Insulin Resistance Can Impair Reduction on Carotid Intima-Media Thickness in Obese Adolescents

Author(s)

Sanches, Priscila de Lima ^[1] ; de Mello, Marco Tulio ^[1] ; Helfestein Fonseca, Francisco Antonio ^[1] ; Elias, Natalia ^[2] ; de Piano, Aline ^[1] ; Carnier, June ^[1] ; Tock, Lian ^[1] ; Oyama, Lila Missae ^[1] ; Tufik, Sergio ^{[1, 2]} ; Damaso, Ana ^[1]

Affiliation

^[1] Univ Fed Sao Paulo UNIFESP, Sao Paulo - Brazil

^[2] AFIP, Sao Paulo - Brazil

• Document type: Journal article
• Source: Arquivos Brasileiros de Cardiologia; v. 99, n. 4, p. 892-897, OCT 2012.
• Web of Science Citations: 6

Abstract

Background: The atherosclerotic process at the endothelial level begins in early ages and seems to be associated with obesity and its comorbidities as insulin resistance. Objective: The aim of this study was to verify the influence of insulin resistance on inflammatory and subclinical markers of atherosclerosis in obese adolescents. Methods: Sixty-six post-pubescent obese adolescents were divided in two groups according to homeostasis model assessment of insulin resistance (HOMA-IR) measurement: with insulin resistance (IR) n=39 and without insulin resistance (NIR) n=27, and submitted to an interdisciplinary intervention over the course of 1 year. Common carotid artery intima-media thickness (cIMT), visceral and subcutaneous adipose tissue was determined by ultrasound. Body composition, blood pressure, HOMA-IR, lipid profile and adipokines concentrations {[}leptin, adiponectin, and plasminogen activator inhibitor type (PAI-1)] were analyzed before and after the therapy. Results: Both groups presented significant improvements in body composition, inflammatory state (reduction of leptin and PAI-1 concentration; increasing of plasma adiponectin) and reduction of cIMT. Only NIR group showed positive correlation between changes in visceral fat (Delta Visceral) and changes in cIMT (Delta cIMT) (r = 0.42; p < 0.05). Simple linear regression analyze revealed Delta Visceral to be an independent predictor to reduction of cIMT in this group (R2 adjusted = 0.14, p = 0.04). The final values of cIMT remained significantly higher in IR group when compared to NIR group. Conclusion: The presence of insulin resistance can impair changes in cIMT leading to early development of atherosclerosis in obese adolescents submitted to an interdisciplinary intervention. (Arq Bras Cardiol 2012;99(4):892-898) (AU)

• FAPESP's process: 11/50414-0 - Influence of hyperleptinemia on inflammatory and atherogenic responses in obese adolescents
• Grantee: Ana Raimunda Dâmaso
• Support type: Regular Research Grants
• FAPESP's process: 06/00684-3 - Orexigenic, anorexigenic, pro and pre-inflamatory factors: effects of a multidisciplinary program for weight reduction in obese adolescents
• Grantee: Ana Raimunda Dâmaso
• Support type: Regular Research Grants