title: Metabolic Setup and Risks in Obese Children.
abstract: BACKGROUND
  In the past decades, the obesity epidemic in children of all ages has been an important research field for detecting the metabolic causes and consequences of obesity, the major focus being on insulin and adipocytokine levels. Metabolic work-up in obese children is recommended in the age group as young as 2-6 years. There is evidence that birth weight can be a factor causing obesity later in life accompanied by metabolic complications.
  
  
  METHODS
  Insulin, leptin, and adiponectin levels were analyzed in 269 obese children and 60 controls, as well as 110 newborn children with different birth weight and different length of gestation, using standard methods.
  
  
  RESULTS
  In 53.6% of the obese children, complications of obesity such as diabetes mellitus, obesity, hyperlipidemia, heart attack or stroke were found in family members. The peak insulinemia on OGTT was significantly higher in the pubertal compared to the prepubertal group (110.5± 75.9 μU/mL versus 72.2±62.7 μU/mL) (p<0.005). Glucose intolerance was confirmed in 24%. The leptin level was significantly higher and the adiponectin level was lower in pubertal obese children compared to the prepubertal children and controls (p<0.05). In newborns the leptin and adiponectin levels were in correlation with anthropometric parameters: body weight (BW), body length (BL), BW/BL, BMI, and the pondered index (p<0.05).
  
  
  CONCLUSIONS
  Obese children have high insulinemia in all ages, reaching its peak towards puberty. The leptin and adiponectin levels might be indicators of the metabolic syndrome. Our findings in newborns might influence the nutritional approach in the future in order to prevent complications of obesity.
authors.affiliation: University Pediatric Clinic, Skopje, Republic of Macedonia.
authors.forename: Mirjana
authors.initials: M
authors.lastname: Kocova
authors.affiliation: University Pediatric Clinic, Skopje, Republic of Macedonia.
authors.forename: Elena
authors.initials: E
authors.lastname: Sukarova-Angelovska
authors.affiliation: University Pediatric Clinic, Skopje, Republic of Macedonia.
authors.forename: Milica
authors.initials: M
authors.lastname: Tanaskoska
authors.affiliation: University Pediatric Clinic, Skopje, Republic of Macedonia.
authors.forename: Snezana
authors.initials: S
authors.lastname: Palcevska-Kocevska
authors.affiliation: Institute of Medical and Experimental Biochemistry, Medical Faculty, Skopje, Republic of Macedonia.
authors.forename: Marija
authors.initials: M
authors.lastname: Krstevska
keywords: adiponectin; children; insulinemia; leptin; metabolic setup; obesity