ArticleJCI insight2021
Metabolic flexibility across the spectrum of glycemic regulation in youth.
Article in JCI insight, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Are Individuals With Type 2 Diabetes Metabolically Inflexible? A Systematic Review and Meta-Analysis.Endocrinology, diabetes & metabolism · 2025Pooled it
- Fat-free/lean body mass in children with insulin resistance or metabolic syndrome: a systematic review and meta-analysis.BMC pediatrics · 2022Pooled it
- Association Between Adipose Tissue Characteristics and Metabolic Flexibility in Humans: A Systematic Review.Frontiers in nutrition · 2021Pooled it
- Retatrutide and lipid and metabolite profiles in participants with obesity with or without type 2 diabetes.The Journal of clinical endocrinology and metabolism · 2026Trial
- Review
- Perspectives on whole body and tissue-specific metabolic flexibility and implications in cardiometabolic diseases.Cell reports. Medicine · 2025Review
- Article
- Pathophysiology and Treatment of Prediabetes and Type 2 Diabetes in Youth.Diabetes care · 2024Review
- Low Levels of Serum Total Vitamin B12 Are Associated with Worse Metabolic Phenotype in a Large Population of Children, Adolescents and Young Adults, from Underweight to Severe Obesity.International journal of molecular sciences · 2023Article
- Recent Advances in the Treatment of Insulin Resistance Targeting Molecular and Metabolic Pathways: Fighting a Losing Battle?Medicina (Kaunas, Lithuania) · 2022Review
- Hepatic-Metabolite-Based Intermittent Fasting Enables a Sustained Reduction in Insulin Resistance in Type 2 Diabetes and Metabolic Syndrome.Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUNDMetabolic flexibility (MF) refers to the relative ability to utilize lipid and carbohydrate substrates and to transition between them. It is not clear whether MF is impaired in obese youth and what the determining factors are.METHODSWe investigated the determinants of MF (increased respiratory exchange ratio [ΔRER] under insulin-stimulated conditions) in pubertal youth (n = 104; 15.6 ± 1.8 years) with obesity across the spectrum of glucose tolerance compared with normal weight (NW) controls, including body composition (fat-free mass [FFM], %body fat), visceral adipose fat (VAT) (MRI), glycemia, and insulin sensitivity (IS) [3-hour hyperinsulinemic-euglycemic clamp with measurement of lipolysis ([2H5] glycerol), free fatty acids (FFAs), and RER (indirect calorimetry)].RESULTSYouth with prediabetes and type 2 diabetes had lower ΔRER and oxidative and nonoxidative glucose disposal compared with NW, with no significant difference in ΔRER between NW and obese with normal glucose tolerance. In multiple regression analysis, ISFFM (β = 0.4, P = 0.004), percentage suppression of FFAs (r = 0.26, P = 0.007), and race/ethnicity (β = -0.23, P = 0.02) contributed to the variance in ΔRER (R2 = 0.30, P < 0.001) independent of percentage body fat (or VAT), sex, Tanner stage, and hemoglobin A1c.ConclusionMF is defective at the extreme of the metabolic phenotype in obese youth with dysglycemia related to a defect in IS limiting substrate utilization.FUNDINGUSDA/ARS Project Number 3092-51000-057.
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Registered trials
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