Prothrombogenic factors and reduced antioxidative defense in children and adolescents with pre-metabolic and metabolic syndrome.
BACKGROUND
The aim of this study was to examine prothrombogenic factors and antioxidative defense in obese children and adolescents with pre-metabolic and metabolic syndrome, and to analyze insulin secretion and resistance, early glycoregulation disorders and lipid status.


METHODS
Insulin sensitivity was determined using the homeostasis model assessment for insulin resistance (HOMA-IR), while insulin secretion was determined using the homeostasis model assessment beta (HOMA-beta). Prothrombogenic factors analyzed were plasma plasminogen activator inhibitor-1 (PAI-1) and fibrinogen. Superoxide dismutase and glutathione peroxidase were measured as markers of antioxidative defense.


RESULTS
Patients with metabolic syndrome were characterized with increased body mass index (BMI), waist circumference, and HOMA-IR and HOMA-beta levels, and all had increased blood pressure and triglyceride levels, low high-density lipoprotein cholesterol levels, increased PAI-1 levels and reduced antioxidative defense levels. Patients with pre-metabolic syndrome had higher levels of basal and mean insulinemia during an oral glucose tolerance test, higher levels of HOMA-beta and lower levels of antioxidative defense compared to patients with metabolic syndrome.


CONCLUSIONS
Negative correlations between antioxidative defense parameters and BMI, abdominal obesity, insulin secretion, systolic blood pressure and atherogenic lipid factors, as well as correlations between PAI-1 and insulin resistance and basal glycemia in the metabolic syndrome group contribute to accelerated atherosclerosis. Positive correlations between PAI-1 and waist circumference and BMI, and negative correlations between BMI and antioxidative defense in the pre-metabolic syndrome patients show that this early stage preceding the metabolic syndrome is also characterized by atherosclerotic complication risks and evident hyperinsulinism and insulin resistance.
Dimitrijevic-Sreckovic
Vesna
V
Institute of Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, Belgrade, Serbia. vesnadsendo@ptt.yu
Colak
Emina
E
Djordjevic
Predrag
P
Gostiljac
Drasko
D
Sreckovic
Branko
B
Popovic
Srdjan
S
Canovic
Fadil
F
Ilic
Miroljub
M
Obrenovic
Radmila
R
Vukcevic
Vladan
V
Nikolic
Dragan
D
Nisic
Tanja
T
Milic
Gordana
G
Pejcic
Gordana
G
D000293:Adolescent; D000328:Adult; D000975:Antioxidants / Q000378:metabolism*; D015992:Body Mass Index; D002648:Child; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D006946:Hyperinsulinism / Q000378:metabolism; D007328:Insulin / Q000378:metabolism; D007333:Insulin Resistance; D000078790:Insulin Secretion; D008055:Lipids / Q000737:chemistry; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis* / Q000235:genetics*; D008954:Models, Biological; D009765:Obesity / Q000150:complications / Q000175:diagnosis; D017395:Plasminogen Activator Inhibitor 1 / Q000378:metabolism
D000975:Antioxidants; D007328:Insulin; D008055:Lipids; D017395:Plasminogen Activator Inhibitor 1