ESPE Abstracts

Background: Over the last years a role for gastrointestinal hormones, such as glucagon-like peptide (GLP-1), in the pathogenesis of obesity and its complications, has been hypothesized. However, there are few data for the paediatric population.

Objective and hypotheses: To assess whether there is a difference in post-load GLP-1 response in obese children compared to normal-weight peers and to assess the relationship with insulin responses.

Method: Ten prepubertal obese children (five boys; mean age (±S.D.): 10.5±1.6 years; BMI-SDS: 2.2±0.5) and ten controls (eight boys; age: 9.9±1.2 years; BMI-SDS: −0.7±0.5) underwent a modified oral glucose tolerance test (OGTT) to evaluate post-load (0–5–10–15–20–30–60–90–120 min) glucose, insulin and GLP-1 responses. Insulin sensitivity (HOMA-IR, WBISI) and secretion (HOMA-ß, insulinogenic index) indexes, area under the curve (AUC) for glucose, insulin and GLP-1 were calculated.

Results: Obese children showed an increased post-load GLP-1 release along with higher AUC insulin and insulin secretion and resistance indexes. GLP-1 AUC was associated with BMI-SDS (r=0.45, P=0.04), HOMA-IR (r=0.53; p=0.01) and fasting glucose (r=0.68; P=0.001).

Conclusion: Obese children showed an increased GLP-1 response to oral glucose. The increased GLP-1 response might likely represent a compensatory mechanism to avoid post-prandial hyperglycaemia and allow a normal glucose tolerance.