Hyperinsulinism as a marker in obese children.

OBJECTIVE

To determine the relationship between insulin and the metabolic profile and eventual weight loss in obese children.

DESIGN

We first attempted to define the metabolic profile for 18 obese children; we then studied weight loss in this group longitudinally.

SETTING

Department of Pediatrics in a university hospital.

PARTICIPANTS

Eighteen randomly selected, young, obese male subjects from 5 to 16 years of age.

INTERVENTIONS

(1) Metabolic screening at the outset, including insulinemia and glycemia after the oral glucose tolerance test and plasma levels of total cholesterol, high-density lipoprotein cholesterol, and triglycerides, and (2) weight loss treatment.

RESULTS

We divided the sample into "normoinsulinemic" and "hyperinsulinemic" groups, similar for all the variables tested except for weight loss and plasma triglyceride levels. A direct relationship between weight loss results and duration of treatment was found for the entire group. The "hyperinsulinemic" group had a lower percentage reduction in excess weight, and the results in this group were not dependent on the duration of treatment.

CONCLUSIONS

The effort to keep "normoinsulinemic" obese children in treatment may be useful; it is advisable to study "hyperinsulinemic" children more in depth.