Insulin resistance in childhood obesity: The role of dietary habits and their association with novel markers of cardiovascular disease

Abstract

Background: Childhood obesity presents numerous comorbidities such as insulin resistance (IR) and dyslipidemia, andcould be associated with alterations in novel markers of cardiovascular (CV) risk like: (1) the activities of associatedenzymes such as lipoprotein associated phospholipase A2 (Lp-PLA2) and paraoxonase 1 (PON 1), (2) reverse cholesteroltransport (RCT), which comprises cellular cholesterol efflux (CCE), in addition to lecithin:cholesterol acyltransferase(LCAT) and cholesteryl ester transfer protein (CETP) activities, and (3) high density lipoprotein (HDL) antioxidant capacity. Moreover, IR could worsen these cardiometabolic alterations. The objective of the present study was to characterize the effect of IR on novel CV markers in a pediatric population with obesity.Methods: Twenty-five obese children and adolescents with IR, and 25 without IR took part in the study. Anthropometricparameters, Tanner stage and dietary habits were registered. Glucose, insulin, non-esterified fatty acid (NEFA), lipid, andhigh sensitivity C reactive protein (hsCRP) levels, plus Lp-PLA2, LCAT, CETP and PON 1 activities, as well as CCE andHDL antioxidant capacity were measured. A cutoff point of 3.16 in Homeostatic Model Assessment for Insulin Resistance(HOMA-IR) determined the presence of IR.Results: No differences were observed in age, sex and Tanner stage. Expectedly, the group with IR displayed higher insulin and NEFA levels (p < 0.05). They also presented increased Lp-PLA2 and decreased PON activities (p < 0.05).Importantly, these differences were associated with dietary habits (p < 0.05).Conclusion: IR present in pediatric obesity associated with vascular specific inflammation and reduced PON 1 activity, inaddition to alterations in glucose metabolism, thus increasing CV risk in adulthood. These proatherogenic disturbanceswere conditioned by dietary habits.