Abstract
BackgroundTo investigate the association between markers of insulin metabolism and carotid intima-media thickness(cIMT) among overweight and obese children and adolescents.MethodsA total of 378 children and adolescents aged from 6 to 13 years, with WHO body mass index Z-Scores ≥2 were enrolled in this study. We measured fasting serum insulin and glucose, conducted a homeostatic model assessment of insulin resistance(HOMA-IR), and calculated the quantitative insulin sensitivity check index(QUICKI). Carotid intima-media thickness was measured in the common carotid artery with high-resolution ultrasonography.ResultsThe study participants consisted of 198 boys and 180 girls with a mean(±SD) age of 9.3 ± 1.7 years, 18.3% being pre-pubertal. In boys, after controlling for confounders, a one-SD increase in fasting insulin and HOMA-IR were associated with 0.351 mm(P < 0.001) and 0.350 mm(P < 0.001) increases in cIMT, respectively. However, a one-SD increase in QUICKI was associated with a − 0.305 mm(P = 0.001) decrease in cIMT. When categorizing into tertiles, a one-SD increase in fasting insulin and HOMA-IR were associated with 87 and 81% increases in the odds of higher categories of cIMT(both P < 0.05). However, a one-SD increase in QUICKI was associated with 37% lower odds of higher categories of cIMT(P = 0.022). No significant associations were found among girls.ConclusionThis study demonstrated that insulin resistance and sensitivity markers were independent predictors of cIMT in overweight and obese boys, but not in girls, highlighting the importance of chronically elevated insulin levels for predisposing these boys to alterations in their vascular structure.
Highlights
To investigate the association between markers of insulin metabolism and carotid intima-media thickness(cIMT) among overweight and obese children and adolescents
Measuring cIMT in children and adolescents with obesity has been recommended by the Association for European Paediatric Cardiology (AEPC), as it is capable of recognizing early vascular alterations and prevent myocardial infarction and stroke [9]
This study demonstrated that markers of insulin metabolism were independent predictors of cIMT in overweight and obese boys, but not in girls
Summary
To investigate the association between markers of insulin metabolism and carotid intima-media thickness(cIMT) among overweight and obese children and adolescents. High-resolution B mode ultrasonography has been frequently used in children and adolescents to measure carotid intima-media thickness (cIMT). Previous observational studies indicated that IMT in children and adolescents elevated with familial hypercholesterolemia [6], type 1 diabetes mellitus [7], and hypertension [8]. With regard to a possible relationship between IMT and insulin resistance/hyperinsulinemia in children and adolescents, the results remain inconsistent, with some studies reporting an adverse relation between insulin resistance and vascular measures [10, 11], while others observed no significant relations at all [12,13,14]. The studies in question did not look for differences based on gender or pubertal status
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