Metabolic syndrome and its components are strongly associated with an inflammatory state and insulin resistance in the pediatric population

Nutr Hosp. 2015 Apr 1;31(4):1513-8. doi: 10.3305/nh.2015.31.4.8264.

Abstract
in English, Spanish

Introduction: Endothelial inflammation and insulin resistance (IR) begin in childhood and constitute the pathophysiological basis of Metabolic Syndrome (MS). The increase levels in plasma of inflammatory markers such as high sensitive PCR (hsPCR), plasminogen activator inhibitor 1 (PAI-1) and tests suggestive of IR such as Insulin (Ins) and alanine aminotransferase (ALT) have been associated with MS in adults, but have not been studied in children.

Objectives: Correlate the presence of MS and its components with the inflammatory and IR markers seen in the pediatric population.

Methods: Cross-sectional study of 337 children (10,9±9,7 years) whose levels of hsPCR, PAI-1, Ins and ALT were determined, along with their association with MS and its individual components.

Results: 37 children had MS (10,4%). The frequency of MS components was: abdominal obesity 38,5%, hypertension (HTN) 21,3%, hypertriglyceridemia 17,8%, HDL 21,3% and hyperglycemia 1,4%. hsPCR, PAI-1, ALT and Ins were higher in the presence of MS and increased progressively when components were came together.

Conclusions: The pediatric population segment with MS had a higher concentration of hsPCR, PAI-1, Ins and ALT.These levels increase proportionally MS components add up, suggesting that even before diagnosis criteria are fulfilled there is a inflammatory state.

La insulino resistencia (IR) y la inflamación endotelial constituyen la base fisiopatológica del Síndrome metabólico (SM) . El aumento de los niveles plasmáticos de mascadores de inflamación como PCRus, Inhibidor del activador de plasminógeni tipo 1 (PAI-1) y parámetros sugerentes de insulino resistencia (IR) como insulina, triglicéridos y Alanino aminotransferasa (ALT) se han asociado a síndrome metabólico en adultos pero han sido menos estudiados en pediatría. Objetivo: Correlacionar los componentes del SM con marcadores de inflamación e IR en población pediátrica. Métodos: Estudio transversal de 337 niños (10,9±9,7 años). Se determinó niveles plasmáticos de PCRus, PAI-1, ALT e Insulina y se evaluó su asociación con Síndrome metabólico y sus criterios de forma individual. Resultados: 37 sujetos tuvieron diagnóstico de SM (10.4%). 38.5% presentó obesidad abdominal, 21.3% Hipertensión arterial, 17.8% Hipertrigliceridemia, 21.3% niveles bajos de HDL y un 1.4% Hiperglicemia. Encontramos que PCRus, PAI-1 y ALT fueron más altas en presencia de SM y aumentaban progresivamente a medida que se agregaban criterios diagnósticos. Conclusión: Este estudio demuestra que en población pediátrica con diagnóstico de SM existen niveles más altos de PCRus, PAI-1, ALT e insulina y que a mayor número de criterios presentes la inflamación pareciera ser mayor lo que sugiere que incluso antes de tener el diagnóstico de SM ya existe un estado pro inflamatorio.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Blood Glucose
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Female
  • Hemodynamics
  • Humans
  • Inflammation / pathology*
  • Inflammation Mediators / blood
  • Insulin Resistance*
  • Lipids / blood
  • Male
  • Metabolic Syndrome / metabolism*
  • Metabolic Syndrome / pathology*

Substances

  • Blood Glucose
  • Inflammation Mediators
  • Lipids