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BMC Pediatrics
Published in: BMC Pediatrics 1/2014

Open Access 01-12-2014 | Research article

Abdominal obesity and low physical activity are associated with insulin resistance in overweight adolescents: a cross-sectional study

Published in: BMC Pediatrics | Issue 1/2014

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Abstract

Background

Previous studies have assessed the metabolic changes and lifestyles associated with overweight adolescents. However, these associations are unclear amongst overweight adolescents who have already developed insulin resistance. This study assessed the associations between insulin resistance and anthropometric, metabolic, inflammatory, food consumption, and physical activity variables amongst overweight adolescents.

Methods

This cross-sectional study divided adolescents (n = 120) between 10 and 18 years old into 3 groups: an overweight group with insulin resistance (O + IR), an overweight group without insulin resistance (O-IR), and a normal-weight control group (NW). Adolescents were matched across groups based on age, sex, pubertal maturation, and socioeconomic strata. Anthropometric, biochemical, physical activity, and food consumption variables were assessed. Insulin resistance was assessed using homeostatic model assessment (HOMA Calculator Version 2.2.2 from ©Diabetes Trials Unit, University of Oxford), and overweight status was assessed using body mass index according to World Health Organization (2007) references. A chi-square test was used to compare categorical variables. ANOVAs or Kruskal-Wallis tests were used for continuous variables. Multiple linear regression models were used to calculate the probability of the occurrence of insulin resistance based on the independent variables.

Results

The risk of insulin resistance amongst overweight adolescents increases significantly when they reach a waist circumference > p95 (OR = 1.9, CIs = 1.3-2.7, p = 0.013) and watch 3 or more hours/day of television (OR = 1.7, CIs = 0.98-2.8, p = 0.033). Overweight status and insulin resistance were associated with higher levels of inflammation (hsCRP ≥1 mg/L) and cardiovascular risk according to arterial indices. With each cm increase in waist circumference, the HOMA index increased by 0.082; with each metabolic equivalent (MET) unit increase in physical activity, the HOMA index decreased by 0.026.

