[Carbohydrate and lipid metabolism disorders in obese children and adolescents]

THE AIM of the study was to assess the incidence of: 1. insulin resistance, hyperinsulinemia, impaired glucose tolerance and dyslipoproteinemia in serum of obese children according to the type of obesity; 2. family history of obesity, hypertension and type 2 diabetes mellitus.

177 obese children (M/F 80/97) aged 10-17.5 yrs and 38 normostenic children (control group) were screened for carbohydrate and lipid metabolism disorders. BMI (> or =97 c) and WHR (M/F> or =0.9/0.85 -- abdominal adiposity) were estimated. Glycemia (mmol/l) and insulinemia (microIU/ml) at 0, 30, 60, 90, 120 minutes of OGTT were measured. Fasting C-peptide (ng/ml), HbAlc (%). total cholesterol, LDL-Ch, HDL-Ch, triglycerides (mmol/l), I/G ratio (microIU/ml/mg%) and ChT/HDL-Ch atherogenic index were also investigated.

Abdominal adiposity was present in 56.5%. fasting hyperinsulinemia (>20.0 microIU/ml) in 32.2%, insulin resistance (I/G>0.30) in 73.7%; in the group of patients with hyperinsulinemia 66.7% had abdominal adiposity. The glycemia ill OGTT was: normal in 57.0% -- group I; 26.6% did not suit the criteria of normal nor impaired glucose tolerance according to American Diabetes Association (ADA) -- group Ia. The impaired glucose tolerance (IGT) was found in 16.4% -- group II, with fasting hyperinsulinemia in 58.6% and I/G ratio > or =0.30 in 41.3%, HbAlc > 6.2% in 34.5%. Atherogenic lipoproteins levels prevailed (p<0.05) in group Ia and II. The incidence of family history of obesity, hypertension and diabetes mellitus type 2 was higher (statistically not significant, p>0.05) in group Ia and II and significantly higher (p<0.05) in all groups of obese children compared to the control group.

The results of our study prove that obesity in children is a risk factor for early diabetes mellitus type 2 and atherosclerosis.