Insulin Resistance, Dyslipidemia and Cardiovascular Changes in a Group of
               Obese Children

Pires, António; Martins, Paula; Pereira, Ana Margarida; Silva, Patricia Vaz; Marinho, Joana; Marques, Margarida; Castela, Eduardo; Sena, Cristina; Seiça, Raquel

doi:10.5935/abc.20140206

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Original Articles • Arq. Bras. Cardiol. 104 (04) • Apr 2015 • https://doi.org/10.5935/abc.20140206 copy

Insulin Resistance, Dyslipidemia and Cardiovascular Changes in a Group of Obese Children

Authorship SCIMAGO INSTITUTIONS RANKINGS

Introduction:

Obesity-related comorbidities are present in young obese children, providing a platform for early adult cardiovascular disorders.

Objectives:

To compare and correlate markers of adiposity to metabolic disturbances, vascular and cardiac morphology in a European pediatric obese cohort.

Methods:

We carried out an observational and transversal analysis in a cohort consisting of 121 obese children of both sexes, between the ages of 6 and 17 years. The control group consisted of 40 children with normal body mass index within the same age range. Markers of adiposity, plasma lipids and lipoproteins, homeostasis model assessment-insulin resistance, common carotid artery intima-media thickness and left ventricular diameters were analyzed.

Results:

There were statistically significant differences between the control and obese groups for the variables analyzed, all higher in the obese group, except for age, high-density lipoprotein cholesterol and adiponectin, higher in the control group. In the obese group, body mass index was directly correlated to left ventricular mass (r=0.542; p=0.001), the homeostasis model assessment-insulin resistance (r=0.378; p=<0.001) and mean common carotid artery intima-media thickness (r=0.378; p=<0.001). In that same group, insulin resistance was present in 38.1%, 12.5% had a combined dyslipidemic pattern, and eccentric hypertrophy was the most common left ventricular geometric pattern.

Conclusions:

These results suggest that these markers may be used in clinical practice to stratify cardiovascular risk, as well as to assess the impact of weight control programs.

Pediatric Obesity; Insulin Resistance; Dyslipidemias; Cardiovascular Diseases

	Obese		Non-obese
Variable	N	Mean ± SEM	N	Mean ± SEM	p-value
Age (years)	121	11.65 ± 0.432	40	12.73 ± 0.270	0.038^ Mann-Whitney U test.
BMI	121	28.465 ± 0.438	40	18.933 ± 0.429	< 0.001^* * Student t test;
WC (cm)	121	93.15 ± 1.197	40	68.16 ± 0.861	< 0.001^ Mann-Whitney U test.
%FM (%)	121	36.840 ± 0.647	40	18.544 ± 0.526	< 0.001^* * Student t test;
Leptin (ng/mL)	118	28.973 ± 1.627	40	4.845 ± 0.706	< 0.001
Adiponectin (µg/mL)	95	3.597 ± 0.140	32	5.173 ± 0.413	0.001
HOMA-IR	118	2.81 ± 0.165	33	1.54 ± 0.151	< 0.001^ Mann-Whitney U test.
LVED (mm)	121	45.92 ± 0.54	40	44.28 ± 0.97	NS
LVSD (mm)	121	29.29 ± 0.43	40	27.34 ± 0.74	< 0.023^* * Student t test;
IVS (mm)	121	7.21 ± 0.16	40	7.11 ± 0.22	NS
PWD (mm)	121	7.51 ± 0.17	40	6.92 ± 0.24	0.045^* * Student t test;
LVM (g)	121	108.27 ± 3.75	40	95.80 ± 5.46	NS
LVMI	121	34.30 ± 0.79	40	28.80 ± 0.99	< 0.001^* * Student t test;
RWT	121	0.33 ± 0.080	40	0.32 ± 0.012	NS
cIMT (mm)	119	0.49 ± 0.005	40	0.44 ± 0.055	0.001^ Mann-Whitney U test.
TC (mg/dL)	121	166.86 ± 2.522	40	163.83 ± 5.394	NS
LDL-C (mg/dL)	121	96.45 ± 2.44	40	82.71±3.74	0.003^* * Student t test;
HDL-C (mg/dL)	121	47.33 ± 0.90	40	59.17 ± 2.04	< 0.001^ Mann-Whitney U test.
TG (mg/dL)	121	92.33 ± 4.94	40	59.15 ± 4.28	< 0.001^ Mann-Whitney U test.
Apo A-I (g/L)	114	1.34 ± 0.018	33	1.47 ± 0.043	0.001^* * Student t test;
Apo B (g/L)	114	0.74 ± 0.016	33	0.66 ± 0.032	0.016^* * Student t test;
Lp (a) (mg/dL)	114	27.42 ± 2.56	33	17.6 ± 2.92	0.014^* * Student t test;
Male N(%)	121	61 (50.8%)	40	29 (70.7%)	0.027^* * Student t test;

