Introduction: Leptin, some cytokines and triglycéride/colesterol -HDL ratio (TG/C-HDL ratio) are markers of insulin-resistance in children and adolescents with overweight/obesity. Due to the high prevalence of this pathology its necessary to find and easy and better routinely marker that identify these patients in the outpatient clinic. Previous results demonstrated that TG/C-HDL ratio >2 was a better predictor of metabolic syndrome (sensitivity 100%; specificity 76.7%) than HOMA or insulin, without differences between sex and pubertal stage (P<0.0001).).
Objective: Define if leptin and some cytokines are better markers of insulin-resistance than TG/C-HDL ratio in the pediatric population with overweight/obesity.
Methods: Patients with overweight/obesity defined by Orbegozo 2008 were included. Anthropometric variables (body mass index, waist circumference) were measured with standard methods. Sexual maturity was evaluated by Tanner staging. Abdominal ultrasound scan was performed to detect liver steatosis. Biochemical data: fasting plasma glucose (FPG), 2h OGTT glucose, insulin, HOMA, lipid profile, and C-peptide were analyzed. Cut off point was considered >95th percentile of each variable. Metabolic syndrome was diagnosed according to criteria of Diabetes International Federation. Leptin, adiponectin and osteocalcin were analyzed by enzymoinmunoanalysis. SPSS.19 was used for statistical analysis.
Results: Data from 110 patients (217 years of age) were included, 40% boys and 44.6% pubertal. BMI 27.77 (19.436.98) kg/m2. There is a positive correlation between TG/C-HDL ratio and HOMA (P 0.04), leptin (P 0.04) and osteocalcin (P 0.06) and negative with adiponectin (P 0.09). Those patients (35) with TG/C-HDL ratio >2 have higher levels of leptin (P 0.02). There were no correlation between leptin y/o cytokines levels with liver steatosisbut interestingly patients with this liver disease have significant higher values of the TG/C-HDLratio (P 0.027).
Conclusions: Due to differences in standard values of leptin and cytokines related to age, sex and pubertal stage, TG/C-HDL ratio >2 could be and effective and simple tool to identify the early stage of potential metabolic syndrome in overweight/obese paediatric population at any age and pubertal stage, avoiding expensive resources.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology