Sex, puberty, and ethnicity have a strong influence on growth and metabolic comorbidities in children and adolescents with obesity: Report on 1300 patients (the Madrid Cohort)
2019; Wiley; Volume: 14; Issue: 12 Linguagem: Inglês
10.1111/ijpo.12565
ISSN2047-6310
AutoresGabriel Ángel Martos‐Moreno, Julián Martínez‐Villanueva, Rocío González‐Leal, Julie A. Chowen, Jesús Argente,
Tópico(s)Diet, Metabolism, and Disease
ResumoSummary Background The capacity to correctly assess insulin resistance and its role in further obesity‐associated metabolic derangement in children is under debate, and its determinants remain largely unknown. Objective We investigated the association of the insulin secretion profile with other metabolic derangements and anthropometric features in children and adolescents with obesity, exploring the role of ethnicity. Patients and Methods Growth and metabolic features, including fasting insulin levels and insulin secretory profile in an oral glucose tolerance test (OGTT), were analyzed according to ethnicity in 1300 patients with obesity (75.8% Caucasians/19.0% Latinos). Results Height and bone age were influenced by sex, ethnicity, and insulinemia. Latino patients had higher insulin ( P < .001), but similar glycemia both prepubertally and postpubertally, compared with Caucasians. Type 2 diabetes was uncommon (0.1%). Impaired glucose tolerance was associated to higher age, BMI, uric acid, and triglyceride levels (all P < .05), as was fasting hyperinsulinism. Impaired fasting glucose or HbA1c 5.7% to 6.4% showed no association with further metabolic derangement. A delayed insulin peak in the OGTT was associated to more severe metabolic disturbances. Conclusions Obesity‐associated hyperglycemia is unusual in our environment whereas fasting and late postprandial hyperinsulinemia are highly prevalent, with this being influenced by race and closely related with lipid metabolism impairment.
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