Ortiz Segura Maria Del Carmen, Del Río Navarro Blanca Estela, Rodríguez Espino Benjamín Antonio, Marchat Laurence A, Sánchez Muñoz Fausto, Villafaña Santiago, Hong Enrique, Meza-Cuenca Fabián, Mailloux Salinas Patrick, Bolaños-Jiménez Francisco, Zambrano Elena, Arredondo-López Abel Armando, Bravo Guadalupe, Huang Fengyang
a Department of Pharmacobiology , Centro de Investigacion de Estudio Avanzados del Instituto Politecnico Nacional , Mexico City , Mexico.
b Department of Allergy , Hospital Infantil de México Federico Gómez (HIMFG) , Mexico City , Mexico.
Endocr Res. 2017 Aug;42(3):252-259. doi: 10.1080/07435800.2017.1294601. Epub 2017 Mar 20.
The aim of this study was to investigate the possible relationship among insulin resistance (IR), endothelial dysfunction, and alteration of adipokines in Mexican obese adolescents and their association with metabolic syndrome (MetS).
Two hundred and twenty-seven adolescents were classified according to the body mass index (BMI) (control: N=104; obese: N=123) and homeostasis model of the assessment-insulin resistance index (HOMA-IR) (obese with IR: N=65). The circulating concentrations of leptin, adiponectin, soluble intercellular adhesion molecule-1 (sICAM-1), and IR were determined by standard methods.
The obese adolescents with IR presented increased presence of MetS and higher circulating concentrations in sICAM-1 in comparison with the obese subjects without IR. The lowest concentrations of adiponectin were observed in the obese with IR. In multivariate linear regression models, sICAM-1 along with triglycerides, total cholesterol, and waist circumference was strongly associated with HOMA-IR (R=0.457, P=0.008). Similarly, after adjustment for age, BMI-SDS, lipids, and adipokines, HOMA-IR remained associated with sICAM-1 (R=0.372, P=0.008). BMI-SDS was mildly associated with leptin (R=0.176, P=0.002) and the waist circumference was mild and independent determinant of adiponectin (R=0.136, P=0.007).
Our findings demonstrated that the obese adolescents, particularly the obese subjects with IR exhibited increased presence of MetS, abnormality of adipokines, and endothelial dysfunction. The significant interaction between IR and endothelial dysfunction may suggest a novel therapeutic approach to prevent or delay systemic IR and the genesis of cardiovascular diseases in obese patients.
本研究旨在调查墨西哥肥胖青少年中胰岛素抵抗（IR）、内皮功能障碍和脂肪因子改变之间的可能关系及其与代谢综合征（MetS）的关联。
根据体重指数（BMI）将227名青少年进行分类（对照组：N = 104；肥胖组：N = 123），并根据评估胰岛素抵抗指数的稳态模型（HOMA-IR）（伴有IR的肥胖组：N = 65）。通过标准方法测定瘦素、脂联素、可溶性细胞间黏附分子-1（sICAM-1）的循环浓度以及IR。
与无IR的肥胖受试者相比，伴有IR的肥胖青少年中MetS的发生率更高，sICAM-1的循环浓度也更高。在伴有IR的肥胖者中观察到脂联素浓度最低。在多变量线性回归模型中，sICAM-1与甘油三酯、总胆固醇和腰围与HOMA-IR密切相关（R = 0.457，P = 0.008）。同样，在调整年龄、BMI-SDS、血脂和脂肪因子后，HOMA-IR仍与sICAM-1相关（R = 0.372，P = 0.008）。BMI-SDS与瘦素轻度相关（R = 0.176，P = 0.002），腰围是脂联素的轻度独立决定因素（R = 0.136，P = 0.007）。
我们的研究结果表明，肥胖青少年，尤其是伴有IR的肥胖受试者，MetS的发生率增加、脂肪因子异常和内皮功能障碍。IR与内皮功能障碍之间的显著相互作用可能提示一种预防或延缓肥胖患者全身性IR和心血管疾病发生的新治疗方法。
