Background: Low-grade vascular inflammation is believed to initiate early atherosclerotic process by inducing\r\ninsulin resistance (IR), with significant gender differences in adults. We evaluated the relationship between surrogate\r\nmeasures of inflammation and IR in obese adolescents.\r\nMethods: The association among markers of inflammation [high-sensitivity c-reactive protein (hs-CRP)] and IR,\r\ncardiometabolic risk factors and body composition was retrospectively examined in 199 obese adolescents\r\n[(111 F/88 M), aged 15.5 �± 1.2 years]. Insulin resistance was assessed using homeostatic model assessment for\r\ninsulin resistance (HOMA-IR).\r\nResults: Males had higher body mass index SD-score (BMI-SDS), fat mass (FM), glucose, insulin, HOMA-IR, HbA1c,\r\nhs-CRP, triglycerides: HDL-C (TG:HDL-C) ratio than females (p < 0.05), whereas females had higher c-peptide: insulin\r\nratio than males (p < 0.05). Also, 50.8% of subjects were identified with metabolic syndrome with similar gender\r\ndistribution (M: 57.9% vs. F: 45.1%, p = 0.32). Hs-CRP was correlated with HOMA-IR in the cohort, even when controlling\r\nfor FM (r = 0.26; p < 0.0001). However, hs-CRP and HOMA-IR displayed a significant correlation only in females (r = 0.37;\r\np < 0.0001) when adjusting for FM and pubertal status. Also, c-peptide: insulin ratio was inversely correlated with\r\nhs-CRP (r = -0.32; p < 0.001) and HOMA-IR (r = -0.62; p < 0.0001) and partially mediated the relationship between\r\nthese biomarkers only among females (�Ÿ = 0.36, p < 0.001 to �Ÿ = 0.18, p < 0.05; Sobel Test: p < 0.01).\r\nConclusions: A positive association between hs-CRP and HOMA-IR was observed only in adolescent girls which\r\nwas influenced by altered hepatic insulin clearance. This implies that obese adolescent girls may be at greatest risk\r\nof developing early atherosclerosis and diabetes.
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