1
|
Daneshzad E, Rostami S, Aghamahdi F, Mahdavi-Gorabi A, Qorbani M. Association of cardiometabolic risk factors with insulin resistance in overweight and obese children. BMC Endocr Disord 2022; 22:320. [PMID: 36529727 PMCID: PMC9761952 DOI: 10.1186/s12902-022-01245-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 10/17/2022] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Regarding the increased prevalence of obesity among children and adolescents, and the impact of obesity on insulin resistance (IR) and other metabolic disorders, this study was performed to determine the association of cardiometabolic risk factors (CMRFs) with IR in overweight and obese children. METHOD In this cross-sectional study 150 overweight and obese children (BMI ≥ 85th and BMI ≥ 95th age-sex specific percentile) and adolescents were selected via convenient sampling method from Endocrinology clinic in Karaj; Iran in 2020. Anthropometric indices, lipid profile, fasting blood glucose (FBG), and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) were evaluated. IR was defined as HOMA-IR ≥ 2.6. Multivariable linear and logistic regression model was used to assess the association of CMRFs with insulin level and IR respectively. RESULTS The mean age of children was 10.37 (± 2.6) years. Fifty-four percent of the participants were girls. IR was increased through increasing age (P < 0.001). In the multivariate logistic regression model, by increasing each unit increment in waist circumference (OR: 1.03, 95% CI: 1.01-1.06), wrist circumference (OR: 1.47, 95% CI: 1.06-2.02) total cholesterol (OR: 1.01, 95% CI: 1.003-1.03) and FBG (OR: 1.11, 95% CI: 1.05-1.18) the odds of IR increased significantly. Moreover, in the adjusted linear regression model, HOMA-IR was associated significantly with waist to height ratio (β: 2.45), and FBG (β: 0.02). CONCLUSION There was a significant association between some CMRFS with IR in overweight and obese children.
Collapse
Affiliation(s)
- Elnaz Daneshzad
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Sayeh Rostami
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Fatemeh Aghamahdi
- Department of Pediatric Endocrinology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.
- Probiotic Research Center, Alborz University of Medical Sciences, Karaj, Iran.
| | | | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
2
|
Du R, Li L, Li P, Wang Y. Impact of Insulin Resistance on Cardiometabolic Risk Factors and an Anthropometry-Based Predictive Nomogram for Insulin Resistance Among Adolescents in China. Front Endocrinol (Lausanne) 2022; 13:852395. [PMID: 35418950 PMCID: PMC8995502 DOI: 10.3389/fendo.2022.852395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/28/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE We aimed to investigate the impact of insulin resistance (IR), as determined by the homeostasis model assessment of insulin resistance (HOMA-IR), on cardiometabolic risk factors (CMRFs), and develop an anthropometry-based predictive nomogram for IR among adolescents in China. DESIGN Data were acquired from a cross-sectional study with a stratified cluster sampling method, conducted among adolescents in Northeast China. PARTICIPANTS A total of 882 adolescents (aged 12-16 years, 468 boys) were included. MEASUREMENTS All participants underwent anthropometric and biochemical examinations. The thresholds of IR included the 90th percentile of the HOMA-IR for adolescents with a normal body mass index (BMI) and fasting plasma glucose (FPG) level within each sex group (Cutoff A), and the 75th percentile for all participants of the same sex (Cutoff B). RESULTS The HOMA-IR was associated with CMRFs. IR, as defined by both cutoffs A and B, was significantly associated with most CMRFs, except decreased HDL-C levels. Excellent concordance (κ = 0.825) was found between these two criteria in diagnosing IR. However, IR using cutoff A, was more closely associated with cardiometabolic risk. The incidence of IR, as defined by cutoff A, was 18.93% and increased from 10.99% to 43.87% based on the different BMI categories. Further, an anthropometry-based predictive model for IR, incorporating sex, age, waist-to-hip ratio, weight and BMI, was developed and presented as a nomogram. CONCLUSIONS IR among adolescents is strongly related to cardiometabolic risk. We developed an anthropometry-based predictive nomogram for IR among adolescents, which may facilitate health counselling and self-risk assessments.
