Metabolic syndrome and risk factors for cardiovascular disease in obese children: the relationship with insulin resistance (HOMA-IR)

Ferreira, Aparecido Pimentel; Oliveira, Carlos E. R.; França, Nanci Maria de

doi:10.2223/jped.1562

Cited by 139 publications

(147 citation statements)

References 26 publications

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“…However, the HOMA-IR is reliable and practical, since it is standardized for a specific population as we chose, based on that of the study of Madeira and cols., whose data came from a cohort of children of similar age to ours and originating from Rio de Janeiro (15). Furthermore, results of HOMA-IR are strongly correlated with those obtained using the euglycemic hyperinsulinemic clamp (r = 0.82) and are thus considered reliable for epidemiologic studies on a large scale (26,27). Regarding the kits used to measure insulin, cross-reactivity with pro-insulin is small (an estimated 8% for the chemiluminescence test).…”

Section: Discussionsupporting

confidence: 57%

2000 CDC or 2007 WHO – What is the most sensitive anthropometric reference for determination of overweight and cardio-metabolic risk in children aged 6–10 years?

Kuba¹,

Leone

Damiani

2015

Arch. Endocrinol. Metab.

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Objective: To compare the two anthropometric standards for screening of overweight and cardiometabolic risk in 6-10-year-old children. Subjects and methods: This cross-sectional study included 175 subjects attending the Referral Center for the Treatment of Children and Adolescents in Campos, Rio de Janeiro. They were classified according to CDC and WHO BMI z scores as normal-weight (zscore > -1 and < 1), overweight (z-score ≥ 1 and < 2) or obese (z-score ≥ 2). Sensitivities and specificities in predicting systolic (SBP), diastolic (DBP) blood pressure and homeostatic model assessment insulin resistance index (HOMA-IR) alterations were calculated. Results: There was a major difference in 11 children who rated overweight by the CDC but were reclassified as obese by the WHO. Their mean z-scores for SBP (1.71 ± 1.54), DBP (2.64 ± 1.83) and HOMA-IR (1.84 ± 0.98) were higher than those classified as overweight by both references (SBP = 0.49 ± 1.34, p < 0.023, DBP = 1.45 ± 0.97, p < 0.04 and HOMA = 1.24 ± 0.67, p < 0.04), but were similar to those classified as obese by both criteria (SBP = 1.25 ± 2.04, p = 0.60, DBP = 1.94 ± 1.19, p = 0.50 and HOMA = 2.09 ± 1.12, p = 0.76). Conclusion: the 2007 WHO reference was the most sensitive in screening for overweight and alterations in blood pressure and HOMA-IR in 6-10-year-old children. Arch Endocrinol Metab. 2015;59(3):220-5

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Section: Discussionsupporting

confidence: 57%

2000 CDC or 2007 WHO – What is the most sensitive anthropometric reference for determination of overweight and cardio-metabolic risk in children aged 6–10 years?

Kuba¹,

Leone

Damiani

2015

Arch. Endocrinol. Metab.

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“…1 In parallel, scientific evidence is mounting up that suggests that the metabolic disorders that habitually accompany excess body fat are already manifest during childhood. [2][3][4][5] The metabolic syndrome is defined as a group of disorders that includes obesity, insulin resistance, dyslipidemia, arterial hypertension and other metabolic anomalies associated with cardiovascular disease, 6,7 and it is possible that this syndrome is already affecting children even before they start school. 4,5 Currently, the greatest difficulty facing both scientific studies and clinicians is the identification of adequate cutoff points for assessing indicators such lipemia, arterial blood pressure, waist circumference, peripheral insulin resistance (PIR), glycemia and insulinemia.…”

Section: Introductionmentioning

confidence: 99%

Determinação dos valores de glicemia, insulinemia e índice (HOMA) em escolares e adolescentes eutróficos

Nogueira‐de‐Almeida

Pinho

Ricco

et al. 2008

J. Pediatr. (Rio J.)

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Objective: To determine fasting glycemia and insulinemia levels and the HOMA index in a group of children and adolescents with normal body mass index (BMI).Methods: This was a cross-sectional study conducted at two public schools in Ribeirão Preto, SP, Brazil. A total of 447 children and adolescents of both sexes, with normal BMI, aged 7 to 17.9 years and of average maturity for their age, underwent anthropometric measurements and provided personal data and a sample of venous blood so that glycemia, insulinemia and HOMA index could be determined. The results obtained for boys and girls were compared for each age range using the Mann-Whitney test. The results within each age band were then compared for boys and girls using the Kruskal-Wallis test.Results: Glycemia results varied from 7 to 8.9 years (p = 0.0005). Fasting insulinemia varied significantly with age in both sexes (p < 0.001), with the highest values observed among children aged 13 to 14.9 years. HOMA indices varied significantly with age in both boys and girls (p < 0.001), with values that increased progressively up to the age band of 13 and 14.9 years.Conclusions: These data demonstrate the necessity of establishing reference curves for these three indicators.J Pediatr (Rio J). 2008;84(2):136-140: Obesity, hyperinsulinism, insulin, metabolic syndrome X.

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“…Although both studies have adopted the same cutoff point, in the aforementioned study, only 10.1% of adolescents were overweight, in contrast to this study, where the entire population had overweight/obesity, stressing the importance of the nutritional status as a risk factor for high blood pressure 16 . In this sense, studies carried out in Belo Horizonte with 672 children aged from 2 to 10 years and 11 months found association between higher mean SBP and DBP with high BMI among children 17 .…”

Section: Discussionmentioning

confidence: 58%

Pressão arterial elevada em crianças e adolescentes com excesso de peso

Noronha

Ramos

et al. 2012

J. Hum. Growth Dev.

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Objective: to evaluate the prevalence of high blood pressure in fat or overweight children and adolescents and its associated factors. Methods: Cross-sectional study including 200 children and adolescents between two and 18 years old. It was measured the abdominal circumference, blood pressure, weight and height. The systolic and diastolic blood pressure were considered high when equal or higher than 90th percentile. The value of the blood pressure in the 25th, 50th and 75 th percentiles were described according to age groups, sex, nutritional state and abdominal circumference. To check the association between high blood pressure and clinical variables it was used qui-square tests and a significant level of 5%. Results: The majority of children and adolescents (70.5 %) had high blood pressure: 6% showed an increase only in the systolic blood pressure, 33% in diastolic blood pressure and 31.5 % in both. Systolic blood pressure values were higher observed in individuals with severe obesity and increased waist circumference, as well as those of the male sex and in the group of adolescents. Among those who had high blood pressure, the normal maximum limit of the systolic blood pressure was observed in the 50th percentile and for the diastolic in the 75 th percentile. The high systolic blood pressure was associated with adolescents with severe obesity. Conclusion: The high prevalence of high blood pressure observed in this study indicates the need to implement policies and actions oriented towards the prevention and control of obesity and its comorbidities, as the case of high blood pressure.

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Metabolic syndrome and risk factors for cardiovascular disease in obese children: the relationship with insulin resistance (HOMA-IR)

Cited by 139 publications

References 26 publications

2000 CDC or 2007 WHO – What is the most sensitive anthropometric reference for determination of overweight and cardio-metabolic risk in children aged 6–10 years?

2000 CDC or 2007 WHO – What is the most sensitive anthropometric reference for determination of overweight and cardio-metabolic risk in children aged 6–10 years?

Determinação dos valores de glicemia, insulinemia e índice (HOMA) em escolares e adolescentes eutróficos

Pressão arterial elevada em crianças e adolescentes com excesso de peso

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