scholarly journals Metabolic Profiles in Obese Children and Adolescents with Insulin Resistance

2018 ◽  
Vol 6 (3) ◽  
pp. 511-518 ◽  
Author(s):  
Marko Kostovski ◽  
Viktor Simeonovski ◽  
Kristina Mironska ◽  
Velibor Tasic ◽  
Zoran Gucev
Keyword(s):  
Insulin Resistance ◽  
Children And Adolescents ◽  
Plasma Glucose ◽  
Metabolic Profile ◽  
Total Serum ◽  
Model Assessment ◽  
Fasting Insulin ◽  
Obese Children ◽  
Insulin Resistant ◽  
Study Results

BACKGROUND: In the past several decades, the increasing frequency of overweight and obese children and adolescents in the world has become a public health problem. It has contributed significantly to the already high tide of diabetes, cardiovascular and cerebrovascular diseases.AIM: To investigate the frequency of insulin resistance and to evaluate the metabolic profile of insulin resistant and non-insulin resistant obese children and adolescents.SUBJECTS AND METHODS: The study included 96 (45 boys, 51 girls) obese children and adolescents aged     4-17 years old (10.50 ± 2.87 years). Only participants with Body Mass Index ≥ 95 percentile were included.  We analysed sera for fasting insulin levels (FI), fasting serum triglycerides (TG), total serum cholesterol (TC), fasting plasma glucose (FPG) and plasma glucose 2 hours after the performance of the oral glucose tolerance test        (2-h G). Homeostatic model assessment for insulin resistance (HOMA-IR) index was calculated as fasting insulin concentration (microunits per millilitre) x fasting glucose concentration (millimolar)/22.5. The value of HOMA-IR above 3.16 was used as a cut-off value for both genders.RESULTS: Insulin resistance was determined in 58.33% of study participants. Insulin resistant participants had significantly higher level of 2-h G (p = 0.02), FI level (p = 0.000) as well as TG levels (p = 0.01), compared to non-insulin resistant group. Strikingly, 70.73% of the pubertal adolescents were insulin resistant in comparison to 49.09% of the preadolescents (p = 0.03). Significantly higher percentage of insulin-resistant participants were girls (p = 0.009). Moreover, a higher percentage of the girls (70.59%) than boys (44.44%) had HOMA-IR above 3.16 and had elevated FI levels (70.59% vs 48.89%). The difference in the frequency of insulin resistance among obese versus severely obese children and adolescents was not significant (p = 0.73, p > 0.05). Our study results also showed positive, but weak, correlation of HOMA-IR with age, FPG, TG and BMI of the participants (p < 0.05).CONCLUSION: Higher percentage of insulin-resistant participants was of female gender and was adolescents. In general, insulin resistant obese children and adolescents tend to have a worse metabolic profile in comparison to individuals without insulin resistance. It is of note that the highest insulin resistance was also linked with the highest concentrations of triglycerides.

scholarly journals Prevalence and Clinical Characteristics of Children and Adolescents with Metabolically Healthy Obesity: Role of Insulin Sensitivity

Life ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. 127 ◽  
Author(s):  
Federica Vinciguerra ◽  
Andrea Tumminia ◽  
Roberto Baratta ◽  
Alfredo Ferro ◽  
Salvatore Alaimo ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Insulin Sensitivity ◽  
Children And Adolescents ◽  
Metabolic Phenotype ◽  
Sensitivity Index ◽  
Insulinogenic Index ◽  
Model Assessment ◽  
Insulin Resistant ◽  
Metabolically Healthy

Obesity represents a major risk factor for metabolic disorders, but some individuals, “metabolically healthy” (MHO), show less clinical evidence of these complications, in contrast to “metabolically unhealthy” (MUO) individuals. The aim of this cross-sectional study is to assess the prevalence of the MHO phenotype in a cohort of 246 overweight/obese Italian children and adolescents, and to evaluate their characteristics and the role of insulin resistance. Homeostasis model assessment–insulin resistance (HOMA-IR), insulin sensitivity index (ISI), insulinogenic index (IGI) and disposition index (DI) were all calculated from the Oral Glucose Tolerance Test (OGTT). MHO was defined by either: (1) HOMA-IR < 2.5 (MHO-IRes), or (2) absence of the criteria for metabolic syndrome (MHO-MetS). The MHO prevalence, according to MHO-MetS or MHO-IRes criteria, was 37.4% and 15.8%, respectively. ISI was the strongest predictor of the MHO phenotype, independently associated with both MHO-IRes and MHO-MetS. The MHO-MetS group was further subdivided into insulin sensitive or insulin resistant on the basis of HOMA-IR (either < or ≥ 2.5). Insulin sensitive MHO-MetS patients had a better metabolic profile compared to both insulin resistant MHO-MetS and MUO-MetS individuals. These data underscore the relevance of insulin sensitivity to identifying, among young individuals with overweight/obesity, the ones who have a more favorable metabolic phenotype.

