Insulin is an independent correlate of plasma homocysteine levels in obesechildren and adolescents

OBJECTIVE - The aim of the study was to investigate whether anthropometric and metabolic risk factors for coronary heart disease (CHD) contribute to t he variation in homocysteine Levels in obese children and adolescents. RESEARCH DESIGN AND METHODS - A total of 84 children and adolescents were a ssessed for fasting total homocysteine, methylenetetrahydrofolate reductase polymorphism (C677T mutation), folate and vitamin B-12 status, and anthrop ometric and metabolic risk factors for CHD. RESULTS - No significant sex differences were found for all available anthr opometric and metabolic characteristics except for homocysteine, which was significantly higher in boys than in girls (7.1 vs. 6.3 mu mol/l: P < 0.05) . After adjustment for age and sex, homocysteine correlated significantly w ith BMI, fat mass, percentage of fat mass, and insulin and showed an invers e correlation with folate levels. Homocysteine did not correlate with vitam in Bu; total cholesterol; LDL. HDL, and VLDL; triglycerides; and glucose. B MI and fat mass correlated significantly with insulin and showed a signific ant inverse correlation with folate. We found no association between homocy steine and the C677T mutation. In multiple regression analyses, insulin was found to be the main correlate of homocysteine. CONCLUSIONS - Our study demonstrates for the first time that insulin is a m ain correlate of homocysteine in obese children and adolescents and suggest s that fat mass-associated hyperinsulinism may contribute to impairment of homocysteine metabolism in childhood obesity.