Researchers in Minnesota say that a low insulin response in the teenage years can be an early predictor of heart disease. They say the insulin resistance is independent of obesity, although obesity may increase the risk of diabetes and insulin resistance.


Dr. Sinaiko says

"The insulin clamp is considered the gold standard to measure insulin resistance, a precursor to type-2 diabetes. Insulin regulates sugars, starches, fats and proteins in the body. When cells become resistant to the effects of insulin, insulin levels increase to regulate metabolism."

Sinaiko is lead author of the study and professor of pediatrics at the University of Minnesota Medical School in Minneapolis.



The insulin clamp is a technique that infuses insulin and glucose into the blood and measures the resulting glucose and insulin levels. Those who require lower amounts of glucose, indicating lower uptake of glucose into muscle cells, were considered insulin resistant, he said.


The study included 357 students averaging 13 years of age. The children underwent a complete physical examination including measurements of blood pressure, height, weight, percentage of body fat, high density lipoprotein cholesterol (HDL-C), triglycerides and fasting insulin levels.


The insulin clamp tests were repeated at age 15 on 309 participants and again at age 19 on 224 participants. Occurring together, insulin resistance, high blood pressure, low HDL-C, high triglycerides and obesity are defined as the metabolic or insulin resistance syndrome, which Sinaiko and other researchers say may trigger type 2 diabetes and atherosclerosis. Sinaiko said the correlation between insulin resistance at age 13 and age 19 was highly significant.


Insulin resistance at age 13 predicted high systolic blood pressure, which is associated with risk of stroke, and high triglycerides at age 19. For every unit increase in insulin resistance there was a 0.41 millimeters of mercury (mm Hg) increase in systolic blood pressure and 1.91 milligrams per deciliter (mg/dl) increase in triglycerides. "This is the first study to show insulin resistance by itself is a significant predictor of cardiovascular disease, beginning in childhood," Sinaiko said.



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