Elsevier

The Journal of Pediatrics

Volume 145, Issue 6, December 2004, Pages 731-736
The Journal of Pediatrics

Original Article
Inflammation, insulin, and endothelial function in overweight children and adolescents: The role of exercise

https://doi.org/10.1016/j.jpeds.2004.08.004Get rights and content

Objectives

To assess subclinical inflammation, fasting insulin, and endothelial function before and after exercise in overweight children and adolescents.

Study design

Twenty-five children (body mass index [BMI] >85th percentile) were assessed for brachial artery flow-mediated dilation (FMD), nitroglycerin-induced dilation, C-reactive protein (CRP), lipids, glucose, insulin, oral glucose tolerance, body composition, aerobic fitness (peak oxygen uptake [VO2peak]), and blood pressure. Twenty of these persons were equally and randomly assigned to either 8 weeks of stationary cycling or to a non-exercising control group.

Results

A baseline correlation was found between CRP and fasting insulin (r = 0.62; P < .001), which remained significant after adjusting for baseline variables (r = 0.53; P < .05). After 8 weeks, significant improvements were observed in the exercise group compared with the control group for VO2peak (exercise group = 21.8 ± 2.1 to 23.2 ± 1.5 mL/kg/minute vs control group = 23.4 ± 1.6 to 20.9 ± 2.2 mL/kg/minute; P < .05), high-density lipoprotein (HDL) cholesterol (exercise group = 1.02 ± 0.03 to 1.10 ± 0.04 mmol/L vs control group = 1.08 ± 0.07 to 0.99 ± 0.09 mmol/L; P < .05), and FMD area under the curve (AUC) (exercise group = 746 ± 66 to 919 ± 94 %•sec vs control group = 731 ± 102 to 515 ± 73 %•sec; P < .05).

Conclusions

In overweight children and adolescents, CRP is independently associated with fasting insulin. Eight weeks of aerobic exercise improves fitness, HDL cholesterol, and endothelial function in this group.

Section snippets

Subjects

Twenty-five healthy, overweight children and adolescents (body mass index [BMI] >85th percentile for age and gender) were recruited from the greater Minneapolis/St. Paul, Minnesota, metropolitan area to participate in this study. Baseline characteristics for all participants are provided in Table I. Following baseline testing, 20 of the subjects were randomized to either the exercise or the control group. All participants and parents/guardians gave written informed assent and consent. The study

Discussion

The baseline association between CRP and fasting insulin is consistent with previous work in adults showing an independent association between chronic, subclinical inflammation and markers of insulin resistance.5., 7. Data from the present study confirm these previous findings in adults and extend the associations between inflammation and fasting insulin, a marker of insulin resistance, to children.

Children make a unique and valuable model for assessing the complex relationship between

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  • Cited by (0)

    Supported in part by Minnesota Obesity Center Grant #: 1 P30 DK 50456-08 (D.R.K.), American Heart Association Pre-Doctoral Grant #: 0315213Z (A.S.K.), and GCRC: M01-RR00400, General Clinical Research Center Program, NCRR/NIH.

    Data presented in this manuscript appear in a dissertation titled “The effects of aerobic exercise training on vascular structure and function in obese children” that was completed at the University of Minnesota in February 2004.

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