Abstract
The evolution of obesity and its resulting comorbidities differs depending upon the age of the subject. The dramatic rise in childhood obesity has resulted in specific needs in defining obesity-associated entities with this disease. Indeed, even the definition of obesity differs for pediatric patients from that employed in adults. Regardless of age, one of the earliest metabolic complications observed in obesity involves perturbations in glucose metabolism that can eventually lead to type 2 diabetes. In children, the incidence of type 2 diabetes is infrequent compared to that observed in adults, even with the same degree of obesity. In contrast, insulin resistance is reported to be frequently observed in children and adolescents with obesity. As this condition can be prerequisite to further metabolic complications, identification of biological markers as predictive risk factors would be of tremendous clinical utility. Analysis of obesity-induced modifications of the adipokine profile has been one classic approach in the identification of biomarkers. Recent studies emphasize the utility of metabolomics in the analysis of metabolic characteristics in children with obesity with or without insulin resistance. These studies have been performed with targeted or untargeted approaches, employing different methodologies. This review summarizes some of the advances in this field while emphasizing the importance of the different techniques employed.
Highlights
In the 21st century new holistic approaches have been developed to tackle the systems biology challenge of discerning all the processes that characterize a living system at the molecular level
There is wide geographic and ethnic variability, we recently demonstrated a minimal incidence of type 2 diabetes mellitus (T2DM) in children despite the high number of patients affected with severe obesity in our country [38]
In both pediatric age groups specific factors, including tumor necrosis factor (TNF)α, eotaxin, insulin-like growth factor (IGF)-1, leptin, triglycerides (TGL), monocyte chemeoattractant protein (MCP)1 and brain derived neurotrophic factor (BDNF), were identified as biomarkers involved in insulin resistance
Summary
In the 21st century new holistic approaches have been developed to tackle the systems biology challenge of discerning all the processes that characterize a living system at the molecular level. Insulin resistance, metabolic syndrome, type 2 diabetes mellitus and many other metabolic alterations have been studied with different metabolomic approaches and technologies. Most of these studies have been focused on adults. There is a need to further our knowledge about how these alterations, which are at times hard to characterize in growing children, debut and how they develop in the pediatric population. In light of our previous experience in the field, we have reviewed the current scientific literature on metabolomic studies in children and adolescents with obesity and/or insulin resistance. In order to provide insight into the type of results that can be obtained by using different metabolomics procedures, we have organized the available literature according to the methodology (i.e., untargeted, semi-targeted, targeted) used to perform the metabolomics study, highlighting the main results obtained with each approach
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