Prediabetic obese adolescents have a more atherogenic lipoprotein profile compared with normoglycemic obese peers

J Pediatr. 2012 Nov;161(5):881-6. doi: 10.1016/j.jpeds.2012.04.006. Epub 2012 May 22.

Abstract

Objective: To compare lipoprotein profiles of prediabetic to normoglycemic obese adolescents.

Study design: Cross-sectional study of 95 obese, pubertal adolescents (12-17 years), who underwent oral glucose tolerance test, lipid panel, and lipoprotein subclass particle analysis (nuclear magnetic resonance spectroscopy). Univariate and linear regression analyses compared prediabetic and normoglycemic groups.

Results: Of 95 obese adolescents enrolled in the study, 22.1% (n = 21) had prediabetes. They were similar to normoglycemic adolescents (n = 74) in age, race, body mass index, standard lipids, total low-density lipoprotein particles (LDL-P), and total high-density lipoprotein particles (HDL-P). However, prediabetics had higher concentrations of small LDL-P (714.0 ± 288.0 vs 537.7 ± 266.5 nmol/L, P = .01) and smaller LDL-P size (20.73 ± 0.41 vs 21.18 ± 0.65 nm, P = .003), than normoglycemic youth. Prediabetics had higher small HDL-P (18.5 ± 3.8 vs 16.6 ± 3.9 umol/L, P = .046), lower large HDL-P (4.49 ± 2.0 vs 6.32 ± 2.6 umol/L, P = .004), and smaller HDL-P size (8.73 ± 0.31 vs 9.01 ± 0.39 nm, P = .003). After adjusting for demographics, Tanner stage, and body mass index using multiple linear regression, all differences remained significant except for small HDL-P. After additional adjustment for Homeostasis Model Assessment-Insulin Resistance Index, only LDL-P size difference remained significant.

Conclusion: Obese prediabetic adolescents have a significantly more atherogenic lipoprotein profile compared with obese normoglycemic peers. Prediabetic adolescents may benefit from more aggressive interventions to decrease future cardiovascular risk.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Atherosclerosis
  • Child
  • Cross-Sectional Studies
  • Female
  • Glucose Tolerance Test
  • Humans
  • Insulin Resistance
  • Lipoproteins / blood
  • Lipoproteins, HDL / blood
  • Lipoproteins, LDL / blood
  • Male
  • Obesity / blood*
  • Obesity / complications
  • Obesity / diagnosis
  • Prediabetic State / blood*
  • Prediabetic State / complications
  • Prediabetic State / diagnosis
  • Regression Analysis

Substances

  • Lipoproteins
  • Lipoproteins, HDL
  • Lipoproteins, LDL