title: Relations among Adiposity and Insulin Resistance with Flow-Mediated Dilation, Carotid Intima-Media Thickness, and Arterial Stiffness in Children.
abstract: OBJECTIVE
  To determine the associations of adiposity and insulin resistance with measures of vascular structure and function in children.
  
  
  METHODS
  A cross-sectional study included 252 children (age 15.1 ± 2.4 years; body mass index percentile 68.2 ± 26.5%; Tanner 2-5). Measurements of body fat percentage were obtained with dual-energy X-ray absorptiometry and visceral adipose tissue (VAT) with computed tomography. Insulin resistance was measured with hyperinsulinemic euglycemic clamp. Vascular measurements for endothelial function (brachial artery flow-mediated dilation [FMD]), vascular structure (carotid intima-media thickness [cIMT]), vascular stiffness (carotid incremental elastic modulus), and pulse wave velocity were analyzed by tertiles of adiposity and insulin resistance. Additional analyses with ANCOVA and linear regression were adjusted for Tanner, sex, race, and family relationship; FMD was also adjusted for baseline artery diameter.
  
  
  RESULTS
  FMD was positively associated with high adiposity (body mass index, body fat percentage, and VAT) (P < .01 all). Insulin resistance was not associated with FMD. cIMT was significantly, positively related to obesity, VAT, and insulin resistance (P < .05 all). No differences in carotid incremental elastic modulus and pulse wave velocity were observed in relation to adiposity or insulin resistance.
  
  
  CONCLUSIONS
  The findings suggest that adiposity is associated with higher FMD, and insulin resistance and VAT are associated with higher cIMT in children. Further research is needed to clarify the progression of these relations.
authors.affiliation: Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN; Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN. Electronic address: jrryder@umn.edu.
authors.forename: Justin R
authors.initials: JR
authors.lastname: Ryder
authors.affiliation: Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN; School of Kinesiology, University of Minnesota, Minneapolis, MN.
authors.forename: Donald R
authors.initials: DR
authors.lastname: Dengel
authors.affiliation: Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN.
authors.forename: David R
authors.initials: DR
authors.lastname: Jacobs
authors.affiliation: Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN.
authors.forename: Alan R
authors.initials: AR
authors.lastname: Sinaiko
authors.affiliation: Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN; Department of Medicine, University of Minnesota Medical School, Minneapolis, MN.
authors.forename: Aaron S
authors.initials: AS
authors.lastname: Kelly
authors.affiliation: Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN.
authors.forename: Julia
authors.initials: J
authors.lastname: Steinberger
mesh_terms: D050154:Adiposity; D000293:Adolescent; D059168:Carotid Intima-Media Thickness; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D063177:Pulse Wave Analysis; D012039:Regional Blood Flow; D059289:Vascular Stiffness; D055815:Young Adult