The role of metabolic syndrome components and adipokines in insulin resistance in prepubertal children

Madeira, Isabel Rey; Bordallo, Maria Alice Neves; Carvalho, Cecília N. M.; Mussi, Fernanda Carneiro; Souza, Flavio Moutinho; Matos, Haroldo José de; Borges, Marcos Antonio

doi:10.1515/jpem.2011.177

Cited by 10 publications

(8 citation statements)

References 39 publications

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“…In a previous study conducted in the same population of the present study, leptin levels were positively associated with insulin resistance after adjusting for sex, age, and BMI Z-score (12).…”

Section: Discussionsupporting

confidence: 58%

“…In a recently published study, our group demonstrated that leptin is positively associated with insulin resistance in prepubertal children after adjusting for sex, age, and body mass index (BMI) Z-score (12). Other authors reported similar results in children (13,14), suggesting a role of leptin as a potential modulator of glucose metabolism and insulin resistance, regardless of obesity.…”

Section: Introductionmentioning

confidence: 55%

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Leptin as a predictor of metabolic syndrome in prepubertal children

Madeira

Bordallo

Rodrigues

et al. 2017

Arch. Endocrinol. Metab.

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Objective: Leptin has been suggested as a potential biomarker of cardiovascular risk. This paper aims to ascertain, based on a sample of prepubertal children, which serum leptin value best suited to identify metabolic syndrome (MS). Subjects and methods: This observational, cross-sectional study recruited children from the outpatient pediatrics clinic, with the purpose of validating serum leptin level cutoffs to identify MS. All obese and overweight children who met eligibility criteria were included in the study, as was a sample of normal-weight children. The sample underwent clinical assessment and blood fasting glucose, lipid profile, insulin, and leptin were measured. Sensitivity and specificity were estimated for each leptin measurement, using MS as the outcome. These values were used to construct a receiver operating characteristic (ROC) curve. The association between MS and leptin was assessed using logistic models to predict MS. Results: A total of 65 normal weight, 46 overweight, and 164 obese children were analyzed (160 boys, 115 girls; age: 93.7 ± 17.8 months). The most appropriate leptin cutoff was 13.4 ng/mL (sensitivity 67.6%; specificity 68.9%; accuracy 72.1%). The logistic model indicated that leptin levels above 13.4 ng/dL were significantly associated with MS and that, for every 1 ng/dL increase in leptin levels, the odds of MS increase by 3% (p = 0.002; OR 1.03; 95% CI 1.01-1.05). Conclusions: Leptin may be a useful biomarker of cardiovascular risk in prepubertal children, with an optimal cutoff of 13.4 ng/mL. Identification of potential new risk markers for cardiovascular disease in children could contribute to the development of preventive strategies.Arch Endocrinol Metab. 2017;61(1):7-13

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Section: Discussionsupporting

confidence: 58%

Section: Introductionmentioning

confidence: 55%

Leptin as a predictor of metabolic syndrome in prepubertal children

Madeira

Bordallo

Rodrigues

et al. 2017

Arch. Endocrinol. Metab.

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“…In other studies, which used multivariate regression analysis, a positive association was found between the female gender and the presence of IR [ 39 40 ]. In our sample, however, no significant difference was seen in the frequency of IR in relation to gender, corroborating previous results obtained in eutrophic children and adolescents [ 19 ] ( Table 2 ).…”

Section: Discussionmentioning

confidence: 97%

Different Criteria for the Definition of Insulin Resistance and Its Relation with Dyslipidemia in Overweight and Obese Children and Adolescents

Nogueira‐de‐Almeida

Mello

2018

Pediatr Gastroenterol Hepatol Nutr

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Purpose: to compare cut off points corrected for age and gender (COOP) with fixed cut off points (FCOP) for fasting plasma insulin and Homeostatic model assessment-insulin resistance (HOMA-IR) for the diagnosis of IR in obese children and adolescents and their correlation with dyslipidemia. Methods: A multicenter, cross-sectional study including 383 subjects aged 7 to 18 years, evaluating fasting blood glucose, plasma insulin, and lipid profile. Subjects with high insulin levels and/or HOMA-IR were considered as having IR, based on two defining criteria: FCOP or CCOP. The frequency of metabolic abnormalities, the presence of IR, and the presence of dyslipidemia in relation to FCOP or CCOP were analyzed using Fisher and Mann-Whitney exact tests. Results: Using HOMA-IR, IR was diagnosed in 155 (40.5%) and 215 (56.1%) patients and, using fasting insulin, 150 (39.2%) and 221 (57.7%), respectively applying FCOP and CCOP. The use of CCOP resulted in lower insulin and HOMA-IR values than FCOP. Dyslipidemia was not related to FCOP or CCOP. Blood glucose remained within normal limits in all patients with IR. There was no difference in the frequency of IR identified by plasma insulin or HOMA-IR, both for FCOP and CCOP. Conclusion: The CCOP of plasma insulin or of HOMA-IR detected more cases of IR as compared to the FCOP, but were not associated with the frequency of dyslipidemia. As blood glucose has almost no fluctuation in this age group, even in the presence of IR, fasting plasma insulin detected the same cases of IR that would be detected by HOMA-IR.

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“…Hyperleptinaemia or leptin resistance has been found associated with triglyceride accumulation in liver, muscle and pancreas, resulting in the lipotoxicity phenomenon that causes IR and steatosis and in hyperinsulinaemic profile distinctive of MS in children . Furthermore, according to the potential role of leptin in inducing fibrosis , recently serum levels of leptin have been reported, together with caspase‐cleaved CK18 fragments, as a good predictor of NASH and fibrosis in paediatric patients with NAFLD .…”

Section: The Role Of Adipose Tissue In Insulin Resistance Metabolic mentioning

confidence: 99%

The potential role of fatty liver in paediatric metabolic syndrome: a distinct phenotype with high metabolic risk?

et al. 2012

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The role of metabolic syndrome components and adipokines in insulin resistance in prepubertal children

Cited by 10 publications

References 39 publications

Leptin as a predictor of metabolic syndrome in prepubertal children

Leptin as a predictor of metabolic syndrome in prepubertal children

Different Criteria for the Definition of Insulin Resistance and Its Relation with Dyslipidemia in Overweight and Obese Children and Adolescents

The potential role of fatty liver in paediatric metabolic syndrome: a distinct phenotype with high metabolic risk?

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