Evidence for association between insulin resistance and premature carotid atherosclerosis in childhood obesity.

ABSTRACT

The present study was undertaken to determine the presence and predictors of the subclinical atherosclerosis in obese children. Fifty obese children [mean age 11.7 +/- 2.5 y, mean body mass index (BMI) 28.2 +/- 4.0 kg/m] and 50 age- and sex-matched healthy nonobese controls (mean age 11.4 +/- 3.73 y, mean BMI 17.6 +/- 3.0 kg/m) were enrolled in the present study. Oral glucose tolerance test was performed to all obese subjects. Common carotid artery intima-media thickness (IMT) was measured by high-resolution B-mode ultrasonography. Carotid artery IMT was significantly increased (0.0476 +/- 0.007 versus 0.033 +/- 0.011 cm; p < 0.001) in the obese group. There were significant relations between carotid artery IMT and insulin sensitivity indexes derived from fasting samples (fasting glucose to insulin ratio (FGIR; p = 0.004, r = -0.404), quantitative insulin-sensitivity check index (QUICK-I; p = 0.002, r = -0.401) and homeostasis model assessment of insulin resistance (HOMA-IR; p = 0.034, r = 0.300) in the obese group. In a multivariate regression model, QUICK-I emerged as independent correlates for mean IMT in obese children with the total variance explained being 20.7% (beta = -0.58, p < 0.001). We concluded that insulin resistance is an independent risk factor for increased carotid artery IMT in obese children.