Collapse
|
3
|
Cardiometabolic risk factors and hypovitaminosis D in adolescents with overweight from a sunny region in northeast Brazil: A cross-sectional study. NUTR HOSP 2021; 39:73-81. [PMID: 34779215 DOI: 10.20960/nh.03745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND obesity can influence vitamin D levels, which in turn might be associated with cardiometabolic risk factors. OBJECTIVES this study assessed the association between 25-hydroxyvitamin D [25(OH)D] levels and cardiometabolic risk factors in adolescents with overweight living in a region of northeastern Brazil. MATERIAL AND METHODS a cross-sectional study was carried out by non-probabilistic sampling in adolescents diagnosed with overweight or obesity. The subjects were divided according to their 25(OH)D status into two groups: sufficient vitamin D and hypovitaminosis D. Biodemographic, lifestyle, cardiometabolic, and biochemical factors were evaluated. A logistic regression model was applied to determine the predictors of hypovitaminosis D. RESULTS we found a high frequency of hypovitaminosis D (45.6 %) in adolescents. Weekly sun exposure was negatively associated with hypovitaminosis D (OR = 0.96; 95 % CI: 0.92-0.99), while significant positive associations were observed between hypovitaminosis D and blood pressure above the 95th percentile (OR = 4.00; 95 % CI: 1.19-13.37), body weight (OR = 1.04; 95 % CI: 1.01-1.07), and fasting insulin (OR = 1.13; 95 % CI: 1.05-1.22). CONCLUSION hypovitaminosis D showed a high prevalence in adolescents with overweight living in a sunny region of northeastern Brazil, and cardiometabolic risk factors such as systemic arterial hypertension, high body weight, and hyperinsulinemia are predictors of hypovitaminosis D.
Collapse
|
4
|
Siqueira de Andrade MI, Oliveira JS, Leal VS, Cabral PC, de Lira PIC. Independent predictors of insulin resistance in Brazilian adolescents: Results of the study of cardiovascular risk in adolescents-Brazil. PLoS One 2021; 16:e0246445. [PMID: 33561171 PMCID: PMC7872259 DOI: 10.1371/journal.pone.0246445] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 01/19/2021] [Indexed: 12/16/2022] Open
Abstract
Considering the current changes in dietary patterns and the increasing prevalence of excess weight throughout the world, several studies have reported insulin resistance, which is a key driver of many chronic diseases, to be an important public health problem in all age groups. Therefore, the aim of the present study was to identify the prevalence and independent predictors of insulin resistance in Brazilian adolescents. A cross-sectional study was conducted with a probabilistic, representative sample of Brazilian adolescents (n = 37,023) who participated in the Study of Cardiovascular Risk in Adolescents. Data were collected on demographic, socioeconomic, lifestyle, anthropometric, and biochemical characteristics as well as antioxidant micronutrient intake (vitamins A, C, E, zinc, and selenium). Insulin resistance was determined using the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and classified based on the 75th percentile of the sample distribution. Insulin resistance was detected in 27% of the adolescents and was more prevalent among those aged 12 to 14 years (PR: 1.26 [95%CI: 1.13;1.41]), those residing in the southern and south-eastern regions of the country (PR: 1.47 [95%CI: 1.27;1.70]), those who were physically inactive (PR: 1.12 [95%CI: 1.02;1.23]), and those did not consume alcohol (PR: 1.50 [95%CI: 1.13;1.99]). The prevalence of insulin resistance was 2.5-fold higher among individuals with severe obesity (PR: 2.49 [95%CI: 2.07;3.00]). Waist circumference indicative of cardiovascular risk and high serum triglyceride levels increased the likelihood of insulin resistance (PR: 1.37 [95%CI: 1.19;1.59] and 1.60 [95%CI: 1.45;1.78], respectively). The prevalence of the outcome was higher among adolescents in the lower quartiles of vitamin E intake (p<0.05). In the present study, the prevalence of insulin resistance was high among Brazilian adolescents and we identified sociodemographic, lifestyle, anthropometric, biochemical, and dietary predictors of this outcome.
