Relation between obesity from childhood to adulthood and the metabolic syndrome: population based study

Abstract

Most researchers agree that obesity is an important modulator of the metabolic syndrome, 1 2 which is a clustering of cardiovascular risk factors associated with insulin resistance-such as hypertension, hypertriglyceridaemia, a low concentration of high density lipoprotein cholesterol, abnormal glucose metabolism, and hyperinsulinaemia.3 Little is known, however, about the association between relative weight change from childhood to adulthood and the development of metabolic syndrome in adulthood. Material, methods, and resultsWe recently published data of a population study for the metabolic syndrome, performed during 1993-4 in Pieksämäki, Finland. All subjects (n = 1008) born in the years 1947, 1952, and 1957 were examined according to a protocol described elsewhere.4 Data on both weight and height at age 7 years (the start of primary school) were also collected.Altogether, 712/1008 (70.6%) subjects participated in the study. Weights and heights at age 7 were traced for 439/712 (61.7%) participants. Obesity was defined both in childhood and in adulthood as a sex specific highest third of the body mass index (weight(kg)/ (height (m) 2 )). The metabolic syndrome was defined as a cluster of (a) hypertension (a systolic blood pressure >140 mm Hg, a diastolic blood pressure >90 mm Hg, or treatment with antihypertensive drugs); (b) dyslipidaemia (hypertriglyceridaemia (>1.70 mmol/l) or a high density lipoprotein cholesterol concentration of < 1.00 mmol/l ( < 1.20 mmol/l in women), or both dyslipidaemia and hypertriglyceridaemia); and (c) insulin resistance (abnormal glucose metabolism according to the World Health Organisation's criteria or hyperinsulinaemia (>78 pmol/l), or both). 2-4Of the 439 subjects, 75 had been obese and 219 not obese in both childhood and adulthood; 71 had not been obese as children but were obese as adults; and 74 had been obese as children but were not obese as adults. The metabolic syndrome was present in 18/219 (8%) men and in 12/220 (5%) women. Of the 30 subjects having this syndrome, 28 were obese as adults; 21 of them had also been obese as children (table). In exact logistic regression analysis (LogXact), the risk of metabolic syndrome was 2.9 (95% confidence interval 1.1 to 7.6) for the subjects who had been obese as children and 26.7 (6.4 to 237) for the subjects who were obese as adults, compared with their non-obese controls. None of the 74 subjects who had been obese as children but who were not obese as adults had the metabolic syndrome. The increased risk of the metabolic syndrome was still present when the population was split into thirds for weight but not when it was split into thirds for height. CommentOur results show that half of the obese children had become obese adults with an especially high risk of the metabolic syndrome and that childhood obesity overall increases the risk for the metabolic syndrome in adulthood. The risk of the syndrome was lower among the obese adults who had not been obese as children than among the obese adults who had also been obese as childr...

Insulin resistance and impaired glucose tolerance in obese children and adolescents referred to a tertiary-care center in Israel

“…45 There is evidence that obesity in childhood increases the risk of onset of the metabolic syndrome in adulthood. 46 In our cohort, patients with decreased insulin sensitivity had a higher prevalence of PCO and obesity complications, including hypertension, fatty liver, pseudotumor cerebri, and sleep apnea. Surprisingly, the insulin resistance indexes were not significantly correlated with the blood lipid profile, except for triglyceride levels.…”

Prevalência de sobrepeso e obesidade em escolares da cidade de Santos, SP

“…Considerando a associação existente entre o excesso de gordura corporal e efeitos danosos à saúde, bem como com o aumento das causas de morbimortalidade (9), além do fato de a obesidade surgida na infância normalmente acompanhar os indivíduos até a vida adulta (33,34), torna-se evidente a necessidade de ações preventivas desde as idades mais precoces. Nesse sentido, a escola deve ocupar papel de destaque tanto em relação à orientação de hábitos alimentares quanto à prática de exercícios físicos.…”

Prevalência de sobrepeso e obesidade em pacientes com diabetes tipo 1

“…Crianças e adolescentes obesos têm risco maior de se tornarem adultos hipertensos (29) e de apresentarem já precocemente níveis pressóricos elevados (30), sendo maior elevação em crianças obesas com distribuição de gordura predominantemente abdominal (31). A relação cinturaquadril (RCQ), índice de distribuição de tecido adiposo regional, é um forte preditor de resistência insulínica e de hiperinsulinemia (32), a qual pode ser relacionada de maneira causal à deterioração do perfil lipídico e pressórico já em crianças e adolescentes (33). Pela dificuldade técnica da obtenção exata da aferição do quadril em nossas consultas médicas, utilizamos as medidas do IMC e cintura para nossas avaliações.…”