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DOI: 10.2337/dc07-0203
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Original Research |
Insulin resistance: link to the components of the metabolic syndrome and biomarkers of endothelial dysfunction in youth
Division of Weight Management & Wellness,, Division of Pediatric Endocrinology, Metabolism and Diabetes Mellitus,, Children's Hospital of Pittsburgh,, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213
Silva.Arslanian{at}chp.edu
ABSTRACT
Objective:We examined the relationship of in vivo insulin sensitivity (IS) to the components of the metabolic syndrome (MetS) and biomarkers of endothelial dysfunction in youth.
Research Design and Methods:Subjects included 216 youths (8-19 years) who participated in a 3-hour hyperinsulinemic-euglycemic clamp.
Results:Independent of race, the frequencies of central obesity, high triglycerides, low HDL, high blood pressure (BP), impaired fasting glucose and impaired glucose tolerance were significantly higher (P <0.05) in the lowest vs. highest quartile of IS. BMI, abdominal adiposity, systolic BP and triglycerides increased, and adiponectin and HDL decreased significantly (P for trend for all <0.05) with decreasing IS in both races. After controlling for BMI, insulin resistance remained associated (P <0.05) with visceral adipose tissue (VAT) in both races (P for trend = 0.01 in Blacks and 0.08 in Whites). In Whites but not Blacks, lower IS was associated (P <0.05) with higher ICAM-1 and E-selectin levels, however these relationships did not remain significant (P >0.05) once VAT is controlled for.
Conclusions:The prevalence of the individual components of MetS increases with decreasing IS in Black and White youth. In Whites but not Blacks insulin resistance is associated with increased circulating endothelial biomarkers. It remains to be determined if lower abdominal adiposity and triglycerides in Blacks underlies the racial differences in risk translation.
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