[Carbohydrate and lipid metabolism disorders in obese children and adolescents].
THE AIM of the study was to assess the incidence of: 1. insulin resistance, hyperinsulinemia, impaired glucose tolerance and dyslipoproteinemia in serum of obese children according to the type of obesity; 2. family history of obesity, hypertension and type 2 diabetes mellitus.


METHODS
177 obese children (M/F 80/97) aged 10-17.5 yrs and 38 normostenic children (control group) were screened for carbohydrate and lipid metabolism disorders. BMI (> or =97 c) and WHR (M/F> or =0.9/0.85 -- abdominal adiposity) were estimated. Glycemia (mmol/l) and insulinemia (microIU/ml) at 0, 30, 60, 90, 120 minutes of OGTT were measured. Fasting C-peptide (ng/ml), HbAlc (%). total cholesterol, LDL-Ch, HDL-Ch, triglycerides (mmol/l), I/G ratio (microIU/ml/mg%) and ChT/HDL-Ch atherogenic index were also investigated.


RESULTS
Abdominal adiposity was present in 56.5%. fasting hyperinsulinemia (>20.0 microIU/ml) in 32.2%, insulin resistance (I/G>0.30) in 73.7%; in the group of patients with hyperinsulinemia 66.7% had abdominal adiposity. The glycemia ill OGTT was: normal in 57.0% -- group I; 26.6% did not suit the criteria of normal nor impaired glucose tolerance according to American Diabetes Association (ADA) -- group Ia. The impaired glucose tolerance (IGT) was found in 16.4% -- group II, with fasting hyperinsulinemia in 58.6% and I/G ratio > or =0.30 in 41.3%, HbAlc > 6.2% in 34.5%. Atherogenic lipoproteins levels prevailed (p<0.05) in group Ia and II. The incidence of family history of obesity, hypertension and diabetes mellitus type 2 was higher (statistically not significant, p>0.05) in group Ia and II and significantly higher (p<0.05) in all groups of obese children compared to the control group.


CONCLUSIONS
The results of our study prove that obesity in children is a risk factor for early diabetes mellitus type 2 and atherosclerosis.
Iwanicka
Zdzisława
Z
Katedra i Klinika Endokrynologii Wieku Rozwojowego, Akademia Medyczna im. Piastów Slaskich, ul. Obrońców Poczty Gdańskiej 66/17, 52-204 Wrocław, Poland.
Głab
Ewa
E
Barg
Ewa
E
D000273:Adipose Tissue; D000293:Adolescent; D050197:Atherosclerosis / Q000209:etiology / Q000517:prevention & control; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D002096:C-Peptide / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology* / Q000378:metabolism / Q000517:prevention & control; D050171:Dyslipidemias / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism*; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood*; D008297:Male; D009765:Obesity / Q000150:complications* / Q000378:metabolism*; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D002096:C-Peptide; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D008055:Lipids; D014280:Triglycerides