Metabolic syndrome and risk factors for cardiovascular disease in obese children: the relationship with insulin resistance (HOMA-IR)

Objective: To identify the prevalence of metabolic syndrome and risk factors for the development of cardiovascular diseases and to investigate their relationship with insulin resistance. Methods: This was a cross-sectional study of 52 obese children. The sample was chosen at random after the body mass index [weight (kg)/stature (m)(2)] of 1,550 schoolchildren had been calculated. Children were defined as obese when their BMI was above the 95th percentile of the Centers for Disease Control and Prevention classification. Blood samples were taken after fasting and glycemia, high-density lipoproteins, triglycerides and insulin were all assayed. Body fat was evaluated using dual energy X-ray absorptiometry. Arterial blood pressure and insulin resistance were also measured. Metabolic syndrome was defined according to National Cholesterol Education Program criteria, with cutoff points adjusted for the age of the sample. Results: Metabolic syndrome was detected in 17.3% of the children investigated. Insulin resistance was significantly different for females (3.8 +/- 2.2; 95%CI 2.9-4.8) and males (2.6 +/- 1.3; 95%CI 2.1-3. 1); p = 0.016. Around 44.2% of the sample exhibited at least two risk factors, and 15% exhibited arterial hypertension. Hypertriglyceridemia was observed in 50 and 70.8% of boys and girls, respectively. Lower than desirable high-density lipoprotein levels were only observed among the girls. Conclusions: Obese children exhibited a high prevalence of metabolic syndrome. The children with greater insulin resistance exhibited more risk factors. In the light of these findings intervention measures are necessary in order to prevent excessive weight gain during childhood.