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Longitudinal analyses among overweight, insulin resistance, and cardiovascular risk factors in children.
Obes Res. 2005 Oct; 13(10):1824-33.OR

Abstract

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 < 0.001), systolic blood pressure (p < 0.001), and diastolic blood pressure (p < 0.001), whereas the children with different changes in HOMA did not differ significantly in their weight changes. Only the children in the highest quartile of weight reduction (decrease in SDS-BMI > 0.5) demonstrated a significant decrease in systolic blood pressure (p < 0.001), diastolic blood pressure (p < 0.001), and triglycerides (p = 0.012), and an increase in high-density lipoprotein-cholesterol (p = 0.023), whereas with a lower degree of weight loss, there were no significant changes in cardiovascular risk factors. In contrast with a lower degree of weight loss, a reduction of >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.

Authors+Show Affiliations

Vestische Hospital for Children and Adolescents, University of Witten/Herdecke, Dr. F. Steiner Strasse 5, 45711 Datteln, Germany. T.Reinehr@kinderklinik-datteln.deNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16286531

Citation

Reinehr, Thomas, et al. "Longitudinal Analyses Among Overweight, Insulin Resistance, and Cardiovascular Risk Factors in Children." Obesity Research, vol. 13, no. 10, 2005, pp. 1824-33.
Reinehr T, de Sousa G, Andler W. Longitudinal analyses among overweight, insulin resistance, and cardiovascular risk factors in children. Obes Res. 2005;13(10):1824-33.
Reinehr, T., de Sousa, G., & Andler, W. (2005). Longitudinal analyses among overweight, insulin resistance, and cardiovascular risk factors in children. Obesity Research, 13(10), 1824-33.
Reinehr T, de Sousa G, Andler W. Longitudinal Analyses Among Overweight, Insulin Resistance, and Cardiovascular Risk Factors in Children. Obes Res. 2005;13(10):1824-33. PubMed PMID: 16286531.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Longitudinal analyses among overweight, insulin resistance, and cardiovascular risk factors in children. AU - Reinehr,Thomas, AU - de Sousa,Gideon, AU - Andler,Werner, PY - 2005/11/16/pubmed PY - 2006/1/25/medline PY - 2005/11/16/entrez SP - 1824 EP - 33 JF - Obesity research JO - Obes. Res. VL - 13 IS - 10 N2 - 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 < 0.001), systolic blood pressure (p < 0.001), and diastolic blood pressure (p < 0.001), whereas the children with different changes in HOMA did not differ significantly in their weight changes. Only the children in the highest quartile of weight reduction (decrease in SDS-BMI > 0.5) demonstrated a significant decrease in systolic blood pressure (p < 0.001), diastolic blood pressure (p < 0.001), and triglycerides (p = 0.012), and an increase in high-density lipoprotein-cholesterol (p = 0.023), whereas with a lower degree of weight loss, there were no significant changes in cardiovascular risk factors. In contrast with a lower degree of weight loss, a reduction of >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. SN - 1071-7323 UR - https://www.unboundmedicine.com/medline/citation/16286531/Longitudinal_analyses_among_overweight_insulin_resistance_and_cardiovascular_risk_factors_in_children_ L2 - https://doi.org/10.1038/oby.2005.222 DB - PRIME DP - Unbound Medicine ER -