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Synergy Between Adiposity, Insulin Resistance, Metabolic Risk Factors, and Inflammation in Adolescents

Diabetes Care
American Diabetes Association
Publication Date
DOI: 10.2337/dc08-1917
  • Original Research
  • Cardiovascular And Metabolic Risk
  • Biology
  • Medicine


Synergy Between Adiposity, Insulin Resistance, Metabolic Risk Factors, and Inflammation in Adolescents RAE-CHI HUANG, MD1 TREVOR A. MORI, PHD1 VALERIE BURKE, MD1 JOHN NEWNHAM, MD1 FIONA J. STANLEY, MD2 LOUIS I. LANDAU, MD1 GARTH E. KENDALL, PHD2,3 WENDY H. ODDY, PHD2 LAWRENCE J. BEILIN, MD1 OBJECTIVE— The purpose of this study was to investigate relationships between inflam- matory markers and components of a metabolic syndrome cluster in adolescents. RESEARCH DESIGN AND METHODS— This was a cross-sectional analysis of an Australian childhood cohort (n � 1,377) aged 14 years. Cluster analysis defined a “high-risk” group similar to adults with metabolic syndrome. Relevant measures were anthropometry, fasting insulin, glucose, lipids, inflammatory markers, liver function, and blood pressure. RESULTS— Of the children, 29% fell into a high-risk metabolic cluster group compared with 2% by a pediatric metabolic syndrome definition. Relative to the “low-risk” cluster, they had higher BMI (95% CI 19.5–19.8 vs. 24.5–25.4), waist circumference (centimeters) (95% CI 71.0–71.8 vs. 83.4–85.8), insulin (units per liter) (95% CI 1.7–1.8 vs. 3.5–3.9), homeostasis model assessment (95% CI 1.7–1.8 vs. 3.5–3.9), systolic blood pressure (millimeters of mercury) (95% CI 110.8–112.1 vs. 116.7–118.9), and triglycerides (millimoles per liter) (95% CI 0.78– 0.80 vs. 1.25–1.35) and lower HDL cholesterol (millimoles per liter) (95% CI 1.44–1.48 vs. 1.20–1.26). Inflammatory and liver function markers were higher in the high-risk group: C-re- active protein (CRP) (P � 0.001), uric acid (P � 0.001), alanine aminotransferase (ALT) (P � 0.001), and �-glutamyl transferase (GGT) (P� 0.001). The highest CRP, GGT, and ALT levels were restricted to overweight children in the high-risk group. CONCLUSIONS— Cluster analysis revealed a strikingly high proportion of 14 year olds at risk of cardiovascular disease–related metabolic disorders. Adiposity and the metabolic syn- drome cluster are synergistic

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