Obesity and insulin sensitivity effects on cardiovascular risk factors: Comparisons of obese dysglycemic youth and adults

The RISE Consortium

Research output: Contribution to journalArticle

Abstract

Background: Obesity and pubertal insulin resistance worsen cardiovascular (CV) risk factors in youth. It is unclear how the relationships of obesity and insulin resistance with CV risk compare to adults. Subjects and Methods: We evaluated 66 pubertal youth (mean ± SD: age 14.2 ± 2.0 years, body mass index [BMI] 36.6 ± 6.0 kg/m2, hemoglobin A1c [HbA1c] 38.5 ± 6.1 mmol/mol) and 355 adults with comparable BMI (age 52.7 ± 9.4 years, BMI 35.1 ± 5.1 kg/m2, HbA1c 39.8 ± 4.2 mmol/mol) participating in a multicenter study. Insulin sensitivity was quantified using hyperglycemic clamps. Assessment of CV risk factors was standardized across sites. Regression analyses compared the impact of insulin sensitivity and CV risk factors between youth and adults. Results: Obese pubertal youth were more insulin resistant than comparably obese adults (P <.001), but with similar slopes for the inverse relationship between insulin sensitivity and obesity. The impact of obesity on CV risk factors was explained by insulin sensitivity (P = NS after adjustment for sensitivity). The two age groups did not differ in relationships between insulin sensitivity and diastolic blood pressure, total cholesterol, and low-density lipoprotein (LDL) cholesterol, after adjusting for obesity. However, while systolic blood pressure (SBP) and high-density lipoprotein (HDL) cholesterol exhibited the expected direct and inverse relationships, respectively with insulin sensitivity in adults, these slopes were flat in youth across the range of insulin sensitivity (P ≤.05 for group differences). Conclusions: Effects of obesity on CV risk factors were attributable to insulin sensitivity in both groups. The relationships between insulin sensitivity and CV risk factors were similar in obese youth and adult groups except for SBP and HDL cholesterol. Clinical Trial Registration: The RISE consortium studies are registered through Clinicaltrials.gov as NCT01779362 (Adult Medication Study); NCT01763346 (Adult Surgery Study); and NCT01779375 (Pediatric Medication Study). Clinical trial registration numbers: NCT01779362, NCT01779375 and NCT01763346 at clinicaltrials.gov.

Original languageEnglish (US)
Pages (from-to)849-860
Number of pages12
JournalPediatric Diabetes
Volume20
Issue number7
DOIs
StatePublished - Nov 1 2019

Fingerprint

Insulin Resistance
Obesity
Blood Pressure
Body Mass Index
HDL Cholesterol
Hemoglobins
Clinical Trials
LDL Cholesterol
Multicenter Studies
Age Groups
Cholesterol
Regression Analysis
Insulin
Pediatrics

Keywords

  • adult
  • cardiovascular risk
  • insulin resistance
  • obesity
  • youth

ASJC Scopus subject areas

  • Internal Medicine
  • Pediatrics, Perinatology, and Child Health
  • Endocrinology, Diabetes and Metabolism

Cite this

Obesity and insulin sensitivity effects on cardiovascular risk factors : Comparisons of obese dysglycemic youth and adults. / The RISE Consortium.

In: Pediatric Diabetes, Vol. 20, No. 7, 01.11.2019, p. 849-860.

