Relationship Between Body Composition and Insulin and Growth Hormone Responses in Obese Adolescents

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Abstract
The clinical characteristics and predicted body composition of ten obese nondiabetic and six normal adolescents were compared in regard to plasma insulin, growth hormone, glucose, free fatty acids and alpha-amino nitrogen in response to different stimuli. Analysis of the data suggested the presence of two groups of patients. In obese Group A there was no family history of obesity, the youngsters first became obese between seven to twelve years of age, had a normal height for age, moderate increase in body weight and estimated total body fat, and normal or less than normal fasting levels of insulin. In obese Group B there was a strongly positive family history of obesity, the subjects became obese in infancy or early childhood, they were tall for their age, had marked increase in total body weight and total body fat as well as significantly higher than normal fasting insulin levels. Hyperinsulinemia was present in Group A during the oral glucose tolerance test and protein glucose meal. Normal insulin responses were observed during the protein meal and the arginine tolerance test. On the other hand, Group B manifested hyperinsulinemia in response to all stimuli. Both obese groups had undetectable plasma growth hormone levels during both the protein and the protein-glucose meal, but normal growth hormone responses during the oral glucose and the arginine tolerance tests. The differences in plasma levels of glucose and free fatty acids were minimal. Significant differences in plasma alpha-amino nitrogen values were observed during the protein-glucose meal. Differences in the hormonal responses of obese adolescents and adults are discussed. Possible explanations for heterogeneous responses of obese adolescents are presented.

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