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Published on: January 7, 2018
In vivo insulin sensitivity and lipoprotein particle size and concentration in black and white children
Stephen F Burns1, SoJung Lee, Silva A Arslanian
1Division of Weight Management and Wellness, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Insights
Racial differences in children's lipoprotein profiles are partly explained by visceral adipose tissue (VAT). Insulin resistance is linked to atherogenic lipoprotein patterns in both black and white youth.
Area of Science:
- Pediatric endocrinology
- Cardiovascular health
- Metabolic syndrome
Background:
- Lipoprotein profiles differ by race and sex in children.
- Visceral adiposity plays a role in these differences.
- Insulin sensitivity is a key factor in metabolic health.
Purpose of the Study:
- To investigate sex-specific black/white differences in lipoprotein profiles.
- To determine the influence of visceral adipose tissue (VAT) on these differences.
- To assess the relationship between insulin sensitivity and lipoprotein profiles in children.
Main Methods:
- Lipoprotein particle size and concentration, and VAT were measured in 226 children (8-18 years).
- A hyperinsulinemic-euglycemic clamp assessed insulin sensitivity in 194 children.
- Statistical analyses examined race, sex, VAT, and insulin sensitivity effects on lipoproteins.
Main Results:
- Black male children had smaller VLDL; black females had larger HDL size than white children.
- Black children generally had larger LDL size.
- After adjusting for VAT and sex, VLDL size and concentrations were more favorable in black children.
- Insulin-resistant children in both racial groups exhibited higher concentrations of small dense LDL and HDL, and large VLDL, with smaller LDL and HDL sizes.
Conclusions:
- Race-related differences in VAT partially explain favorable lipoprotein profiles in black children.
- Insulin resistance is associated with a high-risk atherogenic lipoprotein profile (small dense LDL, small HDL, large VLDL) in all children, similar to adults with coronary artery disease.
Objective:
To examine sex-specific black/white differences in lipoprotein profile and the role of visceral adiposity and to assess the relationship between insulin sensitivity and lipoprotein profiles in each group.
Research Design And Methods:
Fasting lipoprotein particle size and concentration and visceral adipose tissue (VAT) were determined in 226 children (117 black, 101 male) aged 8 to <18 years. The relationship between lipoproteins and insulin sensitivity was evaluated in a subset of 194 children (100 black, 88 male) who underwent a hyperinsulinemic-euglycemic clamp.
Results:
Black male children had smaller VLDL and black female children had larger HDL size than their white counterparts. Overall, blacks had larger LDL size with no sex-specific race differences. After adjusting for VAT and sex, only VLDL size and concentrations remained significantly favorable in blacks. Analysis of lipoprotein particle size and concentration across insulin sensitivity quartiles revealed that in both racial groups, the most insulin-resistant children had higher concentrations of small dense LDL, small HDL, and large VLDL and smaller LDL and HDL sizes than their more insulin-sensitive counterparts.
Conclusions:
The previously reported favorable lipoprotein profiles in black versus white children is partly due to race differences in VAT. In both groups, however, the most insulin-resistant youths have a high-risk atherogenic profile of small dense LDL, small HDL, and large VLDL, akin to the atherogenic lipoprotein pattern in adults with coronary artery disease.
