Diabetes Care 31:576-582, 2008 DOI: 10.2337/dc07-1540 © 2008 by the American Diabetes Association
Overweight Latino Children and Adolescents Have Marked Endothelial Dysfunction and Subclinical Vascular Inflammation in Association With Excess Body Fat and Insulin Resistance
1 Joslin Diabetes Center, Clinical Research Center, Harvard Medical School, Boston, Massachusetts Address correspondence and reprint requests to A. Enrique Caballero, MD, Latino Diabetes Initiative, Joslin Diabetes Center, One Joslin Place, Boston, MA 02215. E-mail: enrique.caballero{at}joslin.harvard.edu OBJECTIVE—We measured plasma markers of endothelial dysfunction, vascular inflammation, and pro-coagulation in obese Hispanic/Latino children and adolescents with normal glucose tolerance and determined their relationship to body composition and indexes of glucose and lipid metabolism. RESEARCH DESIGN AND METHODS—A total of 38 lean or obese Hispanic children and adolescents (10–18 years of age) were selected. The overweight group (n = 21) had a BMI >85th percentile for their age and sex, and the lean group (n = 17) had a BMI between the 25th and 50th percentiles. Studies included an oral glucose tolerance test, measurements of plasma glucose and lipids, several markers of endothelial function and inflammation, and determination of body composition by dual X-ray absorptiometry.
RESULTS—The obese group had higher systolic blood pressure and plasma triglycerides and was more insulin resistant than the lean group. The obese group also had higher plasma soluble intercellular adhesion molecule (259.5 ± 60.0 vs. 223.2 ± 47.5 ng/ml, P = 0.047), tumor necrosis factor- CONCLUSIONS—Overweight Hispanic children and adolescents with normal glucose tolerance exhibit increased plasma markers of endothelial dysfunction and subclinical inflammation in association with obesity and insulin resistance. These abnormalities may predispose them to the development of type 2 diabetes and cardiovascular disease.
Abbreviations: AUC, area under the curve CIR, corrected insulin response CRP, C-reactive protein HOMA, homeostasis model assessment HOMA β-cell, HOMA of β-cell function HOMA-IR, HOMA of insulin resistance hs-CRP, high-sensitivity CRP IL, interleukin ISI, insulin sensitivity index JDC, Joslin Diabetes Center OGTT, oral glucose tolerance test PAI-1, plasminogen activator inhibitor-1 sICAM, soluble intercellular adhesion molecule sVCAM, soluble vascular cell adhesion molecule TNF-
|
|
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||