Conclusions

Sedentary behaviour and a waist circumference > p90 amongst overweight adolescents were associated with insulin resistance, lipid profile alterations, and higher inflammatory states. A screening that includes body mass index, in waist circumference, and physical activity evaluations of adolescents might enable the early detection of these alterations.
Literature
1.
De Boer MD: Obesity, systemic inflammation, and increased risk for cardiovascular disease and diabetes among adolescents: a need for screening tools to target interventions. Nutrition. 2013, 29: 379-386. 10.1016/j.nut.2012.07.003.CrossRef
2.
Friend A, Craig L, Turner S: The prevalence of metabolic syndrome in children: a systematic review of the literature. Metab Syndr Relat Disord. 2013, 11: 71-80. 10.1089/met.2012.0122.CrossRefPubMed
3.
Stupar D, Eide WB, Bourne L, Hendricks M, Iversen PO, Wandel M: The nutrition transition and the human right to adequate food for adolescents in the Cape Town metropolitan area: implications for nutrition policy. Food Policy. 2012, 37: 199-206. 10.1016/j.foodpol.2012.02.007.CrossRef
4.
Popkin BM, Adair LS, Ng SW: Global nutrition transition and the pandemic of obesity in developing countries. Nutr Rev. 2012, 70: 3-21. 10.1111/j.1753-4887.2011.00456.x.CrossRefPubMedPubMedCentral
5.
Instituto Colombiano de Bienestar Familiar, Profamilia, Instituto Nacional De Salud, Escuela de Nutrición y Dietética Universidad de Antioquia, Organización Panamericana de la Salud: Encuesta nacional de la situación nutricional en Colombia. 2006, Bogotá: Panamericana Formas e Impresos, S.A
6.
Profamilia, Instituto Nacional De Salud, Bienestar Familiar, Ministerio de la Proteccion Social, Prosperidad para todos: Encuesta Nacional de la Situación Nutricional en Colombia. 2011, Bogotá: Da Vinci Editores & Cia. SNC
7.
Alvarez LS, Mancilla LP, González LI, Isaza UA: Perfil Alimentario y Nutricional de Medellín. 2010, Medellín: Secretaría de Bienestar Social
8.
Hajer GR, van Haeften TW, Visseren FLJ: Adipose tissue dysfunction in obesity, diabetes, and vascular diseases. Eur Heart J. 2008, 29: 2959-2971. 10.1093/eurheartj/ehn387.CrossRefPubMed
9.
Valerio G, Licenziati MR, Iannuzzi A, Franzese A, Siani P, Riccardi G: Insulin resistance and impaired glucose tolerance in obese children and adolescents from Southern Italy. Nutr Metab Cardiovasc Dis. 2006, 16: 279-284. 10.1016/j.numecd.2005.12.007.CrossRefPubMed
10.
Ochoa Agudelo GM, Arias Arteaga R: Prevalence of the metabolic syndrome in school children and adolescents of the urban area of Medellín, Colombia. Iatreia. 2008, 21: 260-270.
11.
Agudelo G, Velásquez C, Bedoya G, Estrada A, Manjarrés L, Patiño F: Variations in the prevalence of metabolic syndrome in adolescents according to different criteria used for diagnosis: Which definition should be chosen for this age group?. Metab Syndr Relat Disord. 2014, 12: 202-209. 10.1089/met.2013.0127.CrossRefPubMed
12.
13.
Weiss R, Dziura J, Burgert TS, Tamborlane WV, Taksali SE, Yeckel CW: Obesity and metabolic syndrome in children and adolescents. N Engl J Med. 2004, 350: 2362-2374. 10.1056/NEJMoa031049.CrossRefPubMed
14.
Celik T, Iyisoy A, Yuksel UC: Pediatric metabolic syndrome: a growing threat. Int J Cardiol. 2010, 142: 302-303. 10.1016/j.ijcard.2008.11.143.CrossRefPubMed
15.
Cook S, Weitzman M, Auinger P, Nguyen M, Dietz WH: Prevalence of a metabolic syndrome phenotype in adolescents. Arch Pediatr. 2003, 157: 821-827. 10.1001/archpedi.157.8.821.CrossRef
16.
17.
Olivares Reyes JA, Arellano Plancarte A: Bases Moleculares de las Acciones de la Insulina. Revista Educ Bioquím. 2008, 27: 9-18.
18.
Garmendia ML, Lera L, Sánchez H, Uauy R, Albala C: Homeostasis model assessment (HOMA) values in Chilean elderly subjects. Med Chile. 2009, 137: 1409-1416.
19.
