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Metabolic syndrome in obese children born large for gestational age

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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.

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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

References

  1. Wiegand S, Maikowski U, Blankenstein O, Biebermann H, Tarnow P, Gruters A. Type 2 diabetes and impaired glucose tolerance in European children and adolescents with obesity — a problem that is no longer restricted to minority groups. Eur J Endocrinol 2004; 151: 199–206.

    Article  PubMed  CAS  Google Scholar 

  2. Ong KK, Dunger DB. Birth weight, infant growth and insulin resistance. Eur J Endocrinol 2004; 151: U131–U139.

    Article  PubMed  CAS  Google Scholar 

  3. Hediger ML, Overpeck MD, McGlynn A, Kuczmarski RJ, Maurer KR, Davis WW. Growth and fatness at three to six years of age of children born small-or large-for-gestational age. Pediatrics 1999; 104:e33.

    Article  PubMed  CAS  Google Scholar 

  4. Sherry N, Hassoun A, Oberfield SE, et al. Clinical and metabolic characteristics of an obese, Dominican, pediatric population. J Pediatr Endocrinol Metab. 2005; 18: 1063–1071.

    PubMed  Google Scholar 

  5. Wang X, Guyer B, Paige DM. Differences in gestational age-specific birth weight among Chinese, Japanese and white Americans. Int J Epidemiol 1994; 23: 119–128.

    Article  PubMed  CAS  Google Scholar 

  6. Boney CM, Verma A, Tucker R, Vohr BR. Metabolic syndrome in childhood: association with birth weight, maternal obesity, and gestational diabetes mellitus. Pediatrics 2005; 116: 519.

    Article  Google Scholar 

  7. Reaven G. The metabolic syndrome or the insulin resistance syndrome? Different names, different concepts, and different goals. Endocrinol Metab Clin North Am 2004; 33: 283–303.

    Article  PubMed  Google Scholar 

  8. Tresaco B, Bueno G, Pineda I, Moreno LA, Garagorri JM, Bueno M. Homeostatic model assessment (HOMA) index cut-off values to identify the metabolic syndrome in children. J Physiol Biochem 2005; 61: 381–388.

    Article  PubMed  CAS  Google Scholar 

  9. Radikova Z, Koska J, Huckova M et al. Insulin Sensitivity Indices: a Proposal of Cut-Off Points for Simple Identification of Insulin-Resistant Subjects. Exp Clin Endocrinol Diabetes. 2006; 114: 249–256.

    Article  PubMed  CAS  Google Scholar 

  10. Ryder E, Gomez ME, Fernandez V et al. Presence of impaired insulin secretion and insulin resistance in normoglycemic male subjects with family history of type 2 diabetes. Diabetes Res Clin Pract 2003; 60: 95–103.

    Article  PubMed  CAS  Google Scholar 

  11. Matsumoto K, Miyake S, Yano M et al. Glucose tolerance, insulin secretion, and insulin sensitivity in nonobese and obese Japanese subjects. Diabetes Care 1997; 20: 1562–1568.

    Article  PubMed  CAS  Google Scholar 

  12. Surkan PJ, Hsieh CC, Johansson AL, Dickman PW, Cnattingius S. Reasons for increasing trends in large for gestational age births. Obstet Gynecol 2004; 104: 720–726.

    PubMed  Google Scholar 

  13. Ehrenberg HM, Mercer BM, Catalano PM. The influence of obesity and diabetes on the prevalence of macrosomia. Am J Obstet Gynecol 2004; 191: 964–968.

    Article  PubMed  CAS  Google Scholar 

  14. Fowden AL, Hill DJ. Intra-uterine programming of the endocrine pancreas. Br Med Bull 2001; 60: 123–142.

    Article  PubMed  CAS  Google Scholar 

  15. Hediger ML, Overpeck MD, Kuczmarski RJ, McGlynn A, Maurer KR, Davis WW. Muscularity and fatness of infants and young children born small-or large-for-gestational-age. Pediatrics 1998; 102: E60.

    Article  PubMed  CAS  Google Scholar 

  16. Whitaker RC, Pepe MS, Wright JA, Seidel KD, Dietz WH. Early adiposity rebound and the risk of adult obesity. Pediatrics 1998; 101: p. e5

    Article  PubMed  CAS  Google Scholar 

  17. Eriksson JG, Forsen T, Tuomilehto J, Osmond C, Barker DJ. Early adiposity rebound in childhood and risk of Type 2 diabetes in adult life. Diabetologia 2003; 46: 190–194.

    PubMed  CAS  Google Scholar 

  18. Kahn R, Buse J, Ferrannini E, Stern M. The metabolic syndrome: time for a critical appraisal: joint statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care 2005; 28: 2289–2304.

    Article  PubMed  Google Scholar 

  19. Reaven GM. The metabolic syndrome: requiescat in pace. Clin Chem 2005; 51: 931–938.

    Article  PubMed  CAS  Google Scholar 

  20. Golley RK, Magarey AM, Steinbeck KS, Baur LA, Daniels LA. Comparison of metabolic syndrome prevalence using six different definitions in overweight pre-pubertal children enrolled in a weight management study. Int J Obes (Lond). 2006; doi:10.1038/sj.ijo.0803195

  21. Zhang J, Muldoon MF, McKeown RE. Serum cholesterol concentrations are associated with visuomotor speed in men: findings from the third National Health and Nutrition Examination Survey, 1988–1994. Am J Clin Nutr 2004; 80: 291–298.

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Endocrinology, The Children’s Hospital of Zhejiang University School of Medicine, 57 Zhugan Xiang, Hangzhou, 310003, China

    Xiumin Wang,  Li Liang, F. U. Junfen & D. U. Lizhong

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  1. Xiumin Wang
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  2. Li Liang
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  3. F. U. Junfen
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  4. D. U. Lizhong
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Wang, X., Liang, L., Junfen, F.U. et al. Metabolic syndrome in obese children born large for gestational age. Indian J Pediatr 74, 561–565 (2007). https://doi.org/10.1007/s12098-007-0108-9

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  • DOI: https://doi.org/10.1007/s12098-007-0108-9

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