Biochemical predictors of metabolically unhealthy obesity in children and adolescents

Author(s):  
Ah Young Cho ◽  
Jung Gi Roh ◽  
Young Suk Shim ◽  
Hae Sang Lee ◽  
Jin Soon Hwang

Abstract Background Children and adolescents with obesity can now be classified according to metabolic profile, as those with metabolically healthy obesity (MHO) and those with metabolically unhealthy obesity (MUO). We aimed to determine the prevalence of MUO and identify its biochemical predictors in pediatric patients with obesity. Methods We evaluated the medical records of 187 boys and girls with obesity. The children were divided into MHO and MUO groups, and anthropometric and biochemical parameters were assessed. Oral glucose tolerance test (OGTT) was used to identify impaired glucose regulation and hyperinsulinism, and binary logistic regression analysis was used to determine predictors of MUO in children with obesity. Results Of the 187 children, MUO was found in 71.7% (n=134) and MHO in 28.3% (n=53); those in the MHO group were younger than those in the MUO group. Blood pressure, triglyceride, total cholesterol, and uric acid levels were significantly higher in the MUO group than in the MHO group. Further, the MUO group exhibited a significantly higher level of insulin resistance (p<0.05) than the MHO group. Serum levels of uric acid and homeostasis model assessment of insulin resistance index (HOMA-IR) were confirmed as biochemical predictors of the MUO phenotype in children with obesity. Conclusions The ratio of MUO in children with obesity was relatively high; further, serum levels of uric acid and HOMA-IR can be used as biochemical predictors of MUO.

Author(s):  
Renuka Pangaluri ◽  
Shakthiya T ◽  
Vinodhini Vm

 Objective: Polycystic ovarian syndrome (PCOS) is often accompanied by insulin resistance, obesity, and cardiometabolic risk factors. Androgen excess-PCOS recommends oral glucose tolerance test or glycated hemoglobin (HbA1C) to evaluate dysglycemia in PCOS subjects. We undertook this study to evaluate the prevalence of elevated HbA1C levels in PCOS women.Methods: The study was carried out among 100 PCOS patients from SRM Hospital, 100 healthy individuals were included as controls. Fasting glucose, HbA1C, Insulin and Homeostasis Model Assessment-Insulin Resistance Index were estimated.Results: Patients with polycystic ovary syndrome showed a significant increase in HbA1C levels (5.799±1.022; 4.96±0.625, p=0.001) when compared to the control group.Conclusion: We found elevated HbA1C levels in PCOS women categorizing 26% as prediabetes and 28% as having type 2 diabetes mellitus.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A657-A658
Author(s):  
Juan Pablo Hayes Dorado

Abstract Introduction: The association between Helicobacter pylori infection and hyperinsulinemia and insulin resistance has been described. Objective: To investigate the frequency of hyperinsulinemia and insulin resistance in adolescents with Helicobacter pylori infection. Materials and Methods: Prospective, observational and analytical study. Adolescents with Helicobacter pylori infection; July 2019 - June 2020 period. Exclusion criteria: Obesity, hypothyroidism, hepatopathy, nephropathy, collagen disease, corticotherapy, use of proton pump inhibitors and H2 antihistamines. Variables: Antibodies against Helicobacter pylori; fasting plasma glucose and insulinemia, 2-hour plasma glucose and insulinemia after oral glucose tolerance test (OGTT); determination of the insulin resistance index by the Homeostasis Model Assessment (HOMA-IR). Two groups of patients: Those with Helicobacter pylori infection and the other of uninfected adolescents. Results: Patients attended: 34; studied: 19; excluded: 15. Group of non-infected: 20. The HOMA-IR value was 2.5 + -0.8 in adolescents with Helicobacter pylori infection and 1.8 + -0.6 (p = 0.02) in uninfected patients. Conclusions:The values of insulinemia and HOMA-IR were higher in the group of adolescents with Helicobacter pylori infection, compared to those evidenced in the group of uninfected.


