title: [Disorders of lipid metabolism in adolescents with simple obesity].
abstract: BACKGROUND
  Obesity affects approximately 45 millions of children worldwide. Some of them present with secondary dyslipidemia that leads to premature atherosclerosis.
  
  
  OBJECTIVE
  1) Assessment of the frequency and type of dyslipidemia in obese adolescents. 2) An attempt at defining risk factors of atherogenic lipid profile in obese adolescents.
  
  
  METHODS
  In 146 (84 girls/62 boys) obese (mean BMI SDS 4.95, 95% CI 4.62-5.29) adolescents (age 10-18, mean 14.7 years), the levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDLc), high-density lipoprotein cholesterol (HDLc) and triglicerydes (TG) were measured. Atherogenic dyslipidemia was defined as a high TG level with a concomitant low HDLc level. Standard oral glucose tolerance test was performed with the assessment of fasting and after 120' post-load of 75 g of glucose and insulin levels; the insulin resistance index HOMA-IR was calculated.
  
  
  RESULTS
  The mean values of the lipid fractions were in normal ranges: TC 4.64 mmol/L (95% CI 4.48-4.8), LDLc 2.86 mmol/L (95% CI 2.73-2.99), TG 1.4 mmol/L (95% CI 1.3-1.5), and HDLc 1.16 (95% CI 1.1-1.2). However, in 50.69% of the patients (45.24% girls and 58.06% boys), elevated levels of TC, LDLc, and TG were observed respectively in 23.29%, 17.81% and 37.67%, and low HDLc in 15.07% of patients. A total of 10.96% of the patients presented with coexistence of a low HDLc and a high TG. In 26.7%, dyslipidemia was followed by arterial hypertension. There was a reverse correlation between a low HDLc value and BMI SDS [R (-) 0.22, p < 0.05] and not with TC, LDLc, and TG. The relative risk of abnormal lipid profile occurrence was higher in obese patients with insulin resistance (OR 1.72; 95% CI 0.8-3.4; p = 0.12), being significant only for boys (OR 3.67; 95% CI 1.1-12.1; p = 0.03). There was a reverse correlation between fasting insulin level, HOMA-IR and HDLc [R (-) 0.2; p < 0.05; R (-) 0.2; p < 0.05) respectively], as well as TG (R 0.26 ; p < 0.05; R 0.26; p < 0.05, respectively), and between post-load insulin level and TG (R 0.24; p < 0.05).
  
  
  CONCLUSIONS
  1) Lipid disorders occur in about one-half of obese adolescents, of which 10% presents with atherogenic lipid profile. 2) One of the most important risk factors of atherogenic lipid profile occurrence is insulin resistance, especially in boys. The severity of the obesity (BMI-SDS) is of lesser importance.
authors: Klinika Endokrynologii Dzieci i Młodziezy Katedry Pediatrii, Polsko-Amerykański Instytut Pediatrii, Uniwersytet Jagielloński Collegium Medicum, Kraków. malgorzata.wojcik@uj.edu.pl
authors: Małgorzata
authors: M
authors: Wójcik
authors: Dominika
authors: D
authors: Januś
authors: Angelika
authors: A
authors: Maślanka
authors: Anna
authors: A
authors: Olchawa-Czech
authors: Małgorzata
authors: M
authors: Radwańska
authors: Katarzyna
authors: K
authors: Dylag
authors: Katarzyna
authors: K
authors: Dolezal-Ołtarzewska
authors: Dorota
authors: D
authors: Roztoczyńska
authors: Katarzyna
authors: K
authors: Tyrawa
authors: Agata
authors: A
authors: Zygmunt-Górska
authors: Małgorzata
authors: M
authors: Kumorowicz-Czoch
authors: Anna
authors: A
authors: Kalicka-Kasperczyk
authors: Marta
authors: M
authors: Ciechanowska
authors: Małgorzata
authors: M
authors: Stelmach
authors: Joanna
authors: J
authors: Nazim
authors: Jerzy
authors: J
authors: Starzyk
mesh_terms: D000293:Adolescent; D050197:Atherosclerosis / Q000453:epidemiology; D015984:Causality; D002648:Child; D008076:Cholesterol, HDL / Q000378:metabolism; D015897:Comorbidity; D050171:Dyslipidemias / Q000175:diagnosis / Q000453:epidemiology* / Q000378:metabolism*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D015994:Incidence; D007333:Insulin Resistance; D008297:Male; D009765:Obesity / Q000453:epidemiology* / Q000378:metabolism*; D012307:Risk Factors; D014280:Triglycerides / Q000378:metabolism
chemical_list: D008076:Cholesterol, HDL; D014280:Triglycerides