Amylin and Its Relation to Insulin and Lipids
in Obese Children Before and After
Thomas Reinehr,* Gideon de Sousa,* Petra Niklowitz,* and Christian L. Roth†
REINEHR, THOMAS, GIDEON DE SOUSA, PETRA
NIKLOWITZ, AND CHRISTIAN L. ROTH. Amylin and
its relation to insulin and lipids in obese children before and
after weight loss. Obesity. 2007;15:2006–2011.
Objective: There are limited data concerning the relation-
ships between amylin, weight status, lipids, insulin, and
insulin resistance in obese humans. Therefore, the aim was
to study these relationships in cross-sectional and longitu-
Research Methods and Procedures: Fasting amylin, insu-
lin, glucose, triglycerides, low-density lipoprotein (LDL)-
and high-density lipoprotein (HDL)-cholesterol, and per-
centage body fat based on skinfold measurements were
determined in 37 obese children (median age, 11.5 years)
and compared with 16 lean children of the same age and
gender. Furthermore, we analyzed the changes of these
variables in the obese children after participating in a one-
year weight loss intervention program.
Results: Obese children had significantly (p ? 0.01) higher
amylin, triglycerides, LDL-cholesterol, and insulin levels as
compared with the lean children. In multiple linear regres-
sion analysis, amylin was significantly (p ? 0.05) correlated
to insulin and triglycerides, but not to age, gender, pubertal
stage, or BMI. Changes of amylin correlated significantly
(p ? 0.001) to changes of insulin (r ? 0.54) and triglycer-
ides (r ? 0.49), but not to changes of BMI or percentage
body fat. Substantial weight loss in 17 children led to a
significant (p ? 0.05) decrease of amylin, triglycerides, and
insulin, in contrast to the 20 children without substantial
Conclusion: Amylin levels were related to insulin concen-
trations in both cross-sectional and longitudinal analyses,
suggesting a relationship between amylin and insulin secre-
tion. Amylin levels were reversibly increased in obesity and
related to triglyceride concentrations.
Key words: GI hormones, gastroenterology
Amylin, a 37-amino acid protein mainly secreted by the
pancreatic ? cells in response to nutrient stimuli, has mul-
tiple actions, including the inhibiting of gastric emptying
and the secretion of glucagon and insulin, lipase, and amy-
lase (1–4). Furthermore, an involvement of amylin in short-
and long-term effects of the regulation of food intake and
body weight is being discussed based on studies in rodents
(2,5). The central and peripheral administration of amylin in
rodents reduced their food intake in a dose-dependent man-
ner (6,7). When rats were given an amylin antagonist, a
significant increase of energy intake was observed (6).
Although the exact mechanisms remain unclear, amylin
binding sites have been identified in the nucleus of the
solitary tract, nucleus accumbens, and hypothalamus (8).
All these findings pave the way for amylin analogues as
new anti-obesity drugs (1).
In humans, there are only a few studies concerning the
relationship between amylin and overweight. These studies
demonstrated that amylin concentrations correlate with the
degree of overweight and that the basal amylin concentra-
tions are higher in obese than in lean human subjects
(1,9,10). Studies of amylin concentrations in obese humans
losing weight have not been performed as yet. Furthermore,
it is unclear whether the increase of amylin in obesity is a
consequence of obesity per se or a consequence of other
factors associated with obesity.
Because amylin is co-secreted with insulin in the ? cells
of the pancreas, the increase of amylin in obesity could also
Received for review October 4, 2006.
Accepted in final form January 2, 2007.
The costs of publication of this article were defrayed, in part, by the payment of page
charges. This article must, therefore, be hereby marked “advertisement” in accordance with
18 U.S.C. Section 1734 solely to indicate this fact.
*Vestische Hospital for Children and Adolescents Datteln, University of Witten/Herdecke,
Datteln, Germany; and †Department of Pediatrics, University of Bonn, Bonn, Germany.
Address correspondence to Thomas Reinehr, Vestische Hospital for Children and Adoles-
cents Datteln, University of Witten/Herdecke, Dr. F. Steiner Str. 5, 45711 Datteln, Germany.
Copyright © 2007 NAASO
2006 OBESITY Vol. 15 No. 8 August 2007
percentage body fat, but to insulin both in cross-sectional
and longitudinal analyses, the increase of amylin in child-
hood obesity seems to be related to hypersecretion of insulin
in obesity. Further prospective research performing multiple
amylin and triglyceride determinations, especially in re-
sponse to a meal and in insulin-clamp studies, is necessary.
The authors thank Rita Maslak, Children’s Hospital Uni-
versity of Bonn, and Roland Reinehr, University of Du ¨ssel-
dorf, for their kind support in the laboratory. Supported by
the Bonfor Research Foundation, University of Bonn, Ger-
many and by NIH RR0163 and DK 62202.
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OBESITY Vol. 15 No. 8 August 2007 2011