2007 ◽  
Vol 99 (1) ◽  
pp. 44-48 ◽  
Author(s):  
F. J. Tinahones ◽  
F. Cardona ◽  
G. Rojo-Martínez ◽  
M. C. Almaraz ◽  
I. Cardona ◽  
...  

Hyperuricaemia is one of the components of metabolic syndrome. Both oxidative stress and hyperinsulinism are important variables in the genesis of this syndrome and have a close association with uric acid (UA). We evaluated the effect of an oral glucose challenge on UA concentrations. The study included 656 persons aged 18 to 65 years. Glycaemia, insulin, UA and plasma proteins were measured at baseline and 120 min after an oral glucose tolerance test (OGTT). The baseline sample also included measurements of total cholesterol, triacylglycerol (TAG) and HDL-cholesterol. Insulin resistance was calculated with the homeostasis model assessment. UA levels were significantly lower after the OGTT (281·93 (sd92·19)v. 267·48 (sd90·40) μmol/l;P < 0·0001). Subjects with a drop in UA concentrations >40·86 μmol/l (>75th percentile) had higher plasma TAG levels (P = 0·0001), baseline insulin (P = 0·02) and greater insulin resistance (P = 0·034). Women with a difference in plasma concentrations of UA above the 75th percentile had higher baseline insulin levels (P = 0·019), concentration of plasma TAG (P = 0·0001) and a greater insulin resistance index (P = 0·029), whereas the only significant difference in men was the level of TAG. Multiple regression analysis showed that the basal TAG levels, insulin at 120 min, glycaemia at 120 min and waist:hip ratio significantly predicted the variance in the UA difference (r20·077). Levels of UA were significantly lower after the OGTT and the individuals with the greatest decrease in UA levels are those who have greater insulin resistance and higher TAG levels.


2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Jianwei Wang ◽  
Xianglu Rong ◽  
Irene S. I. Um ◽  
Johji Yamahara ◽  
Yuhao Li

PPARs play a pivotal role in regulating lipid and glucose homeostasis and are involved in diverse biological activities in skin. Pomegranate flower (PGF, an antidiabetic therapy inUnaniandAyurvedicmedicines) has been previously demonstrated to activate both PPARalpha/gamma. Here, we found that treatment of mice with the diet containing PGF powder over 55 weeks attenuated ageing-induced abnormal increases in the homeostasis model assessment of insulin resistance, glucose concentrations during oral glucose tolerance test, and adipose insulin resistance index. The diet tended to decrease the excessive peri-ovary fat mass. It, however, increased the thinned subcutaneous fat thickness. In addition, the diet restored decreases in skin water content, epidermis thickness, and collagen density in corium. Thus, our results demonstrate that long-term treatment with theUnaniandAyurvedictherapy ameliorates ageing-induced insulin resistance, which is associated with reversal of ageing-induced fat redistribution. Further, PGF attenuates ageing-mediated undesirable skin abnormalities.


2009 ◽  
Vol 160 (5) ◽  
pp. 785-790 ◽  
Author(s):  
Eirini Maratou ◽  
Dimitrios J Hadjidakis ◽  
Anastasios Kollias ◽  
Katerina Tsegka ◽  
Melpomeni Peppa ◽  
...  

ObjectiveAlthough clinical hypothyroidism (HO) is associated with insulin resistance, there is no information on insulin action in subclinical hypothyroidism (SHO).Design and methodsTo investigate this, we assessed the sensitivity of glucose metabolism to insulin both in vivo (by an oral glucose tolerance test) and in vitro (by measuring insulin-stimulated rates of glucose transport in isolated monocytes with flow cytometry) in 21 euthyroid subjects (EU), 12 patients with HO, and 13 patients with SHO.ResultsAll three groups had comparable plasma glucose levels, with the HO and SHO having higher plasma insulin than the EU (P<0.05). Homeostasis model assessment index was increased in HO (1.97±0.22) and SHO (1.99±0.13) versus EU (1.27±0.16, P<0.05), while Matsuda index was decreased in HO (3.89±0.36) and SHO (4.26±0.48) versus EU (7.76±0.87, P<0.001), suggesting insulin resistance in both fasting and post-glucose state. At 100 μU/ml insulin: i) GLUT4 levels on the monocyte plasma membrane were decreased in both HO (215±19 mean fluorescence intensity, MFI) and SHO (218±24 MFI) versus EU (270±25 MFI, P=0.03 and 0.04 respectively), and ii) glucose transport rates in monocytes from HO (481±30 MFI) and SHO (462±19 MFI) were decreased versus EU (571±15 MFI, P=0.04 and 0.004 respectively).ConclusionsIn patients with HO and SHO: i) insulin resistance was comparable; ii) insulin-stimulated rates of glucose transport in isolated monocytes were decreased due to impaired translocation of GLUT4 glucose transporters on the plasma membrane; iii) these findings could justify the increased risk for insulin resistance-associated disorders, such as cardiovascular disease, observed in patients with HO or SHO.


