Obésité

, Volume 6, Issue 4, pp 235–241 | Cite as

Prévalence du syndrome métabolique chez des enfants obèses tunisiens âgés de 6 à 12 ans

  • M. Abdennebi
  • S. Ben Cheikh
  • A. Bouaziz
  • H. Ochi
  • I. Ayadi
  • I. Khammassi
  • M. Feki
  • N. Kaabachi
  • A. Jmal
  • S. Boukthir
Article / Article
  • 63 Downloads

Résumé

Buts

Déterminer la prévalence du syndrome métabolique (SM) et de ses paramètres, dans une population d’enfants tunisiens obèses et en surpoids et étudier la relation entre SM, leptine et insuline.

Méthodes

Le travail a porté sur une population de 607 enfants âgés de 6 à 12 ans : 75 obèses, 184 en surpoids et 348 témoins de poids normal appariés aux malades selon l’âge et le sexe. Les enfants ont été recrutés dans le cadre d’une enquête épidémiologique portant sur l’étude de l’obésité infantile dans le grand Tunis. L’obésité était définie selon les critères de l’IOTF. Les enfants ont bénéficié d’une mesure des paramètres anthropométriques (poids, taille, tour de taille) et du calcul de l’indice de masse corporelle (IMC, poids/taille2). Un prélèvement sanguin a été pratiqué après 12 heures de jeûne pour le dosage des paramètres biochimiques. L’insulinorésistance était appréciée par le « Homeostasis Model Assesment of Insulin Resistance (HOMA-IR). Le SM était défini par les critères du National Cholesterol Education Program Adult Treatment panel III modifiés par Cook.

Résultats

La prévalence du SM était de 25,3% chez les enfants obèses. Elle était significativement plus élevée que celle trouvée chez les enfants en surpoids (7,6%) et les enfants de poids normal (0,3%) (p < 0,001). La prévalence était plus élevée chez les garçons (37,1%) que chez les filles (15%) (p = 0,035). L’obésité abdominale était présente dans 83,8% des cas. La prévalence de l’hypertension artérielle était de 73%. L’augmentation des triglycérides et la diminution du HDL cholestérol étaient observées dans respectivement 25% et 24% des cas. Aucun des enfants n’a présenté d’élévation de la glycémie à jeun. La leptine était positivement corrélée avec l’IMC (r = 0,545, p < 0,001), le tour de taille (r = 0,542, p < 0,001), la PAS (r = 0,28, p < 0,001), la PAD (r = 0,161, p = 0,011), la glycémie (r = 0,136, p = 0,031), les triglycérides (r = 0,280, p < 0,001), le HOMA (r = 0,389, p < 0,001), l’insuline (r = 0,397, p < 0,001) et le nombre de paramètres du SM (r = 0,284, p < 0,001). Après ajustement par l’IMC, la leptine restait corrélée avec le tour de taille (r = 0,196, p = 0,002), les triglycérides (r = 0,19, p = 0,003), le HOMA (r = 0,283, p < 0,001) et l’insuline (r = 0,284, p < 0,001).

Conclusion

La prévalence du SM chez l’enfant obèse tunisien est de 25,3%. L’obésité abdominale et l’HTA sont les paramètres les plus fréquents. Après ajustement par l’IMC, le tour de taille, les triglycérides, l’insuline et le HOMA présentent une corrélation avec la leptine.

Mots clés

Surpoids Obésité Syndrome métabolique Enfant Leptine 

Prevalence of metabolic syndrome in tunisian obese children aged 6 to 12 years old

Abstract

Aims

To assess the prevalence of metabolic syndrome and its parameters in a cohort of overweight and obese Tunisian schoolchildren and to investigate correlations between metabolic syndrome, leptin and insulin.

Methods

A retrospective study including a sample of 607 schoolchildren (6-12 years; mean: 9.7 ± 1.5 years): obese (n = 75), overweight (n = 184), controls matched to sex and age (n = 348) was conducted. Patients were recruited from a descriptive study conducted in Tunis to assess prevalence of obesity. Overweight and obesity was defined based on international agreed cut-off points. Height, weight, waist circumference were measured and body mass index was calculated. A blood sample was collected from each subject to measure leptin and insulin levels by radioimmunoassay. Insulin resistance was based on the « Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). Metabolic syndrome diagnosis was based on criteria of the National Cholesterol Education Program Adult Treatment panel III modified by Cook.

Results

Prevalence of Metabolic syndrome was 25.3% in obese children (37.1% in boys versus 15% in girls; p = 0.035) compared to 7.6% in overweight and 0.3% in controls (p < 0.001). Prevalence of abdominal obesity, hypertension, hyper triglyceridemia and hypo HDL cholesterol were: 83.8%, 73%, 25% and 24%, respectively. Leptin was positively correlated to BMI (r = 0.545, p < 0.001), waist circumference (r = 0.542, p < 0.001), systolic pressure (r = 0.28, p < 0.001), diastolic pressure (r = 0.161, p = 0.011), glycemia (r = 0.136, p = 0.031), triglycerides levels (r = 0.28, p < 0.001), HOMA (r = 0.389, p < 0.001), insulin (r = 0.397, p < 0.001), and the number of criteria of metabolic syndrome (r = 0.284, p < 0.001). After adjustment for BMI, leptin remained correlated with waist circumference (r = 0.196, p = 0.002), triglycerides levels (r = 0.19, p = 0.003), HOMA (r = 0.283, p < 0.001) and insulin (r = 0.284, p < 0.001).

Conclusions

Prevalence of metabolic syndrome in tunisian obese schoolchildren is 25.3%. Abdominal obesity and hypertension are the most frequent parameters. After adjustment with BMI, waist circumference, triglycerides levels, insulin and HOMA correlate with leptin.

Keywords

Overweight Obesity Metabolic syndrome Child Leptin 

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Copyright information

© Springer-Verlag France 2011

Authors and Affiliations

  • M. Abdennebi
    • 1
  • S. Ben Cheikh
    • 1
  • A. Bouaziz
    • 2
  • H. Ochi
    • 1
  • I. Ayadi
    • 3
  • I. Khammassi
    • 4
  • M. Feki
    • 3
  • N. Kaabachi
    • 3
  • A. Jmal
    • 1
  • S. Boukthir
    • 4
  1. 1.Unité de recherche 04/UR/08603, département des sciences de base AUniversité Tunis El Manar, Faculté de médecineTunisTunisie
  2. 2.Unité de recherche SP06/16, Hôpital d’enfantsUniversité Tunis El ManarTunisTunisie
  3. 3.Laboratoire de biochimiehôpital La RabtaTunisTunisie
  4. 4.Service de pédiatriehôpital régional de BizerteBizerteTunisie

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