The incretin system and type 2 diabetes mellitus in obese children and adolescents
Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
Background: The development of obesity and type 2 diabetes mellitus (T2DM) have been parallel during recent decades. Both diseases have reached epidemic proportions and constitute a threat to mankind. The link between the two diseases is not fully understood. New therapeutic options have been developed targeting the incretin system, which is affected in adult obese individuals with T2DM. There is, however, limited knowledge regarding children and adolescents. Oral intake of nutrients may stimulate different secretory responses of incretins, making it an interesting field for developments of new medical nutritional therapies.
Aim: To investigate the potential correlations between Dipeptidyl peptidas-4 (DPP-4), Glucagon-like peptide-1 (GLP-1), insulin sensitivity, the diet and various parameters of the metabolic syndrome in obese children and adolescents.
Material and methods: Forty-six obese patients and 20 matched controls ≤ 18 years were involved. Metabolic parameters, GLP-1 and DPP-4 were analyzed in blood samples during an oral glucose tolerance test. Nutritional habits were analyzed by a Food Frequency Questionnaire. Anthropometric data were additionally analyzed.
Results: The area under the curve of GLP-1 was significantly blunted for the patients. It was also significantly correlated to dairy intake. Significant correlations between visceral fat and DPP-4 were shown. DPP-4 also significantly negatively correlated with age. The peak of GLP-1 was significantly correlated to insulin-resistance. Fasting-insulin levels were also significantly correlated to visceral fat.
Conclusion: GLP-1 and DDP-4 seems to be altered in obesity and the development of impaired glucose tolerance in children and adolescents. Interestingly, dairy intake seems to affect GLP-1 secretion.
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IdentifiersURN: urn:nbn:se:uu:diva-242288OAI: oai:DiVA.org:uu-242288DiVA: diva2:783042
Programme for Clinical Dietetitians