Researchers know that exosomes, tiny subcellular membrane-bound nanoparticles released from fat cells (and all cells studied), travel through the bloodstream and body, regulating a variety of processes, from growth and development to metabolism. The exosomes are important in lean, healthy individuals in maintaining homeostasis, but when fat gets “sick,” the most common reason for this is too much weight gain—the exosomes from fat cells show an altered phenotype, becoming inflammatory, and they can disrupt how our organs function, from how our skeletal muscle and liver metabolize sugar to how our blood vessels process cholesterol. Robert J. Freishtat (photo), MD, MPH, the Chief of Emergency medicine at Children's National Health System and a Professor of Precision Medicine and Genomics at the George Washington University School of Medicine and Health Sciences, and Sheela N. Magge MD, MSCE, who is now the Director of Pediatric Endocrinology and an Associate Professor of Medicine at the Johns Hopkins School of Medicine, were curious about what this process looked like in teens who fell in the mid-range of obesity. Obesity is a major risk factor for insulin resistance and type 2 diabetes, but Dr. Freishtat and Dr. Magge wanted to know: Why do some teens with obesity develop type 2 diabetes over others? Why are some teens in this mid-range of obesity metabolically healthy while others have metabolic syndrome? Can fat in obese people become sick and drive disease? To test this, Dr. Freishtat and Dr. Magge worked with 55 obese adolescents, ages 12 to 17, as part of a study at Children's National Health System. The participants (32 obese normoglycemic youth and 23 obese hyperglycemic youth) were similar in age, sex, race, pubertal stage, body mass index, and overall fat mass.Login Or Register To Read Full Story