Insulin resistance can impair reduction on carotid intima-media thickness in obese adolescents

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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 (ΔVisceral) and changes in cIMT (Δ cIMT) (r = 0.42; p < 0.05). Simple linear regression analyze revealed ΔVisceral 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.

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Sanches, P. de L., de Mello, M. T., Fonseca, F. A. H., Elias, N., de Piano, A., Carnier, J., … Dâmaso Prof., A. (2012). Insulin resistance can impair reduction on carotid intima-media thickness in obese adolescents. Arquivos Brasileiros de Cardiologia, 99(4), 892–898. https://doi.org/10.1590/S0066-782X2012005000077

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