Circulating branched-chain amino acid concentrations are associated with obesity and future insulin resistance in children and adolescents.
UNLABELLED: What is already known about this subject Circulating concentrations of branched-chain amino acids (BCAAs) can affect carbohydrate metabolism in skeletal muscle, and therefore may alter insulin sensitivity. BCAAs are elevated in adults with diet-induced obesity, and are associated with their future risk of type 2 diabetes even after accounting for baseline clinical risk factors. What this study adds Increased concentrations of BCAAs are already present in young obese children and their metabolomic profiles are consistent with increased BCAA catabolism. Elevations in BCAAs in children are positively associated with insulin resistance measured 18 months later, independent of their initial body mass index.
BACKGROUND: Branched-chain amino acid (BCAA) concentrations are elevated in response to overnutrition, and can affect both insulin sensitivity and secretion. Alterations in their metabolism may therefore play a role in the early pathogenesis of type 2 diabetes in overweight children.
OBJECTIVE: To determine whether paediatric obesity is associated with elevations in fasting circulating concentrations of BCAAs (isoleucine, leucine and valine), and whether these elevations predict future insulin resistance.
METHODS: Sixty-nine healthy subjects, ages 8-18 years, were enrolled as a cross-sectional cohort. A subset of subjects who were pre- or early-pubertal, ages 8-13 years, were enrolled in a prospective longitudinal cohort for 18 months (n = 17 with complete data).
RESULTS: Elevations in the concentrations of BCAAs were significantly associated with body mass index (BMI) Z-score (Spearman's Rho 0.27, P = 0.03) in the cross-sectional cohort. In the subset of subjects that followed longitudinally, baseline BCAA concentrations were positively associated with homeostasis model assessment for insulin resistance measured 18 months later after controlling for baseline clinical factors including BMI Z-score, sex and pubertal stage (P = 0.046).
CONCLUSIONS: Elevations in the concentrations of circulating BCAAs are significantly associated with obesity in children and adolescents, and may independently predict future insulin resistance.
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P30 DK040561 / DK / NIDDK NIH HHS / United States
K12 DK094723 / DK / NIDDK NIH HHS / United States
R01 DK081572 / DK / NIDDK NIH HHS / United States
5P30DK040561-15 / DK / NIDDK NIH HHS / United States
R01 DK081457 / DK / NIDDK NIH HHS / United States
M01 RR001066 / RR / NCRR NIH HHS / United States
K23 DK080658 / DK / NIDDK NIH HHS / United States
K24 DK064545 / DK / NIDDK NIH HHS / United States
UL1 RR025758 / RR / NCRR NIH HHS / United States
M01-RR-01066 / RR / NCRR NIH HHS / United States
1 UL1 RR025758-03 / RR / NCRR NIH HHS / United States
R03 DK084118 / DK / NIDDK NIH HHS / United States
5R01 DK081572-03 / DK / NIDDK NIH HHS / United States