Mahmud Farid H, Hill David J, Cuerden Meaghan S, Clarson Cheril L
Paediatric Endocrinology, Department of Paediatrics, University of Western Ontario, London, Ontario, Canada.
J Pediatr. 2009 Nov;155(5):678-82. doi: 10.1016/j.jpeds.2009.04.060.
To evaluate endothelial function (EF) in a cohort of obese adolescents with impaired insulin sensitivity.
Cardiovascular risk factors and adipocytokines, along with digital hyperemia, were evaluated by peripheral arterial tonometry (PAT) in adolescents with obesity and insulin resistance (IR) in relation to healthy, nonobese controls.
The obese and control subjects were of similar age (13.4+/-1.7 years vs 14.0+/-1.4 years) and sex. The obese subjects had IR (mean homeostasis model of assessment [HOMA] score=5.4; 95% confidence interval=3.3-7.5) and significantly greater body mass index (BMI) (BMI z-score 2.4+/-0.2 kg/m(2) vs 0.0+/-0.8 kg/m(2)) and waist circumference (WC) measures (109.6+/-11.1cm vs 70.5+/-9.4 cm) with elevated low-density lipoprotein cholesterol (LDL-C), triglyceride, and high-sensitivity C-reactive protein levels. The mean PAT ratio was significantly lower in obese adolescents compared with controls (1.51+/-0.4 vs 2.06+/-0.4; P=.002), indicative of impaired EF. Linear regression demonstrated associations between PAT ratio and BMI, WC, age, and LDL-C but not between PAT and leptin, resistin, or adiponectin levels or IR.
Obese adolescents with IR exhibited significantly worse EF as assessed by PAT compared with healthy, nonobese controls, and EF showed a significant association with measures of adiposity and other cardiovascular risk factors.
评估胰岛素敏感性受损的肥胖青少年队列的内皮功能（EF）。
通过外周动脉张力测定法（PAT）评估肥胖和胰岛素抵抗（IR）青少年的心血管危险因素、脂肪细胞因子以及数字充血情况，并与健康、非肥胖对照者进行比较。
肥胖组和对照组受试者年龄（13.4±1.7岁 vs 14.0±1.4岁）和性别相似。肥胖受试者存在IR（平均稳态模型评估[HOMA]评分=5.4；95%置信区间=3.3 - 7.5），体重指数（BMI）显著更高（BMI z评分2.4±0.2 kg/m² vs 0.0±0.8 kg/m²），腰围（WC）测量值也更高（109.6±11.1cm vs 70.5±9.4 cm），同时低密度脂蛋白胆固醇（LDL-C）、甘油三酯和高敏C反应蛋白水平升高。与对照组相比，肥胖青少年的平均PAT比值显著更低（1.51±0.4 vs 2.06±0.4；P = 0.002），表明EF受损。线性回归显示PAT比值与BMI、WC、年龄和LDL-C之间存在关联，但PAT与瘦素、抵抗素或脂联素水平或IR之间无关联。
与健康、非肥胖对照者相比，通过PAT评估，存在IR的肥胖青少年的EF显著更差，且EF与肥胖测量指标和其他心血管危险因素之间存在显著关联。
