title: Relation of acute-phase reaction and endothelial activation to insulin resistance and adiposity in obese children and adolescents.
abstract: OBJECTIVE
  There is increasing evidence that an ongoing cytokine-induced acute-phase response is closely involved in the pathogenesis of type 2 diabetes and associated complications such as dyslipidemia and atherosclerosis. The aim of this study was to investigate the relationship of inflammation and endothelial activation with insulin resistance in childhood obesity.
  
  
  METHODS
  Two hundred and eleven (122 boys) obese children and adolescents were examined. Fasting levels of ultra-sensitive C-reactive protein (CRP), fibrinogen (FB), interleukin-6 (IL-6), interleukin-1beta (IL-1beta), intercellular cell adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), von Willebrand factor (vWF), glucose, insulin, and HbA1c were determined. Insulin resistance was assessed by the homeostasis method.
  
  
  RESULTS
  HOMA IR correlated significantly with all measures of adiposity as well as with majority of inflammation and endothelial dysfunction markers. After adjustment for age, gender, BMI and fat mass, the correlation with insulin resistance remained significant for CRP, ICAM-1 and von Willebrand factor. There was a trend for association between HOMA IR and IL-6 as well as HOMA IR and fibrinogen.
  
  
  CONCLUSIONS
  Acute-phase reaction and endothelial activation correlate with insulin resistance in obese youth. It is possible that the cluster of these pro-atherogenic factors may contribute to the accelerated atherosclerosis in obese children.
authors.affiliation: Independent Laboratory of Propedeutics of Children's Diseases, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Garanty-Bogacka
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Syrenicz
authors.forename: Anhelli
authors.initials: A
authors.lastname: Syrenicz
authors.forename: Aneta
authors.initials: A
authors.lastname: Gebala
authors.forename: Mieczysław
authors.initials: M
authors.lastname: Walczak
mesh_terms: D000210:Acute-Phase Reaction / Q000503:physiopathology*; D000273:Adipose Tissue / Q000502:physiology*; D000293:Adolescent; D000886:Anthropometry; D015415:Biomarkers; D001786:Blood Glucose / Q000378:metabolism; D001823:Body Composition / Q000502:physiology; D002648:Child; D016207:Cytokines / Q000097:blood; D004730:Endothelium, Vascular / Q000502:physiology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006706:Homeostasis / Q000187:drug effects; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D009765:Obesity / Q000503:physiopathology* / Q000628:therapy
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D016207:Cytokines; D006442:Glycated Hemoglobin; D018836:Inflammation Mediators; D007328:Insulin