Glucose alteration and insulin resistance in asymptomatic obese children and adolescents

Assunção, Silvana Neves Ferraz de; Sorte, Ney Christian Amaral Boa; Alves, Crésio de Aragão Dantas; Mendes, Patrícia; Alves, Carlos Roberto Brites; Silva, Luciana Rodrígues

doi:10.1016/j.jpedp.2017.09.010

Cited by 3 publications

(5 citation statements)

References 21 publications

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“…The glucose, insulin, and HOMA‐IR index profiles were elevated at baseline; levels improved after the intervention in the total population. These results are in agreement with studies that have demonstrated abnormalities in glucose metabolism and greater insulin resistance and risk of diabetes mellitus type 2 (DM2) in obese patients, parameters, which would improve with weight loss (6). These levels are consistent with exposure to high levels of blood glucose, which causes an increase of insulin levels as a compensatory response and secondary IR in target organs.…”

Section: Discussionsupporting

confidence: 92%

“…The relationship between obesity and IR, DM2, and an abnormal lipid profile has been studied extensively in the pediatric population (6). There was a significant decrease in HDL‐c in the general population, a consequence of the drop in this value in the female population, which is consistent with previously published data (24,25).…”

Section: Discussionmentioning

confidence: 99%

“…Childhood obesity tends to continue into adulthood, and this population has higher rates of morbidity and mortality (5). Children with obesity have a higher risk of developing chronic, noncommunicable diseases in adulthood, such as hyperlipidemia, impaired glucose tolerance, insulin resistance (IR) (6), diabetes, cardiovascular disease, hypertension, and sleep apnea. It also deteriorates vascular structures and negatively affects cardiac remodeling, causing an abnormal cardiovascular response (7).…”

mentioning

confidence: 99%

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Lifestyle Modification Improves Insulin Resistance and Carotid Intima‐Media Thickness in a Metabolically Healthy Obese Prepubescent Population

Gallardo-Escribano¹,

Vargas-Candela

Vilches-Pérez

et al. 2020

J. pediatr. gastroenterol. nutr.

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Objectives: The aim of this study was to analyze effects of a 12-month lifestyle modification that involved a Mediterranean diet (MedDiet) and physical activity (PA) program in a population of metabolically healthy obese children (MHOCh). Methods: We included a population of MHOCh with ≤1 of the following criteria: waist circumference and blood pressure ≥90 percentile, triglycerides >150 mg/dL, high-density lipoprotein-cholesterol (HDL-c) <40 mg/dL, or impaired fasting glucose. After 12 months of intensive lifestyle modification, anthropometric measurements, glycemic and lipid profiles, adherence to the MedDiet, energy intake, PA, body composition, and carotid intima-media thickness (cIMT) were analyzed. Results: One hundred thirty-one MHOCh (70 boys and 61 girls; P = 0.65, age: 7.9 ± 1.3 years, body mass index [BMI]: 24.7 ± 3.5 kg/m2) were included. After 12 months of intervention, a significant decrease in standard deviation (SD) units of body weight (−0.5 ± 0.1; P < 0.001) and BMI (−0.5 ± 0.1; P < 0.001) were observed in the total population. A significant improvement in adherence to the MedDiet (+2 points) and a significant reduction in protein, fatty acids, total fat, and cholesterol intake in the entire population were observed. All participants did more moderate-vigorous PA, which led to a significant increase in lean and total mass and decrease in total fat. Significant improvements in the glycemic profile (insulin levels [−6.6 μIU/mL, P < 0.001] and HOMA index [−1.2, P < 0.001]) were observed. Participants with pathological cIMT values reduced this cardiovascular predictor to normal values. Conclusions: A 12-month lifestyle modification intervention involving weight loss with MedDiet and PA in MHOCh yielded improvements in MedDiet adherence, lipid intake, moderate-vigorous PA, body composition, insulin resistance, and cIMT.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Lifestyle Modification Improves Insulin Resistance and Carotid Intima‐Media Thickness in a Metabolically Healthy Obese Prepubescent Population

Gallardo-Escribano¹,

Vargas-Candela

Vilches-Pérez

et al. 2020

J. pediatr. gastroenterol. nutr.

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“…Studies assessing impaired glucose metabolism in children and adolescents living with HIV (CALWH) have reported varying prevalence rates, ranging from as low as 1.6% to as high as 40%, depending on the population studied [7][8][9]. However, although impaired glucose metabolism in children, including insulin resistance, could be a risk or predictor of cardiovascular disease in adulthood [10,11], diagnosing glucose impairment in children is challenging as it often presents asymptomatically [12]. Likewise, differences in glucose metabolism between children and adults, attributed to factors such as developmental variations, ageing, and physical inactivity, contribute to subclinical glucose abnormalities in children, which poses diagnostic challenge [13,14].…”

