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Overweight Latino Children and Adolescents Have Marked Endothelial Dysfunction and Sub-clinical Vascular Inflammation in Association with Excess Body Fat and Insulin Resistance.

¹Joslin Diabetes Center, Clinical Research Center, Harvard Medical School, Boston, MA, USA
²Department of Physiology and Pharmacology, Biomedical Institute, Fluminense Federal University, Niteroi, RJ, Brazil

enrique.caballero{at}joslin.harvard.edu

ABSTRACT

Objective: We measured plasma markers of endothelial dysfunction, vascular inflammation and pro-coagulation in obese Hispanic/Latino children and adolescents with normal glucose tolerance and determined their relationship to body composition and indices of glucose and lipid metabolism.

Research Design and Methods: Thirty-eight, lean or obese Hispanic children and adolescents (10 to 18 years of age) were selected: The Overweight group (OG; n=21) had a body mass index (BMI) >85th percentile for their age and sex, and the lean group (LG; n=17) had a BMI between the 25th-50th percentile. Studies included an oral glucose tolerance test, measurements of plasma glucose and lipids, several markers of endothelial function and inflammation and determination of body composition by DEXA.

Results: The OG had higher systolic blood pressure and plasma triglycerides and was more insulin resistant than the LG. The OG also had higher plasma sICAM (259.5±60.0 vs 223.2±47.5 ng/ml, p=0.047 ), TNF- (2.57±1.1 vs 1.74±0.6 pg/ml, p = 0.008), hs-CRP (2.0 vs 0.13 mg/L, p <0.0001 ), PAI-1 (47.0±35.7 vs 12.0±5.2 ng/ml, p <0.0001 ), tPA (6.1±1.9 vs 4.1±0.8 ng/ml, p=0.001 ) and white blood cell count (6.9 vs 5.3 x10³, p=0.031) and lower levels of adiponectin (8.7±3.3 vs 12.6±5.2 µg/ml, p=0.022). No significant differences were observed for sVCAM or IL-6 .

Conclusions: Overweight Hispanic children and adolescents with normal glucose tolerance exhibit increased plasma markers of endothelial dysfunction and sub-clinical inflammation in association with obesity and insulin resistance. These abnormalities may predispose them to the development of type 2 diabetes and cardiovascular disease.

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