Glycolipid metabolic status of overweight/obese adolescents aged 9- to 15-year-old and the BMI-SDS/BMI cut-off value of predicting dyslipidemiain boys, Shanghai, China: a cross-sectional study

Abstract

BackgroundThe prevalence of adolescents’ obesity and overweight has dramatically elevated in China. Obese children were likely to insulin resistance and dyslipidemia, which are risk factors of cardiovascular diseases. However there was no cut-off point of anthropometric values to predict the risk factors in Chinese adolescents. The present study was to investigate glycolipid metabolism status of adolescents in Shanghai and to explore the correlations between body mass index standard deviation score (BMI-SDS) and metabolic indices, determine the best cut-off value of BMI-SDS to predict dyslipidemia.MethodsFifteen schools in Shanghai’s two districts were chosen by cluster sampling and primary screening was done in children aged 9-15 years old. After screening of bodyweight and height, overweight and obese adolescents and age-matched children with normal body weight were randomly recruited in the study. Anthropometric measurements, biochemical measurements of glycolipid profiles were done. SPSS19.0 was used to analyze the data. Receiver operating characteristic (ROC) curves were made and the best cut-off values of BMI-SDS to predict dyslipidemia were determined while the Youden indices were maximum.ResultsFive hundred and thirty-eight adolescents were enrolled in this research, among which 283 have normal bodyweight, 115 were overweight and 140 were obese. No significant differences of the ages among 3 groups were found. There were significant differences of WC-SDS (p<0.001), triacylglycerol (p<0.05), high and low density lipoprotein cholesterol (p<0.01), fasting insulin (p<0.01) and C-peptide (p<0.001) among 3 groups. Significant difference of fasting glucose was only found between normal weight and overweight group. Significant difference of total cholesterol was found between obese and normal weight group. There was no significant difference of glycated hemoglobin among 3 groups. The same tendency was found in boys but not in girls. Only HDL-C reduced and TG increased while BMI elevated in girls. The best cut-off value of BMI-SDS was 1.22 to predict dyslipidemia in boys. The BMI cut-off was 21.67 in boys.ConclusionOverweight and obese youths had reduced insulin sensitivity and high prevalence of dyslipidemia.When BMI-SDS elevated up to 1.22 and BMI was higher than 21.67 in boys, dyslipidemia may happen.

Dislipidemias en niños y adolescentes: factores determinantes y recomendaciones para su diagnóstico y manejo.

“…Para su correcta interpretación es importante conocer la muestra representativa de los estudios y la población que incluyeron. En el análisis realizado se observan 3 artículos cuya muestra incluía a más de 10.000 niños y/o adolescentes 35,43,44 , siendo estos la población estudiada con mayor número de individuos. Otros 5 estudios abarcaron entre 1.000-5.000 sujetos desde la edad escolar hasta la adolescencia tardía 8,30,33,34,42 , 4 artículos contaron con un número muestral de 500-1.000 escolares y adolescentes [36][37][38][39] y otros 6 obtuvieron una muestra inferior a 500 personas, desde la etapa preescolar hasta la adolescencia 25,28,29,31,32,41 .…”

“…En cuanto a las edades de estudio, se hallaron 2 artículos cuya población diana son preescolares 25,28 , mientras que 7 analizaron solo escolares 8,29,30,32,34,35,37 . Otros consideraron un rango de edad más amplio: un artículo abarcó desde el primer año de vida hasta la adolescencia 31 , otro desde los 4 años hasta la pubertad 40 .…”

“…También, hubo 4 artículos que incluyeron sujetos desde la edad escolar hasta la adolescencia [36][37][38][39]44 . Finalmente, 3 estudios se centraron en niños al final de la etapa escolar, púberes y adolescentes 32,35,41 , y por último solo un trabajo se centró en individuos desde la etapa puberal hasta los 23 años 33 .…”

“…Respecto a los parámetros bioquímicos en los estudios incluidos, se observa que gran parte de ellos analizan los niveles de CT, C-HDL, lipoproteínas de baja densidad (C-LDL) y TG 8,25,28,29,32,[34][35][36][38][39][40][41][42][43][44] . En uno de los estudios se valora la relación C-LDL/C-HDL y CT/C-HDL 41 .…”

“…En uno de los estudios se valora la relación C-LDL/C-HDL y CT/C-HDL 41 . Otro tipo de mediciones bioquímicas como glucemia en sangre 8,29,30,[33][34][35]38,39,42,43 , hemoglobina glicosilada 33,35,38,39,43 , insulina, resistencia a la insulina 8,29,35,38,39,42 , hemoglobina A, serolipoproteína A y apolipoproteínas A y B1, se recogen también en algunos de los trabajos revisados 35 .…”