title: [Cardiovascular risk and metabolic profile in obese children and adolescents with low insulin sensitivity].
abstract: BACKGROUND
  Infantile obesity is associated with metabolic disturbances (hyperinsulinism, impaired glucose, dyslipidemia) that determine a higher risk of type 2 diabetes, high blood pressure and atherosclerotic vascular disease in adulthood. Insulin resistance is a central mechanism of complications of obesity and is associated to body fat mass.
  
  
  OBJECTIVE
  To investigate insulin sensitivity and its association with anthropometric and metabolic variables in obese children.
  
  
  METHODS
  We studied 314 children aged 6 to 15 years. Of these, 235 had a body mass index (BMI) over the 95 percentile for age and sex (classified as obese) and 79 had a normal body mass index; 161 were pre-pubescent and 153 were pubescent. Weight, height, percentage of total body fat (% TBF) using the sum of 4 skinfolds, blood pressure (BP), waist circumference (WC), basal glucose (Glu) and insulin (Ins) were measured. Insulin sensitivity (IS) was calculated with the homeostasis model assessment (HOMA) and QUICKI index. Serum lipids, postprandial Glu and Ins were measured only in obese children.
  
  
  RESULTS
  BMI, WC and % TBF had an inverse and significant correlation with basal IS (p <0.001). Obese children had higher BP, basal Ins, and HOMA and a lower QUICKI index, compared to normal weight children. A low basal IS was present in 58% of obese children. Obese children with low IS had higher WC, % TBF, triglycerides, total/HDL-cholesterol ratio, basal and 2-h post glucose Gli and Ins and lower HDL-cholesterol than obese children with normal IS. In prepubescent children, the risk of a low IS was 2.43 times higher with a TBF over 33%. In pubescent children, it was 2.92 times higher with a TBF over 37%.
  
  
  CONCLUSIONS
  Low IS in prepubescent and pubescent obese children is associated with central obesity and a higher cardiovascular.
authors.affiliation: Area de Nutrición Humana, INTA, Universidad de Chile. rburrows@inta.cl
authors.forename: Raquel
authors.initials: R
authors.lastname: Burrows
authors.forename: Medardo
authors.initials: M
authors.lastname: Burgueño
authors.forename: Laura
authors.initials: L
authors.lastname: Leiva
authors.forename: Ximena
authors.initials: X
authors.lastname: Ceballos
authors.forename: Ivette
authors.initials: I
authors.lastname: Guillier
authors.forename: Vivien
authors.initials: V
authors.lastname: Gattas
authors.forename: Lidia
authors.initials: L
authors.lastname: Lera
authors.forename: Cecilia
authors.initials: C
authors.lastname: Albala
mesh_terms: D000293:Adolescent; D001786:Blood Glucose; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology*; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis* / Q000378:metabolism; D009752:Nutritional Status; D009765:Obesity / Q000150:complications* / Q000378:metabolism; D011627:Puberty; D012307:Risk Factors; D012737:Sex Factors
chemical_list: D001786:Blood Glucose