Endocrine Abstracts

Objective To evaluate the prevalence of insulin resistance and metabolic syndrome, to define its components and to reveal their relationships in obese children. Patients and methods A total of 147 obese (BMI higher than 95 centile for age and gender) Caucasian children aged 9-16 years, mean age 13,67±2,43 (75 boys and 72 girls) were examined. Waist and hip circumferences were measured with WHR calculation, arterial blood pressure was registered. Standard 2-h OGTT was performed and fasting immunoreactive insulin (RIA) was evaluated, fasting glucose/insulin ratio <6 considered as insulin resistance. Plasma levels of cholesterol, triglyceride, fibrinogen and plasma fibrinolytic activity were designated. Results Insulin resistance (IR) was revealed in 63 (42,85%) children, although only three of them had insulin level more than 28 microUnits/ml, mean fasting insulin was 15,59 microunits/ml plus/minus 5,96 microunits/ml. Among them combination of 4 main metabolic syndrome components beside IR (total syndrome): arterial hypertension (more than 95 percentiles for age and gender), abdominal obesity (WHR>0,8 in girls and >0,9 in boys), hyperlipidemia (total cholesterol>5,2 mmol/l and trigliceride>2,2 mmol/l), hypercoagulation (fibrinogen>4,0 g\/l, fibrinolytic activity<14%) was determined in 23,8%, 3 components - in 52,4%, 2 components of the syndrome was determined in 23,8% of children. Plasma insulin correlated with BMI (r=0,35, p<0,01), systolic blood pressure (r=0,38, p<0,01), fibrinogen (r=0,36, p<0,03). Correlation between fasting insulin and 2-h-glycemia was negative (r=-0,38, p<0,01).

Conclusions Children with obesity are at high risk of developing insulin resistance and metabolic syndrome, though absolute fasting hyperinsulinemia wasn't revealed in majority of them.