title: Insulin resistance in obese children and adolescents.
abstract: OBJECTIVE
  To evaluate the presence of insulin resistance and its association with other metabolic abnormalities in obese children and adolescents.
  
  
  METHODS
  Retrospective study of 220 children and adolescents aged 5-14 years. Anthropometric measurements were performed (weight, height, and waist circumference) and clinical (gender, age, pubertal stage, and degree of obesity) and biochemical (glucose, insulin, total cholesterol, and fractions, triglycerides) data were analyzed. Insulin resistance was identified by the homeostasis model assessment for insulin resistance (HOMA-IR) index. The analysis of the differences between the variables of interest and the HOMA-IR quartiles was performed by ANOVA or Kruskal-Wallis tests.
  
  
  RESULTS
  Insulin resistance was diagnosed in 33.20% of the sample. It was associated with low levels of high-density lipoprotein cholesterol (HDL-C; p=0.044), waist circumference measurement (p=0.030), and the set of clinical and metabolic (p=0.000) alterations. Insulin-resistant individuals had higher mean age (p=0.000), body mass index (BMI; p=0.000), abdominal circumference (p=0.000), median triglycerides (p=0.001), total cholesterol (p≤0.042), and low-density lipoprotein cholesterol (LDL-C; p≤0.027); and lower HDL-C levels (p=0.005). There was an increase in mean BMI (p=0.000), abdominal circumference (p=0.000), and median triglycerides (p=0.002) as the values of HOMA -IR increased, with the exception of HDL-C, which decreased (p=0.001). Those with the highest number of simultaneous alterations were between the second and third quartiles of the HOMA-IR index (p=0.000).
  
  
  CONCLUSIONS
  The results confirmed that insulin resistance is present in many obese children and adolescents, and that this condition is associated with alterations that represent an increased risk for developing metabolic disorders in adulthood.
authors.affiliation: Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil. Electronic address: monica.nutricardio@hotmail.com.
authors.forename: Monica Cristina dos Santos
authors.initials: MC
authors.lastname: Romualdo
authors.affiliation: Department of Pediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
authors.forename: Fernando José de
authors.initials: FJ
authors.lastname: Nóbrega
authors.affiliation: Department of Pediatrics, Discipline of Nutrology, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
authors.forename: Maria Arlete Meil Schimith
authors.initials: MA
authors.lastname: Escrivão
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D001938:Brazil; D002648:Child; D002675:Child, Preschool; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007328:Insulin; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000378:metabolism; D009765:Obesity / Q000150:complications* / Q000378:metabolism; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D007328:Insulin; D014280:Triglycerides; D002784:Cholesterol
keywords: Adolescent; Adolescente; Child; Criança; Fatores de risco; Insulin resistance; Metabolic syndrome; Obesidade; Obesity; Resistência à insulina; Risk factors; Síndrome metabólica