Frequency of the metabolic syndrome in obese Spanish pediatric population

Objective: Obesity is associated with insulin-resistance (IR), type 2 diabetes (T2D) and a constellation of cardiovascular risk factors at the early years of life. These features define the so-called metabolic syndrome (MS). Aims: To assess the frequency of the MS among obese pediatric Spanish population and analyse the individual contribution and the predictive potential of individual components to the development of the syndrome. Patients and methods: A total of 429 patients, 220 boys and 209 girls, aged 4–18 years, with a body mass index of > 2 standard deviation scores for Spanish normative charts, were included in the study. Forty-seven percent were prepubertal and ten percent had Hispanic ethnicity. HbA1c, lipids, liver enzymes and uric acid levels were determined from blood and a standard 2-h oral glucose tolerance test was performed. MS was defined by the National Cholesterol Education Program’s Adult Treatment Panel III criteria modified by Cook as having at least three features among: obesity, low high-density lipoprotein (HDL), hypertriglyceridemia, hypertension (HTA) or impaired glucose metabolism (IGM). We defined IR as homeostatic model assessment of IR index and/or fasting insulin levels> 95th centile of the control population. Results: Almost 18% of the patients had MS, with significantly higher frequency in Hispanic (32%) than in Caucasian (16%) population. There were no differences by sex or pubertal status. Prevalence of low HDL, HTA, hypertriglyceridemia and IGM were 27, 23, 16 and 7% respectively. No silent T2D was identified. According to International Obesity Task Force charts, 22% of the patients were overweight and not obese, but no differences in the frequency of individual features of MS between these two groups were observed. Among IR patients (35% of our population), the frequency of MS reached 28%. IR predicted the presence of MS independently from age and race. Conclusion: MS is present in 18% of our obese pediatric population. IR is closely associated with the components of MS and strongly predicts its development.

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Parameters of Glucose Homeostasis in the Recognition of the Metabolic Syndrome in Young Adults with Prader–Willi Syndrome

Journal of Clinical Medicine ◽

10.3390/jcm10235635 ◽

2021 ◽

Vol 10 (23) ◽

pp. 5635

Author(s):

Graziano Grugni ◽

Antonio Fanolla ◽

Fiorenzo Lupi ◽

Silvia Longhi ◽

Antonella Saezza ◽

...

Keyword(s):

Metabolic Syndrome ◽

Glucose Homeostasis ◽

Tolerance Test ◽

Oral Glucose ◽

Prader Willi Syndrome ◽

Insulinogenic Index ◽

Glucose Levels ◽

The Metabolic Syndrome ◽

Diagnostic Threshold ◽

Age Related

To verify the accuracy of different indices of glucose homeostasis in recognizing the metabolic syndrome in a group of adult patients with Prader–Willi syndrome (PWS), 102 PWS patients (53 females/49 males), age ±SD 26.9 ± 7.6 yrs, Body Mass Index (BMI) 35.7 ± 10.7, were studied. The following indices were assessed in each subject during an oral glucose tolerance test (OGTT): 1 h (>155 mg/dL) and 2 h (140–199 mg/dL) glucose levels, the oral disposition index (ODI), the insulinogenic index (IGI), the insulin resistance (HOMA-IR) were evaluated at baseline, 1 h and 2 h. Although minor differences among indices were found, according to the ROC analysis, no index performed better in recognizing MetS. Furthermore, the diagnostic threshold levels changed over the years and therefore the age-related thresholds were calculated. The easily calculated HOMA-IR at baseline may be used to accurately diagnose MetS, thus avoiding more complicated procedures.

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Analysis of candidate genes in Polish families with obesity

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm.2004.083 ◽

2004 ◽

Vol 42 (5) ◽

Cited By ~ 6

Author(s):

Malgorzata Malczewska-Malec ◽

Iwona Wybranska ◽

Iwona Leszczynska-Golabek ◽

Lukasz Partyka ◽

Jadwiga Hartwich ◽

...

Keyword(s):

Risk Factors ◽

Insulin Resistance ◽

Insulin Sensitivity ◽

Body Mass ◽

Tolerance Test ◽

Whole Body ◽

Oral Glucose ◽

Sensitivity Index ◽

Model Assessment ◽

The Metabolic Syndrome

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

Acta Endocrinologica ◽

10.1530/eje-09-0446 ◽

2010 ◽

Vol 162 (4) ◽

pp. 719-727 ◽

Cited By ~ 10

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.

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Dysmetabolic features of the overweight patients receiving antipsychotic drugs: A comparison with normal weight and obese subjects

European Psychiatry ◽

10.1016/j.eurpsy.2012.12.001 ◽

2014 ◽

Vol 29 (3) ◽

pp. 179-182 ◽

Cited By ~ 3

Author(s):

P. Manu ◽

C.-U. Correll ◽

M. Wampers ◽

R. van Winkel ◽

W. Yu ◽

...

