Metabolic syndrome in children’s obesity

Scope: In recent decedes global obesity epidemics is the one that is responsible for the appearance of the metabolic syndrome(MS) in children. Although the pathogenesis of the MS is not fully understood, the prooves suggest that the interaction of obesity , insulin resistance and proinflammatory state play a key role in its development and maintenance. The objective of the investigation:Determination of the metabolic syndrome frequency in children with obesity/overweight (according to IDF, 2007) and clinical- biochomical particularities inherent in this group of pacients

Methods: The investigation included 218 children with obesity/ overweight at the age of 10-18 , 46 (21,1%) of them with MS (patients group) and 172 children without MS (control group) Serum insulin was determined through immunochemical method using electrchemiluminescence. Reference values for serum insulin are the following: normal< 15μU/ml, borderline 15-20 μU/ml, increased > 20 μU/ml, [Williams CL et al., 2002]. HOMAI IR index was estimated according to the formula : insulin á jeun (μU/ml,) x glycaemia á jeun (mmol/l)/22,5 [Kozlovoy L.V., 2008]. Reference values for HOMA IR indexes: < 2,5 – normal, 2,5-3,5 – border-line, > 3,5 insulin resistance [Keskin M. et al., 2005]. TNF-α , leptin and serum adiponectin were estimated using immunoenzymatic test , hs-PCR latex-immuno-turbidimetry method.

Results: Statistically significant (p<0,001) AC was correlated, positively with TC (r=+0,45), LDL-C (r=+0,51), TG (r=+0,46), GB (r=+0,25), TAS (r=+0,51) and negatively with HDL-C (r=-0,55). AHT was diagnosed at 84,78% of children with MS and at 40,12% of the ones without MS (p<0,001). Dislipidemia ra-tio was higher at children with MS, as compared to the ones without MS: increase in TC (60,9 vs 31,4%; p<0,01); LDL-C (26,1 vs 13,4%; p<0,001); TG (60,9 vs 16,9%; p<0,001) and dicrease in HDL-C (80,4 vs 17,4%; p<0,001). Modified basal glicemia was stated at 23,9% of children with MS, as compared to 7,6% of the one3s without MS. (p<0,01).Serum insulin was hi-gher at the children with with MS, as compared to the ones without MS (31,32,22 vs 16,70,65 U/ml; p<0,001). The same tendency was stated for HOMA IR index too (6,90,52 vs 3,40,14; p<0,001). Serum insulin showed statistically significant positive correlation (p<0,001), with BMI (r=+0,58), AC (r=+0,65), TC (r=+0,37), LDL-C (r=+0,42;), TG (r=+0,42), GB (r=+0,23), SAT (r=+0,48) and negative with HDL-C (r=-0,48). Chil-dren with MS showed higher level of leptin (20,50,95 vs 11,70,39 ng/ml; p<0,001) ahd lower one of adidonectin (5,20,16 vs 6,80,13 ng/ml; p<0,001). Serum le-vel of hs-PCR (3,70,14 vs 2,30,08 mg/l; p<0,001) and TNF-α (13,10,68 vs 7,50,21 pg/ml; p<0,001) was higher at childten with MS.

Conclusions: 1. MS was diagnosed in 21,10% children with obesity/overweight included in the investigation, but among the components prevailed AHT and hypo-HDL-C. 2. The values of serum insuline and HOMA IR index were higher at children with MS, as compared to the ones without MS and had a statistically signi-ficant negative correlation with obesity indexes, basal glicemia, tension values and lipid spectrum, excluding HDL-C values 3. Children with MS showed the hi-ghest values of serum leptin, TNF-α and hs-PCR and reduced ones of adiponectin that suggests the idea that hypoadiponectinemia and hyperleptinemia are the connection between the obesity and inflamation , but these adipokines can serve as biomarkers to determi-ne the children having the risk of possible metabolic disorders.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)