Resistência insulínica pode prejudicar a redução da espessura mediointimal em adolescentes obesos

• Autor(a) principal: Sanches, Priscila de Lima [UNIFESP]
• Data de Publicação: 2012
• Outros Autores: Mello, Marco Tulio de [UNIFESP], Fonseca, Francisco Antonio Helfenstein [UNIFESP], Elias, Natália, Piano, Aline de [UNIFESP], Carnier, June [UNIFESP], Tock, Lian [UNIFESP], Oyama, Lila Missae [UNIFESP], Tufik, Sergio [UNIFESP], Dâmaso, Ana Raimunda [UNIFESP]
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.1590/S0066-782X2012005000077; http://repositorio.unifesp.br/handle/11600/7359
• topic: Atherosclerosis; risk factors; obesity; adolescents; insulin resistance; Aterosclerose; fatores de risco; obesidade; adolescente; resistência insulina

BACKGROUND: The atherosclerotic process at the endothelial level begins in early ages and seems to be associated with obesity and its comorbidities as insulin resistance. OBJECTIVE: The aim of this study was to verify the influence of insulin resistance on inflammatory and subclinical markers of atherosclerosis in obese adolescents. METHODS: Sixty-six post-pubescent obese adolescents were divided in two groups according to homeostasis model assessment of insulin resistance (HOMA-IR) measurement: with insulin resistance (IR) n=39 and without insulin resistance (NIR) n=27, and submitted to an interdisciplinary intervention over the course of 1 year. Common carotid artery intima-media thickness (cIMT), visceral and subcutaneous adipose tissue was determined by ultrasound. Body composition, blood pressure, HOMA-IR, lipid profile and adipokines concentrations [leptin, adiponectin, and plasminogen activator inhibitor type (PAI-1)] were analyzed before and after the therapy. RESULTS: Both groups presented significant improvements in body composition, inflammatory state (reduction of leptin and PAI-1 concentration; increasing of plasma adiponectin) and reduction of cIMT. Only NIR group showed positive correlation between changes in visceral fat (∆Visceral) and changes in cIMT (∆ cIMT) (r = 0.42; p < 0.05). Simple linear regression analyze revealed ∆Visceral to be an independent predictor to reduction of cIMT in this group (R2 adjusted = 0.14, p = 0.04). The final values of cIMT remained significantly higher in IR group when compared to NIR group. CONCLUSION: The presence of insulin resistance can impair changes in cIMT leading to early development of atherosclerosis in obese adolescents submitted to an interdisciplinary intervention..