Keyword(s):

Metabolic Syndrome ◽

Antipsychotic Drugs ◽

Hemoglobin A1c ◽

Density Lipoprotein ◽

Tolerance Test ◽

Normal Weight ◽

Metabolic Health ◽

Lipoprotein Cholesterol ◽

Oral Glucose ◽

Post Challenge

AbstractBackground:Extensive research indicates that obesity, defined by a body mass index (BMI) greater or equal to 30, is common in patients treated with antipsychotic drugs and is frequently associated with carbohydrate and lipid abnormalities leading to metabolic syndrome and diabetes. In contrast, the metabolic health of overweight patients (BMI = 25–29.9) without metabolic syndrome or diabetes has not been thoroughly investigated.Objective:To assess the metabolic health of overweight patients receiving antipsychotic drugs.Methods:We compared standard metabolic parameters (BMI; waist circumference; hemoglobin A1c; fasting lipids; and fasting and post-challenge glucose and insulin) of normal weight, overweight and obese individuals from a consecutive cohort of antipsychotic-treated patients without metabolic syndrome and/or diabetes.Results:Compared with the normal weight subjects (n = 286), overweight patients (n = 212) had higher fasting insulin resistance as assessed with the homeostatic model (P = 0.023), insulin secretion during the oral glucose tolerance test (P = 0.0037), triglycerides (P = 0.0004) and low-density lipoprotein cholesterol (P = 0.0089), and lower levels of high-density lipoprotein cholesterol (P = 0.0014). The obese (n = 50) were different from the overweight subjects only with respect to higher post-challenge insulin levels (P = 0.0002). The average fasting glucose, post-challenge glucose, and hemoglobin A1c, severity of psychiatric disorders and antipsychotics used were similar in the three groups.Conclusions:Overweight (BMI = 25–29.9) patients receiving antipsychotics are metabolically closer to the obese than to normal weight counterparts. The findings suggest that interventions promoting weight loss and metabolic health are required for overweight patients even in the absence of metabolic syndrome or diabetes.

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Postprandial plasma adiponectin decreases after glucose and high fat meal and is independently associated with postprandial triacylglycerols but not with − 11388 promoter polymorphism

British Journal Of Nutrition ◽

10.1017/s0007114507791857 ◽

2007 ◽

Vol 99 (1) ◽

pp. 76-82 ◽

Cited By ~ 18

Author(s):

Diana Rubin ◽

Ulf Helwig ◽

Michael Nothnagel ◽

Nina Lemke ◽

Stefan Schreiber ◽

...

Keyword(s):

Blood Pressure ◽

Metabolic Syndrome ◽

Area Under The Curve ◽

Tolerance Test ◽

Promoter Polymorphism ◽

Oral Glucose ◽

Single Nucleotide ◽

The Metabolic Syndrome ◽

Serum Adiponectin Concentration ◽

Postprandial Insulin

Adiponectin is discussed to regulate energy balance and insulin sensitivity. Several studies indicated an association of fasting adiponectin with parameters of the metabolic syndrome. We investigated postprandial adiponectin release and its relation to traits of the metabolic syndrome. Serum adiponectin concentration after an oral glucose tolerance test and after ingestion of a standardised mixed, fat-containing meal in 110 male non-diabetic subjects was assessed. Fasting and postprandial adiponectin and the decrease of adiponectin were correlated with anthropometric and metabolic parameters. Subjects were genotyped for adiponectin − 11 388 G/A promoter single nucleotide polymorphism. Adiponectin slightly decreased after both test meals. A significant decrease was attained 5 and 6 h after the lipid load and 2 h after the glucose load. Particularly, the mixed meal postprandial adiponectin showed stronger correlations with most traits of the metabolic syndrome than fasting adiponectin: postprandial adiponectin with HDL (r 0·30) v. fasting adiponectin with HDL (r 0·23); with postprandial insulin (area under the curve): r − 0·20 v. r − 0·16; with fasting insulin: r 0·10 v. r 0·14; with BMI: r − 0·23 v. r − 0·20; with waist: r − 0·18 v. − 0·16; with systolic blood pressure: r − 0·14 v. r − 0·12; with diastolic blood pressure: r − 0·18 v. r − 0·15. In multivariate analysis, postprandial TAG were the only independent predictor of adiponectin. There was no significant association of adiponectin, NEFA and TAG with − 11 388 G/A adiponectin promoter polymorphism. Our findings favour the interpretation that postprandial adiponectin has the strongest and independent associations to postprandial TAG metabolism.

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Increased Aldehyde Formation as a Key Component of the Metabolic Syndrome in Adolescents: A Machine Learning Study

10.20944/preprints202006.0283.v1 ◽

2020 ◽

Author(s):

Kamila Bonifacio ◽

Michael Maes ◽

Carine de Farias ◽

Andressa Matsumoto ◽

Crisieli Tomereli ◽

...

