increase in GH and insulin sensitivity, suggesting that pubertal insulin resistance may be mediated by GH...
  66. ncbi Insulin resistance: link to the components of the metabolic syndrome and biomarkers of endothelial dysfunction in youth
    SoJung Lee
    Division of Weight Management and Wellness, Children s Hospital of Pittsburgh, University of Pittsburgh School of Medicine, PA 15213, USA
    Diabetes Care 30:2091-7. 2007
    ..We examined the relationship of in vivo insulin sensitivity to the components of the metabolic syndrome and biomarkers of endothelial dysfunction in youth...
  67. ncbi Type 2 diabetes in children and adolescents: a review for the primary care provider
    Tamara S Hannon
    Department of Pediatrics, Children s Hospital, University of Pittsburgh Medical Center, PA 15213, USA
    Pediatr Ann 35:880-7. 2006
  68. ncbi Family history of type 2 diabetes is associated with decreased insulin sensitivity and an impaired balance between insulin sensitivity and insulin secretion in white youth
    Silva A Arslanian
    Division of Pediatric Endocrinology, Children s Hospital of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA
    Diabetes Care 28:115-9. 2005
    ..beta-Cell compensation for insulin sensitivity was calculated as the product of insulin sensitivity x first-phase insulin secretion, termed glucose disposition index (GDI)...