Differences in Cardiometabolic Risk between Insulin-Sensitive and Insulin-Resistant Overweight and Obese Children
It is known that 15-30% overweight/obese adults do not suffer cardiometabolic consequences. There is limited literature examining factors that can be used to assess cardiometabolic health in overweight/obese children. If such factors can be identified, they would aid in differentiating those most in...
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| Veröffentlicht in: | Childhood obesity 2015-06, Vol.11 (3), p.289-296 |
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| creator | Khan, Unab I McGinn, Aileen P Isasi, Carmen R Groisman-Perelstein, Adriana Diamantis, Pamela M Ginsberg, Mindy Wylie-Rosett, Judith |
| description | It is known that 15-30% overweight/obese adults do not suffer cardiometabolic consequences. There is limited literature examining factors that can be used to assess cardiometabolic health in overweight/obese children. If such factors can be identified, they would aid in differentiating those most in need for aggressive management.
Baseline data from 7- to 12-year-old, overweight, and obese children enrolled in a weight management program at an urban hospital were analyzed. Homeostatic model assessment for insulin resistance (HOMA-IR) |
| doi_str_mv | 10.1089/chi.2014.0112 |
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Baseline data from 7- to 12-year-old, overweight, and obese children enrolled in a weight management program at an urban hospital were analyzed. Homeostatic model assessment for insulin resistance (HOMA-IR) <2.6 was used to define insulin-sensitive and HOMA-IR ≥2.6 was used to defined insulin-resistant participants. Demographics, physical activity measures, and cardiometabolic risk factors were compared between the two phenotypes. Odds ratios (ORs) examining the association between intermediate endpoints (metabolic syndrome [MetS], nonalcoholic fatty liver disease [NAFLD], systemic inflammation, and microalbuminuria) and the two metabolic phenotypes were evaluated.
Of the 362 overweight/obese participants, 157 (43.5%) were insulin sensitive and 204 (56.5%) were insulin resistant. Compared to the insulin-sensitive group, the insulin-resistant group was older (8.6±1.6 vs. 9.9±1.7; p<0.001) and had a higher BMI z-score (1.89±0.42 vs. 2.04±0.42; p=0.001). After multivariable adjustment, compared to the insulin-sensitive group, the insulin-resistant group had higher odds of having MetS (OR, 5.47; 95% confidence interval [CI]: 1.72, 17.35; p=0.004) and NAFLD (OR, 8.66; 95% CI, 2.48, 30.31; p=0.001), but not systemic inflammation (OR, 1.06; 95% CI: 0.56, 2.03; p=0.86) or microalbuminuria (OR, 1.71; 95% CI, 0.49, 6.04; p=0.403).
Using a HOMA-IR value of ≥2.6, clinical providers can identify prepubertal and early pubertal children most at risk. Focusing limited resources on aggressive weight interventions may lead to improvement in cardiometabolic health.</description><identifier>ISSN: 2153-2168</identifier><identifier>EISSN: 2153-2176</identifier><identifier>DOI: 10.1089/chi.2014.0112</identifier><identifier>PMID: 25774664</identifier><language>eng</language><publisher>United States: Mary Ann Liebert, Inc</publisher><subject>Blood Glucose ; Body Mass Index ; Cardiovascular Diseases - epidemiology ; Cardiovascular Diseases - metabolism ; Cardiovascular Diseases - prevention & control ; Child ; Female ; Humans ; Insulin Resistance ; Male ; Metabolic Syndrome - epidemiology ; Metabolic Syndrome - metabolism ; Metabolic Syndrome - prevention & control ; New York - epidemiology ; Original ; Pediatric Obesity - epidemiology ; Pediatric Obesity - metabolism ; Pediatric Obesity - prevention & control ; Phenotype ; Prevalence ; Randomized Controlled Trials as Topic ; Risk Assessment ; Risk Factors ; Weight Reduction Programs - statistics & numerical data</subject><ispartof>Childhood obesity, 2015-06, Vol.11 (3), p.289-296</ispartof><rights>(©) Copyright 2015, Mary Ann Liebert, Inc.</rights><rights>Copyright 2015, Mary Ann Liebert, Inc. 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c448t-1c34a2749ede80513d233a3a0bddb5977081330baa3efcd1d33a40a5f0c79643</citedby><cites>FETCH-LOGICAL-c448t-1c34a2749ede80513d233a3a0bddb5977081330baa3efcd1d33a40a5f0c79643</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25774664$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Khan, Unab I</creatorcontrib><creatorcontrib>McGinn, Aileen P</creatorcontrib><creatorcontrib>Isasi, Carmen R</creatorcontrib><creatorcontrib>Groisman-Perelstein, Adriana</creatorcontrib><creatorcontrib>Diamantis, Pamela M</creatorcontrib><creatorcontrib>Ginsberg, Mindy</creatorcontrib><creatorcontrib>Wylie-Rosett, Judith</creatorcontrib><title>Differences in Cardiometabolic Risk between Insulin-Sensitive and Insulin-Resistant Overweight and Obese Children</title><title>Childhood obesity</title><addtitle>Child Obes</addtitle><description>It is known that 15-30% overweight/obese adults do not suffer cardiometabolic consequences. There is limited literature examining factors that can be used to assess cardiometabolic health in overweight/obese children. If such factors can be identified, they would aid in differentiating those most in need for aggressive management.
