The insulin-resistance (IR) metabolic syndrome (MetS) leads to high CVD risk in adult life and has been associated with an early state of chronic low–grade inflammation (CLGI). The aim of the present study was to determine the association between a state of CLGI and insulin sensitivity, body composition and MetS prevalence in overweight adolescents. The study included 158 adolescents (BMI ≥85th percentile; eighty-six men) between 13 and 16 years of age, who were assessed for BMI, body composition (% body fat mass (BFM) and % free-fat mass (FFM) by pletysmography, prevalence of MetS for three or more variables (waist circumference (WC) ≥90th percentile; HDL-cholesterol ⩽400 mg/l; TAG≥1100 mg/l; blood arterial pressure ≥90th percentile; fasting glucose ≥100 mg/d), HOMA-IR (glucose×insulin/22.5) and the state of inflammation by C-reactive protein (CRP). Pearson correlation and ψ2 were used to study associations between variables, OR to calculate risk and ANOVA and Tukey test to compare averages between groups. The median and ranges of CRP levels (mg/l) were 0.7 (range 0.04–9.1) in males and 0.7 (range 0.04–6.2) in females. CRP showed a correlation with BMI (P<0.05), WC (P<0.02), % BFM (P<0.05), % FFM (P<0.05), fasting insulin (P<0.001) and HOMA (P<0.001).
Table 1. Pearson correlation for CRP with variables of metabolic and cardiovascular risk
CRP was significantly (P<0.01) associated with an anthropometric and metabolic cardiovascular risk profile. The prevalence and the risk of abdominal obesity (WC≥90th percentile), IR (HOMA≥3.3) and MetS were significantly higher (63%, OR 3.0; 43%, OR 4.1; 26%, OR 4.1 respectively) in adolescents with CRP levels ≥1.12 mg/l (≥tertile 2).
Table 2. Anthropometric, cardiovascular and metabolic profile across the CRP tertile distribution
Mean values were significantly different from those for tertile 1–2 and>tertile 2: **P<0.05. Mean values were significantly different from those for<tertile 1: †P<0.05, ††P<0.01. Mean values were significantly different from those for tertile 1–2: ‡P<0.05, ‡‡P<0.05.
These results confirm that (1) PCR levels in overweight adolescents are associated with a greater cardiovascular and metabolic risk and (2) IR involves inflammatory processes that may play an early role in the development of cardiovascular lesions.
