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ARS Home » Plains Area » Houston, Texas » Children's Nutrition Research Center » Research » Publications at this Location » Publication #319148
Title: Pre-diabetes in overweight youth and early atherogenic risk

Author
item BURNS, STEPHEN - UNIVERSITY OF PITTSBURGH MEDICAL CENTER
item LEE, SOJUNG - UNIVERSITY OF PITTSBURGH MEDICAL CENTER
item BACHA, FIDA - CHILDREN'S NUTRITION RESEARCH CENTER (CNRC)
item TFAYLI, HALA - AMERICAN UNIVERSITY OF BEIRUT
item HANNON, TAMARA - INDIANA UNIVERSITY SCHOOL OF MEDICINE
item ARSLANIAN, SILVA - UNIVERSITY OF PITTSBURGH MEDICAL CENTER

Submitted to: Metabolism
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 8/21/2014
Publication Date: 12/1/2014
Citation: Burns, S.F., Lee, S., Bacha, F., Tfayli, H., Hannon, T.S., Arslanian, S.A. 2014. Pre-diabetes in overweight youth and early atherogenic risk. Metabolism. 63(12):1528-1535.

Interpretive Summary: The size of the fat particles called lipoproteins and the blood levels of inflammation markers may reflect the risk for atherosclerosis better that the traditional lipid profile. It is not clear if youth with prediabetes have worse lipoprotein distribution compared with youth of normal glucose tolerance. We compared lipoprotein particle size and concentration and biomarkers of inflammation in youth with prediabetes to those with normal glucose tolerance. We found that youth with prediabetes have worse lipoprotein particle size distribution (smaller particle size related to higher risk of atherosclerosis). This was related to the amount of abdominal visceral fat and insulin resistance. These results suggest higher risk for atherosclerosis in youth with prediabetes.

Technical Abstract: To compare atherogenic lipoprotein particles and vascular smooth muscle biomarkers in overweight youth with pre-diabetes (PD) vs. normal glucose tolerance (NGT). 144 adolescents (60 black, 84 white; 102 female; PD=45, NGT=99) aged 10-19 years underwent a fasting blood draw and 2-h OGTT. Lipoprotein particle size and subclass concentration and vascular smooth muscle biomarkers (ICAM-1, VCAM-1 and E-selectin) were compared between youth with PD and NGT. Compared with NGT, PD adolescents had smaller LDL (mean+/-SE: 20.5+/-0.1 vs. 21.0+/-0.1 nm; P=0.002) and HDL (8.62+/-0.05 vs. 8.85+/-0.04 nm; P=0.013) size and elevated medium small (159.2+/-10.3 vs. 123.8+/-6.4 nmol/L; P=0.037) and very small (626.3+/-45.4 vs. 458.5+/-26.4 nmol/L; P=0.032) LDL particle concentrations, after adjustment for race and BMI. Further adjusting for fasting insulin or visceral adiposity obviated these differences between the groups except for LDL size. ICAM-1 and E-selectin did not differ in youth with PD but correlated with LDL and HDL size, and small LDL particle concentrations. Overweight adolescents with PD have an atherogenic lipoprotein profile of small LDL and HDL size and increased concentrations of small LDL, moderated by insulin resistance and visceral adiposity, but independently driven by dysglycemia for LDL size. Associations between smooth muscle biomarkers and lipoproteins could be an early signal heralding the atherogenic process. It remains to be determined if correction of dysglycemia and associated lipoprotein abnormalities in obese youth could prove effective in halting this process.