OBJECTIVE -We measured plasma markers of endothelial dysfunction, vascular inflammation, and pro-coagulation in obese Hispanic/Latino children and adolescents with normal glucose tolerance and determined their relationship to body composition and indexes of glucose and lipid metabolism. RESEARCH DESIGN AND METHODS-A total of 38 lean or obese Hispanic children and adolescents (10 -18 years of age) were selected. The overweight group (n ϭ 21) had a BMI Ͼ85th percentile for their age and sex, and the lean group (n ϭ 17) had a BMI between the 25th and 50th percentiles. Studies included an oral glucose tolerance test, measurements of plasma glucose and lipids, several markers of endothelial function and inflammation, and determination of body composition by dual X-ray absorptiometry.RESULTS -The obese group had higher systolic blood pressure and plasma triglycerides and was more insulin resistant than the lean group. The obese group also had higher plasma soluble intercellular adhesion molecule (259.5 Ϯ 60.0 vs. 223.2 Ϯ 47.5 ng/ml, P ϭ 0.047), tumor necrosis factor-␣ (2.57 Ϯ 1.1 vs. 1.74 Ϯ 0.6 pg/ml, P ϭ 0.008), high-sensitivity C-reactive protein (2.0 vs. 0.13 mg/l, P Ͻ 0.0001), plasminogen-activated inhibitor-1 (47.0 Ϯ 35.7 vs. 12.0 Ϯ 5.2 ng/ml, P Ͻ 0.0001), tissue plasminogen activator (6.1 Ϯ 1.9 vs. 4.1 Ϯ 0.8 ng/ml, P ϭ 0.001), and white blood cell count (6.9 vs. 5.3 ϫ 10 3 , P ϭ 0.031) and lower levels of adiponectin (8.7 Ϯ 3.3 vs. 12.6 Ϯ 5.2 g/ml, P ϭ 0.022). No significant differences were observed for soluble vascular cell adhesion molecule or interleukin-6. CONCLUSIONS -Overweight Hispanic children and adolescents with normal glucose tolerance exhibit increased plasma markers of endothelial dysfunction and subclinical inflammation in association with obesity and insulin resistance. These abnormalities may predispose them to the development of type 2 diabetes and cardiovascular disease.

An increased amount of adipose tissue or its disproportionate distribution between central and peripheral body regions is related to the development of insulin resistance, type 2 diabetes mellitus, dyslipidemia, atherosclerosis, and coronary artery disease. Until recently, adipose tissue was regarded as a storage depot for lipids. It is now viewed as a hormonally active organ that plays a crucial metabolic role. The most important products of adipose tissue collectively referred to as adipocytokines, include adiponectin, leptin, tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), resistin, plasminogen-activating inhibitor-I (PAI-1), and angiotensinogen. These low and medium molecular weight proteins play an important role in the adipose tissue physiology and are believed to be a link between obesity, insulin resistance and endothelial dysfunction. This review describes the metabolic role of two of these proteins, adiponectin and leptin, in relation to insulin sensitivity.

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