Childhood obesity: Contributing factors and consequences in Indian children

详细信息    查看全文

• 作者：S.K. Singh ; Dheeraj Kapoor ; Rakesh Goyal ; Amit Rastogi ; Sushil Kumar ; O.P. Mishra
• 关键词：Childhood obesity ; Metabolic syndrome ; Hyperinsulinemia ; Free fatty acid
• 刊名：Diabetes & Metabolic Syndrome: Clinical Research & Reviews
• 出版年：2007
• 出版时间：September 2007
• 年：2007
• 卷：1
• 期：3
• 页码：167-172
• 全文大小：130 K

文摘

Childhood obesity is a risk factor for adult morbidity and mortality, independent of body mass index (BMI) in adulthood, family history of cardiovascular disease or cancer, and smoking. The present study was designed with the objectives to study contributing factors of childhood obesity and its metabolic consequences.

Material and methods

Forty-nine obese and 13 normal children in the age range of 5–12 years were recruited. Subjects with hypothyroidism, Cushing's syndrome and any other disease contributing to endogenous obesity were excluded. Weight and height were recorded and BMI was calculated (weight in kg divided by square of height in meters). Children with weight above 90th percentile for age and sex and BMI > 28.5 or >95th percentile for that age were defined as obese. After an overnight fast (10–12 h) blood was drawn for the determination of plasma glucose, serum insulin, lipid profile and free fatty acids.

Observations

The calorie intake in obese children was significantly higher than controls and fatty meal contributed significantly to high calorie intake. Obese children indulged less in outdoor activities than controls. Liver enzymes were significantly higher in the study group. The levels of hepatic enzymes were raised above normal in 26 (53.06 % ) children. Total cholesterol and LDL cholesterol were higher in the study group, but only the LDL values reached statistical significance. Fasting plasma glucose in the study and control groups were 75.25 ± 13.57 and 66.07 ± 9.52 mg/dL respectively and it was significantly higher in the study group (p = 0.009). Fasting insulin and fasting free fatty acid levels in study group were 31.66 ± 17.58 μU/mL and 379.35 ± 148.00 μmol/L and in control group were 8.6 ± 4.98 μU/mL and 263.84 ± 71.00 μmol/L respectively hence both are significantly higher in the obese children.

The mean insulin glucose ratio in the study group was 0.41 ± 11.20. Sixteen (32.65 % ) children had values of more than 0.4, suggesting insulin resistance but none of the control group had insulin glucose ratio above this level. Insulin free fatty acid ratio was also higher in the study group 8.58 ± 6.34 than control group 3.10 ± 1.19. The mean HOMA-R in the study group and control group were 6.08 ± 3.83 and 1.37 ± 0.73 respectively indicating significant insulin resistance in the obese children.

Conclusion

The environment influence like increased calorie intake and decreased physical activity are major determinants of childhood obesity. The biochemical consequences of childhood obesity are hyperinsulinemia, increased LDL, FFA levels and increased hepatic transaminases. The triglycerides, HDL, fasting hyperglycemia and hypertension do not seem to have association with metabolic syndrome in children as seen in adults. Therefore it is proposed that the diagnostic parameters of metabolic syndrome should be redefined in children with population-based values of these new biochemical parameters.