Acosta García E, Carías D, Páez Valery M, Naddaf G, Zury D: Exceso de peso, resistencia a la insulina y dislipidemia en adolescentes. Acta Bioquím Clín Latinoam. 2012, 46: 365-373.
20.
Koike T, Miyamoto M, Oshida Y: Waist circumference is positively associated with insulin resistance but not with fasting blood glucose among moderately to highly obese young Japanese men. Obes Res Clin Pract. 2009, 3: 109-114. 10.1016/j.orcp.2008.10.006.CrossRef
21.
Simarro Rueda M, Carbayo Herencia JA, Massó Orozco J, Artigao Rodenas LM, Carrión Valero L, Divisón Garrote JA: Association of insulin resistance with different anthropometric measures and cardiovascular risk factors in a non-diabetic population. Endocrinol Nutr. 2011, 58: 464-471. 10.1016/j.endonu.2011.06.003.CrossRefPubMed
22.
Kotlyarevska K, Wolfgram P, Lee J: Is waist circumference a better predictor of insulin resistance than body mass index in U.S. adolescents?. J Adolesc Health. 2011, 49: 330-333. 10.1016/j.jadohealth.2010.12.008.CrossRefPubMedPubMedCentral
23.
Abete I, Goyenechea E, Zulet MA, Martínez JA: Obesity and metabolic syndrome: potential benefit from specific nutritional components. Nutr Metab Cardiovasc Dis. 2011, 21: B1-B15.CrossRefPubMed
24.
Yeste D, Carrascosa A: Obesity-related metabolic disorders in childhood and adolescence. Ann Pediatr (Paris). 2011, 75: 135-e1– 9
25.
Androutsos O, Moschonis G, Mavrogianni C, Roma-Giannikou E, Chrousos GP, Kanaka-Gantenbein C: Identification of lifestyle patterns, including sleep deprivation, associated with insulin resistance in children: the healthy growth study. Eur J Clin Nutr. 2014, 68: 344-349. 10.1038/ejcn.2013.280.CrossRefPubMed
26.
National Cholesterol Education Program, National Heart, Lung, and Blood Institute, National Institutes of Health. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on: Detection, evaluation, and treatment of high blood cholesterol in adults, (adult treatment panel III). Final report. Circulation. 2002, 106: 3143-3421.
27.
Sesé MA, Jiménez-Pavón D, Gilbert CC, González-Gross M, Gottrand F, de Henauw S: Eating behaviour, insulin resistance and cluster of metabolic risk factors in European adolescents: the HELENA study. Appetite. 2012, 59: 140-147. 10.1016/j.appet.2012.04.011.CrossRefPubMed
28.
Mirza N, Palmer M, O’Connell J, Dipietro L: Independent benefits of meeting the 2008 physical activity guidelines to insulin resistance in obese Latino children. J Obes. 2012, 2012: 1-7.CrossRef
29.
Levy-Marchal C, Arslanian S, Cutfield W, Sinaiko A, Druet C, Marcovecchio ML: Insulin resistance in children: consensus, perspective, and future directions. J Clin Endocrinol Metab. 2010, 95: 5189-5198. 10.1210/jc.2010-1047.CrossRefPubMedPubMedCentral
30.
Chu SH, Park J-H, Lee MK, Jekal Y, Ahn KY, Chung JY: The association between pentraxin 3 and insulin resistance in obese children at baseline and after physical activity intervention. Clin Chim Acta. 2012, 413: 1430-1437. 10.1016/j.cca.2012.06.002.CrossRefPubMed
31.
Patiño Villada FA, Márquez Arabia JJ, Uscátegui Peñuela RM, Estrada Restrepo A, Agudelo Ochoa GM, Manjarrés LM: Effect of an intervention with physical exercise and nutritional guidance on the components of the metabolic syndrome among young people with overweight. Iatreia. 2013, 26: 34-43.
32.
Rodríguez-Rodríguez E, Perea JM, López-Sobaler AM, Ortega RM: Obesity, insulin resistance and increase in adipokines levels: importance of the diet and physical activity. Nutr Hosp. 2009, 24: 415-421.PubMed
33.
Bolet Astoviza M, Socorrás Suárez MM: An appropriate feeding to impove the health and to avoid chronic diseases. Rev Cuba Med Gen Integr. 2010, 26: 321-329.
34.
Ambrosini GL, Huang RC, Mori TA, Hands BP, O’Sullivan TA, de Klerk NH: Dietary patterns and markers for the metabolic syndrome in Australian adolescents. Nutr Metab Cardiovasc Dis. 2010, 20: 274-283. 10.1016/j.numecd.2009.03.024.CrossRefPubMed
