title: Pre-diabetes in overweight youth and early atherogenic risk.
abstract: OBJECTIVE
  To compare atherogenic lipoprotein particles and vascular smooth muscle biomarkers in overweight youth with pre-diabetes (PD) vs. normal glucose tolerance (NGT).
  
  
  METHODS
  144 adolescents (60 black, 84 white; 102 female; PD=45, NGT=99) aged 10-19 years underwent a fasting blood draw and 2-h OGTT. Lipoprotein particle size and subclass concentration and vascular smooth muscle biomarkers (ICAM-1, VCAM-1 and E-selectin) were compared between youth with PD and NGT.
  
  
  RESULTS
  Compared with NGT, PD adolescents had smaller LDL (mean±SE: 20.5±0.1 vs. 21.0±0.1 nm; P=0.002) and HDL (8.62±0.05 vs. 8.85±0.04 nm; P=0.013) size and elevated medium small (159.2±10.3 vs. 123.8±6.4 nmol/L; P=0.037) and very small (626.3±45.4 vs. 458.5±26.4 nmol/L; P=0.032) LDL particle concentrations, after adjustment for race and BMI. Further adjusting for fasting insulin or visceral adiposity obviated these differences between the groups except for LDL size. ICAM-1 and E-selectin did not differ in youth with PD but correlated with LDL and HDL size, and small LDL particle concentrations.
  
  
  CONCLUSIONS
  Overweight adolescents with PD have an atherogenic lipoprotein profile of small LDL and HDL size and increased concentrations of small LDL, moderated by insulin resistance and visceral adiposity, but independently driven by dysglycemia for LDL size. Associations between smooth muscle biomarkers and lipoproteins could be an early signal heralding the atherogenic process. It remains to be determined if correction of dysglycemia and associated lipoprotein abnormalities in obese youth could prove effective in halting this process.
authors.affiliation: Division of Weight Management and Wellness, Metabolism and Diabetes Mellitus, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA 15201; Physical Education and Sports Science Academic Group, Nanyang Technological University, Singapore 637616.
authors.forename: Stephen F
authors.initials: SF
authors.lastname: Burns
authors.affiliation: Division of Weight Management and Wellness, Metabolism and Diabetes Mellitus, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA 15201.
authors.forename: SoJung
authors.initials: S
authors.lastname: Lee
authors.affiliation: Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX.
authors.forename: Fida
authors.initials: F
authors.lastname: Bacha
authors.affiliation: Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon.
authors.forename: Hala
authors.initials: H
authors.lastname: Tfayli
authors.affiliation: Departments of Pediatrics, Indiana University School of Medicine, Indianapolis, IN.
authors.forename: Tamara S
authors.initials: TS
authors.lastname: Hannon
authors.affiliation: Division of Weight Management and Wellness, Metabolism and Diabetes Mellitus, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA 15201; Division of Pediatric Endocrinology, Metabolism and Diabetes Mellitus, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA 15201. Electronic address: silva.arslanian@chp.edu.
authors.forename: Silva A
authors.initials: SA
authors.lastname: Arslanian
mesh_terms: D000293:Adolescent; D050197:Atherosclerosis / Q000097:blood / Q000453:epidemiology* / Q000378:metabolism*; D015415:Biomarkers / Q000378:metabolism; D002648:Child; D019040:E-Selectin / Q000097:blood; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D008074:Lipoproteins / Q000097:blood; D008297:Male; D009131:Muscle, Smooth, Vascular / Q000378:metabolism; D050177:Overweight / Q000097:blood / Q000150:complications* / Q000378:metabolism*; D011236:Prediabetic State / Q000097:blood / Q000150:complications* / Q000378:metabolism*; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood; D055815:Young Adult
chemical_list: D015415:Biomarkers; D019040:E-Selectin; D008074:Lipoproteins; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1
keywords: Adolescents; Dyslipidemia; Glycemia; Lipoproteins; Obesity