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).
Conclusion: 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.
Uvod: Epidemija gojaznosti kod dece svih uzrasta u toku poslednjih decenija je plodno polje za istraživanje uzroka i posledica gojaznosti sa glavnim fokusom na uticaju insulinemije i adipocitokina. Metabolička obrada se preporučuje čak i u najmlađoj grupi uzrasta 2–6 godina. Postoje podaci da težina na rođenju može biti faktor pojave i komplikacija gojaznosti kasnije u životu.
Metode: Standardnim testovima analizirani su nivoi insulina, leptina i adiponektina kod 269 gojazne i 60 zdrave dece kao i kod 110 novorođenčadi različite težine na rođenju i različite dužine gestacije.
Rezultati: Faktori rizika za komplikacije gojaznosti kao što su dijabetes melitus, gojaznost, hiperlipidemija, infarkt ili cerebralni insult su nađeni kod 53,6% rođaka gojazne dece. Pik insulinemija na OGTT-u je bila značajno viša u pubertetskoj u poređenju sa pretpubertetskom grupom, 110,5±75,9 μU/mL prema 72,2±62,7 μU/mL (p<0,005). Glikozna intolerancija je potvrđena kod 24% ispitanika. Nivo leptina je signifikantno viši kod gojazne dece a adiponektin je niži u poređenju sa pretpubertetskom decom i kontrolnom grupom (p<0,05). Kod novorođenčadi nivoi leptina i adiponektina su u korelaciji sa antropometrijskim parametrima: težinom, visinom, odnosom težina/visina, indeksom telesne mase i ponderalnim indeksom (p<0,05 i <0,01).
Zaključak: Gojazna deca imaju visoku vrednost insulina u svim uzrastima i ona dostiže najviše vrednosti u pubertetu. Nivoi leptina i adiponektina mogu biti uključeni u indikatore metaboličkog sindroma. Naši nalazi kod novorođenčadi mogli bi uticati na nutritivni pristup ovoj grupi u budućnosti sa ciljem prevencije komplikacija gojaznosti.
Keywords: adiponectin; children; insulinemia; leptin; metabolic setup; obesity.