35.
Nasreddine L, Naja F, Tabet M, Habbal M-Z, El-Aily A, Haikal C: Obesity is associated with insulin resistance and components of the metabolic syndrome in Lebanese adolescents. Ann Hum Biol. 2012, 39: 122-128. 10.3109/03014460.2012.655776.CrossRefPubMedPubMedCentral
36.
Uscátegui Peñuela RM, Álvarez Uribe MC, Laguado Salinas I, Soler Terranova W, Martínez Maluendas L, Arias Arteaga R: Cardiovascular risk factors in children and teenagers aged 6–18 years olf from medillín (Colombia). Ann Pediatr (Paris). 2003, 58: 411-417. 10.1016/S1695-4033(03)78086-2.CrossRef
37.
38.
Fernández JR, Redden DT, Pietrobelli A, Allison DB: Waist circumference percentiles in nationally representative samples of African-American, European American, and Mexican-American children and adolescents. J Pediatr. 2004, 145: 439-444. 10.1016/j.jpeds.2004.06.044.CrossRefPubMed
39.
Lohman TG, Roche AF, Martorell F: Anthropometric standardization reference manual. 1988, Champaign, IL: Human Kinetics Books
40.
De Onis M, Onyango AW, Borghi E, Siyam A, Siekmann J: Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ. 2007, 85: 660-667. 10.2471/BLT.07.043497.CrossRefPubMedPubMedCentral
41.
Colombia. Ministerio de la Protección Social: Resolución 2121 de 2010, Junio 9, por la cual se adoptan los Patrones de crecimiento publicados por la Organización Mundial de la Salud, OMS, en el 2006 y 2007 para los niños, niñas y adolescentes de 0 a 18 años de edad y se dictan otras disposiciones. 2010, Bogotá: El Ministerio
42.
National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents: The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004, 114 (Suppl 2): 555-576.CrossRef
43.
44.
45.
Daniels SR, Benuck I, Christakis DA, Dennison BA, Gidding SS, Gillman MW: Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatrics. 2012, 128 (Suppl 5): 213-259.
46.
Argüeso AR, Díaz Díaz J, Díaz Peromingo J, Rodríguez González A, Castro Mao M, Diz Lois F: Lípidos, colesterol y lipoproteínas. Galicia Clin. 2011, 72: 7-17.
47.
Lee JM, Okumura MJ, Davis MM, Herman WH, Gurney JG: Prevalence and determinants of insulin resistance among U.S. adolescents: a population-based study. Diabetes Care. 2006, 29: 2427-2432. 10.2337/dc06-0709.CrossRefPubMed
48.
Yin J, Li M, Xu L, Wang Y, Cheng H, Zhao X: Insulin resistance determined by Homeostasis Model Assessment (HOMA) and associations with metabolic syndrome among Chinese children and teenagers. Diab Metab Syndr. 2013, 5: 71-10.1186/1758-5996-5-71.CrossRef
49.
Myers GL, Rifai N, Tracy RP, Roberts WL, Alexander RW, Biasucci LM: CDC/AHA workshop on markers of inflammation and cardiovascular disease: application to clinical and public health practice: report from the laboratory science discussion group. Circulation. 2004, 110: 545-549. 10.1161/01.CIR.0000148980.87579.5E.CrossRef
50.
Food and Nutrition Board Institute of Medicine: Dietary Reference Intakes. Application in Dietary Assessment. 2000, Washington DC: National Academy Press
51.
Manjarrés LM: Reliable data collected method about food intake in population studies. Perspect Nutr Hum. 2008, 9: 155-163.
52.
Manjarrés LM, Manjarrés S: Programa de Evaluación de Ingesta Dietética EVINDI v4. [Software]. 2008, Medellín: Universidad de Antioquia-Escuela de Nutrición y Dietética
53.
Colombian Family Welfare Institute: Colombian Food Composition Table. 2007, Bogota: ICBF
54.
55.
56.
Pate RR, Ross R, Trost SG, Sirard JR, Dowda M: Validation of a 3-day physical activity recall instrument in female youth. Pediatr Exerc Sci. 2003, 15: 257-265.
57.
Dowda M, Saunders RP, Hastings L, Gay JM, Evans AE: Physical activity and sedentary pursuits of children living in residential children’s homes. J Phys Act Health. 2009, 6: 195-202.PubMed
