Insulin Resistance
Link to the components of the metabolic syndrome and biomarkers of endothelial dysfunction in youth
- SoJung Lee, PHD,
- Neslihan Gungor, MD,
- Fida Bacha, MD and
- Silva Arslanian, MD
- From the Division of Weight Management and Wellness, Division of Pediatric Endocrinology, Metabolism and Diabetes Mellitus, Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Address correspondence and reprint requests to Silva Arslanian, MD, Director, Weight Management and Wellness Center, Children's Hospital of Pittsburgh, 3705 Fifth Ave., Pittsburgh, PA 15213. E-mail: silva.arslanian{at}chp.edu
Abstract
OBJECTIVE—We examined the relationship of in vivo insulin sensitivity to the components of the metabolic syndrome and biomarkers of endothelial dysfunction in youth.
RESEARCH DESIGN AND METHODS—Subjects included 216 youths (8–19 years of age) who participated in a 3-h hyperinsulinemic-euglycemic clamp.
RESULTS—Independent of race, the frequencies of central obesity, high triglycerides, low HDL, high blood pressure, impaired fasting glucose, and impaired glucose tolerance were significantly higher (P < 0.05) in the lowest versus highest quartile of insulin sensitivity. BMI, abdominal adiposity, systolic blood pressure, and triglycerides increased and adiponectin and HDL decreased significantly (P for trend for all <0.05), with decreasing insulin sensitivity in both races. After controlling for BMI, insulin resistance remained associated (P < 0.05) with visceral adipose tissue in both races (P for trend = 0.01 in blacks and 0.08 in whites). In whites but not blacks, lower insulin sensitivity was associated (P < 0.05) with higher intercellular adhesion molecule-1 (ICAM-1) and E-selectin levels; however, these relationships did not remain significant (P > 0.05) once visceral adipose tissue was controlled for.
CONCLUSIONS—The prevalence of the individual components of metabolic syndrome increases with decreasing insulin sensitivity 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.
- BP, blood pressure
- CVD, cardiovascular disease
- ICAM-1, intercellular adhesion molecule-1
- IGT, impaired glucose tolerance
- IL, interleukin
- ROC, receiver-operating characteristic
- VAT, visceral adipose tissue
- VCAM-1, vascular adhesion molecule-1
Footnotes
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Published ahead of print at http://care.diabetesjournals.org on 7 May 2007. DOI: 10.2337/dc07-0203.
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C Section 1734 solely to indicate this fact.
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- Accepted April 26, 2007.
- Received January 31, 2007.
- DIABETES CARE
