Metabolic syndrome in obese children and adolescents in Serbia: prevalence and risk factors

2015 ◽  
Vol 28 (7-8) ◽  
Author(s):  
Rade Vukovic ◽  
Dragan Zdravkovic ◽  
Katarina Mitrovic ◽  
Tatjana Milenkovic ◽  
Sladjana Todorovic ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Children And Adolescents ◽  
Strong Predictor ◽  
Pubertal Development ◽  
International Diabetes Federation ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Obese Children ◽  
Diet Induced Obesity

AbstractTo assess the prevalence of metabolic syndrome (MS) in obese children and adolescents in Serbia.The study group consisted of 254 subjects (148 female and 106 male), aged 4.6–18.9 years with diet-induced obesity (body mass index ≥95th percentile). Presence of MS using the International Diabetes Federation definition was assessed in all subjects, as well as oral glucose tolerance test and insulin resistance indices.Overall prevalence of MS in all subjects aged ≥10 years was 31.2%, namely, 28.7% in children aged 10 to <16 years and 40.5% in adolescents ≥16 years. When adjusted for age, gender and pubertal development, higher degree of obesity was a strong predictor of MS. Multivariate analysis showed that taller subjects and those with higher degree of insulin resistance were at significantly higher risk of MS, independent of the degree of obesity.High prevalence of MS emphasizes the need for prevention and treatment of childhood obesity.

scholarly journals Insulin resistance and obesity in childhood

2008 ◽  
Vol 159 (suppl_1) ◽  
pp. S67-S74 ◽  
Author(s):  
Francesco Chiarelli ◽  
Maria Loredana Marcovecchio
Keyword(s):  
Insulin Resistance ◽  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Childhood Obesity ◽  
Glucose Tolerance ◽  
Children And Adolescents ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
The Metabolic Syndrome

Childhood obesity is a significant health problem that has reached epidemic proportions around the world and is associated with several metabolic and cardiovascular complications. Insulin resistance is a common feature of childhood obesity and is considered to be an important link between adiposity and the associated risk of type 2 diabetes and cardiovascular disease. Insulin resistance is also a key component of the metabolic syndrome, and its prevalence in the paediatric population is increasing, particularly among obese children and adolescents. Several factors are implicated in the pathogenesis of obesity-related insulin resistance, such as increased free fatty acids and many hormones and cytokines released by adipose tissue.Valid and reliable methods are essential to assess the presence and the extent of insulin resistance, the associated risk factors and the effect of pharmacological and lifestyle interventions. The two most common tests to assess insulin resistance are the hyperinsulinemic euglycemic clamp and the frequently sampled i.v. glucose tolerance test utilizing the minimal model. However, both these tests are not easily accomplished, are time consuming, expensive and invasive. Simpler methods to assess insulin resistance based on surrogate markers derived from an oral glucose tolerance test or from fasting insulin and glucose levels have been validated in children and adolescents and widely used.Given the strong association between obesity, insulin resistance and the development of metabolic syndrome and cardiovascular disease, prevention and treatment of childhood obesity appear to be essential to prevent the development of insulin resistance and the associated complications.

scholarly journals Insulin resistance in obese children: debate on assessment

2009 ◽  
Vol 55 (3) ◽  
pp. 8-12 ◽  
Author(s):  
Olga V. Vasyukova ◽  
A V Vitebskaya
Keyword(s):  
Insulin Resistance ◽  
Children And Adolescents ◽  
Diagnostic Error ◽  
Diagnostic Value ◽  
Tolerance Test ◽  
Immunoreactive Insulin ◽  
Oral Glucose ◽  
Obese Children ◽  
Matsuda Index ◽  
And Gender

No age- and gender-adjusted criteria remain to be a main problem the investigators face when studying insulin resistance in children. This paper compares insulin resistance (IR) indices in 63 children and adolescents with simple (constitutionally exogenous) obesity. The authors demonstrated a low reproducibility of individual baseline values of insulin (not more than 26% as shown by Pearsons correlation analysis). Estimation of IR by means of the design indices calculated from the fasting concentration of immunoreactive insulin and glucose: 40% of obese children and adolescents had no fit of baseline IR indices with the results of an oral glucose tolerance test (OGTT), which may result in a diagnostic error - both hyperdiagnosis (in 12% of patients) and hypodiagnosis (18% of children). According to the results of this study, the values of stimulated insulin release and the Matsuda index, which were determined from the OGTT data, are of the highest diagnostic value in the assessment of insulin resistance in obesity in children and adolescents.

