Impaired vascular function in obese adolescents with insulin resistance

J Pediatr. 2009 Nov;155(5):678-82. doi: 10.1016/j.jpeds.2009.04.060.

Abstract

Objective: To evaluate endothelial function (EF) in a cohort of obese adolescents with impaired insulin sensitivity.

Study design: Cardiovascular risk factors and adipocytokines, along with digital hyperemia, were evaluated by peripheral arterial tonometry (PAT) in adolescents with obesity and insulin resistance (IR) in relation to healthy, nonobese controls.

Results: The obese and control subjects were of similar age (13.4+/-1.7 years vs 14.0+/-1.4 years) and sex. The obese subjects had IR (mean homeostasis model of assessment [HOMA] score=5.4; 95% confidence interval=3.3-7.5) and significantly greater body mass index (BMI) (BMI z-score 2.4+/-0.2 kg/m(2) vs 0.0+/-0.8 kg/m(2)) and waist circumference (WC) measures (109.6+/-11.1cm vs 70.5+/-9.4 cm) with elevated low-density lipoprotein cholesterol (LDL-C), triglyceride, and high-sensitivity C-reactive protein levels. The mean PAT ratio was significantly lower in obese adolescents compared with controls (1.51+/-0.4 vs 2.06+/-0.4; P=.002), indicative of impaired EF. Linear regression demonstrated associations between PAT ratio and BMI, WC, age, and LDL-C but not between PAT and leptin, resistin, or adiponectin levels or IR.

Conclusions: Obese adolescents with IR exhibited significantly worse EF as assessed by PAT compared with healthy, nonobese controls, and EF showed a significant association with measures of adiposity and other cardiovascular risk factors.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Analysis of Variance
  • Biomarkers / analysis*
  • Body Mass Index
  • C-Reactive Protein / analysis
  • Case-Control Studies
  • Cholesterol, LDL / analysis
  • Cohort Studies
  • Confidence Intervals
  • Endothelium, Vascular / pathology*
  • Endothelium, Vascular / physiopathology
  • Female
  • Humans
  • Insulin Resistance*
  • Linear Models
  • Male
  • Manometry
  • Obesity / complications*
  • Obesity / diagnosis
  • Probability
  • Prognosis
  • Reference Values
  • Risk Assessment
  • Triglycerides / analysis
  • Vascular Diseases / epidemiology
  • Vascular Diseases / etiology*
  • Vascular Diseases / physiopathology
  • Waist Circumference

Substances

  • Biomarkers
  • Cholesterol, LDL
  • Triglycerides
  • C-Reactive Protein