Research output: Contribution to journalArticle

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title = "Obesity and insulin sensitivity effects on cardiovascular risk factors: Comparisons of obese dysglycemic youth and adults",
abstract = "Background: Obesity and pubertal insulin resistance worsen cardiovascular (CV) risk factors in youth. It is unclear how the relationships of obesity and insulin resistance with CV risk compare to adults. Subjects and Methods: We evaluated 66 pubertal youth (mean ± SD: age 14.2 ± 2.0 years, body mass index [BMI] 36.6 ± 6.0 kg/m2, hemoglobin A1c [HbA1c] 38.5 ± 6.1 mmol/mol) and 355 adults with comparable BMI (age 52.7 ± 9.4 years, BMI 35.1 ± 5.1 kg/m2, HbA1c 39.8 ± 4.2 mmol/mol) participating in a multicenter study. Insulin sensitivity was quantified using hyperglycemic clamps. Assessment of CV risk factors was standardized across sites. Regression analyses compared the impact of insulin sensitivity and CV risk factors between youth and adults. Results: Obese pubertal youth were more insulin resistant than comparably obese adults (P <.001), but with similar slopes for the inverse relationship between insulin sensitivity and obesity. The impact of obesity on CV risk factors was explained by insulin sensitivity (P = NS after adjustment for sensitivity). The two age groups did not differ in relationships between insulin sensitivity and diastolic blood pressure, total cholesterol, and low-density lipoprotein (LDL) cholesterol, after adjusting for obesity. However, while systolic blood pressure (SBP) and high-density lipoprotein (HDL) cholesterol exhibited the expected direct and inverse relationships, respectively with insulin sensitivity in adults, these slopes were flat in youth across the range of insulin sensitivity (P ≤.05 for group differences). Conclusions: Effects of obesity on CV risk factors were attributable to insulin sensitivity in both groups. The relationships between insulin sensitivity and CV risk factors were similar in obese youth and adult groups except for SBP and HDL cholesterol. Clinical Trial Registration: The RISE consortium studies are registered through Clinicaltrials.gov as NCT01779362 (Adult Medication Study); NCT01763346 (Adult Surgery Study); and NCT01779375 (Pediatric Medication Study). Clinical trial registration numbers: NCT01779362, NCT01779375 and NCT01763346 at clinicaltrials.gov.",
keywords = "adult, cardiovascular risk, insulin resistance, obesity, youth",
author = "{The RISE Consortium} and Ehrmann, {David A.} and Temple, {Karla A.} and Abby Rue and Elena Barengolts and Babak Mokhlesi and {Van Cauter}, Eve and Susan Sam and Miller, {M. Annette} and Kahn, {Steven E.} and Atkinson, {Karen M.} and Palmer, {Jerry P.} and Utzschneider, {Kristina M.} and Tsige Gebremedhin and Abigail Kernan-Schloss and Alexandra Kozedub and Montgomery, {Brenda K.} and Morse, {Emily J.} and Mather, {Kieren J.} and Tammy Garrett and Hannon, {Tamara S.} and Amale Lteif and Aniket Patel and Robin Chisholm and Karen Moore and Vivian Pirics and Linda Pratt and Nadeau, {Kristen J.} and Susan Gross and Zeitler, {Philip S.} and Jayne Williams and Green, {Melanie Cree} and {Garcia Reyes}, Yesenia and Krista Vissat and Arslanian, {Silva A.} and Kathleen Brown and Nancy Guerra and Kristin Porter and Sonia Caprio and Mary Savoye and Bridget Pierpont and Buchanan, {Thomas A.} and Xiang, {Anny H.} and Enrique Trigo and Elizabeth Beale and Hendee, {Fadi N.} and Namir Katkhouda and Krishan Nayak and Mayra Martinez and Cortney Montgomery and Xinhui Wang",
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TY - JOUR

T1 - Obesity and insulin sensitivity effects on cardiovascular risk factors

T2 - Comparisons of obese dysglycemic youth and adults

AU - The RISE Consortium

AU - Ehrmann, David A.

AU - Temple, Karla A.

AU - Rue, Abby

AU - Barengolts, Elena

AU - Mokhlesi, Babak

AU - Van Cauter, Eve

AU - Sam, Susan

AU - Miller, M. Annette

AU - Kahn, Steven E.

AU - Atkinson, Karen M.

AU - Palmer, Jerry P.

AU - Utzschneider, Kristina M.

AU - Gebremedhin, Tsige

AU - Kernan-Schloss, Abigail

AU - Kozedub, Alexandra

AU - Montgomery, Brenda K.

AU - Morse, Emily J.

AU - Mather, Kieren J.

AU - Garrett, Tammy

AU - Hannon, Tamara S.

AU - Lteif, Amale

AU - Patel, Aniket

AU - Chisholm, Robin

AU - Moore, Karen

AU - Pirics, Vivian

AU - Pratt, Linda

AU - Nadeau, Kristen J.

AU - Gross, Susan

AU - Zeitler, Philip S.

AU - Williams, Jayne

AU - Green, Melanie Cree

AU - Garcia Reyes, Yesenia

AU - Vissat, Krista

AU - Arslanian, Silva A.

AU - Brown, Kathleen

AU - Guerra, Nancy

AU - Porter, Kristin

AU - Caprio, Sonia

AU - Savoye, Mary

AU - Pierpont, Bridget

AU - Buchanan, Thomas A.

AU - Xiang, Anny H.

AU - Trigo, Enrique

AU - Beale, Elizabeth

AU - Hendee, Fadi N.