Bioimpacts ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. 173-178
Author(s):  
Yalda Salari Lak ◽  
Sirous Khorram ◽  
Mehran Mesgari Abbasi ◽  
Mohammad Asghari-Jafarabadi ◽  
Ali Tarighat-Esfanjani ◽  
...  

Introduction: Many studies confirm that diabetes mellitus is associated with higher risks of bone fracture. The beneficial effects of Nigella sativa (NS) and clinoptilolite in preventing/reducing some diabetes-related disorders have been shown. This study was conducted to examine the effects of separate and concurrent supplementation of natural nano-sized clinoptilolite (NCLN) and NS on serum bone markers in rats with type 2 diabetes. Methods: A total of 42 (case=36 and control=6) adult male Wistar rats were divided into 2 groups: diabetic and non-diabetic. An oral glucose tolerance test and a homeostatic model assessment of insulin resistance (HOMA-IR) test were conducted to confirm diabetes. Then, the diabetic group was divided into 4 subgroups: [1] control (n=9), [2] NS 1%/food (n=9), [3] NCLN 2%/food (n=9), [4] NS 1%/food + NCLN 2%/food (n=9). After 7 weeks, serum levels of bone markers were determined using ELISA kits. Results: Analysis showed that serum levels of alkaline phosphatase (ALP) in the NCLN group (1318.6 ± 217.5 U/L) was significantly (P<0.05) higher than other intervented groups. On the other hand, serum levels of calcium in NCLN+NS group (10.8 ± 2.6 mg/dL) were higher (P=0.027) compared to all other study groups. However, rats in the NS group had higher (535.8 ± 49.3 pg/mL) PTH (P<0.0001) compared to other supplementation groups. There were no significant differences in vitamin D and osteoprotegerin. Conclusion: The results of the current study suggest that bone mineralization may be affected by concurrent use of NS and NCLN through influencing calcium circulation. Moreover, dietary NS administration is strongly related to an augmented level of PTH.


2009 ◽  
Vol 160 (1) ◽  
pp. 45-52 ◽  
Author(s):  
Lucia Pacifico ◽  
Vito Cantisani ◽  
Caterina Anania ◽  
Elisabetta Bonaiuto ◽  
Francesco Martino ◽  
...  

ObjectiveThe association between hyperuricemia, metabolic syndrome (MS), and atherosclerotic vascular disease has been reported in adults, but very little is known about this association in children. The aims of our study were to ascertain the correlates of uric acid (UA) in a sample of obese children, and to investigate whether UA is associated with carotid intima-media thickness (IMT) independently from classical risk factors including MS.MethodsWe analyzed carotid IMT along with serum triglycerides, total and high-density lipoprotein cholesterol, glucose, insulin, insulin resistance index (as homeostasis model assessment of insulin resistance), alanine aminotransferase, γ-glutamyltransferase, creatinine, and UA in 120 obese children and 50 healthy control children.ResultsUA concentrations were significantly higher in obese children compared with controls; moreover, they correlated with the most established cardiovascular risk factors. In the group of obese children, after adjustment for age, sex, pubertal stage, and creatinine, an independent association between UA levels and the presence of MS syndrome was observed (unstandardized coefficient, 0.044 (95% confidence intervals (CI) 0.015–0.072); P<0.01). Carotid IMT significantly increased in the fourth quartile of UA compared with that in the first, second, and third quartile (0.49 (0.46–0.53), 0.53 (0.49–0.56), and 0.55 (0.52–0.59) vs 0.61 (95% CI, 0.58–0.64); P<0.01). When multivariate analysis was performed after adjusting for age, gender, pubertal stage, creatinine, and MS (considered as a single clinical entity), or the individual components of MS simultaneously included, the association between UA and carotid IMT was significant (P<0.01).ConclusionsIn obese children and adolescents, increased UA levels are associated with carotid atherosclerosis.


