Longitudinal changes in insulin sensitivity, insulin secretion, and β-cell function during puberty

Objective: To determine longitudinal changes in insulin sensitivity (SI), insulin secretion, and β-cell function during puberty in white and black youth. Study design: The tolbutamide-modified frequently sampled intravenous glucose tolerance test and minimal modeling were used to measure SI, the acute insulin response to glucose (AIRg), and β-cell function (disposition index, DI) in white (n = 46) and black (n = 46) children (mean [±SD] age at baseline = 10.2 ± 1.7 years). Growth curve models (including 272 observations) with SI, AIRg, and DI regressed on Tanner stage were run after adjusting for covariates. Results: After adjusting for covariates, growth curve models revealed that SI decreased and subsequently recovered by the end of puberty in whites and blacks (both p < .05), AIRg decreased linearly across Tanner stages in both races (both p < .001), and DI decreased across puberty in blacks (p = .001) but not in whites (p = .2). Conclusions: White and black youth exhibited transient insulin resistance and diminished AIRg during puberty. The progressive decline in DI among blacks versus whites may reflect a unique effect of puberty on β-cell compensation in blacks. Future studies are needed to identify whether this difference contributes to the increased risk of type II diabetes in young blacks.