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Many seemingly healthy children show signs of metabolic syndrome
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More than one-quarter of children in a population-based Swedish cohort exhibited at least one risk factor for metabolic syndrome, including increased waist circumference, insulin resistance and higher levels of triglycerides and LDL cholesterol, according to findings published in Acta Paediatrica.
“Even otherwise-healthy children aged 6 years with overweight have metabolic alterations and insulin resistance,” Emma Kjellberg, MD, from the department of pediatrics at the Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sweden, told Endocrine Today. “At this early age, the insulin resistance is reversible, but if not treated it is a first step toward type 2 diabetes.”
Kjellberg and colleagues analyzed data from 212 children who were part of a population-based cohort of full-term infants recruited from a Swedish maternity ward between 2008 and 2011. Researchers examined the children at a mean age of 6.6 years, assessing body weight, BMI, blood pressure and waist circumference, as well as fasting blood glucose and insulin. Researchers calculated insulin resistance via homeostatic model of insulin resistance. The cohort was stratified by BMI cutoffs at age 6.6 years, and by age- and sex-specific cutoffs for waist circumference at or above the 95th percentile and the 90th percentile, defined as at least 59 cm and 58 cm, respectively, for girls and at least 60 cm and 58.5 cm, respectively, for boys.
Within the cohort, six children had obesity, and 31 had overweight; 29 children (14%) had a large waist circumference, including 20 children with overweight and five with obesity. Among 183 children with normal waist circumference, 14 had overweight and one had obesity, according to researchers.
The researchers found that 28% of children with overweight or obesity and 5% of normal-weight children had insulin resistance, defined as a HOMA-IR value at least 1.93 (P < .001). Researchers observed a positive correlation between HOMA-IR value and waist circumference.
In a multiple regression model, researchers found that both waist circumference (beta = 0.06; P < .001) and BMI (beta = 0.15; P < .001) could explain 25% and 23%, respectively, of the HOMA-IR variance when adjusting for several factors, including sex, birth weight, maternal BMI and education.
The researchers found that five children had triglyceride levels at or above the 95th percentile for age and sex (including one child with normal weight), whereas eight children had LDL cholesterol level above the 95th percentile (including six children with normal weight). Seven children had systolic BP at least 120 mm Hg or diastolic BP at least 80 mm Hg, including four with overweight or obesity (P < .001).
In all, researchers observed that 55 children (26%) had one or more risk factors for metabolic syndrome, with 15 children having two or more risk factors. The researchers found correlations between metabolic clustering and BMI (P < .001) and between metabolic clustering and waist circumference (P < .001).
Larger studies in younger children are needed to investigate at what age and BMI insulin resistance begins, as well as longitudinal studies to see the long-term consequences of these early metabolic alterations,” Kjellberg said. – by Regina Schaffer
For more information:
Emma Kjellberg, MD, can be reached at the Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Box 100, SE-405 30, Gothenburg, Sweden; email: emma.kjellberg@gu.se.
Disclosures: The authors report no relevant financial disclosures.
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