Brar Preneet Cheema, Patel Payal, Katz Stuart
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J Pediatr Endocrinol Metab. 2017 May 24;30(6):635-642. doi: 10.1515/jpem-2016-0404.
Insulin resistance and endothelial dysfunction share a reciprocal relationship that links the metabolic and cardiovascular sequelae of obesity. We characterized the brachial artery reactivity testing (BART) and carotid artery-intima media thickness (CIMT) in adolescents categorized as obese insulin resistant (OIR) and obese not insulin resistant (ONIR). Lipoprotein particle (p) analysis and inflammatory cytokines in OIR and ONIR groups were also analyzed.
Obese adolescents (n=40; mean body mass index [BMI] 35.6) were categorized as ONIR and OIR based on their homeostatic model assessment of insulin resistance (HOMA-IR) calculation (≤or> than 3.4). Ultrasound measured conduit arterial function BART, microvascular function (post-ischemic hyperemia) and conduit artery structure CIMT.
BART did not differ according to IR status (mean±SD: 7.0±4.3% vs. 5.9±3.4% in ONIR and OIR, respectively, p=0.3, but post-ischemic hyperemia was significantly greater in the ONIR group (4.5±2.2 vs. 3.5±3, p=0.04). Atherogenic lipoprotein particles; large VLDL particles and small LDL particles were higher in the OIR compared to ONIR group.
OIR adolescents demonstrate an inflamed atherogenic milieu compared to the ONIR adolescents. Microvascular function, but not conduit vessel structure or function, was impaired in association with IR.
胰岛素抵抗与内皮功能障碍存在相互关系，这种关系将肥胖的代谢和心血管后果联系起来。我们对被归类为肥胖胰岛素抵抗（OIR）和肥胖非胰岛素抵抗（ONIR）的青少年的肱动脉反应性测试（BART）和颈动脉内膜中层厚度（CIMT）进行了特征描述。还分析了OIR组和ONIR组的脂蛋白颗粒（p）分析及炎性细胞因子。
根据胰岛素抵抗的稳态模型评估（HOMA-IR）计算（≤或>3.4），将40名肥胖青少年（平均体重指数[BMI]为35.6）分为ONIR组和OIR组。通过超声测量传导动脉功能BART、微血管功能（缺血后充血）和传导动脉结构CIMT。
BART根据胰岛素抵抗状态无差异（平均值±标准差：ONIR组和OIR组分别为7.0±4.3%和5.9±3.4%，p=0.3），但ONIR组的缺血后充血明显更大（4.5±2.2对3.5±3，p=0.04）。与ONIR组相比，OIR组的致动脉粥样硬化脂蛋白颗粒；大的极低密度脂蛋白颗粒和小的低密度脂蛋白颗粒更高。
与ONIR青少年相比，OIR青少年表现出炎症性致动脉粥样硬化环境。微血管功能与胰岛素抵抗相关受损，但传导血管结构或功能未受损。
