PEDIATRICS Vol. 96 No. 6 December 1995, pp. 1123-1125
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Fasting Insulin Concentration Is Related to Cardiovascular Reactivity to Exercise in Children

Bernard Gutin PhD1, Syed Islam MBBS, DrPH2, Frank Treiber PhD1, Clayton Smith BS1, and Tina Manos EdD3

1 Georgia Prevention Institute, Department of Pediatrics; Medical College of Georgia, Augusta, GA
2 West Virginia University School of Medicine, Morgantown, WV 26506
3 Department of Health Fitness, Springfield College, Springfield, MA 01109

Professor of Pediatrics and Physiology, Georgia Prevention Institute, Medical College of Georgia, Augusta, GA 30912-3710

Objective. One mechanism through which hyperinsulinemia is linked to hypertension is through its stimulation of sympathetic nervous activity. Thus, insulin concentration may be correlated with indices of sympathetic activity before it is associated with resting blood pressure. We tested this hypothesis by determining the relationship of insulin concentration and sympathetically mediated cardiovascular reactivity to exercise in children.

Design. Survey.

Setting. General community.

Participants. Volunteer sample of 46 black and white boys and girls, 9 to 11 years of age.

Interventions. None. Fasting insulin concentration was the main independent variable.

Main outcome measures. Systolic blood pressure and heart rate during a standard submaximal bout of treadmill exercise, and systolic blood pressure at peak effort.

Results. The hypothesis was tested by multiple regression analyses controlled for resting values. Insulin contributed significantly to the regression models for submaximal heart rate (P < .001), submaximal systolic blood pressure (P = .001), and peak systolic blood pressure (P = .006).

Conclusions. Fasting insulin concentration is associated with cardiovascular reactivity to exercise in young children. This supports the hypothesis that the relationship between hyperinsulinemia and hypertension is mediated by sympathetic nervous tone and that the process begins in childhood. Because percent body fat was positively associated with both insulin and cardiovascular reactivity to exercise, prevention of childhood obesity may be a valuable prophylactic measure for these health problems.

Submitted on October 12, 1994
Accepted on January 9, 1995