Insulin resistance: link to the components of the metabolic syndrome and biomarkers of endothelial dysfunction in youth.
OBJECTIVE
We examined the relationship of in vivo insulin sensitivity to the components of the metabolic syndrome and biomarkers of endothelial dysfunction in youth.


METHODS
Subjects included 216 youths (8-19 years of age) who participated in a 3-h hyperinsulinemic-euglycemic clamp.


RESULTS
Independent of race, the frequencies of central obesity, high triglycerides, low HDL, high blood pressure, impaired fasting glucose, and impaired glucose tolerance were significantly higher (P < 0.05) in the lowest versus highest quartile of insulin sensitivity. BMI, abdominal adiposity, systolic blood pressure, and triglycerides increased and adiponectin and HDL decreased significantly (P for trend for all <0.05), with decreasing insulin sensitivity in both races. After controlling for BMI, insulin resistance remained associated (P < 0.05) with visceral adipose tissue in both races (P for trend = 0.01 in blacks and 0.08 in whites). In whites but not blacks, lower insulin sensitivity was associated (P < 0.05) with higher intercellular adhesion molecule-1 (ICAM-1) and E-selectin levels; however, these relationships did not remain significant (P > 0.05) once visceral adipose tissue was controlled for.


CONCLUSIONS
The prevalence of the individual components of metabolic syndrome increases with decreasing insulin sensitivity in black and white youth. In whites but not blacks, insulin resistance is associated with increased circulating endothelial biomarkers. It remains to be determined if lower abdominal adiposity and triglycerides in blacks underlies the racial differences in risk translation.
Lee
SoJung
S
Division of Weight Management and Wellness, Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, PA 15213, USA.
Gungor
Neslihan
N
Bacha
Fida
F
Arslanian
Silva
S
D000293:Adolescent; D044383:Black People / Q000706:statistics & numerical data; D001794:Blood Pressure; D015992:Body Mass Index; D049628:Body Size; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D002648:Child; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D015309:Glucose Clamp Technique; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D024821:Metabolic Syndrome / Q000503:physiopathology*; D009765:Obesity / Q000453:epidemiology; D010414:Pennsylvania / Q000453:epidemiology; D015995:Prevalence; D012372:ROC Curve; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American