Síndrome metabólica em crianças obesas e fatores de risco para doenças cardiovasculares de acordo com a resistência à insulina (HOMA-IR)

Abstract

Objective: To identify the prevalence of metabolic syndrome and risk factors for the development of cardiovascular diseases and to investigate their relationship with insulin resistance.Methods: This was a cross-sectional study of 52 obese children. The sample was chosen at random after the body mass index [weight (kg)/stature (m) 2 ] of 1,550 schoolchildren had been calculated. Children were defined as obese when their BMI was above the 95th percentile of the Centers for Disease Control and Prevention classification. Blood samples were taken after fasting and glycemia, high-density lipoproteins, triglycerides and insulin were all assayed.Body fat was evaluated using dual energy X-ray absorptiometry. Arterial blood pressure and insulin resistance were also measured. Metabolic syndrome was defined according to National Cholesterol Education Program criteria, with cutoff points adjusted for the age of the sample. Results:Metabolic syndrome was detected in 17.3% of the children investigated. Insulin resistance was significantly different for females (3.8±2.2; 95%CI 2.9-4.8) and males (2.6±1.3; 95%CI 2.1-3.1); p = 0.016. Around 44.2% of the sample exhibited at least two risk factors, and 15% exhibited arterial hypertension. Hypertriglyceridemia was observed in 50 and 70.8% of boys and girls, respectively. Lower than desirable high-density lipoprotein levels were only observed among the girls. Conclusions:Obese children exhibited a high prevalence of metabolic syndrome. The children with greater insulin resistance exhibited more risk factors. In the light of these findings intervention measures are necessary in order to prevent excessive weight gain during childhood.J Pediatr (Rio J). 2007;83(1):21-6: Child, obesity, metabolic syndrome.

Influência do sobrepeso e da obesidade na postura, na praxia global e no equilíbrio de escolares

“…They also affirmed that this can lead to the earlier onset of diabetes mellitus type 2 and atherosclerotic diseases 9 .…”

“…Emphasis should be given to the collection of vital signs due to the close link between them and the different risk factors for the development of cardiovascular diseases in childhood and adult life 34 . A direct association between high blood pressure and obesity has been shown in several studies 10,35 , large waist circumference in children has also evidenced a high risk of developing coronary diseases 11 .…”

Correlação entre variáveis de composição corporal e metabólica em adolescentes do sexo feminino

“…Hyperinsulinemia is considered an independent risk factor for cardiovascular diseases, as it has an important role in the development of other components of the metabolic syndrome, such as dyslipidemia, hypertension and hyperuricemia 22 . A high correlation was observed between insulin and HOMA-IR (r=0.983), emphasizing that the isolated level of insulin is a good indicator of insulin resistance.…”

Body mass index percentiles in adolescents of the city of São Paulo, Brazil, and their comparison with international parameters

“…The prevalence of overweight and obesity in Brazil is increasing following the trend seen worldwide (37)(38)(39)(40). The values found for BMI percentiles in both female and male adolescents aged 10 to 15 (Figures 1 and 2) were higher than those proposed by Must and cols.…”