Synergy between Adiposity, Insulin Resistance, Metabolic risk factors and Inflammation in Adolescents

Abstract

Objective: To investigate relationships between inflammatory markers and components of a metabolic syndrome cluster in adolescents.

Research Design and Methods: Cross-sectional analysis of an Australian childhood cohort (n=1377) aged 14 years. Cluster analysis defined a “high risk” group similar to the adult metabolic syndrome. Relevant measures were anthropometry, fasting insulin, glucose, lipids, inflammatory markers, liver function and blood pressure.

Results: 29% of children fell into a “high risk” metabolic cluster group compared to 2% by a paediatric metabolic syndrome definition. Relative to the “low risk” cluster, they had higher body mass index (95% CI 19.5–19.8 vs 24.5–25,4), waist circumference (cm) (95% CI 71.0–71.8 vs 83.4–85.8), insulin (U/L) (95% CI 1.7–1.8 vs 3.5–3.9), HOMA (95%CI 1.7–1.8 vs 3.5–3.9), systolic blood pressure (mmHg) (95% CI 110.8–112.1 vs 116.7–,118.9), triglycerides (mmol/L) (95% CI 0.78–0.80 vs 1.25–1.35) and lower high density lipopropotein (mmol/L) (95% CI 1.44–1.48 vs 1.20–1.26). Inflammatory and liver function markers were higher in the “high risk” group: C reactive protein (CRP) (p<0.001), uric acid (p<0.001), alanine aminotransferases (ALT) (p<0.001) and γ glutamyl transferase (GGT) (p<0.001). Highest CRP, GGT and ALT levels were restricted to overweight children in the “high risk” group.

Conclusions: Cluster analysis revealed a strikingly high proportion of 14 year olds at risk of cardiovascular related metabolic disorders. Adiposity and the metabolic syndrome cluster are synergistic in the pathogenesis of inflammation. Systemic and liver inflammation in the “high risk” cluster is likely to predict diabetes, cardiovascular disease, and non-alcoholic fatty liver disease.