Insulin resistance and lung function in obese asthmatic pre-pubertal children

2018 ◽  
Vol 31 (1) ◽  
pp. 45-51 ◽  
Author(s):  
Paola Di Filippo ◽  
Alessandra Scaparrotta ◽  
Daniele Rapino ◽  
Tommaso de Giorgis ◽  
Marianna Immacolata Petrosino ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Lung Function ◽  
Statistical Significance ◽  
Serum Levels ◽  
Forced Expiratory Volume ◽  
Normal Weight ◽  
Model Assessment ◽  
Obese Children ◽  
Asthmatic Children ◽  
Insulin Resistant

AbstractBackground:Recent findings have supposed that the underlying association between the increased prevalence of both asthma and obesity may be insulin resistance (IR).Methods:Insulin and glucose serum levels were analyzed to calculate the homeostatic model assessment of insulin resistance (HOMA-IR) for IR in 98 pre-pubertal children. Lung function and allergy status evaluation were performed. The study population was divided into four groups: (1) obese asthmatic children (ObA); (2) normal-weight asthmatic children (NwA); (3) normal-weight non-asthmatic children (Nw) and (4) obese non-asthmatic children (Ob).Results:Forced expiratory volume in 1 s (FEV1) was slightly lower in obese subjects compared with normal-weight subjects and forced vital capacity (FVC) appeared lower in asthmatics, whereas between non-asthmatics subjects, it was lower in the obese group than in the normal-weight one. The post hoc analysis revealed a statistically significant reduction in FEV1, peak expiratory flow (PEF), forced expiratory flows (FEF) between 50% and 25% of the FVC (FEF50and FEF25) between ObA and Nw and in FEV1, FVC, PEF, FEF50and FEF25between NwA and Nw, but no statistically significant differences of lung function parameters were observed between ObA and NwA. We found an inverse relationship between HOMA-IR and all spirometric parameters, although without any statistical significance. We also observed a significantly lower FVC in insulin-resistant children (HOMA-IR>95th percentile) (p=0.03).Conclusions:This study suggests that lung function could be early altered in obese children, already in pre-pubertal age. Although IR should not manifest its effects on lungs in pre-pubertal obese children, the prevention or treatment of obesity in the pre-pubertal period may prevent definitive negative effects on lungs.

scholarly journals Parameters of Metabolic Syndrome in Obese Children and Adolescents

PRILOZI ◽  
2018 ◽  
Vol 39 (1) ◽  
pp. 105-114
Author(s):  
Marko Kostovski ◽  
Zoran Gucev ◽  
Velibor Tasic ◽  
Momir Polenakovic
Keyword(s):  
Children And Adolescents ◽  
Plasma Glucose ◽  
Severe Obesity ◽  
Total Serum ◽  
Total Serum Cholesterol ◽  
Obese Patients ◽  
Obese Children ◽  
Severely Obese ◽  
Study Participants ◽  
Carbohydrate Intolerance

Abstract Background: Obesity is the most common chronic metabolic disease in children and adolescents. It has reached epidemic ranges and is a significant global problem. Objective: This study aimed to investigate the possible metabolic disturbances in children and adolescents with obesity and severe obesity. Subjects and methods: This cross-sectional study included 158 (82 boys, 76 girls) obese children and adolescents between ages of 0 and 17years (10.43 ± 3.11 years). The obesity was defined according to the sex- and age-specific growth charts proposed by the Centers for Disease Control and Prevention as BMI ≥ 95th percentile. Severe obesity was classified as 120% of the 95th percentile for age and sex. Study participants underwent medical assessment and analysis of: ALT, AST, fasting serum triglycerides, total serum cholesterol, fasting plasma glucose and plasma glucose from oral glucose tolerance test. Results: The majority of study participants were severely obese (69.92%). The highest distribution of abnormal biochemical results was seen in elevated ALT (53.91%) followed by elevated triglycerides (34.75%). The prevalence of abnormal total cholesterol level was significantly higher (p=0.04) in the group of obese children compared to the severely obese children. The levels of total cholesterol were also statistically higher in the group of adolescents compared to preadolescents (p=0.02). An important number of obese patients (2.5%) and even higher number of severely obese patients (5.26%) had carbohydrate intolerance. Conclusion: There was a significant elevation of ALT, total serum cholesterol and triglycerides in all study participants. High serum lipids and high hepatic enzymes (as introduction in non-alcoholic fatty liver disease) are alarming. Strikingly, there was carbohydrate intolerance in an important number of patients. Treatment and education of patients and parents is mandatory. Preventive measures in the society concerning childhood obesity are necessary.

