Adolescent Gastric By-Pass and Diabetic Precursors

青少年胃绕道手术和糖尿病前兆

• 批准号: 7078566
• 负责人: THOMAS HARRIS INGE
• 金额: $ 14.55万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-07-01 至 2009-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7078566
• 关键词: adolescence (12-20); age difference; blood glucose; blood tests; body composition; body physical activity; carbohydrate metabolism; clinical research; disease /disorder prevention /control; glucose tolerance test; human middle age (35-64); human subject; insulin; insulin sensitivity /resistance; noninsulin dependent diabetes mellitus; nutrient intake activity; obesity; pancreatic islet function; personal log /diary; stomach /intestine bypass; weight loss; young adult human (21-34)

DESCRIPTION (provided by applicant): Abstract: Overweight and obesity are the most common metabolic disorders affecting the U.S. with 31% of adults and 16% of adolescents now meeting Centers for Disease Control criteria for these conditions. As the obesity epidemic has unfolded, so too has the increase in prevalence of type 2 diabetes in children and adults. The single most effective treatment for type 2 diabetes in severely obese adults may be bariatric surgery, a procedure that is most commonly performed in the 5th and 6th decades of life. While it is clear that rapid and profound weight loss can significantly improve carbohydrate metabolism in adults, it is not clear to what degree diabetes is reversible in these patients. The pathophysiology of type 2 diabetes in adolescents and children is not well understood and no studies have yet examined the effect of surgical weight loss on insulin resistance, insulin production, or glucose tolerance in severely obese young people. However, it seems likely that bariatric surgery could improve these conditions in youth. Understanding the relative benefits of surgically induced weight reduction on carbohydrate metabolism in adolescents compared to middle-aged subjects is important for determining optimal timing of this intervention. This knowledge may also lead to key insights into obesity-induced diabetes. In this project we will test the hypothesis that bariatric surgical intervention will more effectively improve defects in insulin sensitivity, pancreatic beta cell function, and glucose tolerance in adolescents compared to adults. Two specific aims are proposed 1) to compare the derangements of carbohydrate metabolism among very severely obese (body mass index >40 kg/m2) adolescents and adults referred for bariatric surgery; and 2) To assess improvement in carbohydrate metabolism longitudinally (during and after surgical weight loss) in adolescents and adults and compare differences in the mechanisms of improvement between the two groups. These data will provide critical information about age-related metabolic outcomes of bariatric surgery and could inform the design of larger studies to examine the role of early bariatric surgery for treatment or even prevention of diabetes or the metabolic syndrome in patients at high risk for these dangerous conditions.

描述（由申请人提供）： 摘要：超重和肥胖是影响美国31％和16％的青少年的最常见代谢障碍，现在符合这些疾病的疾病控制标准中心。随着肥胖症流行的发展，儿童和成人2型糖尿病患病率的增加也是如此。严重肥胖的成年人中2型糖尿病的最有效治疗方法可能是减肥手术，该手术通常是在生命的第5和6年中最常进行的。虽然很明显，快速而深刻的体重减轻可以显着改善成年人的碳水化合物代谢，但尚不清楚这些患者在哪种程度上可逆的糖尿病。青少年和儿童中2型糖尿病的病理生理尚不清楚，并且尚未研究手术体重减轻对严重肥胖年轻人的胰岛素抵抗，胰岛素产生或葡萄糖耐受性的影响。但是，减肥手术似乎可以改善青少年的这些状况。与中年受试者相比，了解青少年碳水化合物代谢的手术诱导体重减轻的相对益处对于确定这种干预的最佳时机很重要。这些知识也可能导致对肥胖引起的糖尿病的关键见解。在该项目中，我们将检验以下假设：与成人相比，青少年的减肥手术干预将更有效地改善胰岛素敏感性，胰腺β细胞功能和葡萄糖耐受性的缺陷。提出了两个具体目的1）比较非常肥胖（体重指数> 40 kg/m2）青少年和参考减肥手术的成年人的碳水化合物代谢的危险； 2）在青少年和成年人中纵向评估碳水化合物代谢的改善（手术减肥期间和之后），并比较两组之间改善机制的差异。这些数据将提供有关减肥手术与年龄相关的代谢结果的关键信息，并可以为大型研究的设计提供信息，以检查早期减肥手术在治疗甚至预防糖尿病或代谢综合征对这些危险状况的高风险中的作用。

项目成果

Nutritional consequences of bariatric surgery.

减肥手术的营养后果。

• DOI: 10.1097/01.mco.0000232913.07355.cf
• 发表时间: 2006
• 期刊: Current opinion in clinical nutrition and metabolic care
• 影响因子: 3.1
• 作者: Xanthakos,StavraA;Inge,ThomasH
• 通讯作者: Inge,ThomasH

Dietary assessment of adolescents undergoing laparoscopic Roux-en-Y gastric bypass surgery: macro- and micronutrient, fiber, and supplement intake.

• DOI: 10.1016/j.soard.2011.11.016
• 发表时间: 2012-05
• 期刊: Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
• 作者: Jeffreys RM;Hrovat K;Woo JG;Schmidt M;Inge TH;Xanthakos SA
• 通讯作者: Xanthakos SA

Controversial Issues: When the drugs don't work, can surgery provide a different outcome for diabetic adolescents?

• DOI: 10.1016/j.soard.2015.03.006
• 发表时间: 2015-07-01
• 期刊: SURGERY FOR OBESITY AND RELATED DISEASES
• 影响因子: 3.1
• 作者: Bearnish, Andrew J.;D'Alessio, David A.;Inge, Thomas H.
• 通讯作者: Inge, Thomas H.

Bariatric surgery in adolescents: an update.

• DOI: 10.1016/j.admecli.2006.06.001
• 发表时间: 2006-10
• 期刊: Adolescent medicine clinics
• 作者: S. Xanthakos;S. Daniels;T. Inge

Preparation of a severely obese adolescent for significant and long-term weight loss: an illustrative case.

• DOI: 10.1007/s00383-013-3311-y
• 发表时间: 2013-08
• 期刊: Pediatric surgery international
• 影响因子: 1.8
• 作者: Kruger AJ;Hrovat KB;Xanthakos SA;Inge TH
• 通讯作者: Inge TH