Background:​ Effects of lifestyle interventions on early biomarkers of oxidative stress and CVD risk in youth with prediabetes are unknown.

Objective:​ To evaluate the effects of a lifestyle intervention to prevent type 2 diabetes among obese prediabetic Latino adolescents on oxidized lipoproteins.

Design:​ In a quasi-experimental design, 35 adolescents (51.4% male, age 15.5(1.0) y, body mass index (BMI) percentile 98.5(1.2), and glucose 2 hours after an oral glucose tolerance test-OGTT 141.2(12.2) mg/dL) participated in a 12-week intervention that included weekly exercise (three 60 min- sessions) and nutrition education (one 60 min-session). Outcomes measured at baseline and post-intervention were:​ fasting oxidized LDL and oxidized HDL (oxLDL and oxHDL) as oxidative stress variables;​ dietary intake of fresh fruit and vegetable (F&V) and fitness (VO 2 max) as behavioral variables;​ weight, BMI, body fat, and waist circumference as anthropometric variables;​ fasting glucose and insulin, 2hour glucose and insulin after an OGTT, insulin resistance (HOMA-IR), and lipid panel (triglycerides, total cholesterol, VLDL-c, LDL-c, HDL-c, and Non-HDL) as cardiometabolic variables.

Results:​ Comparing baseline to post-intervention, significant decreases in oxLDL concentration were shown (51.0(14.0) and 48.7(12.8) U/L, p=0.022);​ however, the intervention did not decrease oxHDL (395.2(94.6) and 416.1(98.4) ng/mL, p=0.944). F&V dietary intake (116.4(97.0) and 165.8(91.0) g/d, p=0.025) and VO 2 max (29.7(5.0) and 31.6(4.7) ml*kg^-1*min^-1, p<0.001) significantly increased. Within-subjects correlations between changes in F&V intake and oxidized lipoproteins, adjusted for VO 2 max changes, were non-significant (R=-0.15, p=0.52 for oxLDL;​ R=0.22, p=0.25 for oxHDL). Anthropometric variables were significantly reduced (weight -1.3% p=0.042;​ BMI -2.2% and BMI percentile -0.4%, p=0.001;​ body fat -6.6% and waist circumference -1.8%, p=0.025). Cardiometabolic variables significantly improved, including reductions in glucose 2hour (-19.3% p<0.001), fasting insulin (-12.9% p=0.008), insulin 2hour (- 53.5% p<0.001), and HOMA-IR (-12.5% p=0.015), with 23 participants (66%) that reverted toward a normal glucose tolerance status. Most lipid panel significantly changed (triglycerides -10.2% p=0.032;​ total cholesterol -5.4% p=0.002;​ VLDL-c -10.4% p=0.029;​ HDL-c -3.2% p=0.022;​ and Non-HDL -5.5% p=0.0007).

Conclusion:​ The intervention resulted in differential effects on oxidized lipoproteins and significant improvements in behavioral, anthropometric and cardiometabolic variables, reducing the high metabolic risk of obese prediabetic kids.