Metabolic syndrome in obese children born large for gestational age

  • Xiumin Wang
  • Li Liang
  • F. U. Junfen
  • D. U. Lizhong
Original Article

Abstract

Objective

This study was to compare the prevalence of metabolic syndrome (MS) and insulin release in Chinese obese children born large-for-gestational age (LGA) with those born appropriate-for-gestational age (AGA).

Methods

Obese children were divided into LGA group (n = 60) and AGA group (n = 312); clinical and metabolic characteristics were collected. An oral glucose tolerance test was performed to detect glucose and insulin concentration at 0, 30, 60, 90, and 120 min. Differences between parameters were compared in the two groups and MS was determined.

Results

The age of adiposity rebound (AR) was earlier and the period from AR to hospitalization was longer in LGA group than AGA group (4.58 ± 3.35 years vs 5.64 ± 3.08 yr, p=0.016 and 5.87 ± 2.85 yr, vs 4.98 ± 2.7 yr, p=0.02). There were no differences in β-cell function, insulin resistance, insulin sensitivity and Disposition index between the two groups. Fasting insulin (FINS) and area under curve of insulin (AUCI) showed differences between two groups. The prevalence of MS was 65% for LGA group, which was significantly higher than AGA group (42.3%). LGA status increased the risk of MS with hazard ratios of 2.53 [95% confidence intervals (CI): 1.42–4.51]. Timing of AR showed significant negative correlation with hypertriglyceridemia (r = −0.497, P = 0.01). Multiple logistic regression analysis identified age at AR as an independent factor associated with blood triglyceride level. The prevalence of hypertension and hypertriglyceridemia was independently associated with LGA [adjusted odds ratios (95% CI) 2.41 (1.39–4.36), P = 0.003; 2.18(1.21–3.72), P = 0.016].

Conclusions

There was a younger trend in age of AR in obese children born LGA. The prevalence of MS was particularly higher in obese pediatric populations born LGA. Hypertension and hypertriglyceridemia were better components for diagnosis of MS in obese children.

Key words

Metabolic syndrome Large-for-gestational age Hypertension Hypertriglyceridemia Insulin resistance Obesity in children Dyslipidemia 

Abbreviations

ATP III

Third Report of the National Cholesterol Education Program’s Adult Treatment Panel

WHO

World Health Organization

LGA

large-for-gestational age

AGA

appropriate-for-gestational age

MS

metabolic syndrome

AR

adiposity rebound

FINS

fasting serum insulin

FBG

fasting blood glucose

AUCG

area under curve of insulin

AUCI

area under curve of insulin

IR

insulin resistance

DI

disposition index

HOMA-IR

homeostasis model assessment-insulin resistance index

HOMA-ISI

HOMA insulin sensitivity index

HOMA-BCF

HOMA beta-cell function

ΔI30

increase in insulin level at 30 min after glucose loading

ΔG30

increase in glucose level at 30 min after glucose loading

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Copyright information

© Dr. K C Chaudhuri Foundation 2007

Authors and Affiliations

  • Xiumin Wang
    • 1
  • Li Liang
    • 1
  • F. U. Junfen
    • 1
  • D. U. Lizhong
    • 1
  1. 1.Department of EndocrinologyThe Children’s Hospital of Zhejiang University School of MedicineHangzhouChina

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