Eyzaguirre Francisca, Bancalari Rodrigo, Román Rossana, Silva Ricardo, Youlton Ronald, Urquidi Cinthyia, García Hernán, Mericq Verónica
Pediatric Endocrinology, Pontificia Universidad Católica de Chile, Santiago, Chile.
J Pediatr Endocrinol Metab. 2012;25(1-2):51-6. doi: 10.1515/jpem.2011.446.
BACKGROUND/OBJECTIVES: Extremes of birthweight (BW) have been associated with increased rates of metabolic risks. The objective was to study the prevalence of metabolic risks markers among obese and overweight (OW) subjects according to BW.
SUBJECTS/METHODS: A cross-sectional study was performed in a cohort of 1002 patients (2-18 years, 40.6% male) evaluated for OW or obese subjects in two private clinics. Anthropometrics, fasting lipids, glycemia, and insulin were obtained.
Of the subjects, 76.1% were born appropriate for gestational age (AGA), 10.9% small for gestational age (SGA), and 13% large for gestational age (LGA). Children born LGA presented a more severe degree of obesity compared with those born AGA and SGA (p<0.0001). No differences in glycemia, insulin, and lipid levels were detected among the groups. Abnormal glucose was found in 37 subjects: one with type 2 diabetes mellitus (from the previously glucose-intolerant subjects), 10 with glucose intolerance, and 27 with impaired fasting glucose. According to Boney criteria, 6.6% of the patients (6-18 years old) exhibited metabolic syndrome (MS) (69.4% AGA, 12.9% SGA, and 17.7% LGA).
Being born LGA represents a higher risk of severe obesity. At this age, the most frequent component of MS was an abnormal lipid profile with low high-density lipoprotein and high triglycerides. Finally, the most frequent finding associated with abnormalities of glucose tolerance was a family history of diabetes. Thus, BW, lipid profile, and family history are mandatory when these patients are evaluated.
背景/目的：出生体重（BW）的极端情况与代谢风险发生率增加有关。目的是根据出生体重研究肥胖和超重（OW）受试者中代谢风险标志物的患病率。
受试者/方法：对两家私人诊所中1002例接受OW或肥胖评估的患者（2至18岁，40.6%为男性）队列进行了横断面研究。获取了人体测量数据、空腹血脂、血糖和胰岛素数据。
受试者中，76.1%出生时为适于胎龄儿（AGA），10.9%为小于胎龄儿（SGA），13%为大于胎龄儿（LGA）。与AGA和SGA出生的儿童相比，LGA出生的儿童肥胖程度更严重（p<0.0001）。各组之间在血糖、胰岛素和血脂水平方面未检测到差异。37名受试者发现血糖异常：1例患有2型糖尿病（来自先前糖耐量异常的受试者），10例糖耐量异常，27例空腹血糖受损。根据博尼标准，6.6%的患者（6至18岁）表现出代谢综合征（MS）（69.4%为AGA，12.9%为SGA，17.7%为LGA）。
出生时为LGA代表严重肥胖的风险更高。在这个年龄段，MS最常见的组成部分是异常血脂谱，即高密度脂蛋白低和甘油三酯高。最后，与糖耐量异常相关的最常见发现是糖尿病家族史。因此，在评估这些患者时，出生体重、血脂谱和家族史是必不可少的。
