کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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5719771 | 1607422 | 2016 | 7 صفحه PDF | دانلود رایگان |
ObjectiveTo investigate the physical and metabolic determinants of endothelial dysfunction, an early marker of subclinical atherosclerosis, in normal weight and overweight adolescents with and without type 2 diabetes mellitus.Study designA cross-sectional study of 81 adolescents: 21 normal weight, 25 overweight with normal glucose tolerance, 19 overweight with impaired glucose regulation, and 16 with type 2 diabetes mellitus underwent evaluation of reactive hyperemia index (RHI) and augmentation index (AIx) at heart rate 75âbpm by peripheral arterial tonometry; oral glucose tolerance test, lipid profile, and hyperinsulinemic-euglycemic clamp to measure insulin sensitivity; and dual energy X-ray absorptiometry scan and abdominal magnetic resonance imaging for percentage of body fat and abdominal fat partitioning.ResultsParticipants across tertiles of RHI (1.2â±â0.02, 1.5â±â0.02, and 2.0â±â0.05, Pâ<â.001) had similar age, sex, race, lipid profile, and blood pressure. Body mass index z-score, percentage body fat, abdominal fat, and hemoglobin A1c decreased, and insulin sensitivity increased from the first to third tertile. RHI was inversely related to percentage body fat (râ=ââ0.29, Pâ=â.008), total (râ=ââ0.37, Pâ=â.004), subcutaneous (râ=ââ0.39, Pâ=â.003), and visceral (râ=ââ0.26, Pâ=â.04) abdominal fat. AIx at heart rate 75âbpm was higher (worse) in the lower RHI tertiles (Pâ=â.04), was positively related to percentage body fat (râ=â0.26, Pâ=â.021), and inversely related to age, insulin sensitivity, and inflammatory markers (tumor necrosis factor-α and plasminogen activator inhibition-1).ConclusionsChildhood obesity, particularly abdominal adiposity, is associated with endothelial dysfunction manifested by worse reactive hyperemia and higher AIx. Insulin resistance appears to mediate this relationship.
Journal: The Journal of Pediatrics - Volume 178, November 2016, Pages 171-177