Abstract P088: Obesity, Hypertension and Insulin Resistance in a Primary Pediatric Setting in Southern Italy

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Giampaolo De Filippo ◽  
Domenico Rendina ◽  
Domenico Viggiano ◽  
Antonio Fasolino ◽  
Paola Sabatini ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Body Weight ◽  
Children And Adolescents ◽  
Diagnostic Criteria ◽  
Southern Italy ◽  
Serum Insulin ◽  
High Density Lipoproteins ◽  
Obese Children ◽  
Campania Region

Background: Obesity is the main risk factor for essential hypertension (EH) in childhood. The O.Si.Me. study (Obesity and Metabolic Syndrome in children and adolescents) evaluated the prevalence of metabolic syndrome (MetS) and its constitutive traits in a sample of obese children and adolescents living in Campania, southern Italy. Patients and methods: Four hundred and fifteen children and adolescents consecutively referred to the National Health Service participating Outpatient Clinics for minor health problems and found to have a Body Mass Index (BMI) Z-score > 2.0 were enrolled in the study. The entire sample was screened for MetS, which was defined as the presence of at least 2 of the following alterations in addition to obesity: fasting hyperglycemia, low levels of high-density lipoproteins cholesterol, hypertriglyceridemia, and EH. The present analysis evaluated the clinical characteristics of the O.Si.Me subgroup of EH participants (systolic and/or diastolic BP ≥ 95 th percentile for age, gender and height) as compared with normotensive participants. Results: The prevalence of EH in the O.Si.Me population was 23.6 % (98/415, 48M and 50F.) and two-thirds of the EH participants met the MetS diagnostic criteria. The EH participants featured serum insulin and HOMA-IR levels significantly higher compared with normotensive ones (11.6±0.6 vs. 9.5±0.4 μIU/ml, p = 0.014; 2.6±0.1 vs. 2.2±0.1, p = 0.028 for insulin and HOMA-IR, respectively). These differences were common to boys and girls and remained significant after correction for age, pubertal stage, body weight, length, BMI, gestational age at birth, duration of breastfeeding and anthropometric parental parameters. Accordingly, children and adolescents with EH had a a relative risk of being insulin resistant (defined as a HOMA-IR ≥2.5) significantly greater compared to those without. Moreover, they exhibited higher serum creatinine levels (53.8±7.1 vs. 35.4±6.8 μmol/l, p=0.025) accounting for gender and body weight. Conclusions: More than a quarter of obese children and adolescents meet the diagnostic criteria for EH in the Campania region in southern Italy. These obese boys and girls have an increased prevalence of insulin resistance and apparently an initial reduction in renal function compared with obese children and adolescents with normal BP.

scholarly journals The Role of Insulin-Like Growth Factor (IGF) Binding Protein-2 in the Insulin-Mediated Decrease in IGF-I Bioactivity

Endocrinology ◽  
2009 ◽  
Vol 150 (11) ◽  
pp. 5192-5192
Author(s):  
Ayman M. Arafat ◽  
Martin O. Weickert ◽  
Jan Frystyk ◽  
Joachim Spranger ◽  
Christof Schöfl ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Glucose Tolerance ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Igf System ◽  
Igf I ◽  
Igf Binding

ABSTRACT Context: Insulin interacts with the GH-IGF system by a reciprocal regulation of IGF-binding proteins (IGFBP) and GH, which in turn regulate insulin sensitivity via bioactive IGF-I. This network is linked to metabolic syndrome and cardiovascular diseases. Objective: We evaluated the effect of glucose and insulin on IGFBP-1-4, particularly IGFBP-2, in the regulation of bioactive IGF-I and its relation to insulin resistance. Setting: The study was conducted at an endocrinology center. Research Design and Methods: Twenty-four healthy subjects (12 men; aged 21–72 yr; body mass index 25.9 ± 0.9 kg/m2) and 19 subjects with impaired glucose tolerance (IGT; eight men; aged 26–71 yr; body mass index 28.9 ± 1.2 kg/m2 ) were prospectively studied using oral glucose tolerance test and hyperinsulinemic euglycemic clamp. Results: During the clamp, insulin decreased IGF-I bioactivity in both IGT subjects and controls (−16.2 ± 2.8 and −13.9 ± 3.3%, respectively; P &lt; 0.01). In addition, insulin increased IGFBP-2 and GH and decreased IGFBP-1 and -4 but did not alter total IGF-I, IGF-II, or IGFBP-3 levels. During the oral glucose tolerance test, GH and IGFBP-1 were markedly suppressed. Subjects with IGT showed more pronounced insulin resistance and lower GH, IGFBP-1, and IGFBP-2 levels (P &lt; 0.05). In multiple regression analysis, IGFBP-2 was an independent predictor of insulin sensitivity (β = 0.36, P &lt; 0.05) and IGF-I bioactivity (β = −0.5, P &lt; 0.05). Conclusions: Our data indicate that insulin acutely decreases IGF-I bioactivity through differential modulation of IGFBPs. Furthermore, IGFBP-2 plays a central role in the insulin-IGF system cross talk and is closely linked to insulin resistance, thereby providing a further explanation for its association with the metabolic syndrome.

scholarly journals Association of postprandial and fasting triglycerides with traits of the metabolic syndrome in the Metabolic Intervention Cohort Kiel

2010 ◽  
Vol 162 (4) ◽  
pp. 719-727 ◽  
Author(s):  
Diana Rubin ◽  
Ulf Helwig ◽  
Michael Nothnagel ◽  
Ulrich R Fölsch ◽  
Stefan Schreiber ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Lipid Metabolism ◽  
Cell Function ◽  
International Diabetes Federation ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Middle Aged ◽  
The Metabolic Syndrome ◽  
Β Cell Function ◽  
Design And Methods

