Insulin resistance in adolescents with Down syndrome: a cross-sectional study

Abstract

BackgroundThe prevalence of diabetes mellitus is higher in individuals with Down syndrome (DS) than in the general population; it may be due to the high prevalence of obesity presented by many of them. The aim of this study was to evaluate the insulin resistance (IR) using the HOMA (Homeostasis Model Assessment) method, in DS adolescents, describing it according to the sex, body mass index (BMI) and pubertal development.Methods15 adolescents with DS (8 males and 7 females) were studied, aged 10 to 18 years, without history of disease or use of medication that could change the suggested laboratory evaluation. On physical examination, the pubertal signs, acanthosis nigricans (AN), weight and height were evaluated. Fasting plasma glucose and insulin were analysed by the colorimetric method and RIA-kit LINCO, respectively. IR was calculated using the HOMA method. The patients were grouped into obese, overweight and normal, according to their BMI percentiles. The EPIINFO 2004 software was used to calculate the BMI, its percentile and Z score.ResultsFive patients were adults (Tanner V or presence of menarche), 9 pubertal (Tanner II – IV) and 1 prepubertal (Tanner I). No one had AN. Two were obese, 4 overweight and 9 normal. Considering the total number of patients, HOMA was 1.7 ± 1.0, insulin 9.3 ± 4.8 μU/ml and glucose 74.4 ± 14.8 mg/dl. The HOMA values were 2.0 ± 1.0 in females and 1.5 ± 1.0 in males. Considering the nutritional classification, the values of HOMA and insulin were: HOMA: 3.3 ± 0.6, 2.0 ± 1.1 and 1.3 ± 0.6, and insulin: 18.15 ± 1.6 μU/ml, 10.3 ± 3.5 μU/ml and 6.8 ± 2.8 μU/ml, in the obese, overweight and normal groups respectively. Considering puberty, the values of HOMA and insulin were: HOMA: 2.5 ± 1.3, 1.4 ± 0.6 and 0.8 ± 0.0, and insulin: 13.0 ± 5.8 μU/ml, 7.8 ± 2.9 μU/ml and 4.0 ± 0.0 μU/ml, in the adult, pubertal and prepubertal groups respectively.ConclusionThe obese and overweight, female and adult patients showed the highest values of HOMA and insulin.

Down’s syndrome in diabetic patients aged <20 years: an analysis of metabolic status, glycaemic control and autoimmunity in comparison with type 1 diabetes

“…Our data are in agreement with the findings of a study from Scotland, which also reported better glycaemic control and lower insulin doses in Down's syndrome patients with diabetes [11]. In contrast, a study from Brazil observed insulin resistance (without manifest diabetes) in overweight adolescent girls with Down's syndrome [12]. This was not confirmed by our data.…”

Population-Based Prevention of Obesity

“…[321][322][323] Adults with Down syndrome who live at home have higher rates of overweight and obesity than those who live in group homes. [321][322][323] Hypotonia (weak muscle tone) may lead to reduced physical activity and may thus contribute to the high prevalence of overweight. Overweight and obesity are also common in persons with schizophrenia and schizoaffective disorder.…”

Narrativas sobre síndrome de Down no Festival Internacional de Filmes sobre Deficiência Assim Vivemos

“…É, também, uma das condições genéticas mais frequentes, com incidência de um entre setecentos nascidos vivos 6 , sendo tomada como exemplo, por profissionais de saúde, para explicar sobre riscos e tecnologias de rastreamento e diagnóstico pré-natais. 7 propõe como etnografia textual.…”