Normal-Weight 14-Year-Old Girl with Acanthosis Nigricans and Markedly Increased Hepatic Steatosis: Evidence for the Important Role of Ectopic Fat Deposition in the Pathogenesis of Insulin Resistance in Childhood and Adolescence

被引:3
作者
Springer, Fabian [2 ]
Nguyen, Huu Phuc [3 ]
Machann, Juergen [2 ]
Schweizer, Roland [1 ]
Ranke, Michael B. [1 ]
Binder, Gerhard [1 ]
Schick, Fritz [2 ]
Ehehalt, Stefan [1 ]
机构
[1] Univ Childrens Hosp, DE-72076 Tubingen, Germany
[2] Univ Tubingen Hosp, Dept Diagnost & Intervent Radiol, Sect Expt Radiol, Tubingen, Germany
[3] Univ Tubingen Hosp, Dept Med Genet, Tubingen, Germany
来源
HORMONE RESEARCH IN PAEDIATRICS | 2010年 / 74卷 / 05期
关键词
Acanthosis nigricans; Children; Hepatic steatosis; Insulin resistance; Magnetic resonance imaging; Magnetic resonance spectroscopy; WAIST CIRCUMFERENCE; METABOLIC SYNDROME; AFRICAN-AMERICAN; OBESE CHILDREN; SENSITIVITY; DISEASE; MUSCLE; LIVER; HYPERINSULINEMIA; OVERWEIGHT;
D O I
10.1159/000319707
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: major factor in the development of insulin resistance is obesity. While the contribution of intrahepatic lipids to insulin resistance is well established in adults, there are only few reports in childhood and adolescence. Aim: To investigate the correlation between ectopic fat deposition and insulin sensitivity in a normal-weight girl with acanthosis nigricans before and after lifestyle intervention. Methods: Variations in body fat composition and intrahepatic lipids were monitored by means of anthropometric measures and by means of methods based on magnetic resonance imaging and magnetic resonance spectroscopy. Results: We present the case of a normal-weight 14-year-old Caucasian girl with pronounced hepatic steatosis together with acanthosis nigricans, increased waist-circumference and increased visceral fat. During a 7-month period of lifestyle intervention, the girl lost 7.1 kg in weight. Acanthosis nigricans, whole-body insulin sensitivity index (WBISI) and homeostasis model assessment (HOMA) improved significantly (before intervention: WBISI 0.42, HOMA 22.2; after intervention: WBISI 1.35, HOMA 6.9). Even though all lipid compartments were decreased in size, the intrahepatic lipids showed an extraordinarily great reduction. Conclusion: This case presentation of a normal-weight girl with acanthosis nigricans and markedly increased hepatic steatosis provides support for the association between intrahepatic fat deposition and insulin resistance in adolescence. Copyright (C) 2010 S. Karger AG, Basel
引用
收藏
页码:376 / 380
页数:5
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