Section: Introductionmentioning

confidence: 99%

High prevalence of impaired glucose metabolism among children and adolescents living with HIV in Ghana

Ayanful‐Torgby,

Shabanova,

Essuman

et al. 2024

HIV Medicine

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BackgroundAntiretroviral therapy (ART)‐associated metabolic abnormalities, including impairment of glucose metabolism, are prevalent in adults living with HIV. However, the prevalence and pathogenesis of impaired glucose metabolism in children and adolescents living with HIV, particularly in sub‐Saharan Africa, are not well characterized. We investigated the prevalence of impaired glucose metabolism among children and adolescents living with perinatally infected HIV in Ghana.MethodsIn this multicentre, cross‐sectional study, we recruited participants from 10 paediatric antiretroviral treatment clinics from January to June 2022 in 10 facilities in Greater Accra and Eastern regions of Ghana. We determined impaired glucose metabolism in the study sample by assessing fasting blood sugar (FBS), insulin resistance as defined by the homeostatic model assessment for insulin resistance (HOMA‐IR) index and glycated haemoglobin (HbA1c) levels. The prevalence of impaired glucose metabolism using each criterion was stratified by age and sex. The phenotypic correlates of glucose metabolism markers were also assessed among age, sex, body mass index (BMI) and waist‐to‐hip ratio (WHR).ResultsWe analysed data from 393 children and adolescents living with HIV aged 6–18 years. A little over half (205/393 or 52.25%) of the children were female. The mean age of the participants was 11.60 years (SD = 3.50), with 122/393 (31.00%) aged 6–9 years, 207/393 (52.67%) aged 10–15 years, and 62/393 (15.78%) aged 16–18 years. The prevalence rates of glucose impairment in the study population were 15.52% [95% confidence interval (CI): 12.26–19.45], 22.39% (95% CI: 18.54–26.78), and 26.21% (95% CI: 22.10–30.78) using HbA1c, HOMA‐IR, and FBS criteria, respectively. Impaired glucose metabolism detected by FBS and HOMA‐IR was higher in the older age group, whereas the prevalence of abnormal HbA1c levels was highest among the youngest age group. Age and BMI were positively associated with FBS and HOMA‐IR (p < 0.001). However, there was negative correlation of WHR with HOMA‐IR (p < 0.01) and HbA1c (p = 0.01).ConclusionThe high prevalence of impaired glucose metabolism observed among the children and adolescents living with HIV in sub‐Saharan Africa is of concern as this could contribute to the development of metabolic syndrome in adulthood.

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“…Essa doença favorece o surgimento de distúrbios metabólicos, como hipertensão, dislipidemia, resistência insulínica, intolerância à glicose e hiperglicemia. Ainda que sejam esperadas alterações glicêmicas nos obesos, a diabetes mellitus tipo 2 tem baixo índice de prevalência em crianças e adolescentes (ASSUNÇÃO et al, 2018). O Índice de Massa Corpórea (IMC) é a principal relação usada para classificar o indivíduo como obeso ou não (SAADATI et al, 2020).…”

Section: Introductionunclassified

Relação Entre Índice De Massa Corpórea E Nível De Glicemia Entre Adolescentes Da Rede Pública E Privada Do Município De Anápolis - Go

Lacerda¹,

Fernandes²,

Abadia³

et al. 2022

Saúde Integrativa: A Saúde Nos Conecta!

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Glucose alteration and insulin resistance in asymptomatic obese children and adolescents

Cited by 3 publications

References 21 publications

Lifestyle Modification Improves Insulin Resistance and Carotid Intima‐Media Thickness in a Metabolically Healthy Obese Prepubescent Population

Lifestyle Modification Improves Insulin Resistance and Carotid Intima‐Media Thickness in a Metabolically Healthy Obese Prepubescent Population

High prevalence of impaired glucose metabolism among children and adolescents living with HIV in Ghana

Relação Entre Índice De Massa Corpórea E Nível De Glicemia Entre Adolescentes Da Rede Pública E Privada Do Município De Anápolis - Go

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