Keyword(s):

Machine Learning ◽

Metabolic Syndrome ◽

Uric Acid ◽

Task Force ◽

International Diabetes Federation ◽

Density Lipoprotein ◽

Support Vector ◽

Lipid Hydroperoxides ◽

Radical Trapping ◽

The Metabolic Syndrome

Purpose: To investigate the alterations in nitro-oxidative stress (OS) and antioxidant status in adolescents with metabolic syndrome (MetS) and whether these alterations occur independently from effects of overweight or obesity.Methods: Blood was collected in 47 adolescents with MetS and 94 adolescents without MetS as assessed with the International Diabetes Federation criteria. The International Obesity Task Force (IOTF) criteria were used to classify the subjects into those with overweight or obesity. We measured nitro-oxidative biomarkers including nitric oxide metabolites (NOx), lipid hydroperoxides (LOOH), and malondialdehyde (MDA), and antioxidant biomarkers, i.e. total radical-trapping antioxidant parameter (TRAP), paraoxonase (PON)-1 activity, thiol (SH-) groups, as well as tumor necrosis factor-α, glucose, insulin, triglycerides, uric acid and high-density lipoprotein cholesterol (HDL-C).Results: Logistic regression analysis showed that increased MDA and NOx and a lowered TRAP/uric acid ratio were associated with MetS. Machine learning including soft independent modeling of class analogy (SIMCA) showed that the top-3 most important features of MetS were increased glucose and MDA and lowered HDL-C. Support vector machine using MDA, glucose, insulin, HDL-C, triglycerides and body mass index as input variables yielded a 10-fold cross-validated accuracy of 89.8% when discriminating MetS from controls. The association between MetS and increased MDA was independent from the effects of overweight-obesity. glucose, insulin, triglycerides and HDL-C.Conclusion: In adolescents, increased MDA formation is a key component of MetS, indicating that increased production of reactive oxygen species with consequent lipid peroxidation and aldehyde formation participate in the development of MetS.

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Association between insulin resistance and cardinal rheological parameters in young healthy Japanese individuals during 75 g oral glucose tolerance test

Endocrine Metabolic & Immune Disorders - Drug Targets ◽

10.2174/1871530321666210720124554 ◽

2021 ◽

Vol 21 ◽

Author(s):

Larasati Martha ◽

Takao Kimura ◽

Akihiro Yoshida ◽

Katsuhiko Tsunekawa ◽

Tomoyuki Aoki ◽

...

Keyword(s):

Insulin Resistance ◽

Platelet Count ◽

Density Lipoprotein ◽

Tolerance Test ◽

Rheological Parameters ◽

Oral Glucose ◽

Insulinogenic Index ◽

Model Assessment ◽

Matsuda Index ◽

Wbc Count

Background: Insulin resistance is a well-known predictor and risk factor for Type 2 Diabetes Mellitus (T2DM). Higher hematocrit induced by higher insulin resistance affects blood rheology. Objective: This study intended to reveal the association between indices of insulin resistance and hemorheological parameters during a 75 g oral glucose tolerance test (75-g OGTT). Methods: A total of 575 healthy young Japanese participants took 75-g OGTT. We then analyzed the association between insulin resistance indices and hematological parameters. Results: The Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) was significantly correlated with hematocrit (Ht), hemoglobin (Hb), Red Blood Cell (RBC), White Blood Cell (WBC), platelet count, lipid parameters, and Body Mass Index (BMI). The Matsuda index was negatively correlated with RBC count, WBC count, platelet count, Total Cholesterol (TC), Low-Density Lipoprotein-Cholesterol (LDL-C), triglyceride (TG), and positively correlated with High-Density Lipoprotein-Cholesterol (HDL-C). The disposition index was negatively correlated with Hb, RBC count, LDL-C, and BMI, while remaining positively correlated with HDL-C. The Homeostasis Model Assessment of beta cell (HOMA- IR ) was positively correlated with WBC count, platelet count, TC, LDL-C, and TG. The insulinogenic index was positively correlated with WBC count, platelet count, and TC. Multiple regression analysis revealed that HOMA-IR was independently associated with TG, and the Matsuda index was independently associated with TG, WBC count, and platelet count. The insulinogenic index was independently associated with WBC count. Conclusion: Cardinal rheological parameters reflected insulin resistance and were released even in the young, healthy Japanese individuals within the physiological range of glycemic control.

