Abstract
Objective: To verify the prevalence of metabolic syndrome and insulin resistance in obese adolescents and its relationship with different body composition indicators. Methods: A cross-sectional study comprising 79 adolescents aged ten to 18 years old. The assessed body composition indicators were: body mass index (BMI), body fat percentage, abdominal circumference, and subcutaneous fat. The metabolic syndrome was diagnosed according to the criteria proposed by Cook et al. The insulin resistance was determined by the Homeostasis Model Assessment for Insulin Resistance (HOMA-IR) index for values above 3.16. The analysis of ROC curves was used to assess the BMI and the abdominal circumference, aiming to identify the subjects with metabolic syndrome and insulin resistance. The cutoff point corresponded to the percentage above the reference value used to diagnose obesity. Results: The metabolic syndrome was diagnosed in 45.5% of the patients and insulin resistance, in 29.1%. Insulin resistance showed association with HDL-cholesterol (p=0.032) and with metabolic syndrome (p=0.006). All body composition indicators were correlated with insulin resistance (p<0.01). In relation to the cutoff point evaluation, the values of 23.5 and 36.3% above the BMI reference point allowed the identification of insulin resistance and metabolic syndrome. The best cutoff point for abdominal circumference to identify insulin resistance was 40%. Conclusions: All body composition indicators, HDL-cholesterol and metabolic syndrome showed correlation with insulin resistance. The BMI was the most effective anthropometric indicator to identify insulin resistance.
Highlights
Recent data obtained from the Household Budget Survey (HBS) from 2008 to 2009, confirmed the sharp increase in obesity in adolescents over the last 34 years in Brazil
Objetivo: Verificar a prevalência da síndrome metabólica e da resistência à insulina em adolescentes obesos e sua relação com diferentes indicadores de composição corporal
Metabolic syndrome (MS) is a disorder represented by a set of risk factors for cardiovascular disease and, in children and adolescents, the initial changes of each of the factors of MS may occur in varied associations, which, even with little expression, determine an unfavorable cardiovascular profile for these young people[3]
Summary
Recent data obtained from the Household Budget Survey (HBS) from 2008 to 2009, confirmed the sharp increase in obesity in adolescents over the last 34 years in Brazil. The fat accumulation is associated with the presence of hypertension and metabolic changes, such as increased triglyceride and blood glucose levels and low HDL-cholesterol[2]. Metabolic syndrome (MS) is a disorder represented by a set of risk factors for cardiovascular disease and, in children and adolescents, the initial changes of each of the factors of MS may occur in varied associations, which, even with little expression, determine an unfavorable cardiovascular profile for these young people[3]. The level of risk for cardiovascular disease in children rises with increasing obesity[2]. The result is early deposition of fatty plaques in the coronary arteries of adolescents[4]; and the outcome in adulthood is the high incidence of premature mortality from cardiovascular disease in individuals who were obese adolescents[5]
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