Decreased GlycA after lifestyle intervention among obese, prediabetic adolescent Latinos

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 2 diabetes, cardiovascular events, and all-cause mortality in adults. Objective: The purpose of the current study is to examine changes in GlycA following lifestyle intervention among obese, prediabetic Latino youth. Methods: Obese, prediabetic Latino youth (n=27; 15.5±1.1 years, 13 male/14 female) completed a 12week lifestyle intervention that included weekly nutrition education and three days/week 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: Following the lifestyle intervention GlycA was significantly reduced (445.3±51.3 μmol/L to 419.0±50.0 μmol/L, p=0.01) (mean±SD). 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<0.001), total cholesterol (154.1±30.3 mg/dL to 143.3±29.1 mg/dL, p=0.003), and 2-hour glucose (141.0±13.2 mg/dL to 115.9±31.4 mg/dL, p<0.001). Decreases in GlycA were associated with decreases in 2-hour glucose (r=0.49, p=0.008) and BMI (r=0.41, p=0.03). 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.

Title: Human Serum/Plasma Glycoprotein Analysis by 1H-NMR, an Emerging Method of Inflammatory Assessment

“…A second study in an adolescent population showed a significant reduction in GlycA after 12 weeks of lifestyle intervention consisting of weekly nutrition and health classes delivered by promoters (bilingual, bicultural health educators) and 3 days per week of moderate to vigorous physical activity. Decreases in GlycA were associated with decreases in 2-hour glucose (p < 0.008) and BMI (p < 0.03) [161].…”

GlycA measured by NMR spectroscopy is associated with disease activity and cardiovascular disease risk in chronic inflammatory diseases

“…Circulating GlycA levels are favorably modified by lifestyle changes such as exercise in the absence of dietary modifications [ [55] , [56] , [57] ]. Exercise training reduces GlycA independent of age, sex, race, baseline body mass index and beyond baseline GlycA levels, and occurred with 14 different interventions and seven distinct populations [ 56 ].…”

Nuclear Magnetic Resonance Derived Biomarkers for Evaluating Cardiometabolic Risk in Youth and Young Adults Across the Spectrum of Glucose Tolerance

“…Next, we demonstrated that GlycA correlated with insulin resistance, and there was a stepwise increase in GlycA across categories of obesity and glucose tolerance ( Figure 2B ). Some, but not all studies ( 39 ), have identified GlycA as an independent correlate of HOMA-IR, with the added advantage that GlycA had low intra-individual variability in youth and adults compared to other inflammatory markers such as C-reactive protein ( 33 , 40 , 41 ). GlycA is a promising assay because it is an integrated marker of inflammation derived from a composite signal of N-acetyl methyl group resonances from several of the most abundant inflammation response serum proteins ( 11 ).…”

“…In population-based studies, elevated levels were indicators of chronic asymptomatic systemic inflammation from childhood to adulthood ( 42 ). However, its value in predicting cardiometabolic diseases in youth is unclear, and in prior analysis, it was not related to exercise-induced improvements in insulin resistance in a cohort of Latino adolescents ( 39 ). In agreement with adult studies, our study findings demonstrate a moderately strong correlation of GlycA with insulin resistance and provide new knowledge about the relationship of this inflammatory marker in youth with abnormal glucose tolerance.…”