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 ,Revised 23 February 2009 ,Accepted 24 April 2009.

References 

  1. Franks PW, Hanson RL, Knowler WC, Moffett C, Enos G, Infante AM, et al. Childhood predictors of young-onset type 2 diabetes. Diabetes. 2007;56:2964–2972
  2. Kahn SE, Hull RL, Utzschneider KM. Mechanisms linking obesity to insulin resistance and type 2 diabetes. Nature. 2006;444:840–846
  3. Rewers M, Hamman R. Risk factors for non–insulin-dependent diabetes. In Diabetes in America. 2nd edition. NIH Publication 95-1468. Bethesda, MD: National Diabetes Data Group, National Institute of Diabetes and Digestive and Kidney Disease, National Institutes of Health; 1995.
  4. Groop LC. Insulin resistance: the fundamental trigger of type 2 diabetes. Diabetes Obes Metab. 1999;1(Suppl 1):S1–S7
  5. Arslanian S. Type 2 diabetes mellitus in children: pathophysiology and risk factors. J Pediatr Endocrinol Metab. 2000;13:1385–1394
  6. Kavey RE, Allada V, Daniels SR, Hayman LL, McCrindle BW, Newburger JW, et al. American Heart Association Expert Panel. Cardiovascular risk reduction in high-risk pediatric patients: a scientific statement from the American Heart Association Expert Panel on Population and Prevention Science; the Councils on Cardiovascular Disease in the Young, Epidemiology and Prevention, Nutrition, Physical Activity and Metabolism, High Blood Pressure Research, Cardiovascular Nursing, and the Kidney in Heart Disease; and the Interdisciplinary Working Group on Quality of Care and Outcomes Research, endorsed by the American Academy of Pediatrics. Circulation. 2006;114:2710–2738
  7. Brunner H, Cockcroft JR, Deanfield J, Donald A, Ferrannini E, Halcox J, et al. Endothelial function and dysfunction, part II: association with cardiovascular risk factors and diseases. A statement by the Working Group on Endothelins and Endothelial Factors of the European Society of Hypertension. J Hypertens. 2005;23:233–246
  8. Kuvin JT, Patel AR, Sliney KA, Pandian NG, Sheffy J, Schnall RP, et al. Assessment of peripheral vascular endothelial function with finger arterial pulse wave amplitude. Am Heart J. 2003;146:168–174
  9. Bonetti PO, Pumper GM, Higano ST, Holmes DR, Kuvin JT, Lerman A. Noninvasive identification of patients with early coronary atherosclerosis by assessment of digital reactive hyperemia. J Am Coll Cardiol. 2004;44:2137–2141
  10. Hamburg NM, Keyes MJ, Larson MG, Vasan RS, Schnabel R, Pryde MM, et al. Cross-sectional relations of digital vascular function to cardiovascular risk factors in the Framingham Heart Study. Circulation. 2008;117:2467–2474
  11. Haller MJ, Stein J, Shuster J, Theraque D, Silverstein J, Shatz DA, et al. Peripheral arterial tonometry demonstrates altered endothelial function in children with type 1 diabetes. Pediatr Diabetes. 2007;8:193–198
  12. Mahmud FH, Kanji N, Van Um S, Clarson C. Endothelial function is impaired both fasting and after a high-fat meal in adolescents with type 1 diabetes mellitus. J Pediatr. 2008;152:557–562
  13. Keskin M, Kurtoglu S, Kendirci M, Atabek E, Yazici C. Homeostasis model assessment is more reliable than the fasting/insulin ratio and quatitative insulin sensitivity check index among obese children and adolescents. Pediatrics. 2005;115:e500–e503
  14. Kuczmarski RJ, Ogden CL, Grummer-Strawn LM, Flegal KM, Guo SS, Wei R, et al. CDC Growth Charts, United States. Advance Data From Vital and Health Statistics 314. Hyattsville, MD: National Center for Health Statistics; 2000;
  15. Lambert M, Delvin EE, Paradis G, O'Loughlin J, Hanley JA, Levy E. C-reactive protein and features of the metabolic syndrome in a population-based sample of children and adolescents. Clin Chem. 2004;50:1762–1768
  16. Katzmaryzyk P. Waist circumference percentiles for Canadian youth. Eur J Clin Nutr. 2004;58:1011–1015
  17. Fernadez JR, Redden DT, Pietrobelli A, Allisson DB. Waist circumference percentiles in nationally representative samples of African-American, European-American, and Mexican-American children and adolescents. J Pediatr. 2004;145:439–444
  18. Giannini C, deGiorgis T, Scarinci A, Ciampini M, Marchovecchio ML, Chiarelli F, et al. Obese-related effects of inflammatory markers and insulin resistance on increased carotid media thickness in pre-pubertal children. Atherosclerosis. 2008;197:448–456
  19. Reinehr T, Keiss W, DeSousa G, Stifel-Agner B, Wuncsh R. Intima-media thickness in childhood obesity relations to inflammatory marker, glucose metabolism and blood pressure. Metabolism. 2006;55:113–118
  20. Tounian P, Aggoun Y, Dubern B, Varille V, Guy-Grand B, Sidi D, et al. Presence of increased stiffness of the common carotid artery and endothelial dysfunction in severely obese children: a prospective study. Lancet. 2001;358:1400–1404
  21. Iannuzzi A, Licenziati MR, Acampora C, Renis M, Agrusta M, Romano L, et al. Carotid artery stiffness in obese children with the metabolic syndrome. Am J Cardiol. 2006;97:528–531
  22. Balletschofer BM, Rittig K, Sock J, Lehn-Stefan A, Overkamp D, Dietz K, et al. Insulin-resistant young subjects at risk of accelerated atherosclerosis exhibit a marked reduction in peripheral endothelial function early in life but not differences in intimal medial thickness. Atheroscerosis. 2003;171:3030–3039
  23. Mimoun E, Aggoun Y, Pousset M, Dubern B, Bougle D, Giradet JP, et al. Asssociation of arterial stiffness and endothelial dysfunction with metabolic syndrome on obese children. J Pediatr. 2008;153:65–70
  24. Gungor N, Thompson T, Sutton-Tyrrell K, Janosky J, Arslanian S. Early signs of cardiovascular disease in youth with obesity and type 2 diabetes. Diabetes Care. 2005;28:1219–1221
  25. Wildman RP, Mackey H, Bostom A, Thompson T, Sutton-Tyrrell K. Measures of obesity are associated with vascular stiffness in young and older adults. Hypertension. 2003;42:468–473
  26. Nohria A, Gerhard-Herman M, Creager MA, Hurley MA, Hurley S, Mitra D, et al. Role of nitric oxide in the regulation of digital pulse volume amplitude in humans. J Appl Physiol. 2006;101:545–548
  27. Tomfohr LM, Martin TM, Miller GE. Symptoms of depression and impaired endothelial function in healthy adolescent women. J Behav Med. 2008;31:137–143
  28. Freedman DS, Khan LK, Dietz WH, Sanivastan SR, Berenson GS. Relationship of childhood obesity to coronary heart disease risk factors in adulthood: the Bogalusa Heart Study. Pediatrics. 2001;108:712–718
  29. Pankow JS, Jacobs DR, Steinberger J, Moran A, Sinaiko AR. Insulin resistance and cardiovascular disease risk factors in children of parents with the insulin resistance (metabolic) syndrome. Diabetes Care. 2004;27:775–780

 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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