Insulin resistance and metabolic syndrome in children with obesity
- HUANG Yong-lan, LIN Wen-chun, HUANG Jun-jing, ZHANG Wen, LIU Li
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Abstract
【Objective】 To observe the rates of occurrence of insulin resistance (IR) and metabolic syndrome (MS) and the association between IR and MS in a group of Chinese obese children. 【Methods】 Oral glucose tolerance test (OGTT) was done and serum insulin was measured in 76 children (49 males and 27 females) with obesity aged between 3 and 14 years old. Fasting blood sample was also obtained to measure total cholesterol, triglycerides, HDL-C, LDL-C, uric acid, liver function and androgen in serum. 【Results】 In the 76 obese children, 68.4% of them had IR, 27.6% had impaired glucose tolerance or type II diabetes, 61.8% had dyslipidemia, 14.5% had hypertension, 28.9% had hyperuricemia, 26.3% had increased ALT. Hyperandrogenism was found in 6 out of the 27 female children. 32.9% met the criteria of MS. The rates of impaired glucose tolerance, dyslipidemia and MS were 34.6%, 73.1% and 44.2%, respectively, in children with IR, which were significantly higher than those without IR(P< 0.05 or 0.01, respectively). Out of the 20 cases with delayed or absent insulin responsive peak, 13 of them had impaired glucose tolerance and one was diagnosed with Type II diabetes. 【Conclusions】 Insulin resistance and MS are very common in children with obesity. The occurrence of MS is strongly and positively related to IR.
Key words
insulin resistance / metabolic syndrome / obesity / children
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References
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[3] 李辉,宗心南,季成叶.中国2～18岁儿童青少年超重和肥胖筛查体重指数界值点的研究[J].中华流行病学杂志,2010,31(6):616-620.
[4] Ten S, Maclaren N. Insulin resistance syndrome in children[J]. J Clin Endocrinol Metab,2004, 89(6):2526-2539.
[5] 中华医学会糖尿病学分会代谢综合征研究协作组.中华医学会糖尿病学分会关于代谢综合征的建议[J]. 中华糖尿病杂志, 2004,12(3):156-161.
[6] 丁宗一,饶安伶,张璿. 北京市城区(7～18岁)儿童青少年单纯肥胖症流行病调查[J]. 临床儿科杂志,1988,6(5):293-295.
[7] Lee JM, Okumura MJ, Davis MM, et al. Prevalence and determinants of insulin resistance among U.S. adolescents: a population-based study[J]. Diabetes Care,2006,29(11):2427-2432.
[8] Bremer AA, Auinger P, Byrd RS. Sugar-Sweetened Beverage Intake Trends in US Adolescents and Their Association with Insulin Resistance-Related Parameters[J]. J Nutr Metab, 2010,19:64-76.
[9] Bremer AA, Auinger P, Byrd RS. Relationship between insulin resistance-associated metabolic parameters and anthropometric measurements with sugar-sweetened beverage intake and physical activity levels in US adolescents: findings from the 1999~2004 National Health and Nutrition Examination Survey[J]. Arch Pediatr Adolesc Med, 2009,163(4):328-335.
[10] Sacher PM, Kolotourou M, Chadwick PM, et al. Randomized controlled trial of the MEND program: a family-based community intervention for childhood obesity[J]. Obesity (Silver Spring), 2010,18(S1):62-68.
[11] Clarson CL, Mahmud FH, Baker JE, et al. Metformin in combination with structured lifestyle intervention improved body mass index in obese adolescents, but did not improve insulin resistance[J]. Endocrine,2009, 36(1):141-146.
