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Gender differences in the association of insulin resistance and high-sensitivity c-reactive protein in obese adolescents

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Title: Gender differences in the association of insulin resistance and high-sensitivity c-reactive protein in obese adolescents
Author(s): Alemzadeh, R.; Kichler, J.
Subject(s): Metabolic syndrome Diabetes c-reactive protein Obesity Dyslipidemia
Abstract: Background: Low-grade vascular inflammation is believed to initiate early atherosclerotic process by inducing insulin resistance (IR), with significant gender differences in adults. We evaluated the relationship between surrogate measures of inflammation and IR in obese adolescents. Methods: The association among markers of inflammation [high-sensitivity c-reactive protein (hs-CRP)] and IR, cardiometabolic risk factors and body composition was retrospectively examined in 199 obese adolescents [(111 F/88 M), aged 15.5 ± 1.2 years]. Insulin resistance was assessed using homeostatic model assessment for insulin resistance (HOMA-IR). Results: Males had higher body mass index SD-score (BMI-SDS), fat mass (FM), glucose, insulin, HOMA-IR, HbA1c, hs-CRP, triglycerides: HDL-C (TG:HDL-C) ratio than females (p < 0.05), whereas females had higher c-peptide: insulin ratio than males (p < 0.05). Also, 50.8% of subjects were identified with metabolic syndrome with similar gender distribution (M: 57.9% vs. F: 45.1%, p = 0.32). Hs-CRP was correlated with HOMA-IR in the cohort, even when controlling for FM (r = 0.26; p < 0.0001). However, hs-CRP and HOMA-IR displayed a significant correlation only in females (r = 0.37; p < 0.0001) when adjusting for FM and pubertal status. Also, c-peptide: insulin ratio was inversely correlated with hs-CRP (r = −0.32; p < 0.001) and HOMA-IR (r = −0.62; p < 0.0001) and partially mediated the relationship between these biomarkers only among females (β = 0.36, p < 0.001 to β = 0.18, p < 0.05; Sobel Test: p < 0.01). Conclusions: A positive association between hs-CRP and HOMA-IR was observed only in adolescent girls which was influenced by altered hepatic insulin clearance. This implies that obese adolescent girls may be at greatest risk of developing early atherosclerosis and diabetes
Issue Date: 2014
Publisher: BioMed Central
Citation Info: Alemzadeh, R. and Kichler, J. Gender differences in the association of insulin resistance and high-sensitivity c-reactive protein in obese adolescents. Journal of Diabetes and Metabolic Disorders. 2014. 13(1). DOI: 10.1186/2251-6581-13-35.
Type: Article
Description: This is a copy of an article published in the Journal of Diabetes and Metabolic Disorders © 2014 BioMed Central Publications. © 2014 Alemzadeh and Kichler; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.
ISSN: 2251-6581
Sponsor: This study was funded by the Diabetes Research Fund, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI.
Date Available in INDIGO: 2016-01-14

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