The Journal of Pediatrics
Volume 155, Issue 5 , Pages 678-682, November 2009

Impaired Vascular Function in Obese Adolescents with Insulin Resistance

  • Farid H. Mahmud, MD

      Affiliations

    • Paediatric Endocrinology, Department of Paediatrics, University of Western Ontario and Lawson Health Research Institute, London, Ontario, Canada
    • Corresponding Author InformationReprint requests: Dr. Farid H. Mahmud, Pediatric Endocrinology, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8.
    • ,
  • David J. Hill, DPhil

      Affiliations

    • Departments of Physiology, Medicine, and Paediatrics, University of Western Ontario and Lawson Health Research Institute, London, Ontario, Canada
    • ,
  • Meaghan S. Cuerden, MSc

      Affiliations

    • Division of Nephrology, University of Western Ontario and Lawson Health Research Institute, London, Ontario, Canada
    • ,
  • Cheril L. Clarson, BM, BS

      Affiliations

    • Paediatric Endocrinology, Department of Paediatrics, University of Western Ontario and Lawson Health Research Institute, London, Ontario, Canada

Received 18 November 2008; received in revised form 23 February 2009; accepted 24 April 2009. published online 13 July 2009.

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±0.2kg/m2 vs 0.0±0.8kg/m2) and waist circumference (WC) measures (109.6±11.1cm vs 70.5±9.4cm) 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.

BMI, Body mass index, BP, Blood pressure, cIMT, Carotid intima-medial thickness, EF, Endothelial function, HDL-C, High-density lipoprotein cholesterol, HOMA, Homeostasis model of assessment, hsCRP, High-sensitivity C-reactive protein, IR, Insulin resistance, LDL-C, Low-density lipoprotein cholesterol, PAT, Peripheral arterial tonometry, T2D, Type 2 diabetes, TChol, Total cholesterol, TG, Triglycerides, WC, Waist circumference

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 Supported by research funds granted by the Lawson Foundation. The authors declare no potential, perceived, or real conflicts of interest.

PII: S0022-3476(09)00456-9

doi:10.1016/j.jpeds.2009.04.060

The Journal of Pediatrics
Volume 155, Issue 5 , Pages 678-682, November 2009

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