Components of the metabolic syndrome (MTS), hyperinsulinemia, and insulin resistance in obese Israeli children and adolescents

Summary Background The metabolic syndrome (MTS) is important risk factor for cardiovascular disease in adults and until recently, it was rarely described in children. Aim The aim of our study was to evaluate the frequency of individual MTS components in obese children, and determine risk factors for their early development. Subjects and methods Data of 374 obese children (mean age of 11.4 ± 2.3 years), (f/m = 211/163), (BMI ≥ 95th percentile) were included in the study, of whom 242 were >10 years. Nine adolescents were referred with overt diabetes. All subjects underwent full clinical and laboratory evaluation, and their data was compared to 191, age, and sex-matched healthy lean controls. Data of OGTT performed on 111 obese children (101 >10 years) and 66, age- and sex-matched healthy controls (22 >10 years) was analyzed. Insulin secretion and insulin sensitivity were determined with validated OGTT derived indices. Results Results of OGTT showed that 3/101 (3%) adolescents had diabetes, 8 (8%) impaired glucose tolerance (IGT), and 4 (4.%), impaired fasting glucose (IFG) A significantly higher frequency of MTS components was found in obese children when compared to controls, not always associated with insulin resistance. Predictors of early/full presentation of MTS components included: BMI > 33; family history of T2DM; female gender; age >15 years; elevated fasting insulin, and insulin resistance. Conclusion About 50% of obese children in Israel present one or more MTS components, and 15% have CHO intolerance. Early and full MTS development seems to be associated with family history of T2DM. In obese prepubertal children development of MTS components are independent of hyperinsulinemia and insulin resistance.