Decreased GlycA after lifestyle intervention among obese, prediabetic adolescent Latinos

J Clin Lipidol. 2019 Jan-Feb;13(1):186-193. doi: 10.1016/j.jacl.2018.09.011. Epub 2018 Sep 22.

Abstract

Background: Obese youth with prediabetes are at increased risk for premature morbidity and mortality through multiple mechanisms, including increased systemic inflammation. GlycA is a novel measure of systemic inflammation that predicts type II diabetes, cardiovascular events, and all-cause mortality in adults.

Objective: The purpose of the present study was to examine changes in GlycA after lifestyle intervention among obese, prediabetic Latino youth.

Methods: Obese, prediabetic Latino youth (n = 27; 15.5 ± 1.1 years, 13 males/14 females) completed a 12-week lifestyle intervention that included weekly nutrition education and 3 d/wk of moderate to vigorous physical activity. Prediabetes was characterized by an expanded definition of impaired glucose tolerance, using 2-hour glucose ≥120 mg/dL after an oral glucose tolerance test. GlycA was assessed at baseline and 12 weeks using nuclear magnetic resonance spectroscopy.

Results: After the lifestyle intervention, GlycA was significantly reduced (445.3 ± 51.3 μmol/L to 419.0 ± 50.0 μmol/L, P = .01) (mean ± standard deviation). Additional improvements were observed in multiple cardiovascular risk factors, including body mass index (BMI; 34.8 ± 5.0 kg/m2 to 34.0 ± 5.1 kg/m2, P < .001), total cholesterol (154.1 ± 30.3 mg/dL to 143.3 ± 29.1 mg/dL, P = .003), and 2-hour glucose (141.0 ± 13.2 mg/dL to 115.9 ± 31.4 mg/dL, P < .001). Decreases in GlycA were associated with decreases in 2-hour glucose (r = 0.49, P = .008) and BMI (r = 0.41, P = .03).

Conclusion: These data are consistent with the hypothesis that lifestyle intervention might improve GlycA levels in obese, prediabetic adolescent Latinos, but randomized trial evidence is needed. Healthy lifestyle modifications among high-risk youth may decrease future risk of cardiometabolic disease through reducing systemic inflammation, in addition to improving traditional cardiovascular risk factors.

Keywords: Cardiovascular disease; Impaired glucose tolerance; Inflammation; Latino; Pediatric obesity; Type II diabetes.

Publication types

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

MeSH terms

  • Adolescent
  • Body Mass Index
  • Female
  • Healthy Lifestyle
  • Hispanic or Latino*
  • Humans
  • Insulin Resistance
  • Male
  • Obesity / epidemiology
  • Obesity / metabolism*
  • Obesity / mortality
  • Polysaccharides / metabolism*
  • Prediabetic State / epidemiology
  • Prediabetic State / metabolism*
  • Prediabetic State / mortality
  • Risk Reduction Behavior
  • Survival Analysis
  • United States / epidemiology

Substances

  • Polysaccharides