Skip to main content

ORIGINAL RESEARCH article

Front. Endocrinol.
Sec. Pediatric Endocrinology
Volume 15 - 2024 | doi: 10.3389/fendo.2024.1368570
This article is part of the Research Topic Endocrine and Metabolic Consequences of Childhood Obesity Volume III View all 10 articles

Rise in fasting and dynamic glucagon levels in children and adolescents with obesity is moderate in subjects with impaired fasting glucose but accentuated in subjects with impaired glucose tolerance or type 2 diabetes

Provisionally accepted
Thomas Pixner Thomas Pixner 1,2Tatsiana Chaikouskaya Tatsiana Chaikouskaya 3,4Wanda Lauth Wanda Lauth 5Georg Zimmermann Georg Zimmermann 5Katharina Mörwald Katharina Mörwald 2,4Julia Lischka Julia Lischka 2,4Dieter Furthner Dieter Furthner 1Elisabeth Awender Elisabeth Awender 2,4Sabine Geiersberger Sabine Geiersberger 6Katharina Maruszczak Katharina Maruszczak 2,4Anders Forslund Anders Forslund 7Christian Heinz Anderwald Christian Heinz Anderwald 2,8,9Janne Cadamuro Janne Cadamuro 10Daniel Weghuber Daniel Weghuber 2,4*Peter Bergsten Peter Bergsten 11
  • 1 Department of Pediatric and Adolescent Medicine, Salzkammergutklinikum Voecklabruck, Voecklabruck, Austria
  • 2 Paracelsus Medical University, Salzburg, Austria
  • 3 Independent researcher, Dijon, France
  • 4 Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University Salzburg, Salzburg, Salzburg, Austria
  • 5 Biostatistics and Big Medical Data, IDA Lab, Paracelsus Medical University, Salzburg, Salzburg, Austria
  • 6 Clinical Research Center, Salzburg State Clinics, Paracelsus Medical University, Salzburg, Salzburg, Austria
  • 7 Department of Women's and Children's Health, Faculty of Medicine, Uppsala University, Uppsala, Uppsala, Sweden
  • 8 Clinical Department of Endocrinology and Metabolism, University Clinic for Internal Medicine III, Medical University of Vienna, Vienna, Vienna, Austria
  • 9 Direction, Arnoldstein Healthcare Centre, Arnoldstein, Austria
  • 10 Department of Laboratory Medicine, Paracelsus Medical University, Salzburg, Salzburg, Austria
  • 11 Department of Medical Cell Biology, Faculty of Medicine, Uppsala University, Uppsala, Uppsala, Sweden

The final, formatted version of the article will be published soon.

    Fasting levels of glucagon are known to be elevated in youth and adults with type 2 diabetes mellitus (T2D). Children and adolescents with obesity were previously reported to show increasing fasting and post-glucose-challenge hyperglucagonemia across the spectrum of glucose tolerance, while no data are available in those with impaired fasting glucose (IFG).Individuals from the Beta-JUDO study population (Uppsala and Salzburg 2010-2016) (n=101, age 13.3±2.8, m/f =50/51) were included (90 with overweight or obesity, 11 with normal weight). Standardized OGTT were performed and plasma glucose, glucagon and insulin concentrations assessed at baseline, 5, 10, 15, 30, 60, 90 and 120 minutes. Patients were grouped according to their glycemic state in six groups with normal glucose metabolism (NGM) and normal weight (NG-NW), NGM with obesity or overweight (NG-O), impaired glucose tolerance (IGT), impaired fasting glucose (IFG), IGT+IFG and T2D, and in two groups with NGM and impaired glucose metabolism (IGM), for statistical analysis.Glucagon concentrations were elevated in young normoglycemic individuals with overweight or obesity (NG-O) compared to normoglycemic individuals with normal weight. Glucagon levels, fasting and dynamic, increased with progressing glycemic deterioration, except in IFG, where levels were comparable to those in NG-O. All glycemic groups showed an overall suppression of glucagon during OGTT. An initial increase of glucagon could be observed in T2D. In T2D, glucagon showed a strong direct linear correlation with plasma glucose levels during OGTT. Glucagon in adolescents, as in adults, may play a role in the disease progression of T2D.

    Keywords: Glucagon, OGTT, Obesity, pediatric, Liver-alpha cell axis, Insulin, Diabetes Mellitus

    Received: 10 Jan 2024; Accepted: 14 Jun 2024.

    Copyright: © 2024 Pixner, Chaikouskaya, Lauth, Zimmermann, Mörwald, Lischka, Furthner, Awender, Geiersberger, Maruszczak, Forslund, Anderwald, Cadamuro, Weghuber and Bergsten. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Daniel Weghuber, Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University Salzburg, Salzburg, A-5020, Salzburg, Austria

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.