Separate regression models were also tested with the individual components of MS (considered as continuous or categorical measures) simultaneously included in the same equation. We took the maximum value of cIMT as the dependent variable in the regression models because the strongest association between the different measurements of IMT and coronary risk factors in otherwise healthy individuals
is achieved by applying the maximum value of IMT and not the mean value of IMT.17 A P value of less than check details 0.05 was considered statistically significant. A total of 250 obese children and adolescents, 100 with ultrasound-diagnosed NAFLD (and elevated ALT) and 150 without liver involvement, as well as 150 healthy normal-weight subjects were included in the study analysis (Fig. 1). None of the 250 obese children had type 2 diabetes mellitus. Baseline clinical and laboratory characteristics of the study population are presented in Table 1. MS, as well as MS components, were significantly more prevalent in obese children with NAFLD than in those without NAFLD (Table 2). At baseline, no differences were observed in the diameter of the brachial artery among the study groups (Table 1). In response to ischemia, obese children with NAFLD had significantly reduced
FMD compared to those without NAFLD and CP-690550 in vitro to healthy controls. In addition, percent FMD was remarkably larger in obese children without MS compared to obese children with MS (12.8% [95% CI, 11.0 to 14.5] versus 7.78% [5.30 to 10.2]; P < 0.01). When subdividing the obese population into subjects with and without MS, and with and without NAFLD, the FMD response was lower in children with MS and NAFLD than in those without MS and NAFLD (Fig. 2A). In
the entire study population, low percent FMD was significantly associated selleck with BMI-SDS, WC, high arterial BP, high triglycerides, high glucose, IR, CRPHS levels, and low HDL cholesterol after adjustment for age, gender, and Tanner stage (Table 3). Moreover, low percent FMD was associated with MS and NAFLD (Table 3). When the obese group was analyzed separately, low percent FMD was significantly associated with BMI-SDS, WC, high glucose, IR, CRPHS levels, and low HDL cholesterol, as well as with MS and NAFLD (Table 3). None of the variables were associated with FMD in the healthy group after correction for age, gender, and Tanner stage. When multiple logistic regression analysis was performed after adjusting for age, gender, Tanner stage, and MS (considered as a single clinical entity), NAFLD was significantly associated with low percent FMD (Table 4). Even after adjustment for age, gender, Tanner stage, and the individual components of MS, NAFLD remained significantly associated with low percent FMD. In this model, other covariates independently associated with low percent FMD were high glucose or IR (Table 4). Similar results were found when we considered FMD as a continuous measure and performed multivariate linear regression analyses.