Insulin Resistance, Obesity, Type 2 Diabetes Mellitus
Conditions
Keywords
Obesity, Pediatric Health, Type 2 Diabetes, Insulin Resistance, Metformin Therapy
Brief summary
The investigators want to learn more about obesity, the development of insulin resistance, and Type 2 Diabetes in children. The investigators will do this through collecting information about children's health and conducting experiments on a variety of samples.
Interventions
None listed
Sponsors
National Institutes of Health (NIH)
National Institute of General Medical Sciences (NIGMS)
University of Arkansas
Arkansas Children's Hospital Research Institute
Study design
Observational model
OTHER
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
5 Years to 17 Years
Healthy volunteers
Yes
Inclusion criteria
* Age 5-9 years and Tanner stage as reported by parent no greater than stage 1 OR Age 5 years - 17 years 5 months, diagnosed with type 2 diabetes mellitus or insulin resistance * Either healthy lean (BMI≥ 5th percentile and \<85th percentile for age/sex) or obese (BMI ≥ 95th percentile for age/sex) * For those with BMI≥ 95th percentile for age/sex, parental verbal confirmation will be obtained that the child had a history of BMI≥ 95th percentile for age/sex for at least six months prior to study enrollment
Exclusion criteria
* Genetic or physical conditions impacting mobility over past year as determined by the Principal Investigator (PI) * Having known chronic illnesses/disorders that may independently affect study outcome measures: type 1 diabetes mellitus, neurologic (e.g. epilepsy), developmental (developmental delay, autism spectrum disorder), endocrine (thyroid, Cushing's), hepatic, autoimmune, cardiac and renal disorders. Also, chronic lung disorders except well controlled asthma that does not require permanent use of inhaled/oral steroids * Taking any of the following medications that can affect study outcome: antipsychotics, thyroid hormone replacement therapy, inhaled/oral steroids, insulin, anabolic drugs (growth hormone replacement therapy and oxandrolone) and stimulants * BMI\<5th percentile for age/sex (classified as underweight based on Centers for Disease Control and Prevention growth charts) * Subjects determined ineligible by the PI.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Altered circulating blood cell bioenergetics | After completion of all study visits, approximately 2 years. | The investigators hypothesize that when compared to normal weight or obese insulin sensitive children, obese insulin resistant children will exhibit altered circulating blood cell bioenergetics. |
| Oxidized plasma redox state | After completion of all study visits, approximately 2 years. | The investigators hypothesize that when compared to normal weight or obese insulin sensitive children, obese insulin resistant children will exhibit a more oxidized plasma redox state. |
| Alterations in resting energy expenditure | After completion of all study visits, approximately 2 years. | The investigators hypothesize that when compared to normal weight or obese insulin sensitive children, obese insulin resistant children will be associated with alterations of decreased resting energy expenditure. |
| Alterations in fatty acid oxidation | After completion of all study visits, approximately 2 years. | We hypothesize that when compared to normal weight or obese insulin sensitive children, obese insulin resistant children will be associated with alterations of impaired fatty acid oxidation (FAO). |
| Poor oxidative capacity | After completion of all study visits, approximately 2 years. | The investigators hypothesize that poor oxidative capacity over time may distinguish between metabolically healthy obese (MHO) and metabolically unhealthy obese (MUO) phenotypes. |
| Predicting Type 2 Diabetes development | After completion of all study visits, approximately 2 years. | The investigators hypothesize that poor oxidative capacity over time may be predictive of Type 2 Diabetes development. |
| Bioenergetics in Type 2 Diabetes with metformin | 6 months | The investigators hypothesize that the change in bioenergetics will be improved in obese Type 2 Diabetes children at 6 months of metformin therapy that will be prescribed as part of their clinical care. |
| Resting Energy Expenditure in Type 2 Diabetes with metformin | 6 months | The investigators hypothesize that the change in resting energy expenditure will be improved in obese Type 2 Diabetes children at 6 months of metformin therapy that will be prescribed as part of their clinical care. |
| Fatty Acid Oxidation in Type 2 Diabetes with metformin | 6 months | The investigators hypothesize that the change in fatty acid oxidation will be improved in obese Type 2 Diabetes children at 6 months of metformin therapy that will be prescribed as part of their clinical care. |
Countries
United States
Outcome results
None listed