Journal of the American Society of Hypertension
Volume 1, Issue 3 , Pages 200-207, May 2007

Overweight and hyperinsulinemia provide individual contributions to compromises in brachial artery distensibility in healthy adolescents and young adults

  • Elaine M. Urbina, MD

      Affiliations

    • The Division of Preventive Cardiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
    • Department of Pediatrics, Division of Endocrinology, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
    • Corresponding Author InformationCorresponding author: Elaine M. Urbina, MD, Division of Preventive Cardiology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, MLC-7002, Cincinnati, Ohio 45229. Tel: 513-636-8265; fax: 513-636-0162.
    • ,
  • Judy A. Bean, PhD

      Affiliations

    • The Division of Biostatistics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
    • ,
  • Stephen R. Daniels, MD, PhD

      Affiliations

    • Department of Pediatrics, University of Colorado School of Medicine, Denver, Colorado, USA
    • ,
  • David D’Alessio, MD

      Affiliations

    • Department of Internal Medicine, Division of Endocrinology, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
    • ,
  • Lawrence M. Dolan, MD

      Affiliations

    • The Division of Endocrinology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
    • Department of Pediatrics, Division of Endocrinology, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA

Received 1 December 2006; accepted 25 January 2007.

Abstract 

Brachial artery distensibility (BrachD) was measured in healthy children to identify associations with atherosclerotic risk factors. Nine hundred sixty-nine black and white subjects, 13–22 years of age, were classified as lean (L) or overweight (O) and as hyperinsulinemic (H-I) or normoinsulinemic (N-I). Blood pressure (BP) and BrachD were obtained with a DynaPulse Pathway instrument. Analysis of variance was performed, looking for group mean differences. Correlations between BrachD and risk variables were examined. Determinates of BrachD were determined by backward elimination regression, stratified by body mass index (BMI)-insulin group. Decreased BrachD correlated with male gender, O, higher BP, heart rate, fasting glucose, and log of fasting insulin after adjusting for pulse pressure (PP). BrachD was greatest in L+N-I, with progressive decreases seen in L+H-I, O+N-I, and O+H-I subjects. Regression modeling found that PP and HR were major determinates of BrachD. Glucose was significant for subjects with N-I, regardless of adiposity. Excluding BP, glucose remained important in N-I subjects. Gender was significant for all. HR retained significance only in O subjects, regardless of insulin level. In healthy adolescents, hyperinsulinemia and obesity adversely affect brachial artery function, with overweight contributing to a greater degree. In normoinsulinemic subjects, fasting glucose was inversely related to BrachD. Metabolic factors may play a role in vascular function in youth.

Keywords: Elasticity, obesity, insulin, pediatrics

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 This research was supported in part by a National Institutes of Health (NIH) Landmarks in the Progression to Type 2 Diabetes Grant (R01 DK59183), as well as by NIH grant 0M01 RR 08084 and by a Trustee Grant from Cincinnati Children’s Hospital. The authors gratefully acknowledge the work of the PSD research team and the administration, staff, teachers, students, and parents of the Princeton School District.Conflict of interest: none.

PII: S1933-1711(07)00038-1

doi:10.1016/j.jash.2007.01.008

Journal of the American Society of Hypertension
Volume 1, Issue 3 , Pages 200-207, May 2007

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