Key result
Insulin resistance in obese adolescents was associated with impaired microvascular function (post-ischemic hyperemia 3.5 vs 4.5, p=0.04) but not conduit vessel function (BART 5.9% vs 7.0%, p=0.3).
Why the study?
Does insulin resistance impair endothelial function and structure in obese adolescents?
Cross-Sectional (n=40)
Does insulin resistance impair endothelial function and structure in obese adolescents?
Absolute Event Rate: 5.9% vs 7%
p-value: p=0.3
In obese adolescents, insulin resistance is associated with impaired microvascular function and an atherogenic lipoprotein profile, but not with changes in conduit vessel structure or function.
No difference in BART by IR status in obese adolescents; leaves open whether IR independently drives endothelial dysfunction and requires longitudinal confirmation.
BACKGROUND: Insulin resistance and endothelial dysfunction share a reciprocal relationship that links the metabolic and cardiovascular sequelae of obesity. We characterized the brachial artery reactivity testing (BART) and carotid artery-intima media thickness (CIMT) in adolescents categorized as obese insulin resistant (OIR) and obese not insulin resistant (ONIR). Lipoprotein particle (p) analysis and inflammatory cytokines in OIR and ONIR groups were also analyzed. METHODS: Obese adolescents (n=40; mean body mass index [BMI] 35.6) were categorized as ONIR and OIR based on their homeostatic model assessment of insulin resistance (HOMA-IR) calculation (≤or> than 3.4). Ultrasound measured conduit arterial function BART, microvascular function (post-ischemic hyperemia) and conduit artery structure CIMT. RESULTS: BART did not differ according to IR status (mean±SD: 7.0±4.3% vs. 5.9±3.4% in ONIR and OIR, respectively, p=0.3, but post-ischemic hyperemia was significantly greater in the ONIR group (4.5±2.2 vs. 3.5±3, p=0.04). Atherogenic lipoprotein particles; large VLDL particles and small LDL particles were higher in the OIR compared to ONIR group. CONCLUSIONS: OIR adolescents demonstrate an inflamed atherogenic milieu compared to the ONIR adolescents. Microvascular function, but not conduit vessel structure or function, was impaired in association with IR.
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Brar et al. (2017) conducted a cross-sectional in Obesity (n=40). Insulin resistance vs. Obese not insulin resistant (ONIR) was evaluated on Brachial artery reactivity testing (BART) (p=0.3). Insulin resistance in obese adolescents was associated with impaired microvascular function (post-ischemic hyperemia 3.5 vs 4.5, p=0.04) but not conduit vessel function (BART 5.9% vs 7.0%, p=0.3).
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