title: Insulin Sensitivity and Inflammation Mediate the Impact of Fitness on Cerebrovascular Health in Adolescents.
abstract: OBJECTIVE
  To investigate in adolescents the relationships between retinal vessel diameter, physical fitness, insulin sensitivity, and systemic inflammation.
  
  
  METHODS
  We evaluated 157 adolescents, 112 with excessive weight and 45 lean, all without type 2 diabetes mellitus. All received detailed evaluations, including measurements of retinal vessel diameter, insulin sensitivity, levels of inflammation, and physical fitness.
  
  
  RESULTS
  Overweight/obese adolescents had significantly narrower retinal arteriolar and wider venular diameters, significantly lower insulin sensitivity, and physical fitness. They also had decreased levels of anti-inflammatory and increased levels of proinflammatory markers as well as an overall higher inflammation balance score. Fitness was associated with larger retinal arteriolar and narrower venular diameters and these relationships were mediated by insulin sensitivity. We demonstrate that inflammation also mediates the relationship between fitness and retinal venular, but not arterial diameter; insulin sensitivity and inflammation balance score jointly mediate this relationship with little overlap in their effects.
  
  
  CONCLUSIONS
  Increasing fitness and insulin sensitivity and reducing inflammation among adolescents carrying excess weight may improve microvascular integrity. Interventions to improve physical fitness and insulin function and reduce inflammation in adolescents, a group likely to benefit from such interventions, may reduce not only cardiovascular disease in middle age, but also improve cerebrovascular function later in life.
authors.affiliation: 1 Department of Psychiatry, New York University School of Medicine , New York, NY.
authors.forename: Po Lai
authors.initials: PL
authors.lastname: Yau
authors.affiliation: 1 Department of Psychiatry, New York University School of Medicine , New York, NY.
authors.forename: Naima
authors.initials: N
authors.lastname: Ross
authors.affiliation: 1 Department of Psychiatry, New York University School of Medicine , New York, NY.
authors.forename: Andrew
authors.initials: A
authors.lastname: Tirsi
authors.affiliation: 1 Department of Psychiatry, New York University School of Medicine , New York, NY.
authors.forename: Arslan
authors.initials: A
authors.lastname: Arif
authors.affiliation: 1 Department of Psychiatry, New York University School of Medicine , New York, NY.
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Ozinci
authors.affiliation: 1 Department of Psychiatry, New York University School of Medicine , New York, NY.|2 Department of Medicine, New York University School of Medicine , New York, NY.|3 Department of Radiology, New York University School of Medicine , New York, NY.|4 Nathan Kline Institute for Psychiatric Research , Orangeburg, NY.
authors.forename: Antonio
authors.initials: A
authors.lastname: Convit
mesh_terms: D000293:Adolescent; D001160:Arterioles / Q000473:pathology; D001921:Brain / Q000098:blood supply*; D059345:Cerebral Small Vessel Diseases; D016207:Cytokines / Q000097:blood; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000503:physiopathology*; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D055806:Microvessels / Q000473:pathology*; D010101:Oxygen Consumption; D063766:Pediatric Obesity / Q000503:physiopathology*; D010809:Physical Fitness / Q000502:physiology*; D012171:Retinal Vessels / Q000473:pathology; D014699:Venules / Q000473:pathology; D055815:Young Adult
chemical_list: D016207:Cytokines
keywords: cerebral microvasculature; fitness; inflammation; insulin sensitivity; obesity; retinal vessel health