Metformin effectiveness and safety in the management of overweight/obese nondiabetic children and adolescents: metabolic benefits of the continuous exposure to metformin at 12 and 24 months

2016 ◽  
Vol 29 (5) ◽  
Author(s):  
Pedro Marques ◽  
Catarina Limbert ◽  
Laura Oliveira ◽  
Maria Inês Santos ◽  
Lurdes Lopes
Keyword(s):  
Insulin Resistance ◽  
Adverse Effects ◽  
Children And Adolescents ◽  
Lifestyle Intervention ◽  
Resistance Index ◽  
Continuous Exposure ◽  
Model Assessment ◽  
Obesity Prevalence ◽  
Insulin Resistant ◽  
Clinical Records

Abstract Introduction: Childhood obesity prevalence is rising and new therapeutical approaches are needed. Metformin is likely beneficial in obese and/or insulin-resistant children/adolescents, but its role in this setting is still unclear. We aimed to evaluate the effectiveness, in terms of weight loss and insulin resistance, and safety of metformin in nondiabetic overweight/obese children and adolescents. Methods: We retrospectively reviewed clinical records of 78 nondiabetic obese/overweight [body mass index (BMI)≥85th/95th percentile for age and sex] children and adolescents. Anthropometric and metabolic outcomes of 39 patients treated with metformin (mean daily dose: 1.3±0.5 g) were analyzed and compared to lifestyle intervention alone at different follow-up times (12 and 24 months). Results: The mean age of the 78 patients was 13.3 years, 41 were females and mean BMI and BMI-SDS were 32.8 kg/m2 and 3.1, respectively. There was a decrease in mean BMI-SDS within each treatment group in all periods, except at 24 months for lifestyle intervention. However, the change in BMI-SDS was not significantly superior in the metformin group when compared to lifestyle intervention. Metformin had greater effectiveness over lifestyle intervention alone in reducing fasting insulin levels and homeostasis model assessment for insulin-resistance index (HOMA-IR) at both 12 and 24 months. Five patients had gastrointestinal adverse effects (12.8%), four requiring dose reduction, but metformin could be resumed in all. Conclusion: Metformin for nondiabetic obese/overweight children and adolescents resulted in a noteworthy insulin resistance improvement, without significant BMI advantage when compared to lifestyle intervention. Metformin metabolic and anthropometric effects appear to be beneficial up to 24 months, without relevant adverse effects, highlighting its potential long-term benefits.

Serum omentin-1 levels in obese children

2019 ◽  
Vol 32 (3) ◽  
pp. 247-251 ◽  
Author(s):  
Senay Zengi ◽  
Oguzhan Zengi ◽  
Aysegul Kirankaya ◽  
Suat Hayri Kucuk ◽  
Emine Erdogan Kutanis ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Children And Adolescents ◽  
Polycystic Ovary ◽  
Subcutaneous Fat ◽  
Control Group ◽  
Diabetic Patients ◽  
Healthy Children ◽  
Model Assessment ◽  
Fat Tissue ◽  
Obese Children

Abstract Background Obesity is an important cause of morbidity, and it has an increasing frequency in childhood. Studies have reported that 33% of adults and 20–27% of children and adolescents are obese. Recently, it has been shown that the prevalence of obesity in the childhood group is higher than the past years. Omentin-1 is an adipokine which is synthesized from the visceral fat tissue but not synthesized in the subcutaneous fat tissue. Omentin-1 has been shown to increase insulin-mediated glucose uptake, especially in the adipose tissue. Studies have shown that plasma omentin-1 levels, which play an important role in the pathogenesis of insulin resistance, are significantly lowered in obese, polycystic ovary syndrome (PCOS) and diabetic patients. The aim of this study was to investigate the relationship between obesity and omentin-1 levels in children. Methods The study included obese children with a body mass index (BMI) greater than the 95th percentile and healthy children with a BMI lower than the 85th percentile. Obese and healthy individuals had similar age and sex distributions. Glucose, insulin, lipid profiles, thyroid panels and metabolic markers were evaluated. Results The levels of omentin-1 in obese children were significantly lower than in the control group (p<0.05). Results of Spearman’s correlation analysis for all participants showed that omentin-1 levels were negatively related with triglycerides, total cholesterol, serum free thyroxine (FT4), insulin, homeostatic model assessment of insulin resistance (HOMA-IR), body weight, waist circumference (WC) and BMI percentile values. Conclusions Our findings indicate that serum omentin-1 levels are lower in obese children than in non-obese individuals. Omentin-1 can be used as a metabolic biomarker in children and adolescents.

