title: Insulin resistance and endothelial function in children and adolescents.
abstract: OBJECTIVE
  Insulin resistance (IR) impairs cellular response to insulin due to a dysfunction in glucose metabolism, associated with an increased cardiovascular risk. The aim of our study was to investigate the relationship among homeostasis model assessment index (HOMA index), endothelial function and vascular morphology in order to better stratify cardiovascular risk in children and adolescents.
  
  
  METHODS
  A total of 150 children and adolescents (55 pre-pubertal, mean age 10.4 ± 3.1 years) were enrolled. Anthropometric [body mass index (BMI), waist circumference (WC)], laboratory [blood lipids, inflammatory markers, insulinemia, glycemia], HOMA index and ultrasound parameters [flow-mediated dilatation (FMD), common carotid intima-media thickness (cIMT) and antero-posterior diameter of infra-renal abdominal aorta (APAO)] were assessed.
  
  
  RESULTS
  cIMT was positively related to age (r=0.274, p<0.01), BMI (r=0.318, p<0.01), WC (r=0.315, p<0.01) and triglycerides (r=0.230, p<0.01). APAO measurements showed a linear positive correlation with age (r=0.435, p<0.01), BMI (r=0.505, p<0.01), WC (r=0.487, p<0.01), triglycerides (r=0.280, p<0.01), C-reactive protein (r=0.209, p<0.05), fasting insulin (r=0.378, p<0.01) and HOMA index (r=0.345, p<0.01). FMD was inversely related to age (r=-0.251, p<0.01), rough BMI (r=-0.318, p<0.01), WC (r=-0.340, p<0.01), fasting insulin (r=-0.281, p<0.01) and HOMA index (r=-0.282, p<0.01). Multiple regression analysis found no influence of HOMA index on APAO and cIMT. HOMA index was an independent predictor for brachial artery FMD worsening after the statistical adjustment.
  
  
  CONCLUSIONS
  HOMA index increase induced a worsening in endothelial function since childhood.
authors.affiliation: U.O.C. B. Trambusti, Giovanni XXIII Hospital, Bari, Italy.
authors.forename: Vito Leonardo
authors.initials: VL
authors.lastname: Miniello
authors.affiliation: Department of biomedicine and Human Oncology, Pediatric Section, University "A.Moro" of Bari, Bari, Italy.
authors.forename: Maria Felicia
authors.initials: MF
authors.lastname: Faienza
authors.affiliation: Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University "A. Moro" of Bari, Bari, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Scicchitano
authors.affiliation: Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University "A. Moro" of Bari, Bari, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Cortese
authors.affiliation: Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University "A. Moro" of Bari, Bari, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Gesualdo
authors.affiliation: Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University "A. Moro" of Bari, Bari, Italy.
authors.forename: Annapaola
authors.initials: A
authors.lastname: Zito
authors.affiliation: Dipartimento di studi aziendali e giusprivatistici, University "A. Moro" of Bari, Bari, Italy.
authors.forename: Marina
authors.initials: M
authors.lastname: Basile
authors.affiliation: Dipartimento di studi aziendali e giusprivatistici, University "A. Moro" of Bari, Bari, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Recchia
authors.affiliation: Dipartimento di studi aziendali e giusprivatistici, University "A. Moro" of Bari, Bari, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Leogrande
authors.affiliation: Dipartimento di studi aziendali e giusprivatistici, University "A. Moro" of Bari, Bari, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Viola
authors.affiliation: Department of biomedicine and Human Oncology, Pediatric Section, University "A.Moro" of Bari, Bari, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Giordano
authors.affiliation: Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University "A. Moro" of Bari, Bari, Italy. Electronic address: marcomatteo.ciccone@uniba.it.
authors.forename: Marco Matteo
authors.initials: MM
authors.lastname: Ciccone
mesh_terms: D000293:Adolescent; D050197:Atherosclerosis / Q000175:diagnosis / Q000503:physiopathology*; D002648:Child; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006706:Homeostasis; D006801:Humans; D007333:Insulin Resistance; D008297:Male
keywords: Anterior–posterior diameter of infra-renal abdominal aorta; Atherosclerosis; Flow-mediated dilatation of brachial artery; HOMA index; Intima–media thickness of common carotid artery