Endocrine Abstracts

Obesity is associated with the development of the metabolic syndrome, and the current epidemic of childhood obesity raises enormous concerns regarding future pandemics of diabetes and cardiovascular disease.
We report preliminary data from 26 obese caucasian children (age 3.8-17.8yrs; 16 prepubertal/10 adolescents; mean Body Mass Index Standard Deviation Score (BMI SDS) +3.85 - range 2.61-6.66) who attend our paediatric obesity clinic. BMI SDS was calculated using British 1990 growth reference data and fasting blood was analysed for lipid profiles and insulin sensitivity (Homeostasis Model Assessment). Blood pressures (BP) were recorded in 22.
All adolescents showed a reduction in insulin sensitivity and 50% had a systolic BP above the 95th centile. In the pre-pubertal group, 50% had reduced insulin sensitivity and 30% a systolic BP above the 95th centile. Serum lipid levels (triglycerides and total cholesterol; Low/High-Density Lipoproteins (HDL/LDL)) were analysed with both BMI SDS and insulin sensitivity using Pearson's product moment correlation coefficient. In the obese adolescent group, a significant positive correlation existed between BMI SDS and the total cholesterol/HDL ratio (r=0.52(CI 0.026-0.805);p<0.05). Surprisingly, however, was the finding of a significant positive correlation in all children between insulin sensitivity and both LDL (r=0.41(CI 0.024-0.686);p<0.05) and total cholesterol (r=0.45(CI 0.078-0.714);p<0.05), suggesting that the presence of insulin resistance appears to be associated with better lipid profiles in this group of obese children. There was no correlation between BMI SDS and insulin sensitivity in accordance with data from previous studies.
Taken together this data would suggest that obese adolescents show significant evidence of a clustering of cardiovascular risk factors, with the degree of obesity being an important determinant of the associated cardiovascular risk. Our results also seem to suggest that insulin resistance may be associated with a healthier lipid profile in obese children, although larger studies will be needed to investigate this further.