Can the Metabolic Syndrome identify children with insulinresistance

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Can the Metabolic Syndrome identify children with insulin-resistance? Valeria Hirschler, M.D, Maria L Calcagno, Claudio Aranda, Gustavo Maccallini and Mauricio Jadzinsky, M.D. Durand Hospital, Buenos Aires, Argentina E-mail:vhirschler@intramed.net

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Haffner SM Diabetes. 41: 715–722. 1992 Obesity plays a central role in the Metabolic Syndrome, which also includes insulin resistance, hypertension and hyperlipidemia. Early identification of the Metabolic Syndrome is important in order to identify those most at risk for T2DM Background

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Objective: To determine the association between children's Metabolic Syndrome and Insulin-resistance

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167 school children were examined. Mean age = 6.7 +/-3 y April-August 2004 BMI, waist, BP, Tanner, glucose, Insulin, Lipids, CRP, adiponectin 73 were Obese, 41 overweight Methods

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Inclusion criteria Normal physical examinations Normal renal and thyroid function Exclusion criteria Use of medication that alters BP or glucose or lipid metabolism

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Criteria for Pediatric Metabolic Syndrome. *based on our measurements of 5130 normal children (unpublished data)

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Results

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2.0 1.7 -0.1 2.6 1.3 -0.4 128.3 73 67.8 35.3 51.5 53 116.8 101.4 96.6 89.1 85.6 83.1 2.6 1.5 0.8 21.5 28.7 30.4 0.5 0.3 0.2 * P<0.05; ** P<0.01 Clinical and metabolic characteristics according to OW/OB

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Prevalence of risk factors for the MS

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Results 129 (77%), 20 (12%), 10 (6%), and 8 (5%) were Tanner stage I, II, III, and IV respectively HOMA-IR for patients with one through four components for metabolic syndrome was higher (Beta = 0.6; 95%CI: 0.4-0.7; P<0.0001) The prevalence of metabolic syndrome rises with increasing Tanner stage as insulin-resistance increases in puberty ( p=0.019).

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0 1 2 1,2 1,52 2 HOMA-IR: OR 1.52 p=0.007 Logistic Regression Analysis Dependent variable: metabolic syndrome; N=167

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Conclusion Insulin-resistance was associated with pediatric metabolic syndrome. This suggests that early identification of metabolic syndrome could predict future CVD and T2DM

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