The relationship between serum FGF-23 concentration and insulin resistance, prediabetes and dyslipidemia in obese children and adolescents

2019 ◽  
Vol 32 (7) ◽  
pp. 707-714 ◽  
Author(s):  
Yesim Kutluturk ◽  
Aysehan Akinci ◽  
Ibrahim Halil Ozerol ◽  
Saim Yologlu
Keyword(s):  
Insulin Resistance ◽  
Glucose Tolerance ◽  
Children And Adolescents ◽  
Bone Mineralization ◽  
Significant Negative Correlation ◽  
Fasting Insulin ◽  
Obese Children ◽  
C Peptide ◽  
Obese Subjects ◽  
Fgf 23

Abstract Background Obesity is known to cause metabolic disturbances including insulin resistance, dyslipidemia and alters bone mineralization. The effects of obesity on fibroblast growth factor 23 (FGF-23), which is important in bone mineralization, have not yet been clarified. Our aim was to investigate the association between FGF-23 concentration and obesity-associated dysmetabolism. Methods Subjects comprised 46 obese children and adolescents. The same number of age-matched, healthy controls were recruited. Markers of bone mineralization and glucose metabolism were measured. Thyroid function and insulin resistance were investigated in both groups. In obese subjects; an oral glucose tolerance test (OGTT) was performed and hemoglobin A1c and lipid fractions were measured. Bone mineral density and hepatic steatosis were investigated. Results Serum FGF-23, α-klotho and 1,25(OH)2D3 concentrations were significantly lower while fasting insulin, fasting glucose, C-peptide and alkaline phosphatase (ALP) concentrations and homeostasis model assessment of insulin resistance (HOMA-IR) were significantly higher in the obese group compared to controls. A significant negative correlation was observed between free tri-iodothyronine (fT3) and both FGF-23 and α-klotho in the obese group. Significant negative correlation was found between FGF-23 and C-peptide and a positive correlation was found between FGF-23 and high density lipoprotein-cholesterol (HDL-c) in the obese subjects with impaired glucose tolerance (IGT). Significant negative correlations were found between FGF-23 and both fasting insulin levels and C-peptide levels in the obese subjects with hepatic steatosis. Conclusions In our study, insulin resistance-associated hyperinsulinism and/or lower 1,25(OH)2D3 levels, both present in obese children and adolescents, may lead to decreased serum FGF-23 concentrations in obese subjects.

scholarly journals Influence of subclinical hypothyroidism on metabolic parameters in obese children and adolescents

2020 ◽  
Vol 63 (3) ◽  
pp. 110-114
Author(s):  
Ozlem Kara
Keyword(s):  
Insulin Resistance ◽  
Children And Adolescents ◽  
Subclinical Hypothyroidism ◽  
Serum Insulin ◽  
Control Group ◽  
Model Assessment ◽  
Obese Children ◽  
Cross Sectional ◽  
Sh Group ◽  
The Mean

Background: Subclinical hypothyroidism (SH) is a common condition in obese children. However, its effect on glucose and lipid metabolism in obese children remains controversial.Purpose: The present study aimed to investigate the association between SH and metabolic parameters.Methods: A total of 215 obese children and adolescents aged 6–18 years were included in this retrospective cross-sectional study. The patients’ anthropometric measurements such as thyrotropin (TSH), free thyroxine (fT4), fasting plasma glucose, and insulin levels, as well as homeostasis model assessment for insulin resistance (HOMA-IR) index, and lipid profiles were evaluated. The patients were allocated to the SH group (fT4 normal, TSH 5–10 mIU/L) (n=77) or the control group (fT4 normal, TSH<5 mIU/L) (n=138). The glucose and lipid metabolisms of the 2 groups were compared.Results: SH was identified in 77 of 215 patients (36%). Mean body mass index was similar in both groups. The mean serum insulin, HOMA-IR, and triglyceride (TG) levels were higher and the mean high-density lipoprotein cholesterol level was lower in the SH group than in the control group (<i>P</i>=0.007, <i>P</i>=0.004, <i>P</i>=0.01, and <i>P</i>=0.02, respectively). A positive correlation was observed between TSH level and insulin level, HOMA-IR, and TG level.Conclusion: SH was identified in some of the obese children and adolescents. A clear association was observed between SH, insulin resistance, and dyslipidemia in obese children.

