Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Department of Radiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Obes Facts. 2021;14(3):271-282. doi: 10.1159/000514720. Epub 2021 May 5.
Overweight (Ow) and obesity among adults and children increases the risk of metabolic consequences. Metabolic syndrome (MS) and impaired glucose metabolism are well-known risk factors for cardiovascular diseases and type 2 diabetes. The aim of this study was to evaluate the prevalence of MS and impaired glucose metabolism among Ow and obese (Ob) children and adolescents (aged 10-17 years) in Lithuania, and to evaluate the associations between insulin resistance (IR) indices and anthropometric parameters as well as metabolic disturbances.
The study population consisted of 344 OwOb children and adolescents of all pubertal stages. Oral glucose tolerance tests (OGTTs), IR and β cell function indices, lipid profile, and anthropometric parameters of all subjects were analyzed. MS was defined according to the International Diabetes Federation consensus guidelines.
MS was found in 21.3% of the OwOb children and adolescents, and 12.1% had impaired glucose metabolism (6.9% with impaired fasting glucose, 4.5% with impaired glucose tolerance, and 0.6% with type 2 diabetes). IR was directly related to body mass index and waist circumference, waist-to-height and waist-to-hip ratios, and sum of skin-fold thicknesses. Children with MS were more insulin-resistant, had higher odds ratio for prediabetes and had a more disturbed lipid profile than subjects without MS. Moreover, total cholesterol and low-density lipoprotein cholesterol levels were significantly lower in the more mature OwOb adolescents.
MS and lipid profile disturbances are common in OwOb children and adolescents. MS is directly associated with IR. Therefore, OwOb children and adolescents should be carefully followed up for metabolic abnormalities during late childhood as these can persist into adulthood.
成年人和儿童超重(Ow)和肥胖会增加代谢后果的风险。代谢综合征(MS)和葡萄糖代谢受损是心血管疾病和 2 型糖尿病的已知危险因素。本研究旨在评估立陶宛超重和肥胖(Ob)儿童和青少年(10-17 岁)中 MS 和葡萄糖代谢受损的患病率,并评估胰岛素抵抗(IR)指数与人体测量参数以及代谢紊乱之间的相关性。
研究人群包括所有青春期阶段的 344 名 OwOb 儿童和青少年。对所有受试者进行口服葡萄糖耐量试验(OGTT)、IR 和β细胞功能指数、血脂谱以及人体测量参数分析。MS 根据国际糖尿病联合会共识指南进行定义。
在 OwOb 儿童和青少年中,发现 21.3%存在 MS,12.1%存在葡萄糖代谢受损(6.9%为空腹血糖受损,4.5%为葡萄糖耐量受损,0.6%为 2 型糖尿病)。IR 与体重指数和腰围、腰围与身高比以及腰围与臀围比以及皮褶厚度总和直接相关。患有 MS 的儿童更具胰岛素抵抗性,发生糖尿病前期的几率更高,且血脂谱更紊乱,与无 MS 的受试者相比。此外,MS 组的总胆固醇和低密度脂蛋白胆固醇水平明显较低。
MS 和血脂谱紊乱在 OwOb 儿童和青少年中很常见。MS 与 IR 直接相关。因此,OwOb 儿童和青少年在儿童后期应密切关注代谢异常,因为这些异常可能会持续到成年期。