@article{3094674,
    title = "Elevated total and central adiposity and low physical activity are associated with insulin resistance in children",
    author = "Krekoukia, M. and Nassis, G.P. and Psarra, G. and Skenderi, K. and Chrousos, G.P. and Sidossis, L.S.",
    journal = "Metabolism: Clinical and Experimental",
    year = "2007",
    volume = "56",
    number = "2",
    pages = "206-213",
    issn = "0026-0495",
    doi = "10.1016/j.metabol.2006.09.014",
    keywords = "biological marker;  C reactive protein;  glucose;  high density lipoprotein cholesterol;  insulin;  intercellular adhesion molecule 1;  interleukin 6;  lipid;  lipoprotein;  triacylglycerol;  vascular cell adhesion molecule 1, accelerometer;  age distribution;  article;  bicycle ergometry;  blood sampling;  body fat;  body mass;  cardiopulmonary function;  childhood disease;  cholesterol blood level;  clinical article;  cohort analysis;  controlled study;  correlation analysis;  dietary intake;  disease association;  female;  functional status;  glucose blood level;  homeostasis;  human;  inflammation;  insulin blood level;  insulin resistance;  lean body weight;  lipid blood level;  lipoprotein blood level;  male;  medical record;  obesity;  physical activity;  priority journal;  protein blood level;  risk factor;  school child;  sex ratio;  skinfold thickness;  statistical analysis;  triacylglycerol blood level;  waist circumference, Adiposity;  Algorithms;  Anthropometry;  Biological Markers;  Body Composition;  Body Mass Index;  Child;  Diet;  Female;  Humans;  Inflammation;  Insulin;  Insulin Resistance;  Lipids;  Lipoproteins;  Male;  Motor Activity;  Obesity;  Physical Fitness",
    abstract = "The aim of this study was 2-fold: (1) to examine insulin resistance, blood lipid levels, and inflammatory markers in 9- to 11.5-year-old obese and lean children and (2) to identify factors that influence insulin resistance in this cohort of youths. Body mass index, skinfold thickness, waist circumference, physical activity (4-day triaxial accelerometer), cardiorespiratory fitness (submaximal bicycle ergometer test), and dietary intake (3-day food records) were evaluated in 27 obese and 27 lean boys and girls. Fasting blood samples were analyzed for insulin, glucose, lipids and lipoproteins, C-reactive protein (CRP), interleukin 6, soluble intercellular adhesion molecule, and soluble vascular cell adhesion molecule. Homeostasis model assessment (HOMA) was used to evaluate insulin resistance (HOMA-IR). Obese children presented higher HOMA-IR, CRP, and blood lipid levels (all P < .01) compared with lean children. Total body fat and waist circumference were positively associated with fasting insulin (r ≥ 0.51), HOMA-IR (r ≥ 0.56), CRP (r ≥ 0.51), and blood triacylglycerol (r ≥ 0.38), and were inversely correlated with high-density lipoprotein cholesterol (r ≥ -0.39; all P < .01). Cardiorespiratory fitness was inversely associated with HOMA-IR (r = -0.24; P < .05), but this association disappeared when adjusted for age, sex, and fat mass. Waist circumference and total daily physical activity explained 49% of the variance in HOMA-IR in these children. In conclusion, these findings suggest that total and central adiposity are positively associated and physical activity is negatively associated with insulin resistance in children. Interventions to improve glucose metabolism in youth should target at reducing total body and abdominal fat and increasing physical activity. The lack of association between inflammatory markers and HOMA-IR suggests that obesity may precede the elevation of these markers in the evolution of insulin resistance in youth. © 2007 Elsevier Inc. All rights reserved."
}