58.
Ainsworth BE, Haskell WL, Whitt MC, Irwin ML, Swartz AM, Strath SJ: Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc. 2000, 32: 498-516. 10.1097/00005768-200009001-00009.CrossRef
59.
60.
Saito E, Okada T, Abe Y, Odaka M, Kuromori Y, Iwata F: Abdominal adiposity is associated with fatty acid desaturase activity in boys: implications for C-reactive protein and insulin resistance. Prostaglandins Leukot Essent Fatty Acids. 2013, 88: 307-311. 10.1016/j.plefa.2013.01.005.CrossRefPubMed
61.
Giannini C, de Giorgis T, Scarinci A, Ciampani M, Marcovecchio ML, Chiarelli F: Obese related effects of inflammatory markers and insulin resistance on increased carotid intima media thickness in pre-pubertal children. Atherosclerosis. 2008, 197: 448-456. 10.1016/j.atherosclerosis.2007.06.023.CrossRefPubMed
62.
63.
Meshkani R, Adeli K: Hepatic insulin resistance, metabolic syndrome and cardiovascular disease. Clin Biochem. 2009, 42: 1331-1346. 10.1016/j.clinbiochem.2009.05.018.CrossRefPubMed
64.
Maffeis C, Banzato C, Brambilla P, Cerutti F, Corciulo N, Cuccarolo G: Insulin resistance is a risk factor for high blood pressure regardless of body size and fat distribution in obese children. Nutr Metab Cardiovasc Dis. 2010, 20: 266-273. 10.1016/j.numecd.2009.04.005.CrossRefPubMed
65.
Nolan CJ, Damm P, Prentki M: Type 2 diabetes across generations: from pathophysiology to prevention and management. Lancet. 2011, 378: 169-181. 10.1016/S0140-6736(11)60614-4.CrossRefPubMed
66.
Fedewa MV, Gist NH, Evans EM, Dishman RK: Exercise and insulin resistance in youth: a meta-analysis. Pediatrics. 2014, 133: 163-174. 10.1542/peds.2013-2718.CrossRef
67.
Moran A, Jacobs DR, Steinberger J, Hong CP, Prineas R, Luepker R: Insulin resistance during puberty: results from clamp studies in 357 children. Diabetes. 1999, 48: 2039-2044. 10.2337/diabetes.48.10.2039.CrossRefPubMed
68.
Rizzo NS, Ruiz JR, Oja L, Veidebaum T, Sjöström M: Associations between physical activity, body fat, and insulin resistance (homeostasis model assessment) in adolescents: the European Youth Heart Study. Am J Clin Nutr. 2008, 87: 586-592.PubMed
69.
Rosenbloom AL, Silverstein JH, Amemiya S, Zeitler P, Klingensmith GJ: Type 2 diabetes in children and adolescents. Pediatr Diabetes. 2009, 10: 17-32.CrossRefPubMed
70.
American College of Sports Medicine: Exercise and type 2 diabetes. Off J Am Coll Sport Med. 2000, 32: 1345-1360.
71.
Colberg SR, Sigal RJ, Fernhall B, Regensteiner JG, Blissmer BJ, Rubin RR: Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement executive summary. Diabetes Care. 2010, 33: 2692-2696. 10.2337/dc10-1548.CrossRefPubMedPubMedCentral
72.
Zanuso S, Jimenez A, Pugliese G, Corigliano G, Balducci S: Exercise for the management of type 2 diabetes: a review of the evidence. Acta Diabetol. 2010, 47: 15-22. 10.1007/s00592-009-0126-3.CrossRefPubMed
73.
Suh S, Jeong I-K, Kim MY, Kim YS, Shin S, Kim SS: Effects of resistance training and aerobic exercise on insulin sensitivity in overweight korean adolescents: a controlled randomized trial. Diabetes Metab J. 2011, 35: 418-426. 10.4093/dmj.2011.35.4.418.CrossRefPubMedPubMedCentral
74.
Anderson CB, Hagströmer M, Yngve A: Validation of the PDPAR as an adolescent diary: effect of accelerometer cut points. Med Sci Sports Exerc. 2005, 7: 1224-1230.CrossRef
75.
Gutin B, Owens S: The influence of physical activity on cardiometabolic biomarkers in youths: a review. Pediatr Exerc Sci. 2011, 23: 169-185.PubMed
Metadata
Title
Abdominal obesity and low physical activity are associated with insulin resistance in overweight adolescents: a cross-sectional study
Publication date
01-12-2014
Published in
BMC Pediatrics / Issue 1/2014
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/1471-2431-14-258

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