Nutrients ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1264 ◽  
Author(s):  
Elettra Mancuso ◽  
Maria Perticone ◽  
Rosangela Spiga ◽  
Carolina Averta ◽  
Mariangela Rubino ◽  
...  

Magnesium (Mg2+) levels are associated with insulin resistance, hypertension, atherosclerosis, and type 2 diabetes (T2DM). We evaluated the clinical utility of physiological Mg2+ in assessing subclinical cardiovascular organ damage including increased carotid artery intima- media thickness (c-IMT) and left ventricular mass index (LVMI) in a cohort of well-characterized adult non-diabetic individuals. Age- and gender-adjusted correlations between Mg2+ and metabolic parameters showed that Mg2+ circulating levels were correlated negatively with body mass index (BMI), fasting glucose, and 2h-oral glucose tolerance test (OGTT) glucose. Similarly, Mg2+ levels were significantly and negatively related to c-IMT and LVMI. A multivariate regression analysis revealed that age (β = 0.440; p < 0.0001), BMI (β = 0.225; p < 0.0001), and Mg2+ concentration (β = −0.122; p < 0.01) were independently associated with c-IMT. Age (β = 0.244; p = 0.012), Mg2+ (β = −0.177; p = 0.019), and diastolic blood pressure (β = 0.184; p = 0.038) were significantly associated with LVMI in women, while age (β = 0.211; p = 0.019), Mg2+ (β = −0.171; p = 0.038) and the homeostasis model assessment index of insulin resistance (HOMA-IR) (β = −0.211; p = 0.041) were the sole variables associated with LVMI in men. In conclusion, our data support the hypothesis that the assessment of Mg2+ as part of the initial work-up might help unravel the presence of subclinical organ damage in subjects at increased risk of cardiovascular complications.


Author(s):  
Malgorzata Malczewska-Malec ◽  
Iwona Wybranska ◽  
Iwona Leszczynska-Golabek ◽  
Lukasz Partyka ◽  
Jadwiga Hartwich ◽  
...  

AbstractThis study analyzes the relationship between risk factors related to overweight/obesity, insulin resistance, lipid tolerance, hypertension, endothelial function and genetic polymorphisms associated with: i) appetite regulation (leptin, melanocortin-3-receptor (MCR-3), dopamine receptor 2 (D2R)); ii) adipocyte differentiation and insulin sensitivity (peroxisome proliferator-activated receptor-γThe 122 members of 40 obese Caucasian families from southern Poland participated in the study. The genotypes were analyzed by restriction fragment length polymorphism-polymerase chain reaction (RFLP-PCR) or by direct sequencing. Phenotypes related to obesity (body mass index (BMI), fat/lean body mass composition, waist-to-hip ratio (WHR)), fasting lipids, glucose, leptin and insulin, as well as insulin during oral glucose tolerance test (OGTT) (4 points within 2 hours) and during oral lipid tolerance test (OLTT) (5 points within 8 hours) were assessed. The insulin sensitivity indexes: homeostasis model assessment of insulin resistance, whole body insulin sensitivity index, hepatic insulin sensitivity and early secretory response to an oral glucose load (HOMA-IR, ISI-COMP, ISI-HOMA and DELTA) were calculated.The single gene mutations such as CWe conclude that the polymorphisms we investigated were weakly correlated with obesity but significantly modified the risk factors of the metabolic syndrome.


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