Evidence for association between insulin resistance and premature carotid atherosclerosis in childhood obesity

• Published in: Pediatric research Vol. 61; no. 3; pp. 345 - 349
• Main Authors: ATABEK, Mehmet Emre, PIRGON, Ozgur, KIVRAK, Ali Sami
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01-03-2007
• Subjects: Adolescent; Age of Onset; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Carotid Arteries - pathology; Carotid Artery Diseases - etiology; Carotid Artery Diseases - pathology; Carotid Artery Diseases - physiopathology; Case-Control Studies; Child; Female; General aspects; Glucose Tolerance Test; Humans; Insulin - blood; Insulin Resistance - physiology; Male; Medical sciences; Metabolic diseases; Obesity; Obesity - complications; Obesity - pathology; Obesity - physiopathology; Risk Factors; Endocrinopathy; Human; Premature; Obesity; Pediatrics; Pancreatic hormone; Nutrition disorder; Cardiovascular disease; Insulin; Artery; Vascular disease; Target tissue resistance; Association; Blood vessel; Carotid; Atherosclerosis; Insulin resistance; Circulatory system; Child; Nutritional status
• ISSN: 0031-3998; 1530-0447
• DOI: 10.1203/pdr.0b013e318030d206

The present study was undertaken to determine the presence and predictors of the subclinical atherosclerosis in obese children. Fifty obese children [mean age: 11.7 +/- 2.5 y, mean body mass index (BMI): 28.2 +/- 4.0 kg/m] and 50 age- and sex-matched healthy nonobese controls (mean age: 11.4 +/- 3.73 y, mean BMI: 17.6 +/- 3.0 kg/m) were enrolled in the present study. Oral glucose tolerance test was performed to all obese subjects. Common carotid artery intima-media thickness (IMT) was measured by high-resolution B-mode ultrasonography. Carotid artery IMT was significantly increased (0.0476 +/- 0.007 versus 0.033 +/- 0.011 cm; p < 0.001) in the obese group. There were significant relations between carotid artery IMT and insulin sensitivity indexes derived from fasting samples (fasting glucose to insulin ratio (FGIR; p = 0.004, r = -0.404), quantitative insulin-sensitivity check index (QUICK-I; p = 0.002, r = -0.401) and homeostasis model assessment of insulin resistance (HOMA-IR; p = 0.034, r = 0.300) in the obese group. In a multivariate regression model, QUICK-I emerged as independent correlates for mean IMT in obese children with the total variance explained being 20.7% (beta = -0.58, p < 0.001). We concluded that insulin resistance is an independent risk factor for increased carotid artery IMT in obese children.