Relation of body mass index and insulin resistance to cardiovascular risk factors, inflammatory factors, and oxidative stress during adolescence.
BACKGROUND
This study assessed the relation of fatness and insulin resistance and their interaction with cardiovascular risk factors, inflammatory factors, and oxidative stress in thin and heavy adolescents.


RESULTS
Euglycemic insulin clamp studies were performed on 295 (169 male, 126 female) adolescents (mean+/-SE age, 15+/-0.1 years). Comparisons were made between (1) heavy and thin adolescents; (2) insulin-sensitive and insulin-resistant adolescents; and (3) thin insulin-sensitive (T-IS), thin insulin-resistant (T-IR), heavy insulin-sensitive (H-IS), and heavy insulin-resistant (H-IR) adolescents. Summed z scores were used to determine clustering of risk factors (fasting insulin, triglycerides, HDL-C, and systolic blood pressure [SBP]) among the groups. SBP, triglycerides, and fasting insulin were significantly higher and HDL-C significantly lower in the heavy adolescents. Fasting insulin and triglycerides were significantly higher and HDL-C significantly lower in the insulin-resistant adolescents. Among the 4 groups, the risk factors and cluster score followed a pattern of risk as follows: T-IS<T-IR<H-IS<H-IR, with H-IR significantly greater than the other groups and showing an interaction between fatness and insulin resistance.


CONCLUSIONS
These results show the significant association of both fatness and insulin resistance and their significant interaction with cardiovascular risk factors in adolescence. The finding that insulin resistance may be acting interactively with fatness suggests that interventions directed at insulin resistance in addition to weight loss may be required to alter early development of cardiovascular risk.
Sinaiko
Alan R
AR
Department of Pediatrics, University of Minnesota Medical School, 420 Delaware St SE, Box 491 UMHC, Minneapolis, MN 55455, USA. Sinai001@tc.umn.edu
Steinberger
Julia
J
Moran
Antoinette
A
Prineas
Ronald J
RJ
Vessby
Bengt
B
Basu
Samar
S
Tracy
Russell
R
Jacobs
David R
DR
D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology*; D016000:Cluster Analysis; D005260:Female; D015309:Glucose Clamp Technique; D006801:Humans; D007249:Inflammation / Q000209:etiology*; D007333:Insulin Resistance; D008297:Male; D009765:Obesity; D018384:Oxidative Stress; D044469:Racial Groups; D012307:Risk Factors
D015415:Biomarkers; D001786:Blood Glucose