Indices of insulin resistance and adiposity can detect obesity-related morbidity in pediatrics

Abdelhamed, Marwa H; Salah, Shaimaa; ALqudsi, Khloud K; Jan, Majd M; Alahdal, Duaa K; Alfaifi, Saher A; Jafar, Nuha M; Alyahyawi, Naseem; Al-Agha, Abdulmoein

doi:10.15537/smj.2022.43.2.20210720

Cited by 4 publications

(7 citation statements)

References 31 publications

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“…Similar results were found by Faria et al ( 17 ) in Brazilian adolescents and by Vásquez et al ( 18 ) in a cohort of Chilean children aged 4, 7, and 10 years; however, in both studies, not all the participants were overweight. The observation of a moderate correlation between body fat and HOMA-IR was also observed in a study of overweight Saudi Arabian children and adolescents aged between 2 and 20 years ( 19 ). Excess body fat can lead to metabolic changes, including inflammatory mechanisms, which increases insulin resistance and may help to partially explain this finding.…”

Section: Discussionsupporting

confidence: 52%

“…In BFP analyses, the cutoff point <34% of body fat may be able to rule out changes in HDL-c (high specificity), while the cutoff point > 36.6% may be able to predict changes in the HOMA-IR index (high sensitivity). In the study by Abdelhamed et al ( 19 ), a cut-off of 46.1% of BFP was shown to have the best sensitivity/specificity ratio for detecting obesity-related morbidities in Saudi children and adolescents. The joint analysis of several biochemical parameters (grouped as “obesity-related morbidities”) to estimate the accuracy of the BFP in predicting laboratory changes in overweight individuals may have contributed to the difference between the Saudi work and the present study.…”

Section: Discussionmentioning

confidence: 97%

“…It should be noted that, in an attempt to establish new anthropometric cutoffs capable of predicting or ruling out dyslipidemia and glycemic alterations, the interpretation of the area under the curve (AUC) value should be considered ( 31 ). While studying overweight individuals aged between 2 and 20 years in Saudi Arabia, Abdelhamed et al ( 19 ) found AUC between 0.638 and 0.657 for the parameters BFP, WC, and BMI capable of predicting “obesity-related morbidities,” a condition that included, in addition to dyslipidemia, pre/hypertension, pre/diabetes, and hypovitaminosis D. In a study involving 3,327 overweight European children and adolescents aged 3 to 16 years, the authors found an AUC of 0.57, 0.58, and 0.59 when analyzing the BFP values capable of predicting changes in HDL-c, LDL-c, and TG, respectively; in this study, the authors found no differences between the AUCs of BFP and BMI ( 32 ).…”

Section: Discussionmentioning

confidence: 99%

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Anthropometric Indicators of Body Composition Associated With Lipid and Glycemic Profiles in Overweight Brazilian Children and Adolescents From 2008 to 2020

et al. 2022

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BackgroundAnthropometric indicators have been used to predict health problems. The objective was to determine which indicators present better correlation with dyslipidemia, hyperglycemia and peripheral insulin resistance, as well as the cutoff points capable of predicting lipid and glycemic alterations in Brazilian children and adolescents.MethodsA cross-sectional study conducted with 568 overweight individuals, aged between 5 and 18 years, living in Southeast and South Brazilian regions, submitted to anthropometric and body composition evaluation by bioimpedance, in addition to fasting laboratory tests [total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), fasting glycemia, and homeostasis model assessment–insulin resistance (HOMA-IR)]. Pearson's correlation was used to evaluate the association between anthropometric indicators and serum biomarkers. The ROC curve with Youden's J index was used to suggest anthropometric cutoff points with better ability to predict or rule out lipid and glycemic changes.ResultsCutoff points obtained for the z-score of body mass index (BMI), waist circumference (WC), and waist circumference for height (WC/H) showed high specificity (52 to 87%) and low sensitivity (23 to 59%), indicating greater ability to exclude changes in HDL-c, TG, and HOMA-IR levels. Cutoff points suggested for BMI ranged from +1.86 to +2.20 z-score. WC cutoff points ranged from +1.29 to +1.72, and, for the WC/H index, from +1.21 to +1.25. It was suggested the use of the following cutoff points to rule out changes in HDL-c, TG, and HOMA-IR values in clinical practice: BMI < z-score +2 and WC/H < z-score +1.29. In body fat percentage (BFP) analyses, the cutoff point < of 34% may be able to rule out changes in HDL-c (specificity of 70%), while the cutoff point > 36.6% may be able to predict changes in the HOMA-IR index (sensitivity of 76%).ConclusionIt is not yet possible to state which anthropometric parameter has the best correlation with lipid and glycemic alterations in overweight children and adolescents. We suggest considering BMI, WC, and WC/H cutoff points together to rule out changes in HDL-c, TG, and HOMA-IR, and use the BFP cutoff point to predict changes in HOMA-IR.