Baseline data from 7- to 12-year-old, overweight, and obese children enrolled in a weight management program at an urban hospital were analyzed. Homeostatic model assessment for insulin resistance (HOMA-IR) <2.6 was used to define insulin-sensitive and HOMA-IR ≥2.6 was used to defined insulin-resistant participants. Demographics, physical activity measures, and cardiometabolic risk factors were compared between the two phenotypes. Odds ratios (ORs) examining the association between intermediate endpoints (metabolic syndrome [MetS], nonalcoholic fatty liver disease [NAFLD], systemic inflammation, and microalbuminuria) and the two metabolic phenotypes were evaluated.
Of the 362 overweight/obese participants, 157 (43.5%) were insulin sensitive and 204 (56.5%) were insulin resistant. Compared to the insulin-sensitive group, the insulin-resistant group was older (8.6±1.6 vs. 9.9±1.7; p<0.001) and had a higher BMI z-score (1.89±0.42 vs. 2.04±0.42; p=0.001). After multivariable adjustment, compared to the insulin-sensitive group, the insulin-resistant group had higher odds of having MetS (OR, 5.47; 95% confidence interval [CI]: 1.72, 17.35; p=0.004) and NAFLD (OR, 8.66; 95% CI, 2.48, 30.31; p=0.001), but not systemic inflammation (OR, 1.06; 95% CI: 0.56, 2.03; p=0.86) or microalbuminuria (OR, 1.71; 95% CI, 0.49, 6.04; p=0.403).
Using a HOMA-IR value of ≥2.6, clinical providers can identify prepubertal and early pubertal children most at risk. Focusing limited resources on aggressive weight interventions may lead to improvement in cardiometabolic health.</description><subject>Blood Glucose</subject><subject>Body Mass Index</subject><subject>Cardiovascular Diseases - epidemiology</subject><subject>Cardiovascular Diseases - metabolism</subject><subject>Cardiovascular Diseases - prevention & control</subject><subject>Child</subject><subject>Female</subject><subject>Humans</subject><subject>Insulin Resistance</subject><subject>Male</subject><subject>Metabolic Syndrome - epidemiology</subject><subject>Metabolic Syndrome - metabolism</subject><subject>Metabolic Syndrome - prevention & control</subject><subject>New York - epidemiology</subject><subject>Original</subject><subject>Pediatric Obesity - epidemiology</subject><subject>Pediatric Obesity - metabolism</subject><subject>Pediatric Obesity - prevention & control</subject><subject>Phenotype</subject><subject>Prevalence</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Weight Reduction Programs - statistics & numerical data</subject><issn>2153-2168</issn><issn>2153-2176</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqFkUtLLDEQhYMoKurSrTS4cdNjXp3ubC7I-LiCMKDuQzqpduLtSWuSHvHfm1HvoG5MLRKqPk5V6iB0SPCE4EaemrmbUEz4BBNCN9AuJRUrKanF5votmh10EOMjzodJRrDcRju0qmsuBN9Fz-eu6yCANxAL54upDtYNC0i6HXpnilsX_xUtpBcAX1z7OPbOl3fgo0tuCYX2dp29hehi0j4VsyWEF3AP8_QOzFqIUEznrre50T7a6nQf4eDz3kP3lxf307_lzezqenp2UxrOm1QSw7imNZdgocEVYZYyppnGrbVtJesaN4Qx3GrNoDOW2FzlWFcdNrUUnO2hPx-yT2O7AGvAp6B79RTcQodXNWinvle8m6uHYaly94qJKgucfAqE4XmEmNTCRQN9rz0MY1Skfh9L5rX-iopGYCFzZPT4B_o4jMHnRawoLqWklGSq_KBMGGIM0K3nJlitnFfZebVyXq2cz_zR18-u6f8-szfOe6qk</recordid><startdate>201506</startdate><enddate>201506</enddate><creator>Khan, Unab I</creator><creator>McGinn, Aileen P</creator><creator>Isasi, Carmen R</creator><creator>Groisman-Perelstein, Adriana</creator><creator>Diamantis, Pamela