title: Effect of fat loss on arterial elasticity in obese adolescents with clinical insulin resistance: RESIST study.
abstract: BACKGROUND
  Reduced arterial elasticity contributes to an obesity-related increase in cardiovascular risk in adults.
  
  
  OBJECTIVE
  To evaluate the effect of fat loss on arterial elasticity in obese adolescents at risk of type 2 diabetes.
  
  
  METHODS
  A secondary data analysis of the RESIST study was performed in two hospitals in Sydney, Australia.
  
  
  METHODS
  The study included 56 subjects (ages, 10 to 17 y; 25 males) with prediabetes and/or clinical features of insulin resistance.
  
  
  METHODS
  A 12-month lifestyle plus metformin intervention.
  
  
  RESULTS
  Arterial elasticity and systemic vascular resistance were measured using radial tonometry pulse contour analysis, percentage body fat (%BF) was measured by dual-energy x-ray absorptiometry, and insulin sensitivity index was derived from an oral glucose tolerance test and lipids.
  
  
  RESULTS
  Adolescents (n = 31) with decreased %BF (mean change [range], -4.4% [-18.3 to -0.01%]) after the intervention had significant increases in the mean large arterial elasticity index (mean change [95%CI], 5.1 [1.9 to 8.2] mL/mm Hg * 10; P = .003) and insulin sensitivity index (0.5 [0.1 to 0.9]; P = .010) and a decrease in systemic vascular resistance (-82 [-129 to -35] dyne * s * cm(-5); P = .001). There were no significant changes in these parameters in adolescents who increased their %BF. Nor was there any significant change in the mean small arterial elasticity index in either group.
  
  
  CONCLUSIONS
  Long-term follow-up of these adolescents is warranted to assess whether the observed changes in vascular elasticity will lead to a clinical benefit including reduced cardiovascular morbidity and mortality.
authors: Discipline of Pediatrics and Child Health (M.H., M.G., L.A.B., K.C.D., M.E.C., C.T.C., S.P.G.), The Children's Hospital at Westmead Clinical School, University of Sydney, Westmead, NSW 2145, Australia; Institute of Endocrinology and Diabetes (M.H., M.G., P.Z.B.-A., K.C.D., M.E.C., C.T.C., S.P.G.), and Kids Research Institute (L.A.B., C.T.C.), The Children's Hospital at Westmead, Westmead, NSW 2145, Australia; The Charles Perkins Centre and School of Biological Sciences (C.S.T.), University of Sydney, Camperdown, NSW 2006, Australia; Department of Endocrinology (C.S.T.), Royal Prince Alfred Hospital, Camperdown, NSW 2006, Australia; and School of Women and Children's Health (M.E.C.), University of New South Wales, Randwick, NSW 2031, Australia.
authors: Mandy
authors: M
authors: Ho
authors: Megan
authors: M
authors: Gow
authors: Louise A
authors: LA
authors: Baur
authors: Paul Z
authors: PZ
authors: Benitez-Aguirre
authors: Charmaine S
authors: CS
authors: Tam
authors: Kim C
authors: KC
authors: Donaghue
authors: Maria E
authors: ME
authors: Craig
authors: Chris T
authors: CT
authors: Cowell
authors: Sarah P
authors: SP
authors: Garnett
mesh_terms: D015502:Absorptiometry, Photon; D000273:Adipose Tissue / Q000378:metabolism* / Q000503:physiopathology; D000293:Adolescent; D001823:Body Composition / Q000502:physiology; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000453:epidemiology / Q000378:metabolism*; D004040:Dietary Carbohydrates / Q000008:administration & dosage*; D004044:Dietary Proteins / Q000008:administration & dosage; D004548:Elasticity; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007333:Insulin Resistance / Q000502:physiology*; D008019:Life Style; D008297:Male; D008687:Metformin / Q000627:therapeutic use; D009765:Obesity / Q000178:diet therapy* / Q000453:epidemiology / Q000503:physiopathology; D011236:Prediabetic State / Q000453:epidemiology / Q000378:metabolism*; D012307:Risk Factors; D014655:Vascular Resistance / Q000502:physiology; D059289:Vascular Stiffness / Q000502:physiology
chemical_list: D004040:Dietary Carbohydrates; D004044:Dietary Proteins; D007004:Hypoglycemic Agents; D008687:Metformin