ObjectivePostprandial (pp) lipid metabolism is associated with insulin resistance and type 2 diabetes. In young men, pp triglycerides (TGs) are more strongly associated with traits of metabolic syndrome (MS) than fasting TGs. We established a cohort of middle-aged men selected for traits of MS and pp lipid metabolism to determine if fasting TGs or pp TGs are more closely related to MS.Research design and methodsA total of 1558 men were characterized for MS. A total of 755 men underwent an oral metabolic tolerance test consisting of a standardized high-fat meal and an oral glucose tolerance test. Blood samples were drawn in the fasting state and hourly until 9 h to determine pp TGs and free fatty acids. Glucose and insulin were analyzed until 5 h pp.ResultsIn the overall cohort, 329 subjects (21.1%) had a complete MS based on the Adult Treatment Panel III criteria, and 650 subjects (41.7%) had a complete MS based on the International Diabetes Federation criteria. The association of pp TGs with MS parameters was not stronger than the association of fasting TGs with them. Pp TGs were independently associated with β-cell function.ConclusionsPp TGs did not show a higher correlation with MS traits than fasting TGs. This finding is probably due to the high incidence of overweight subjects in this middle-aged cohort.

scholarly journals Tyrosine Is Associated with Insulin Resistance in Longitudinal Metabolomic Profiling of Obese Children

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Christian Hellmuth ◽  
Franca Fabiana Kirchberg ◽  
Nina Lass ◽  
Ulrike Harder ◽  
Wolfgang Peissner ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Weight Loss ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Clinical Markers ◽  
Obese Children ◽  
Intervention Programme ◽  
Before And After ◽  
Branched Chain ◽  
One Year

In obese children, hyperinsulinaemia induces adverse metabolic consequences related to the risk of cardiovascular and other disorders. Branched-chain amino acids (BCAA) and acylcarnitines (Carn), involved in amino acid (AA) degradation, were linked to obesity-associated insulin resistance, but these associations yet have not been studied longitudinally in obese children. We studied 80 obese children before and after a one-year lifestyle intervention programme inducing substantial weight loss >0.5 BMI standard deviation scores in 40 children and no weight loss in another 40 children. At baseline and after the 1-year intervention, we assessed insulin resistance (HOMA index), fasting glucose, HbA1c, 2 h glucose in an oral glucose tolerance test, AA, and Carn. BMI adjusted metabolite levels were associated with clinical markers at baseline and after intervention, and changes with the intervention period were evaluated. Only tyrosine was significantly associated with HOMA (p<0.05) at baseline and end and with change during the intervention (p<0.05). In contrast, ratios depicting BCAA metabolism were negatively associated with HOMA at baseline (p<0.05), but not in the longitudinal profiling. Stratified analysis revealed that the children with substantial weight loss drove this association. We conclude that tyrosine alterations in association with insulin resistance precede alteration in BCAA metabolism. This trial is registered with ClinicalTrials.gov IdentifierNCT00435734.

scholarly journals Plasma concentrations of retinol in obese children and adolescents: relationship to metabolic syndrome components

2014 ◽  
Vol 32 (1) ◽  
pp. 50-54 ◽  
Author(s):  
Marcia Teske ◽  
Ana Paula B. Melges ◽  
Fabiola Isabel S. de Souza ◽  
Fernando Luiz A. Fonseca ◽  
Roseli Oselka S. Sarni
Keyword(s):  
Metabolic Syndrome ◽  
Glucose Tolerance ◽  
Children And Adolescents ◽  
Plasma Concentrations ◽  
Oral Glucose ◽  
Inverse Association ◽  
Obese Children ◽  
Arterial Blood ◽  
Plasma Retinol ◽  
Metabolic Syndrome Components

Objective: To evaluate obese children and adolescents' retinol plasma levels and to correlate them with metabolic syndrome components. Methods: Cross-sectional study with 61 obese children and adolescents (body mass index Z score - ZBMI>+2). Pubertal development, arterial blood pressure, body weight and height for nutritional classification and waist circumference were obtained. A 15mL blood sample was collected (after a 12-hour fasting in a low luminosity room) for retinol determination (cut-off inadequate if <30µg/dL), lipid profile (HDL-c, LDL-c, and triglycerides), oral glucose tolerance test (fasting and 120 minutes) and for high sensitivity C-reactive protein. Spearman correlation and multiple linear regression were used in the statistical analysis. Results: Mean age was 10.7±2.7 years. There was a predominance of male gender 38/61 (62%) and pre-pubertal 35/61 (57%) subjects. The average plasmatic retinol was 48.5±18.6ug/dL. Retinol deficiency and severe obesity were observed in 6/61 (10%) and 36/61 (59%), respectively. Glucose level at 120 minutes was the independent and predictive variable of plasma retinol levels [β=-0.286 (95%CI -0.013 - -0.001)]. Conclusions: An independent and inverse association between plasma retinol levels and glucose tolerance was observed, suggesting an important contribution of this vitamin in the morbidities associated to obesity in children and adolescents.

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