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Prevalence of Metabolic Syndrome in an Adult Urban Population of the West of Iran

Experimental Diabetes Research ◽

10.1155/2009/136501 ◽

2009 ◽

Vol 2009 ◽

pp. 1-5 ◽

Cited By ~ 21

Author(s):

F. Sharifi ◽

S. N. Mousavinasab ◽

M. Saeini ◽

M. Dinmohammadi

Keyword(s):

Metabolic Syndrome ◽

Urban Population ◽

Density Lipoprotein ◽

Cardiovascular Prevention ◽

Hdl Cholesterol ◽

Normal Subjects ◽

The West ◽

The Metabolic Syndrome ◽

Low Hdl ◽

Prevalence Of Obesity

Objectives. We determine the prevalence of the metabolic syndrome in an urban population of Zanjan, a province located to the west of Tehran.Methods. Randomly selected adults>20 years were studied using stratified sampling. Target study sample was 2941 (1396 males and 1545 females). Metabolic syndrome was diagnosed using Adult Treatment Panel-III (ATP-III) guidelines when any three of the following were present: central obesity, raised triglycerides≥150 mg/dl, low high-density lipoprotein (HDL) cholesterol, blood pressure≥130/≥85 mm Hg, and diabetes or fasting plasma glucose (FPG)≥100 mg/dl.Results. Metabolic syndrome was present in 697 (23.7%) subjects (CI 95%:22%–25%,P= .001), prevalence was 23.1% in men and 24.4% in women (P: .4). The prevalence increased from 7.5% in the population younger than 30 y to 45.6% in ages more than 50 years. Low HDL was the most common metabolic abnormality in both sexes. Most of those with metabolic syndrome had three components of the syndrome (75.6%), 170 subjects (24.4%) had four and none had five components simultaneously. The prevalence of obesity (BMI≥30 kg/m2), hypercholesterolemia (≥200 mg/dl) and high LDL cholesterol (≥130 mg/dl) was greater in the metabolic syndrome group than normal subjects (P= .00).Conclusions. There is a high prevalence of metabolic syndrome in this urban population of the northern west of Iran. Focus of cardiovascular prevention should be undertaken in this area.

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Serum apoA1 (Apolipoprotein A-1), Insulin Resistance, and the Risk of Gestational Diabetes Mellitus in Human Pregnancy—Brief Report

Arteriosclerosis Thrombosis and Vascular Biology ◽

10.1161/atvbaha.119.313195 ◽

2019 ◽

Vol 39 (10) ◽

pp. 2192-2197 ◽

Cited By ~ 2

Author(s):

Ravi Retnakaran ◽

Chang Ye ◽

Philip W. Connelly ◽

Anthony J. Hanley ◽

Mathew Sermer ◽

...

Keyword(s):

Insulin Resistance ◽

Glucose Tolerance ◽

Cell Function ◽

Density Lipoprotein ◽

Tolerance Test ◽

Oral Glucose ◽

Model Assessment ◽

Human Pregnancy ◽

Matsuda Index ◽

Β Cell Function

Objective: apoA1 (apolipoprotein A-1) is the main lipoprotein associated with HDL (high-density lipoprotein) cholesterol. It was recently reported that intravenous infusion of apoA1 could lower insulin resistance in pregnant rats, leading to the suggestion that apoA1 could provide a target for reducing pregnancy-induced insulin resistance and the risk of gestational diabetes mellitus (GDM) in humans. However, the effects of apoA1 on insulin resistance and risk of GDM in human pregnancy are not known. Thus, we sought to systematically evaluate the relationships of apoA1 with glucose homeostasis and metabolic function in pregnant women. Approach and Results: In this study, 870 pregnant women were recruited in late second trimester and underwent metabolic characterization, including an oral glucose tolerance test on which 214 were diagnosed with GDM. Metabolic characterization included assessment of glucose tolerance, insulin sensitivity/resistance (Matsuda index, homeostasis model assessment of insulin resistance), pancreatic β-cell function, lipids (LDL [low-density lipoprotein] cholesterol, HDL cholesterol, triglycerides, apoB [apolipoprotein B], and apoA1), CRP (C-reactive protein), and adiponectin. Serum apoA1 was strongly correlated with HDL (r=0.79, P <0.0001) and weakly so with adiponectin (r=0.12, P =0.0004) but showed no association with measures of insulin sensitivity/resistance, β-cell function, glycemia, or CRP. There were no significant differences across apoA1 tertiles in mean adjusted Matsuda index ( P =0.24), homeostasis model assessment of insulin resistance ( P =0.08), or area under the glucose curve on the oral glucose tolerance test ( P =0.96). Moreover, there were no differences in risk of GDM across tertiles of apoA1, both before ( P =0.67) and after covariate adjustment ( P =0.78). Conclusions: Serum apoA1 is not associated with insulin resistance or the risk of GDM in human pregnancy.

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Insulin resistance and obesity in childhood

Acta Endocrinologica ◽

10.1530/eje-08-0245 ◽

2008 ◽

Vol 159 (suppl_1) ◽

pp. S67-S74 ◽

Cited By ~ 120

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.

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