M</creator><creator>Ginsberg, Mindy</creator><creator>Wylie-Rosett, Judith</creator><general>Mary Ann Liebert, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>7TS</scope><scope>5PM</scope></search><sort><creationdate>201506</creationdate><title>Differences in Cardiometabolic Risk between Insulin-Sensitive and Insulin-Resistant Overweight and Obese Children</title><author>Khan, Unab I ; 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There is limited literature examining factors that can be used to assess cardiometabolic health in overweight/obese children. If such factors can be identified, they would aid in differentiating those most in need for aggressive management.
Baseline data from 7- to 12-year-old, overweight, and obese children enrolled in a weight management program at an urban hospital were analyzed. Homeostatic model assessment for insulin resistance (HOMA-IR) <2.6 was used to define insulin-sensitive and HOMA-IR ≥2.6 was used to defined insulin-resistant participants. Demographics, physical activity measures, and cardiometabolic risk factors were compared between the two phenotypes. Odds ratios (ORs) examining the association between intermediate endpoints (metabolic syndrome [MetS], nonalcoholic fatty liver disease [NAFLD], systemic inflammation, and microalbuminuria) and the two metabolic phenotypes were evaluated.
Of the 362 overweight/obese participants, 157 (43.5%) were insulin sensitive and 204 (56.5%) were insulin resistant. Compared to the insulin-sensitive group, the insulin-resistant group was older (8.6±1.6 vs. 9.9±1.7; p<0.001) and had a higher BMI z-score (1.89±0.42 vs. 2.04±0.42; p=0.001). After multivariable adjustment, compared to the insulin-sensitive group, the insulin-resistant group had higher odds of having MetS (OR, 5.47; 95% confidence interval [CI]: 1.72, 17.35; p=0.004) and NAFLD (OR, 8.66; 95% CI, 2.48, 30.31; p=0.001), but not systemic inflammation (OR, 1.06; 95% CI: 0.56, 2.03; p=0.86) or microalbuminuria (OR, 1.71; 95% CI, 0.49, 6.04; p=0.403).
Using a HOMA-IR value of ≥2.6, clinical providers can identify prepubertal and early pubertal children most at risk. Focusing limited resources on aggressive weight interventions may lead to improvement in cardiometabolic health.</abstract><cop>United States</cop><pub>Mary Ann Liebert, Inc</pub><pmid>25774664</pmid><doi>10.1089/chi.2014.0112</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Childhood obesity, 2015-06, Vol.11 (3), p.289-296 |
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| subjects | Blood Glucose Body Mass Index Cardiovascular Diseases - epidemiology Cardiovascular Diseases - metabolism Cardiovascular Diseases - prevention & control Child Female Humans Insulin Resistance Male Metabolic Syndrome - epidemiology Metabolic Syndrome - metabolism Metabolic Syndrome - prevention & control New York - epidemiology Original Pediatric Obesity - epidemiology Pediatric Obesity - metabolism Pediatric Obesity - prevention & control Phenotype Prevalence Randomized Controlled Trials as Topic Risk Assessment Risk Factors Weight Reduction Programs - statistics & numerical data |
| title | Differences in Cardiometabolic Risk between Insulin-Sensitive and Insulin-Resistant Overweight and Obese Children |
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