Effect of diet and physical exercise treatment on insulin resistance syndrome of schoolchildren.
BACKGROUND
Insulin resistance syndrome (IRS) of schoolchildren may contribute to cardiovascular diseases (CVD) of young adults. The investigation of different steps, baseline screening parameters and treatment of IRS may help the prevention.


METHODS
Schoolchildren (53 boys and 61 girls age 5-17 years) because of adverse family history of CVD, hypertension, and obesity were investigated. Patients were divided into 3 groups according to baseline plasma glucose level (PGL) 120 and 180 min. after glucose consumption (GC): (1) PGL < or = 5.5 mmol/L 180 min. after GC, (2) PGL > or = 5.5 mmol/L 180 min. but < or = 7.8 mmol/L 120 min. after GC (3) PGL > or = 7.8 mmol/L 120 min. after GC. Body mass index (BMI), blood pressure (BP) and parameters of glucose and lipid metabolism were measured at baseline and after two year's lifestyle modification.


RESULTS
No significant difference was found in the prevalence of cardiovascular risk factors (CRF) between groups 2 and 3. Fasting PGL > 5.5 mmol/L was found in 1, 2, and 6 cases; HOMA index > 4.4 in 7 (24%), 21 (37%), and 9 (35%) subjects; OGIS index < 400 in 3(10%), 29(51%) and 11 (42%) schoolchildren of groups 1, 2, 3, respectively. Lifestyle modification significantly improved BMI, systolic BP, serum triglyceride and HDL-cholesterol levels and insulin sensitivity.


CONCLUSIONS
PGL measured 180 minutes after GC may define an important subgroup of pre-diabetic children. The similar prevalance of CRF in both praediabetic groups underlines the importance of this subgroup. Lifestyle modification for two years improves CRF in this population.
Szamosi
Anna
A
2nd Department of Pediatrics, Medical Faculty, Semmelweis University, H-1094 Budapest Tüzoltóu., 7, Hungary. szatam@gyer2.sote.hu
Czinner
Antal
A
Szamosi
Tamas
T
Sallai
Agnes
A
Hatunic
Mensud
M
Berla
Zita
Z
Tomsits
Erika
E
Almássy
Zsuzsa
Z
Nolan
John J
JJ
D000293:Adolescent; D019540:Area Under Curve; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control; D004032:Diet; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000517:prevention & control; D007333:Insulin Resistance; D008019:Life Style; D050356:Lipid Metabolism / Q000502:physiology; D008137:Longitudinal Studies; D008297:Male; D009765:Obesity / Q000517:prevention & control; D012307:Risk Factors; D016896:Treatment Outcome
D001786:Blood Glucose