Comparison of various maternal anthropometric indices of obesity for identifying metabolic syndrome in offspring

Optimal Cutoff Points for Anthropometric Variables to Predict Insulin Resistance in Polycystic Ovary Syndrome

BACKGROUND

Insulin resistance (IR) is a major cardiometabolic risk factor in females with polycystic ovary syndrome (PCOS). The euglycemic clamp is the gold standard method to measure IR. However, considering the time and cost that it takes, surrogate markers of IR are now widely used. The current study aimed at evaluating the cutoff points of even less invasive anthropometric and body composition variables to predict IR in females with PCOS.

METHODS

The current cross sectional study selected 224 females with PCOS, using Rotterdam criteria, referred to reproductive endocrinology research center; 88 of which were diagnosed with insulin resistance. Receiver operating characteristics curve was used to explore the best cutoff values of each anthropometric and body composition measures. IR was defined as homeostasis model assessment formula greater or equal to 2.6: HOMA-IR = fasting insulin (mU/L) × fasting plasma glucose (mM/L)/22.5.

RESULTS

The highest area under the curve (0.751) was for the multiplication of waist circumference (WC) by body mass index (BMI), as a single index. The highest sensitivity and specificity were for body water (BW) percentage (82% for values greater than 32.85%) and WC (79% for values greater than 88 cm), respectively.

CONCLUSIONS

It was concluded that there were simple anthropometric variables; e.g., WC × BMI, percentage of BW, and WC that could help to estimate IR in clinical settings especially when the gold standard or surrogate markers of IR were unavailable.

Association of the Pro12Ala Polymorphism with the Metabolic Parameters in Women with Polycystic Ovary Syndrome

AIM:

To investigate the association of peroxisome proliferator-activated receptor gamma (PPARG) Pro12Ala polymorphism with polycystic ovary syndrome (PCOS) and its effect on the metabolic parameters in PCOS women.

METHODS:

The study used PCR to identify the presence of the PPARG Pro12Ala polymorphism in 100 PCOS women and 120 age-matched healthy women. All participants were subjected to anthropometry, biochemical and metabolic evaluation.

RESULTS:

Significant difference in the genotypes distributions of PPARG Pro12Ala polymorphism was observed among PCOS women and controls (p = 0.03). The frequency of the polymorphic allele Ala was significantly higher in PCOS cases than that in the controls (OR = 2.01, p = 0.01). The carries of the variant allele Ala in PCOS women showed significant higher values in body mass index (BMI), systolic and diastolic blood pressure, waist circumference, waist to hip ratio, sum of skin folds, fasting blood glucose, fasting blood insulin, HOMA-IR, fasting triglycerides, total cholesterol and low-density lipoprotein than non-carriers.

CONCLUSION:

The PPARG Pro12Ala polymorphism might contribute to the risk of PCOS and abnormal metabolic parameters and could be considered as a biomarker for early diagnosis and clinic prediction of metabolic complications.

Parental determinants of metabolic syndrome among adolescent Asian Indians: A cross-sectional analysis of parent-offspring trios

BACKGROUND

The aim of the present study was to investigate the relationship between parental metabolic syndrome (MS) and the risk of MS and associated abnormalities in adolescent offspring.

METHODS

This cross-sectional study was performed on 304 adolescents (12-16 years; 236 children with at least one parent and 124 father-mother-child trios) recruited from four schools representing different socioeconomic strata from Vellore, India. Anthropometric data was collected and blood pressure, blood glucose, and lipids were measured.

RESULTS

The prevalence of MS in adolescent offspring, fathers, and mothers was 3.3%, 52.5%, and 48.7% respectively. The most commonly observed metabolic abnormality among adolescents was lower high-density lipoprotein. Maternal waist circumference (WC) was strongly correlated with adolescent body mass index (P = 0.007), WC (P < 0.001), serum triglycerides (P = 0.02), and systolic (P = 0.005) and diastolic (P = 0.01) blood pressure. Maternal MS status was significantly associated with a greater risk of central obesity (WC odds ratio [OR] 2.02; 95% confidence interval [CI] 1.21-3.17) in offspring. Both parents having MS conferred a significant effect on the child's WC (OR 1.21; 95% CI 1.72-2.07) and increased risk of MS (OR 6.19; 95% CI 1.64-23.26).

CONCLUSIONS

This study highlights the possible heritable parental components that may contribute to the MS phenotype in offspring: MS in adolescent offspring is related to parental MS status, and maternal traits reflect offspring adiposity and metabolic traits more strongly than paternal factors. Therefore, adolescent children of parents with MS should be targets for primordial prevention of cardiometabolic disease.

Stressed hearts in children with obesity and diabetes: a cause for concern?

Obesity in young people is an emerging public health problem, particularly because of its association with type 2 diabetes. Since obesity and diabetes contribute to the development of cardiovascular disease in adults, the question arises as to whether or not these conditions may be associated with cardiovascular abnormalities in children and adolescents. In this issue of Diabetologia, Shah et al. report the results of a cross-sectional study of heart structure and function in 612 adolescents and young adults (aged 10-24 years) subdivided into three groups: (1) those with obesity and type 2 diabetes; (2) those with type 2 diabetes but without obesity; and (3) lean healthy controls. Their results revealed that left ventricular mass (indexed to body surface area) was greater in the obese individuals than in lean controls. Left ventricular systolic function was more dynamic in obese participants and obese participants with type 2 diabetes compared with lean controls, whereas systolic function was comparable in obese patients with or without type 2 diabetes. Furthermore, compared with the healthy lean control participants, diastolic function was impaired in the obese group and further impaired in the obese individuals with diabetes. These results, and those of a few other similar studies, lend support to the notion that obesity and diabetes in children cause subtle abnormalities in cardiovascular structure and function. The present commentary discusses potential mechanisms and possible clinical ramifications for such findings.