Obstetrical & Gynecological Survey · 2004 · 15 citations · 0 references
MedicineEndocrinologyPediatricsAdolescent HealthPediatric EndocrinologyPediatric EpidemiologyChildhood ObesityDiabetes MellitusInsulin ResistanceMetabolic SyndromeObesity EpidemiologyBlood PressureChildhood Obesity PrevalenceImpaired Glucose ToleranceMetabolic Syndrome EpidemiologyOverweight In ChildhoodPediatric Insulin ResistancePediatric Metabolic SyndromeSex Differences In Obesity
The prevalence and magnitude of childhood obesity are increasing dramatically. The study examined how different obesity levels affect the prevalence of metabolic syndrome and its association with insulin resistance, C‑reactive protein, and adiponectin in a large, multiethnic cohort of children and adolescents. The authors performed a standard glucose‑tolerance test and measured blood pressure, lipids, C‑reactive protein, and adiponectin, adjusting triglycerides, HDL, and BP for age and sex and standardizing BMI to a z‑score. Metabolic syndrome prevalence rose with obesity severity—reaching 50 % in severely obese children—and was strongly linked to higher BMI z‑scores, insulin resistance, elevated C‑reactive protein, and lower adiponectin, indicating early cardiovascular risk markers.
The prevalence and magnitude of childhood obesity are increasing dramatically. We examined the effect of varying degrees of obesity on the prevalence of the metabolic syndrome and its relation to insulin resistance and to C-reactive protein and adiponectin levels in a large, multiethnic, multiracial cohort of children and adolescents.We administered a standard glucose-tolerance test to 439 obese, 31 overweight, and 20 nonobese children and adolescents. Baseline measurements included blood pressure and plasma lipid, C-reactive protein, and adiponectin levels. Levels of triglycerides, high-density lipoprotein cholesterol, and blood pressure were adjusted for age and sex. Because the body-mass index varies according to age, we standardized the value for age and sex with the use of conversion to a z score.The prevalence of the metabolic syndrome increased with the severity of obesity and reached 50 percent in severely obese youngsters. Each half-unit increase in the body-mass index, converted to a z score, was associated with an increase in the risk of the metabolic syndrome among overweight and obese subjects (odds ratio, 1.55; 95 percent confidence interval, 1.16 to 2.08), as was each unit of increase in insulin resistance as assessed with the homeostatic model (odds ratio, 1.12; 95 percent confidence interval, 1.07 to 1.18 for each additional unit of insulin resistance). The prevalence of the metabolic syndrome increased significantly with increasing insulin resistance (P for trend, <0.001) after adjustment for race or ethnic group and the degree of obesity. C-reactive protein levels increased and adiponectin levels decreased with increasing obesity.The prevalence of the metabolic syndrome is high among obese children and adolescents, and it increases with worsening obesity. Biomarkers of an increased risk of adverse cardiovascular outcomes are already present in these youngsters.