ESPE Abstracts

Introduction and aims: Obesity is often associated with elevated insulin levels and resistance to insulin action (IR). Insulin regulates the lipid metabolism. In overweight children, IR may well play a greater role than obesity in the development of lipid alterations. This study sought to ascertain whether there was any difference in lipid levels between obese and non-obese children, and to test for correlations between IR markers and BMI.

Patients and methods: This transversal study in obese prepubertal children (6–9 years old) included 58 obese children and 61 non-obese controls. Lipid profiles, baseline insulin levels, and insulin resistance index (HOMA-IR) were measured in all subjects.

Results: The composition of the two groups was similar, with no significant difference in age or gender. Mean insulin levels (P=0.038), HOMA-IR values (P=0.009), and triglyceride levels (P<0.001) were significantly higher in the obese group than in controls, while HDL-C (P=0.004) and Apo-A1 levels (P<0.001) were significantly lower. Simple linear correlation analysis in obese children revealed a positive correlation between BMI and triglyceride levels, and a negative correlation between BMI and HDL-C and Apo-A1 levels. A significant association was observed between triglyceride, HDL- and Apo-A1 levels and both baseline insulin levels and HOMA-IR values. Total cholesterol and LDL-C displayed no correlation with either insulin levels or the IR index. Multiple regression analysis showed that the three variables tested (BMI, insulin, and HOMA) were independent prediction factors for triglyceride levels, while insulin was an independent prediction factor for HDL-C and Apo-A1.

Conclusions: The lipid profile in obese children is similar to that of obese adults. Changes in lipid-related variables appear to depend more on insulin levels than on the degree of obesity.