Collapse
Affiliation(s)
| | - Juliana Souza Oliveira
- Departamento de Nutrição, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
- Núcleo de Nutrição, Centro Acadêmico de Vitória, Universidade Federal de Pernambuco, Vitória de Santo Antão, Pernambuco, Brazil
| | - Vanessa Sá Leal
- Departamento de Nutrição, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
- Núcleo de Nutrição, Centro Acadêmico de Vitória, Universidade Federal de Pernambuco, Vitória de Santo Antão, Pernambuco, Brazil
| | - Poliana Coelho Cabral
- Departamento de Nutrição, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
| | | |
Collapse
|
5
|
Jurkovičová J, Hirošová K, Vondrová D, Samohýl M, Štefániková Z, Filová A, Kachútová I, Babjaková J, Argalášová Ľ. The Prevalence of Insulin Resistance and the Associated Risk Factors in a Sample of 14-18-Year-Old Slovak Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18030909. [PMID: 33494341 PMCID: PMC7908586 DOI: 10.3390/ijerph18030909] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/14/2021] [Accepted: 01/18/2021] [Indexed: 02/06/2023]
Abstract
The prevalence of cardiometabolic risk factors has increased in Slovakian adolescents as a result of serious lifestyle changes. This cross-sectional study aimed to assess the prevalence of insulin resistance (IR) and the associations with cardiometabolic and selected lifestyle risk factors in a sample of Slovak adolescents. In total, 2629 adolescents (45.8% males) aged between 14 and 18 years were examined in the study. Anthropometric parameters, blood pressure (BP), and resting heart rate were measured; fasting venous blood samples were analyzed; and homeostasis model assessment (HOMA)-insulin resistance (IR) was calculated. For statistical data processing, the methods of descriptive and analytical statistics for normal and skewed distribution of variables were used. The mean HOMA-IR was 2.45 ± 1.91, without a significant sex differences. IR (cut-off point for HOMA-IR = 3.16) was detected in 18.6% of adolescents (19.8% males, 17.6% females). IR was strongly associated with overweight/obesity (especially central) and with almost all monitored cardiometabolic factors, except for total cholesterol (TC) and systolic BP in females. The multivariate model selected variables such as low level of physical fitness, insufficient physical activity, breakfast skipping, a small number of daily meals, frequent consumption of sweetened beverages, and low educational level of fathers as significant risk factors of IR in adolescents. Recognizing the main lifestyle risk factors and early IR identification is important in terms of the performance of preventive strategies. Weight reduction, regular physical activity, and healthy eating habits can improve insulin sensitivity and decrease the incidence of metabolic syndrome, type 2 diabetes, and cardiovascular disease (CVD).
Collapse
|
6
|
The relationship between cardiometabolic risks and vitamin D levels with the degree of obesity. Turk Arch Pediatr 2020; 54:256-263. [PMID: 31949417 PMCID: PMC6952469 DOI: 10.14744/turkpediatriars.2019.98372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 10/01/2019] [Indexed: 01/02/2023]
Abstract
Aim: The aim of this study was to evaluate the cardiometabolic risk factors including vitamin D levels according to the degree of obesity in adolescents. Material and Methods: This is a retrospective cross-sectional study. A total of 363 overweight/obese adolescents aged between 11 and 18 years who were evaluated in our clinic from January 2012 to December 2015 were included in the study. The degree of obesity was calculated as the body mass index standard deviation. Hypertension, dyslipidemia, hyperinsulinemia, hyperglycemia, insulin resistance, and vitamin D deficiency were defined as cardiometabolic risk factors. Mann-Whitney U, Chi-square, Spearman and Pearson’s correlation tests, and linear regressions analyses were used for statistical analyses. Results: Of the 319 (n=319/363) adolescents, all of whose cardiometabolic risk factors were known, 267 (85.7%) had at least one cardiometabolic risk factor. The body mass index standard deviation had a positive correlation with the number of cardiometabolic risk factors (p<0.001). In the linear regression models in which sex and age were considered as covariates, an increase of one unit in the body mass index standard deviation led to an increase of 6.085 mm Hg in systolic blood pressure, 4.4 mm Hg in diastolic blood pressure, 1.59 points in HOMA-IR, 13% in insulin level, and a decrease of 2.16 ng/mL in vitamin D levels. Conclusion: In adolescents, the number of cardiometabolic risk factors increases as the degree of obesity increases. The determination of the severity of obesity can help to identify individuals at greater risk for higher blood pressure, impaired glucose metabolism, and lower serum vitamin D levels. On the other hand, the degree of obesity may not reflect the presence of abnormal lipid and glucose levels.
