Improvement in HOMA-IR is an independent predictor of reduced carotid intima-media thickness in obese adolescents participating in an interdisciplinary weight-loss program.
The aim of this study was to verify whether a 1-year interdisciplinary weight-loss program improved common carotid artery intima-media thickness (IMT) and whether insulin resistance and/or inflammation (as measured by the markers plasminogen activator inhibitor type-1 and adiponectin) might underlie obesity in adolescents. A group of 29 post-pubescent obese adolescents were submitted to an interdisciplinary intervention over the course of 1 year. Common carotid artery IMT was determined ultrasonographically. Body composition, blood pressure (BP), glycemia, insulinemia, homeostasis model assessment of insulin resistance (HOMA-IR), lipid profile and adipokine concentrations were analyzed before and after the intervention. The interdisciplinary weight-loss program promoted a significant improvement in body composition, insulin concentration, HOMA-IR, lipid profile, BP and inflammatory state, in addition to significantly decreasing the common carotid artery IMT. Furthermore, this study demonstrated that the difference between baseline and final values of HOMA-IR (ΔHOMA-IR) was negatively correlated with concomitant changes in the adiponectin concentration (Δadiponectin; r=-0.42; P=0.02) and positively correlated with changes in common carotid artery IMT (Δcarotid IMT; r=0.41; P=0.03). Multiple regression analysis adjusted by age, cardiovascular risk factors and inflammatory markers showed that ΔHOMA-IR was an independent predictor of significant changes in common carotid artery IMT. This investigation demonstrated that an interdisciplinary weight-loss program promoted a reduction of the common carotid artery IMT in obese Brazilian adolescents, and the improvement of HOMA-IR was an independent predictor of carotid IMT changes in this population.
Post-Graduate Program of Nutrition, Universidade Federal de São Paulo, São Paulo, Brazil. priscila.sanches@unifesp.br
Priscila
P
de Lima Sanches
Marco Túlio
MT
de Mello
Natália
N
Elias
Francisco Antonio Helfenstein
FA
Fonseca
Aline
A
de Piano
June
J
Carnier
Lila Missae
LM
Oyama
Lian
L
Tock
Sergio
S
Tufik
Ana Raimunda
AR
Dâmaso
D054392:Adipokines / Q000097:blood; D052242:Adiponectin / Q000097:blood; D000293:Adolescent; D001786:Blood Glucose / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology; D001938:Brazil; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control; D004038:Diet, Reducing; D015444:Exercise; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood; D008297:Male; D009765:Obesity / Q000178:diet therapy / Q000473:pathology / Q000628:therapy*; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D011613:Psychotherapy; D017539:Tunica Intima / Q000000981:diagnostic imaging* / Q000473:pathology; D014463:Ultrasonography; D015431:Weight Loss
D054392:Adipokines; D052242:Adiponectin; D001786:Blood Glucose; D007328:Insulin; D008055:Lipids; D017395:Plasminogen Activator Inhibitor 1