Insulin resistance and the metabolic syndrome in obese French children.
OBJECTIVE
To estimate the frequency of the metabolic syndrome (MS) and of the insulin resistance syndrome (IRS) in overweight or obese French children and to determine the risk factors.


METHODS
A total of 308 overweight and obese children [166 girls, 142 boys, aged 7-17 years; median body mass index (BMI) 4.7 standard deviation (SD) (Q1-Q3: 3.9-5.8) adjusted for age and sex] were included. The frequency of the MS was assessed with the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) criteria and the frequency of the IRS with World Health Organization (WHO) criteria.


RESULTS
The overall frequency of MS and IRS was 15.9% and 42.5%, respectively. The most common component, after abdominal obesity (95.8%) and IR (71.8%), was elevated systolic blood pressure (28.6%). The frequency of glucose tolerance disorders was low (3.6%). The frequency of MS was independently influenced by homeostatic model assessment (HOMA) (P = 0.06) and waist-to-hip ratio (P = 0.09), whereas the frequency of IRS was influenced by adiposity (degree of obesity: P = 0.02; waist-to-hip ratio: P = 0.05), puberty (P = 0.05) and mother's BMI (P = 0.01). Ethnicity had no effect on either MS or IRS.


CONCLUSIONS
Metabolic complications and IR are frequent in overweight and obese children whereas the frequency of glucose tolerance disorders is very low. IRS is more prevalent than MS, indicating a major role of IR, which could precede the other metabolic complications in obese children. IRS is a relevant marker for the risk of type 2 diabetes (T2D) and cardiovascular complications in obese European children.
Druet
Céline
C
INSERM Unit 690, Hôpital Robert Debré, Paris, France. drucel@yahoo.fr
Dabbas
Myriam
M
Baltakse
Véronique
V
Payen
Catherine
C
Jouret
Béatrice
B
Baud
Christine
C
Chevenne
Didier
D
Ricour
Claude
C
Tauber
Maïthé
M
Polak
Michel
M
Alberti
Corinne
C
Levy-Marchal
Claire
C
D000293:Adolescent; D002648:Child; D004812:Epidemiologic Methods; D005260:Female; D005602:France; D006801:Humans; D006973:Hypertension / Q000150:complications; D007333:Insulin Resistance; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000209:etiology; D009765:Obesity / Q000150:complications*; D011627:Puberty; D013599:Systole; D049629:Waist-Hip Ratio