Overweight Latino Children and Adolescents Have Marked Endothelial Dysfunction and Subclinical Vascular Inflammation in Association With Excess Body Fat and Insulin Resistance

  1. A. Enrique Caballero, MD1,
  2. Kelb Bousquet-Santos, DSC2,
  3. Ludivina Robles-Osorio, MD1,
  4. Valeria Montagnani, RN1,
  5. Geetha Soodini, MD1,
  6. Sriurai Porramatikul, MD1,
  7. Osama Hamdy, MD1,
  8. Antonio C.L. Nobrega, MD, DSC2 and
  9. Edward S. Horton, MD1
  1. 1Joslin Diabetes Center, Clinical Research Center, Harvard Medical School, Boston, Massachusetts
  2. 2Department of Physiology and Pharmacology, Biomedical Institute, Fluminense Federal University, Niterüi, Rio de Janeiro, Brazil
  1. Address correspondence and reprint requests to A. Enrique Caballero, MD, Latino Diabetes Initiative, Joslin Diabetes Center, One Joslin Place, Boston, MA 02215. E-mail: 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 indexes of glucose and lipid metabolism.

RESEARCH DESIGN AND METHODS—A total of 38 lean or obese Hispanic children and adolescents (10–18 years of age) were selected. The overweight group (n = 21) had a BMI >85th percentile for their age and sex, and the lean group (n = 17) had a BMI between the 25th and 50th percentiles. 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 dual X-ray absorptiometry.

RESULTS—The obese group had higher systolic blood pressure and plasma triglycerides and was more insulin resistant than the lean group. The obese group also had higher plasma soluble intercellular adhesion molecule (259.5 ± 60.0 vs. 223.2 ± 47.5 ng/ml, P = 0.047), tumor necrosis factor-α (2.57 ± 1.1 vs. 1.74 ± 0.6 pg/ml, P = 0.008), high-sensitivity C-reactive protein (2.0 vs. 0.13 mg/l, P < 0.0001), plasminogen-activated inhibitor-1 (47.0 ± 35.7 vs. 12.0 ± 5.2 ng/ml, P < 0.0001), tissue plasminogen activator (6.1 ± 1.9 vs. 4.1 ± 0.8 ng/ml, P = 0.001), and white blood cell count (6.9 vs. 5.3 × 103, 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 soluble vascular cell adhesion molecule or interleukin-6.

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

Footnotes

  • Published ahead of print at http://care.diabetesjournals.org on 14 December 2007. DOI: 10.2337/dc07-1540.

    E.C. is on the speaker's bureau and advisory boards of Amylin Pharmaceuticals, Inc.; Eli Lilly and Company; sanofi-aventis U.S.; and Takeda Pharmaceuticals North America, Inc. and is on the advisory board of Pfizer Inc. E.S.H. has served as a member of an advisory board for sanofi-aventis, Inc. O.H. is on the speaker bureau of Takeda, Amylin, Merk, and Novo Nordisk and is on the advisory board of Takeda Pharmaceuticals North America, Inc.

    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.

    • Accepted December 7, 2007.
    • Received August 6, 2007.
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  1. Diabetes Care vol. 31 no. 3 576-582
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