[Cardiovascular risk and metabolic profile in obese children and adolescents with low insulin sensitivity]
Raquel Burrows1, Medardo Burgueño, Laura Leiva
1Area de Nutrición Humana, INTA, Universidad de Chile. rburrows@inta.cl
Insights
Obese children often have low insulin sensitivity (IS), linked to higher body fat and central obesity. This increases their risk for cardiovascular issues, even before puberty.
Area of Science:
- Pediatrics
- Endocrinology
- Metabolic Health
Background:
- Infantile obesity is linked to metabolic disturbances like hyperinsulinism, impaired glucose, and dyslipidemia.
- These disturbances elevate the risk of type 2 diabetes, hypertension, and atherosclerotic vascular disease in adulthood.
- Insulin resistance, associated with body fat mass, is a central mechanism in obesity complications.
Purpose of the Study:
- To investigate insulin sensitivity (IS) in obese children.
- To explore the association between IS and anthropometric and metabolic variables in this population.
Main Methods:
- A study involving 314 children (6-15 years), with 235 classified as obese based on BMI.
- Measurements included weight, height, % total body fat (% TBF), blood pressure (BP), waist circumference (WC), basal glucose (Glu), and insulin (Ins).
- Insulin sensitivity was assessed using homeostasis model assessment (HOMA) and QUICKI index; lipids and postprandial measures were taken in obese children.
Main Results:
- Obese children exhibited significantly lower insulin sensitivity (IS) compared to normal-weight children.
- Higher BMI, WC, and % TBF were inversely correlated with basal IS (p <0.001).
- Low IS was observed in 58% of obese children, associated with increased cardiovascular risk factors.
Conclusions:
- Low insulin sensitivity (IS) in obese prepubescent and pubescent children is linked to central obesity.
- This association suggests a heightened cardiovascular risk in affected children.
- Early identification and management of insulin resistance in pediatric obesity are crucial.
Background:
Infantile obesity is associated with metabolic disturbances (hyperinsulinism, impaired glucose, dyslipidemia) that determine a higher risk of type 2 diabetes, high blood pressure and atherosclerotic vascular disease in adulthood. Insulin resistance is a central mechanism of complications of obesity and is associated to body fat mass.
Aim:
To investigate insulin sensitivity and its association with anthropometric and metabolic variables in obese children.
Patients And Methods:
We studied 314 children aged 6 to 15 years. Of these, 235 had a body mass index (BMI) over the 95 percentile for age and sex (classified as obese) and 79 had a normal body mass index; 161 were pre-pubescent and 153 were pubescent. Weight, height, percentage of total body fat (% TBF) using the sum of 4 skinfolds, blood pressure (BP), waist circumference (WC), basal glucose (Glu) and insulin (Ins) were measured. Insulin sensitivity (IS) was calculated with the homeostasis model assessment (HOMA) and QUICKI index. Serum lipids, postprandial Glu and Ins were measured only in obese children.
Results:
BMI, WC and % TBF had an inverse and significant correlation with basal IS (p <0.001). Obese children had higher BP, basal Ins, and HOMA and a lower QUICKI index, compared to normal weight children. A low basal IS was present in 58% of obese children. Obese children with low IS had higher WC, % TBF, triglycerides, total/HDL-cholesterol ratio, basal and 2-h post glucose Gli and Ins and lower HDL-cholesterol than obese children with normal IS. In prepubescent children, the risk of a low IS was 2.43 times higher with a TBF over 33%. In pubescent children, it was 2.92 times higher with a TBF over 37%.
Conclusions:
Low IS in prepubescent and pubescent obese children is associated with central obesity and a higher cardiovascular.
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