AU - Katkhouda, Namir

AU - Nayak, Krishan

AU - Martinez, Mayra

AU - Montgomery, Cortney

AU - Wang, Xinhui

PY - 2019/11/1

Y1 - 2019/11/1

N2 - Background: Obesity and pubertal insulin resistance worsen cardiovascular (CV) risk factors in youth. It is unclear how the relationships of obesity and insulin resistance with CV risk compare to adults. Subjects and Methods: We evaluated 66 pubertal youth (mean ± SD: age 14.2 ± 2.0 years, body mass index [BMI] 36.6 ± 6.0 kg/m2, hemoglobin A1c [HbA1c] 38.5 ± 6.1 mmol/mol) and 355 adults with comparable BMI (age 52.7 ± 9.4 years, BMI 35.1 ± 5.1 kg/m2, HbA1c 39.8 ± 4.2 mmol/mol) participating in a multicenter study. Insulin sensitivity was quantified using hyperglycemic clamps. Assessment of CV risk factors was standardized across sites. Regression analyses compared the impact of insulin sensitivity and CV risk factors between youth and adults. Results: Obese pubertal youth were more insulin resistant than comparably obese adults (P <.001), but with similar slopes for the inverse relationship between insulin sensitivity and obesity. The impact of obesity on CV risk factors was explained by insulin sensitivity (P = NS after adjustment for sensitivity). The two age groups did not differ in relationships between insulin sensitivity and diastolic blood pressure, total cholesterol, and low-density lipoprotein (LDL) cholesterol, after adjusting for obesity. However, while systolic blood pressure (SBP) and high-density lipoprotein (HDL) cholesterol exhibited the expected direct and inverse relationships, respectively with insulin sensitivity in adults, these slopes were flat in youth across the range of insulin sensitivity (P ≤.05 for group differences). Conclusions: Effects of obesity on CV risk factors were attributable to insulin sensitivity in both groups. The relationships between insulin sensitivity and CV risk factors were similar in obese youth and adult groups except for SBP and HDL cholesterol. Clinical Trial Registration: The RISE consortium studies are registered through Clinicaltrials.gov as NCT01779362 (Adult Medication Study); NCT01763346 (Adult Surgery Study); and NCT01779375 (Pediatric Medication Study). Clinical trial registration numbers: NCT01779362, NCT01779375 and NCT01763346 at clinicaltrials.gov.

AB - Background: Obesity and pubertal insulin resistance worsen cardiovascular (CV) risk factors in youth. It is unclear how the relationships of obesity and insulin resistance with CV risk compare to adults. Subjects and Methods: We evaluated 66 pubertal youth (mean ± SD: age 14.2 ± 2.0 years, body mass index [BMI] 36.6 ± 6.0 kg/m2, hemoglobin A1c [HbA1c] 38.5 ± 6.1 mmol/mol) and 355 adults with comparable BMI (age 52.7 ± 9.4 years, BMI 35.1 ± 5.1 kg/m2, HbA1c 39.8 ± 4.2 mmol/mol) participating in a multicenter study. Insulin sensitivity was quantified using hyperglycemic clamps. Assessment of CV risk factors was standardized across sites. Regression analyses compared the impact of insulin sensitivity and CV risk factors between youth and adults. Results: Obese pubertal youth were more insulin resistant than comparably obese adults (P <.001), but with similar slopes for the inverse relationship between insulin sensitivity and obesity. The impact of obesity on CV risk factors was explained by insulin sensitivity (P = NS after adjustment for sensitivity). The two age groups did not differ in relationships between insulin sensitivity and diastolic blood pressure, total cholesterol, and low-density lipoprotein (LDL) cholesterol, after adjusting for obesity. However, while systolic blood pressure (SBP) and high-density lipoprotein (HDL) cholesterol exhibited the expected direct and inverse relationships, respectively with insulin sensitivity in adults, these slopes were flat in youth across the range of insulin sensitivity (P ≤.05 for group differences). Conclusions: Effects of obesity on CV risk factors were attributable to insulin sensitivity in both groups. The relationships between insulin sensitivity and CV risk factors were similar in obese youth and adult groups except for SBP and HDL cholesterol. Clinical Trial Registration: The RISE consortium studies are registered through Clinicaltrials.gov as NCT01779362 (Adult Medication Study); NCT01763346 (Adult Surgery Study); and NCT01779375 (Pediatric Medication Study). Clinical trial registration numbers: NCT01779362, NCT01779375 and NCT01763346 at clinicaltrials.gov.

KW - adult

KW - cardiovascular risk

KW - insulin resistance

KW - obesity

KW - youth

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JO - Pediatric Diabetes

JF - Pediatric Diabetes

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