Insulin resistance in obese children and adolescents

Abstract

Objective: To evaluate the presence of insulin resistance and its association with other metabolic abnormalities in obese children and adolescents. Methods: Retrospective study of 220 children and adolescents aged 5-14 years. Anthropometric measurements were performed (weight, height, and waist circumference) and clinical (gender, age, pubertal stage, and degree of obesity) and biochemical (glucose, insulin, total cholesterol, and fractions, triglycerides) data were analyzed. Insulin resistance was identified by the homeostasis model assessment for insulin resistance (HOMA-IR) index. The analysis of the differences between the variables of interest and the HOMA-IR quartiles was performed by ANOVA or Kruskal-Wallis tests. Results: Insulin resistance was diagnosed in 33.20% of the sample. It was associated with low levels of high-density lipoprotein cholesterol (HDL-C; p = 0.044), waist circumference measurement (p = 0.030), and the set of clinical and metabolic (p = 0.000) alterations. Insulin-resistant individuals had higher mean age (p = 0.000), body mass index (BMI; p = 0.000), abdominal circumference (p = 0.000), median triglycerides (p = 0.001), total cholesterol (p ≤ 0.042), and low-density lipoprotein cholesterol (LDL---C; p ≤ 0.027); and lower HDL-C levels (p = 0.005). There was an increase in mean BMI (p = 0.000), abdominal circumference (p = 0.000), and median DOI se refere ao artigo: http://dx.Insulin resistance in obese children and adolescents 601 triglycerides (p = 0.002) as the values of HOMA -IR increased, with the exception of HDL-C, which decreased (p = 0.001). Those with the highest number of simultaneous alterations were between the second and third quartiles of the HOMA---IR index (p = 0.000). Conclusion: The results confirmed that insulin resistance is present in many obese children and adolescents, and that this condition is associated with alterations that represent an increased risk for developing metabolic disorders in adulthood. Resistência à insulina em crianças e adolescentes obesos ResumoObjetivo: Avaliar a presença de resistência à insulina e sua relação com outras alterações metabólicas, em crianças e adolescentes obesos. Métodos: Estudo retrospectivo de 220 crianças e adolescentes de 5 a 14 anos. Foram realizadas avaliações antropométricas (peso, estatura e circunferência abdominal), clínicas (sexo, idade, estágio puberal e grau de obesidade) e bioquímicas (glicemia, insulina, colesterol total e frações, triglicerídeos). A resistência à insulina foi identificada pelo índice HOMA-IR. A análise das diferenças entre as variáveis de interesse e os quartis do HOMA-IR foi realizada pelos testes ANOVA ou Kruskal-Wallis. Resultados: A resistência à insulina foi diagnosticada em 33,20% da amostra. Associou-se a níveis baixos de HDL-C (p = 0,044), medida da circunferência abdominal aumentada (p = 0,030) e ao conjunto de alterações clínicas e metabólicas (p = 0,000). Os indivíduos resistentes apresentaram maiores médias de idade (p = 0,000), IMC (p = 0,000), medida da circunferência abdominal...

Second-Generation Antipsychotics in Adolescent Psychiatric Patients: Metabolic Effects and Impact of an Early Weight Change to Predict Longer Term Weight Gain

“…In the present cohort of adolescent psychiatric patients, a worrisome obesity prevalence of 10% was observed at baseline, which is higher than the 3.5% obesity prevalence reported in general pediatric and young populations (age range [15][16][17][18][19][20][21][22][23][24] in Switzerland(2012). This high prevalence of obesity underlines the higher cumulative risk profile of this adolescent psychiatric population, showing as in adults, the intertwining between mental illness and somatic disorders.…”

“…In addition, important WG during SGA treatment is associated with poor treatment adherence (Rettew, et al 2015) and may also have strong psychological consequences on adolescent development. Of note, the persistence of obesity at adulthood varies from 20-50% when it starts before sexual maturity and from 50-70% when arising before puberty (Romualdo, et al 2014, Sweeting 2008. Thus, obese children are atrisk for further metabolic complications in adulthood such as dyslipidemia or type 2 diabetes.…”

Association between insulin resistance and haematological parameters: A cohort study from adolescence to adulthood

“…Nevertheless, a chronic exposure to higher HOMA‐IR levels, even within a normal range, is associated with increased haematological components in young adults. This is particularly important in our current context of an increasing prevalence of obesity in children and young adults, influencing the incidence of IR early in life and that were shown to present a strong tracking to 21 years of age,to test the possible effect of diet (as confounder or as interaction) on the association between haematological parameters and HOMA‐IR.…”

“…However, population‐based studies on the association between IR and alterations in haematological parameters are scarce, mainly conducted in adults and elderly populations, and cross‐sectional in design . Therefore, little is known about this association in the transition from adolescence to adulthood, although an increased prevalence of IR has been observed in young individuals, likely driven by the increasing prevalence of obesity . The study of the effects of IR in early life stages, before the onset of clinical disease, may be important to better understand the mechanisms underlying CVD.…”

Relação de polimorfismos nos genes ADIPOQ, TMEM18, FNDC5 e concentrações séricas de Adiponectina e Irisina com aumento de parâmetros de adiposidade em crianças e adolescentes

“…Na categoria glicose, mais da metade (61,12%) dos escolares classificados como risco, estavam com excesso de peso. Ainda, a média dessa variável estava maior nos indivíduos com IMC >25 kg/m² (89± 9mg/dL p=0,027) do que nos eutróficos (87±7,34mg/dL) Romualdo et al (2014). observaram resistência insulínica em crianças e adolescentes obesos, e que esta condição está associada com alterações clínicas e metabólicas.Referente ao perfil lipídico, escolares com excesso de peso foram maioria na classificação de risco para os níveis séricos de LDL-c (53,15%) e triglicerídeos (51,73%), ainda, as médias dessas variáveis estavam elevadas nessa categoria quando comparadas com os eutróficos.…”