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OBJECTIVE: It has been questioned whether insulin resistance or obesity is the central abnormality contributing to the cardiovascular risk factors dyslipidemia and hypertension in obesity. RESEARCH METHODS AND PROCEDURES: We studied weight status SD score (SDS)-BMI, lipids (triglycerides, low-density lipoprotein- and high-density lipoprotein-cholesterol), blood pressure, and insulin resistance index as homeostasis model assessment (HOMA) model over a 1-year period in 229 obese white children (median age 12 years). RESULTS: Any degree of decrease in HOMA was associated with significant decreases in triglycerides (p 0.5) demonstrated a significant decrease in systolic blood pressure (p 0.5 SDS-BMI was associated with a significant decrease in HOMA (p < 0.001). DISCUSSION: Because blood pressure and triglycerides decreased with any degree of decrease in HOMA, independently of changes in weight status, these findings support the hypothesis that insulin resistance is the central abnormality contributing to these cardiovascular risk factors. Therefore, improving insulin resistance seems more important than reducing overweight to prevent or treat hypertension and dyslipidemia in obese children.
Reinehr et al. (Sat,) studied this question.