scholarly journals Study of Markers for Assessment of Insulin Resistance in Obese Children and Adolescents

2021 ◽  
pp. 89-95
Author(s):  
Sarah Ibrahim El Shall ◽  
Ahmed Mohamed Hassan ◽  
Wesam Salah Mohamed ◽  
Mona Hasan Hafez ◽  
Adel Ali Erfan
Keyword(s):  
Insulin Resistance ◽  
Children And Adolescents ◽  
Patient Group ◽  
Serum Insulin ◽  
Control Group ◽  
Healthy Children ◽  
Model Assessment ◽  
Obese Children ◽  
Fasting Serum ◽  
Group I

Background: 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 aim of this work was to evaluate Homeostatic model assessment of insulin resistance (HOMA-IR) for assessment of insulin resistance among obese children and adolescents. Methods: This case control study included 40 children and adolescent with ages of 6 to 16 years who were classified into: Group I: 20 obese children and adolescents (body mass index (BMI) > 95th percentile on Egyptian growth curves and Group II: 20 healthy children as a control group of matched age and sex to group 1 and who had normal BMI. All subjects underwent 1) Thorough history taking 2) Full clinical examination 3) Laboratory investigations: Fasting blood glucose, Fasting serum insulin level, HOMA-IR, HbA1c.and OGTT. Results: There is no significant statistical difference as regard age, height, sex and puberty staging in both groups. The mean for weight, BMI, waist circumference, hip circumference, waist/hip ratio and acanthosis nigricans were found to be significantly higher in patient group. FBG, fasting serum insulin, HbA1c and HOMA-IR were significantly higher in patient group than in control group (p <0.001). HOMA-IR was significantly correlated with HbA1c and OGTT in obese patients (p<0.001*). Conclusions: HOMA-IR can be used in assessment of insulin resistance among obese children and adolescents.

Triglyceride/glucose index is a reliable alternative marker for insulin resistance in South American overweight and obese children and adolescents

2019 ◽  
Vol 32 (10) ◽  
pp. 1163-1170 ◽  
Author(s):  
João Carlos Locateli ◽  
Wendell Arthur Lopes ◽  
Caroline Ferraz Simões ◽  
Gustavo Henrique de Oliveira ◽  
Karine Oltramari ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Children And Adolescents ◽  
Fasting Glucose ◽  
Surrogate Marker ◽  
South American ◽  
Model Assessment ◽  
Obese Children ◽  
Cross Sectional ◽  
Tyg Index ◽  
Triglyceride Glucose Index

Abstract Background The aim of the present study was to investigate the correlation between the triglyceride/glucose index (TyG index) and homeostasis model assessment of insulin resistance (HOMA-IR). Additionally, we compared the ability of the TyG index and triglycerides/high-density lipoprotein cholesterol (TG/HDL-c) index and the combination of these two indices (TyG index plus TG/HDL-c) to predict insulin resistance (IR) in South American overweight and obese children and adolescents. Methods A cross-sectional study was carried out in 345 overweight adolescents aged 10–18 years, from both the sexes. The TyG index was calculated as Ln (fasting triglycerides [mg/dL] × fasting glucose [mg/dL])/2, while the TG/HDL-c index was calculated by the division of TG (mg/dL) by HDL-c (mg/dL). HOMA-IR was calculated with the formula: fasting insulin (FI) (U/mL) × fasting glucose (mmol/L)/22.5. The cut-off point used to determine the presence of IR was HOMA-IR ≥ 3.16. Results The TyG index showed a positive correlation with HOMA-IR. The area under the receiver operating characteristic (ROC) curve of the TyG index was 0.74, indicating good sensitivity (75.7%) and specificity (67.4%). Furthermore, the TyG index cut-off point of >4.44 was established for IR prediction in this population. Conclusions The TyG index is a simple and cost-effective surrogate marker of IR in South American overweight children and adolescents. Moreover, due to its good accessibility, it can be used in large epidemiological studies.

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