Steatosis and Insulin Resistance: Prevalence and Association With Cardiovascular Risk in Obese Adolescents

Abstract

Background: Steatosis is strongly associated with obesity, even in childhood. Insulin resistance (IR) is one of the comorbidities of pediatric obesity, associated with cardiovascular risk (CVR). The goals of this study were to characterize steatosis and IR presence in the context of pediatric obesity and to assess the connection between them and with CVR markers.

Methods: It was a retrospective study including 184 adolescents (10.6 1.9 years) with primary obesity. All data refer to the first evaluation. Based on a study protocol (www.gneiop.pt), anthropometric parameters, body composition (InBody), lipid profile, basal glucose and insulin, homeostatic model assessment of insulin resistance (HOMA-IR) and liver ultrasonography were collected. The value of P <= 0.05 was considered significant.

Results: It is a young population with a considerable obesity (BMI z score = 2.29 0.76). From those who were evaluated, one-third present steatosis or IR. Regardless of gender and chronologic age, there is a significant positive association between IR and cardiovascular risk factor (CVRF) occurrence. IR is associated with a probability of more than three times and with a relative risk 2.5 times higher for the aggregation of two or more CVRFs (P = 0.014).

Conclusion: A non-negligible prevalence of steatosis and of IR was observed in obese young adolescents. IR and steatosis are associated with an increased aggregation of CVRF. The presence of IR, but not of steatosis, shows a strong predictability concerning the risk of aggregation of two or more CVRFs. For this reason, it should be part of the clinical assessment of the obese adolescent.




Int J Clin Pediatr. 2015;4(4):171-177
doi: http://dx.doi.org/10.14740/ijcp205w