	BMI (Kg/m²)		WC (cm)		%FM (%)
Variable	Pearson correlation	p-value	Pearson correlation	p-value	Pearson correlation	p-value
LVED (mm)	0,54^** correlation is significant at the 0.05 level and at the * 0.01 level (2-tailed).	< 0.001	0.53^** correlation is significant at the 0.05 level and at the * 0.01 level (2-tailed).	< 0.001	-0.05	0.593
LVSD (mm)	0.46^** correlation is significant at the 0.05 level and at the * 0.01 level (2-tailed).	< 0.001	0.47^** correlation is significant at the 0.05 level and at the * 0.01 level (2-tailed).	< 0.001	-0.06	0.497
IVS (mm)	0.20^* correlation is significant at the 0.05 level and at the * 0.01 level (2-tailed).	0.034	0.16	0.103	0.16	0.082
PWD (mm)	0.34^** correlation is significant at the 0.05 level and at the * 0.01 level (2-tailed).	< 0.001	0.32^** correlation is significant at the 0.05 level and at the * 0.01 level (2-tailed).	0.001	0.14	0.124
LVM (g)	0,54^** correlation is significant at the 0.05 level and at the * 0.01 level (2-tailed).	< 0.001	0,52^** correlation is significant at the 0.05 level and at the * 0.01 level (2-tailed).	< 0.001	0.09	0.324
LVMI	0.26^** correlation is significant at the 0.05 level and at the * 0.01 level (2-tailed).	< 0.001	0.10	0.298	0.09	0.311
RWT	0.06	0.508	0.05	0.578	0.17	0.064
cIMT (mm)	0.21^* correlation is significant at the 0.05 level and at the * 0.01 level (2-tailed).	0.025	0.19^* correlation is significant at the 0.05 level and at the * 0.01 level (2-tailed).	0.047	0.03	0.725
Leptin (ng/mL)	0.34^** correlation is significant at the 0.05 level and at the * 0.01 level (2-tailed).	< 0.001	0.34^** correlation is significant at the 0.05 level and at the * 0.01 level (2-tailed).	< 0.001	0.29^** correlation is significant at the 0.05 level and at the * 0.01 level (2-tailed).	0.002
Adiponectin (µg/mL)	0.18^* correlation is significant at the 0.05 level and at the * 0.01 level (2-tailed).	0.046	0.27^** correlation is significant at the 0.05 level and at the * 0.01 level (2-tailed).	0.004	0.22^** correlation is significant at the 0.05 level and at the * 0.01 level (2-tailed).	0.016
HOMA-IR	0.38^** correlation is significant at the 0.05 level and at the * 0.01 level (2-tailed).	< 0.001	0.36^** correlation is significant at the 0.05 level and at the * 0.01 level (2-tailed).	< 0.001	0.35^** correlation is significant at the 0.05 level and at the * 0.01 level (2-tailed).	< 0.001

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