학술논문
Hyperglucagonemia in Pediatric Adiposity Associates With Cardiometabolic Risk Factors but Not Hyperglycemia
Clinical Research Article
Clinical Research Article
Document Type
Academic Journal
Author
Stinson, Sara E.; Jonsson, Anna E.; de Retana Alzola, Ierai Fernandez; Lund, Morten A.V.; Frithioff-Bojsoe, Christine; Holm, Louise Aas; Fonvig, Cilius E.; Pedersen, Oluf; Angquist, Lars; Sorensen, Thorkild I.A.; Hoist, Jens J.; Christiansen, Michael; Holm, Jens-Christian; Hartmann, Bolette; Hansen, Torben
Source
Journal of Clinical Endocrinology & Metabolism. June 2022, Vol. 107 Issue 6, p1569, 8 p.
Subject
Language
English
ISSN
0021-972X
Abstract
Glucagon opposes the glucose-lowering actions of insulin and stimulates hepatic glucose production (1). Glucagon also mediates several nonglucose-related metabolic effects, including regulation of amino acid metabolism (ureagenesis) (2); stimulation of [...]
Context: In adults, hyperglucagonemia is associated with type 2 diabetes, impaired glucose tolerance, and obesity. The role of glucagon in pediatric overweight/obesity remains unclear. Objective: We examined whether fasting concentrations of glucagon are elevated in youth with overweight/obesity and whether this associates with cardiometabolic risk profiles. Methods: Analyses were based on the cross-sectional HOLBAEK study, including children and adolescents 6 to 19 years of age, with overweight/obesity from an obesity clinic group (n = 2154) and with normal weight from a population-based group (n = 1858). Fasting concentrations of plasma glucagon and cardiometabolic risk outcomes were assessed, and multiple linear and logistic regressions models were performed Results: The obesity clinic group had higher glucagon concentrations than the population-based group (P< 0.001). Glucagon positively associated with body mass index (BMI) standard deviation score (SDS), waist, body fat %, liver fat %, alanine transaminase (ALT), high-sensitivity C-reactive protein, homeostasis model assessment of insulin resistance, insulin, C-peptide, LDL-C, triglycerides, SDS of diastolic and systolic blood pressure, and was inversely associated with fasting glucose. The inverse relationship between glucagon and glucose was attenuated in individuals with high BMI SDS and high fasting insulin. Glucagon was associated with a higher prevalence of insulin resistance, increased ALT, dyslipidemia, and hypertension, but not with hyperglycemia. Glucagon was positively associated with fasting total glucagon-like peptide-1. Conclusion: Compared with normal weight peers, children and adolescents with overweight/obesity had elevated concentrations of fasting glucagon, which corresponded to worsened cardiometabolic risk outcomes, except for hyperglycemia.This suggests hyperglucagonemia in youth may precede impairments in glucose regulation. Key Words: adolescent, cardiometabolic risk, child, glucagon, hyperglycemia, obesity
Context: In adults, hyperglucagonemia is associated with type 2 diabetes, impaired glucose tolerance, and obesity. The role of glucagon in pediatric overweight/obesity remains unclear. Objective: We examined whether fasting concentrations of glucagon are elevated in youth with overweight/obesity and whether this associates with cardiometabolic risk profiles. Methods: Analyses were based on the cross-sectional HOLBAEK study, including children and adolescents 6 to 19 years of age, with overweight/obesity from an obesity clinic group (n = 2154) and with normal weight from a population-based group (n = 1858). Fasting concentrations of plasma glucagon and cardiometabolic risk outcomes were assessed, and multiple linear and logistic regressions models were performed Results: The obesity clinic group had higher glucagon concentrations than the population-based group (P< 0.001). Glucagon positively associated with body mass index (BMI) standard deviation score (SDS), waist, body fat %, liver fat %, alanine transaminase (ALT), high-sensitivity C-reactive protein, homeostasis model assessment of insulin resistance, insulin, C-peptide, LDL-C, triglycerides, SDS of diastolic and systolic blood pressure, and was inversely associated with fasting glucose. The inverse relationship between glucagon and glucose was attenuated in individuals with high BMI SDS and high fasting insulin. Glucagon was associated with a higher prevalence of insulin resistance, increased ALT, dyslipidemia, and hypertension, but not with hyperglycemia. Glucagon was positively associated with fasting total glucagon-like peptide-1. Conclusion: Compared with normal weight peers, children and adolescents with overweight/obesity had elevated concentrations of fasting glucagon, which corresponded to worsened cardiometabolic risk outcomes, except for hyperglycemia.This suggests hyperglucagonemia in youth may precede impairments in glucose regulation. Key Words: adolescent, cardiometabolic risk, child, glucagon, hyperglycemia, obesity