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

SummaryBackground

The 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.

Objective

We 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 Methods

Growth 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).

Results

Height 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.

Conclusions

Obesity‐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


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