Sex, puberty, and ethnicity have a strong influence on growth and metabolic comorbidities in children and adolescents with obesity: Report on 1300 patients (the Madrid Cohort)

Pediatric obesity - Tập 14 Số 12 - 2019
Gabriel Ángel Martos‐Moreno1,2,3, Julián Martínez‐Villanueva2, Rocío González‐Leal2, Julie A. Chowen1,2, Jesús Argente4,1,2,3
1CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
2Department of Endocrinology, Research Institute “La Princesa” Hospital Infantil Universitario Niño Jesús Avenida Menéndez Pelayo 65E‐28009 Madrid Spain
3Department of Pediatrics, Universidad Autónoma de Madrid, Madrid, Spain
4CEI UAM + CSIC IMDEA Food Institute Madrid Spain

Tóm tắt

SummaryBackgroundThe capacity to correctly assess insulin resistance and its role in further obesity‐associated metabolic derangement in children is under debate, and its determinants remain largely unknown.ObjectiveWe investigated the association of the insulin secretion profile with other metabolic derangements and anthropometric features in children and adolescents with obesity, exploring the role of ethnicity.Patients and MethodsGrowth and metabolic features, including fasting insulin levels and insulin secretory profile in an oral glucose tolerance test (OGTT), were analyzed according to ethnicity in 1300 patients with obesity (75.8% Caucasians/19.0% Latinos).ResultsHeight and bone age were influenced by sex, ethnicity, and insulinemia. Latino patients had higher insulin (P < .001), but similar glycemia both prepubertally and postpubertally, compared with Caucasians. Type 2 diabetes was uncommon (0.1%). Impaired glucose tolerance was associated to higher age, BMI, uric acid, and triglyceride levels (all P < .05), as was fasting hyperinsulinism. Impaired fasting glucose or HbA1c 5.7% to 6.4% showed no association with further metabolic derangement. A delayed insulin peak in the OGTT was associated to more severe metabolic disturbances.ConclusionsObesity‐associated hyperglycemia is unusual in our environment whereas fasting and late postprandial hyperinsulinemia are highly prevalent, with this being influenced by race and closely related with lipid metabolism impairment.

Từ khóa


Tài liệu tham khảo

10.1111/ijpo.12185

10.1111/nyas.13204

Kelly TL, 2005, Pediatric BMD reference database for US white children, Bone, 36, S32

10.1038/ijo.2011.238

10.1111/j.2047-6310.2013.00176.x

10.1016/B978-0-12-407766-9.00006-7

10.1111/j.1399-5448.2007.00271.x

10.1038/oby.2010.68

10.1038/ijo.2016.92

10.1038/ijo.2017.137

10.2337/diab.37.12.1595

10.2337/dc12-0246

Hernández M, 1988, Instituto de Investigación sobre Crecimiento y Desarrollo. Fundación Faustino Orbegozo

Cole TJ, 2000, Establishing a standard definition for child overweight and obesity world‐wide: international survey, BMJ Evid Based Med, 320, 1240

10.1016/j.jpeds.2004.06.044

10.1542/peds.114.2.S2.555

10.1097/00000441-195909000-00030

10.2337/dc19-Sint01

10.1111/j.1464-5491.1995.tb00399.x

10.1016/j.jpeds.2011.12.050

10.1159/000183894

10.1017/S1368980015001937

10.1111/ijpo.12440

10.1097/MED.0b013e32835b7f15

10.1210/jc.2014-1384

10.1016/S0022-3476(98)70144-1

10.1055/s-0035-1559795

10.1002/ajhb.21191

10.1001/jama.2014.3201

10.2337/dc09-S202

10.1111/j.1399-5448.2009.00528.x

10.1111/dme.12269

Report from the Panamerican Health Organization (PHO/WO).2006. . URL:https://www.paho.org/hq/index.php?option=com_content&view=article&id=6717:2012‐about‐diabetes&Itemid=39447&lang=es. Accessed february 21st 2019.

10.1007/s00592-011-0285-x

10.1111/pedi.12461

10.1007/s40618-016-0576-8

10.1177/0009922814528571

10.1016/S0895-7061(02)02953-9

10.1016/j.arcmed.2016.01.003

10.1016/j.metabol.2011.09.003

10.1038/ijo.2011.123

10.7326/0003-4819-139-10-200311180-00007

10.1016/j.jacl.2015.06.008

10.1371/journal.pone.0116110

10.1089/thy.2015.0005

10.1111/j.1467-789X.2012.01033.x

10.1111/j.2047-6310.2014.218.x

10.1056/NEJMoa031049

10.1210/jc.2016-2573

10.1097/01.hjh.0000239291.32883.e3

Thông tin
Thông tin xuất bản

Pediatric obesity

Tập 14 Số 12

Thông tin tác giả