Effects of maturational stage on insulin sensitivity during puberty
JS Cook, RP Hoffman, MA Stene and JR Hansen
Department of Pediatrics, University of Iowa College of Medicine, Iowa City 52242.
During puberty, plasma insulin levels increase, and insulin sensitivity
decreases along with multiple other physical and hormonal changes. To
determine 1) the time course of the decrease in insulin sensitivity in
relationship to Tanner stage of genital development, and 2) how this change
relates to changes in GH secretion, insulin-like growth factor-I (IGF-I),
IGF-binding protein-3, and gonadal steroid secretion, we studied 58 healthy
children and adolescents (34 males and 24 females; age 7-15 yr) using
overnight GH sampling and frequently sampled iv glucose tolerance tests.
The insulin sensitivity index (ISI) was calculated using the program
MINMOD. ISI differed significantly by Tanner stage (P < 0.05, by
analysis of variance) with a decrease from Tanner stage 1 to 2 (P <
0.05). IGF-I and IGF-binding protein-3 followed opposite patterns to ISI,
with lower levels in Tanner stage 1 than in stages 2-5 (P < 0.05). Mean
GH levels did not increase until Tanner stage 4 (P < 0.05) and then fell
during Tanner stage 5. Multiple linear regression analysis revealed
negative relationships among ISI, IGF-I, and body mass index. No
relationship was found with GH. We conclude that the pubertal change in ISI
is not necessarily associated with increased GH secretion, but is
associated with increased GH peripheral effect, as indicated by the
relationship between ISI and IGF- I.
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