Collapse
|
7
|
Cardenas-Vargas E, Nava JA, Garza-Veloz I, Torres-Castañeda MC, Galván-Tejada CE, Cid-Baez MA, Castañeda-Arteaga RE, Ortiz-Castro Y, Trejo-Ortiz PM, Araujo-Espino R, Mollinedo-Montaño FE, Muñoz-Torres JR, Martinez-Fierro ML. The Influence of Obesity on Puberty and Insulin Resistance in Mexican Children. Int J Endocrinol 2018; 2018:7067292. [PMID: 30254673 PMCID: PMC6140127 DOI: 10.1155/2018/7067292] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 06/13/2018] [Indexed: 12/20/2022] Open
Abstract
Obesity is considered the main risk factor associated with the development of insulin resistance (IR). The aim of this study was to evaluate the influence of obesity on puberty onset and IR in Mexican children. A total of 378 children (189 boys and 189 girls) aged 8-14 years participated in the study. IR was estimated using the homeostasis model assessment for IR (HOMA-IR). The mean fasting glucose (FG) and basal insulin levels were 82 mg/dl and 11.0 μIU/ml in boys and 77.3 mg/dl and 12.3 μIU/ml in girls (P < 0.05). Subjects with obesity at Tanner stages II-V showed increased FG levels (P < 0.05). In boys with obesity, there was a decrease in HOMA-IR in Tanner stage IV and differences in age between boys with normal weight and those with obesity in Tanner V, being older the boys with obesity. Obesity in children and adolescents was associated with higher HOMA-IR values. In boys with obesity, IR increased at the end of pubertal maturation, with a delay in puberty. These findings should be considered on the establishment of IR cutoff values for pubertal population in Mexico and in the establishment of strategies to prevent the health problems related to obesity.
Collapse
Affiliation(s)
- Edith Cardenas-Vargas
- Hospital General Zacatecas “Luz González Cosío”, Servicios de Salud de Zacatecas, Zacatecas, 98160 ZAC, Mexico
- Molecular Medicine Laboratory, Unidad Academica de Medicina Humana y C.S., Universidad Autonoma de Zacatecas, Zacatecas, 98160 ZAC, Mexico
| | - Jairo A. Nava
- Molecular Medicine Laboratory, Unidad Academica de Medicina Humana y C.S., Universidad Autonoma de Zacatecas, Zacatecas, 98160 ZAC, Mexico
| | - Idalia Garza-Veloz
- Molecular Medicine Laboratory, Unidad Academica de Medicina Humana y C.S., Universidad Autonoma de Zacatecas, Zacatecas, 98160 ZAC, Mexico
- Unidad Academica de Ingenieria Electrica, Universidad Autonoma de Zacatecas, Zacatecas, 98160 ZAC, Mexico
| | - Mayra C. Torres-Castañeda
- Servicio de Endocrinologia Pediatrica, Hospital General “Gaudencio González Garza, ” Centro Medico Nacional La Raza, Instituto Mexicano del Seguro Social (IMSS), 02990 Ciudad de Mexico, Mexico
| | - Carlos E. Galván-Tejada
- Unidad Academica de Ingenieria Electrica, Universidad Autonoma de Zacatecas, Zacatecas, 98160 ZAC, Mexico
| | - Miguel A. Cid-Baez
- Molecular Medicine Laboratory, Unidad Academica de Medicina Humana y C.S., Universidad Autonoma de Zacatecas, Zacatecas, 98160 ZAC, Mexico
| | - Rosa E. Castañeda-Arteaga
- Hospital General Zacatecas “Luz González Cosío”, Servicios de Salud de Zacatecas, Zacatecas, 98160 ZAC, Mexico
- Molecular Medicine Laboratory, Unidad Academica de Medicina Humana y C.S., Universidad Autonoma de Zacatecas, Zacatecas, 98160 ZAC, Mexico
| | - Yolanda Ortiz-Castro
- Molecular Medicine Laboratory, Unidad Academica de Medicina Humana y C.S., Universidad Autonoma de Zacatecas, Zacatecas, 98160 ZAC, Mexico
| | - Perla M. Trejo-Ortiz
- Unidad Academica de Enfermeria, Universidad Autonoma de Zacatecas, Zacatecas, 98160 ZAC, Mexico
| | - Roxana Araujo-Espino
- Unidad Academica de Enfermeria, Universidad Autonoma de Zacatecas, Zacatecas, 98160 ZAC, Mexico
| | | | - Jose R. Muñoz-Torres
- Molecular Medicine Laboratory, Unidad Academica de Medicina Humana y C.S., Universidad Autonoma de Zacatecas, Zacatecas, 98160 ZAC, Mexico
| | - Margarita L. Martinez-Fierro
- Molecular Medicine Laboratory, Unidad Academica de Medicina Humana y C.S., Universidad Autonoma de Zacatecas, Zacatecas, 98160 ZAC, Mexico
- Unidad Academica de Ingenieria Electrica, Universidad Autonoma de Zacatecas, Zacatecas, 98160 ZAC, Mexico
| |
Collapse
|