Sapunar Jorge, Aguilar-Farías Nicolás, Navarro Juan, Araneda Gustavo, Chandia-Poblete Damian, Manríquez Víctor, Brito Roberto, Cerda Alvaro
Centro de Excelencia en Medicina Traslacional, CEMT-BIOREN, Universidad de La Frontera, Temuco, Chile.
Centro de Investigación en Epidemiología Cardiovascular y Nutricional, EPICYN, Universidad de La Frontera, Temuco, Chile.
Rev Med Chil. 2018 Sep;146(9):978-986. doi: 10.4067/s0034-98872018000900978.
Childhood and adolescent obesity is a major public health problem in Chile.
To characterize cardiometabolic risk factors in a population of schoolchildren from Carahue, Chile.
Cross-sectional assessment of 208 children aged 10.4 ± 1.0 years (106 women). A clinical evaluation was carried out including pubertal development according to Tanner and anthropometric parameters. A fasting blood sample was obtained to measure glucose, insulin and lipid profile. HOMA-IR and Quicki indices were calculated. Insulin resistance (IR) was established according to Burrows criteria and Barja criteria, previously proposed for the Chilean pediatric population. The metabolic syndrome (MetS) was established using the modified Cook criteria.
Thirty eight percent of children had overweight and 33.1% obesity. MetS was only observed in obese subjects and the frequency in this subgroup was 38%. The prevalence of IR was 51% according to the Burrows criteria and 19% according to Barja criteria. It was more common in participants who were overweight, obese or had abdominal obesity. Children with insulin resistance according to Barja criteria, had worse anthropometric measures than their counterparts without resistance. When Burrows criteria was used, no differences in anthropometric measures were observed between participants with or without resistance. The frequency of MetS was 26 and 18% in children with insulin resistance according to Barja and Burrows criteria, respectively. Insulin levels and insulin sensitivity indexes were positively correlated with anthropometric parameters.
There was a high prevalence of overweight, obesity and MetS in these participants. Our results suggest that the IR criteria according to Barja allows to identify cases with higher metabolic risk.
儿童和青少年肥胖是智利的一个主要公共卫生问题。
对智利卡拉韦的一群学童的心脏代谢危险因素进行特征描述。
对208名年龄为10.4±1.0岁的儿童（106名女性）进行横断面评估。进行了临床评估，包括根据坦纳标准评估青春期发育和人体测量参数。采集空腹血样以测量血糖、胰岛素和血脂谱。计算HOMA-IR和Quicki指数。根据先前为智利儿科人群提出的伯罗斯标准和巴尔亚标准确定胰岛素抵抗（IR）。使用改良的库克标准确定代谢综合征（MetS）。
38%的儿童超重，33.1%的儿童肥胖。仅在肥胖受试者中观察到代谢综合征，该亚组中的频率为38%。根据伯罗斯标准，IR的患病率为51%，根据巴尔亚标准为19%。在超重、肥胖或有腹部肥胖的参与者中更常见。根据巴尔亚标准有胰岛素抵抗的儿童，其人体测量指标比无抵抗的同龄人更差。当使用伯罗斯标准时，有或无抵抗的参与者之间在人体测量指标上未观察到差异。根据巴尔亚和伯罗斯标准，有胰岛素抵抗的儿童中代谢综合征的频率分别为26%和18%。胰岛素水平和胰岛素敏感性指数与人体测量参数呈正相关。
这些参与者中超重、肥胖和代谢综合征的患病率很高。我们的结果表明，根据巴尔亚的胰岛素抵抗标准可以识别出代谢风险较高的病例。
