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Early atherogenesis and visceral fat in obese adolescents

International Journal of Obesity volume 38, pages 954–958 (2014)Cite this article

Subjects

Abstract

Background/Objectives:

Little information is available as to the cause of increased thickening of the intima-media of the carotid artery (cIMT) in the pediatric population. Therefore, cIMT was compared in obese adolescents and normal-weight controls, and associations between cIMT and lipid and non-lipid cardiovascular risk factors were assessed.

Subjects/Methods:

Subjects included 61 obese non-diabetic male and female volunteers aged 12–18 years inclusive with a body mass index (BMI) >95th percentile for age and 2-h blood glucose <200 mg dl−1 matched to 25 normal-weight control volunteers with normal glucose levels. Each subject underwent a 2-h glucose tolerance test and measurement of hemoglobin A1c, ultrasensitive C-reactive protein, fasting insulin, blood lipids, visceral, subcutaneous abdominal and hepatic fat, and cIMT.

Results:

Maximum cIMT was 0.647±0.075 mm in the obese subjects versus 0.579±0.027 mm in normal-weight controls (P<0.001). There was no difference in maximum cIMT between male and female subjects. There were significant correlations between maximum cIMT and BMI z-score, 2-h glucose, fasting insulin, homeostasis model assessment (HOMA), total low-density lipoprotein (LDL) cholesterol, very LDL cholesterol, high-density lipoprotein (HDL) cholesterol, HDL2 cholesterol, HDL3 cholesterol, triglycerides, remnant lipoprotein cholesterol, intermediate-density lipoprotein cholesterol, lipoprotein(a), apoprotein B100, abdominal subcutaneous fat volume, visceral fat volume and hepatic phase difference. On multiple regression analysis, visceral fat was the most significant predictor of maximum cIMT. Two-hour blood glucose, HOMA and systolic blood pressure were also significant predictors of maximum cIMT.

Conclusions:

cIMT was increased in the obese adolescents compared with the normal-weight-matched controls. Visceral fat was a key predictor of arterial wall thickening in these subjects. The results suggest that the focus of cardiovascular disease prevention in the adolescent obese should be visceral obesity, and not blood lipids or lipid subclasses.

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Acknowledgements

We acknowledge the editorial assistance of Jacqueline Grove and the recruiting contributions of Kim Kopfer, both employed by Lehigh Valley Health Network. This study was funded by the Department of Pediatrics at Lehigh Valley Hospital, Allentown, PA, USA.

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Author notes

  1. B Blech and S Gensler: These authors are not affiliated with any institution.

Authors and Affiliations

  1. Department of Pediatrics, Lehigh Valley Health Network, Allentown, PA, USA

    A H Slyper

  2. Department of Radiology, Lehigh Valley Health Network, Allentown, PA, USA

    H Rosenberg

  3. Division of Cardiovascular Medicine, Scripps Clinic, La Jolla, CA, USA

    A Kabra

  4. Network Office of Research and Innovation, Lehigh Valley Health Network, Allentown, PA, USA

    M J Weiss

  5. Cardiovascular Research Institute, Lehigh Valley Health Network, Allentown, PA, USA

    M Matsumura

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  1. A H Slyper
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Correspondence to A H Slyper.

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Slyper, A., Rosenberg, H., Kabra, A. et al. Early atherogenesis and visceral fat in obese adolescents. Int J Obes 38, 954–958 (2014). https://doi.org/10.1038/ijo.2014.11

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