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Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

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Anthropometric Indicators of Body Composition Associated With Lipid and Glycemic Profiles in Overweight Brazilian Children and Adolescents From 2008 to 2020

et al. 2022

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“…[ 28 ] and indirectly suggest a decrease in insulin sensitivity due to the increased IR reported by Abdelhamed et al . [ 29 ]…”

Section: Discussionmentioning

confidence: 99%

The role of adipokines and ghrelin in interactions and clinical implications in childhood obesity

Haddawi,

Al-Ziaydi,

Al-Khalidi

2024

Journal of Education and Health Promotion

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BACKGROUND: Childhood obesity is a growing global health concern, especially prevalent in the Arabian Peninsula, and is known to contribute to metabolic syndrome and insulin resistance. This study aimed to investigate the interplay between adipokines (leptin and adiponectin), ghrelin, and insulin homeostasis in childhood obesity. MATERIAL AND METHODS: A case–control study was conducted in Babylon involving 120 children/adolescents (7–17 years). The participants were divided into two groups: 60 obese and 60 healthy controls. Anthropometric and biochemical measures were examined, applying World Health Organization (WHO) growth standards to categorize weight status. Data on blood lipids, glucose, adipokines, and ghrelin were collected in Babylon (Merjan Medical City), ensuring accuracy and providing insights into pediatric obesity’s metabolic and hormonal status. RESULT: Clinical, anthropometric, and laboratory attributes of children were evaluated, with classification as normal-weight or obese based on BMI/Z-score and Waist Circumference. The obese group exhibited elevated triglycerides and insulin levels, as well as reduced adiponectin levels (P ≤ 0.001). Leptin levels showed a positive correlation with BMI/Z-score (r = 0.352, P = 0.006). A diagnostic model demonstrated the significant diagnostic capacity of leptin (AUC > 99%) and its importance in predicting childhood obesity. Each unit increase in leptin elevated the probability of obesity by a factor of 1.197 (95% CI: 1.0507–1.3632, P = 0.0068). CONCLUSION: The study revealed significant differences in clinical, biochemical, and biological markers of obesity between the research groups and the control group. Leptin emerged as a significant predictor of obesity, demonstrating high diagnostic accuracy. The complex interactions among these adipokines underscore the necessity for comprehensive obesity management strategies.

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“…Similarly, Joseph et al [ 30 ] reported that HOMA-IR was positively correlated with BFM and WC, and Rajesh et al [ 20 ] reported that HOMA-IR was positively correlated with BFM. Marwa et al [ 31 ] stated in their study that BMI and WC had significant AUCs in predicting IR in obese children and adolescents, and that BMI had the highest sensitivity and WC the highest specificity.…”

Section: Discussionmentioning

confidence: 99%

The Relationship between Anthropometric Measurements and Vitamin D Levels and Insulin Resistance in Obese Children and Adolescents

Çiğri

İnan

2022

Children

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Objective: Our investigation aimed to determine the effect of vitamin D levels on the development of insulin resistance in obese adolescents and children and the influences of anthropometric measurements on predicting the development of insulin resistance. Materials and Methods: In this study, demographic data, laboratory findings, and anthropometric measurements of 150 adolescents and children that had obesity diagnoses between May 2021 and September 2022 were evaluated retrospectively. Those with and without insulin resistance were studied with regard to vitamin D levels, biochemical parameters, and anthropometric measurements. Three groups of patients were created: those with low levels of vitamin D (<20 ng/mL), those with insufficient levels (20–30 ng/mL), and those having normal levels (≥30 ng/mL). Groups were compared in terms of homeostatic model score (HOMA-IR) and anthropometric measurements. Correlation analysis was carried out to ascertain the correlation of anthropometric measurements with HOMA-IR. To ascertain the cutoff, specificity, and sensitivity values of anthropometric parameters in predicting insulin resistance in patients, receiver operating characteristic (ROC) analysis was carried out. Results: Vitamin D levels of obese adolescents and children with insulin resistance were substantially lower than those without insulin resistance (p < 0.001). As the vitamin D level increased, all anthropometric measurements except for the body fat percentage decreased significantly with the HOMA-IR score (p < 0.05). HOMA-IR demonstrated a strong positive relation with waist circumference (rs = 0.726, p < 0.001). Waist circumference had high specificity and sensitivity in predicting insulin resistance (87.3% and 87.4%, respectively). Conclusions: A significant relationship was observed between insulin resistance development and low levels of vitamin D in obese children and adolescents. As vitamin D levels increase, anthropometric measurements are more stable and do not increase. Waist circumference is the most effective anthropometric measurement for predicting the development of insulin resistance in obese adolescents and children.

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Indices of insulin resistance and adiposity can detect obesity-related morbidity in pediatrics

Cited by 4 publications

References 31 publications

Anthropometric Indicators of Body Composition Associated With Lipid and Glycemic Profiles in Overweight Brazilian Children and Adolescents From 2008 to 2020

Anthropometric Indicators of Body Composition Associated With Lipid and Glycemic Profiles in Overweight Brazilian Children and Adolescents From 2008 to 2020

The role of adipokines and ghrelin in interactions and clinical implications in childhood obesity

The Relationship between Anthropometric Measurements and Vitamin D Levels and Insulin Resistance in Obese Children and Adolescents

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