Leptin, insulin and thyroid hormones in a cohort of Egyptian obese Down syndrome children: a comparative study

Abstract

BackgroundObesity is a major worldwide health problem. It is commonly observed in Down syndrome individuals than in the general population. The reason for increased risk of obesity in DS is unclear.The current study was designed to clarify differences in some obesity- related hormones in a group of prepubertal Down syndrome children.MethodsThirty six Egyptian children with Down syndrome were enrolled in this study, divided according to their body mass index (BMI) into 23 obese and13 non obese. Another group of 43 non Down children were recruited, they were divided according to their BMI into 20 patients having simple obesity and 23 non obese, as control groups. Fasting blood samples were collected for estimation of fasting blood glucose (FBG), insulin, leptin, free thyroxin (FT4), thyroid stimulating hormones (TSH) and creatine kinase (CK). Insulin resistance was assessed by Homeostasis Model Assessment method (HOMA-IR). The ratio of leptin to BMI (LEP/BMI) was used as an index of leptin resistance.ResultsMedian values of FBG, insulin, and HOMA-IR were significantly higher in Down versus non Down groups, while median values of leptin and leptin resistance were non-significantly different among Down versus non Down groups. Median TSH values were non- significantly different between obese Down and obese non Down. Although the median values of TSH and FT4 were within normal range in Down groups, four cases of subclinical hypothyroidism were encountered. Leptin levels were correlated with insulin and IR but not with TSH in Down groups.ConclusionIncreased circulating leptin, a marker of leptin resistance in obese children with Down syndrome seems to be similar to that in children with simple obesity. Elevated FBG and insulin in obese Down children highlights the presence of early IR. Associated myopathy evidenced by mildly elevated CK levels could be an added factor for obesity in such group of patients.

Nonalcoholic Fatty Liver Disease in Italian Children with Down Syndrome: Prevalence and Correlation with Obesity-Related Features

“…39 As expected, these comorbidities also are frequent in overweight/obese children with DS. 14,18,19 Congenital heart diseases are the main causes of death among young with DS (<20 years old). 40 However, children and adults with DS also experienced excess mortality as the result of other causes, such as cancers, infections, type 2 diabetes, and liver cirrhosis.…”

“…In addition, several studies reported that high levels of leptin, a well-known adipocytokine, could be an additional determinant of obesity in children with DS. [13][14][15] Similarly to children without DS, obesity in children with DS is associated with several diseases including obstructive sleep apnea, 16 orthopedic and gait abnormalities, 17 and metabolic syndrome features such as dyslipidemia and hyperinsulinemia. 14,18,19 Epidemiologic studies found together with the increase in pediatric obesity, an increased prevalence of nonalcoholic fatty liver disease (NAFLD).…”

Children with Down's syndrome display high rates of hyperuricaemia

“…At the same time, we are also seeing greater problems with lifestyle‐related diseases in the general population. Although the exact prevalence of these lifestyle‐related diseases in patients with Down's syndrome remains uncertain, a number of previous studies have examined dyslipidaemia, insulin resistance and hyperuricaemia, especially in late adolescence or adulthood . Obesity plays a key role in the occurrence of these morbidities in individuals with intellectual disabilities, including Down's syndrome .…”

“…Patients with Down's syndrome experience a number of complications, including cardiac malformation, hypothyroidism, hearing impairment, ophthalmic problems and coeliac disease, and they are also more susceptible to leukaemia . In addition, a variety of metabolic disorders have been observed in Down's syndrome, such as dyslipidaemia , insulin resistance and hyperuricaemia, abnormally high levels of uric acid in the blood . Although the exact cause of these metabolic disorders remains unclear, obesity is thought to play an important role, especially if it starts in late adolescence .…”

A case report with the peculiar concomitance of 2 different genetic syndromes

“…An increase in CK serum levels is not a typical feature of DS, although a significant increase in CK values is reported in obese DS patients compared with nonobese ones. [9] Our patient, who had both high serum CK levels and a myopathic electromyography pattern, underwent skeletal muscular biopsy, which revealed a weak Dys 3 immunostain compatible with a diagnosis of BMD. The diagnosis was confirmed by DMD gene analysis, which revealed an intronic splice-site mutation causing exon 15 skipping and keeping the reading frame intact.…”