The Relationship among Insulin Resistance, Blood Profiles and Nutrient Intake in Overweight or Obese Children and Adolescents

Article information

Korean J Community Nutr. 2012;17(5):530-542

Publication date (electronic) : 2012 October 31

doi : https://doi.org/10.5720/kjcn.2012.17.5.530

Department of Food and Nutrition, Gangneung-Wonju National University, Gangneung, Korea.

Corresponding author: Eun-Kyung Kim, Department of Food and Nutrition, Gangneung-Wonju National University, 7, Jukheon-gil, Gangneung, Gangwon-do 210-702, Korea. Tel: (033) 640-2336, Fax: (033) 640-2330, ekkim@gwnu.ac.kr

Received 2012 July 18; Revised 2012 September 26; Accepted 2012 October 05.

Abstract

The purposes of this study were to investigate blood profiles and nutrient intakes of groups that are different in obese levels, and to find the credible predictor of insulin resistance. The subjects were classified as normal weight (%IBW ≤ 110), obese without MS and obese with MS according to IDF definition of the risk group in metabolic syndrome (MS). Subjects of this study were included 137 (59 boys, 78 girls) free living children and adolescents (mean age 12.6 ± 3.4 years) in Gangneung area, South Korea. %IBW of normal weight (94.9%), obese without MS (123.8%) and obese with MS (131.5%) were significantly different among groups. HOMA-IR had positive correlations with TG (r = 0.634), waist circumference (r = 0.553), atherogenic index (r = 0.513), %IBW (r = 0.453) and ALT (r = 0.360), but showed negative correlations with HDL cholesterol (r = -0.417, p < 0.001). HOMA-IR showed positive correlation with polyunsaturated fatty acid intake (p < 0.05). The energy intake of obese with MS was 1762 kcal/day which was not significantly different from those of normal weight and obese without MS. Total fatty acid intakes of two obese groups were significantly higher than that of normal weight. The results of this study suggest that waist circumference and ALT as well as TG, atherogenic index and weight can be credible indices to predict the insulin resistance in children and in adolescents. In addition, nutrition education and adequate diet should be provided to prevent MS in children and in adolescents.

Keywords: children; adolescents; insulin resistance; metabolic syndrome; nutrient intake

Notes

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (2010-0004472).

References

1. Angelico F, Del Ben M, Conti R, Francioso S, Feole K, Fiorello S, Cavallo MG, Zalunardo B, Lirussi F, Alessan Dri C. Insulin resistance, the metabolic syndrome and nonalcoholic fatty liver disease. J Clin Endocrinol Metab 2005. 901578–1582.

2. Ardern CI, Katzmarzyk PT, Janssen I, Ross R. Discrimination of health risk by combined body mass index and waist circumference. Obes Res 2003. 11135–142.

3. Berg JE, Hostmark AT. Cardiovascular risk determination: discrepancy between total cholesterol evaluation and two compound laboratory indices in Norway. J Epidemiol Community Health 1994. 48338–343.

4. Brambilla P, Bedogni G, Moreno LA, Goran MI, Gutin B, Fox KR. Cross validation of anthropometry against magnetic resonance imaging for the assessment of visceral and subcutaneous adipose tissue in children. Int J Obes (Lond) 2006. 3023–30.

5. Bugianesi E, Gastaldelli A, Vanni E, Gambino R, Cassader M, Baldi S, Ponti V, Pagano G, Ferrannini E, Rizzetto M. Insulin resistance in non-diabetic patients with non-alcoholic fatty liver disease: Sites and mechanisms. Diabetologia 2005. 48634–642.

6. Chen CM, Zhao W, Yang Z, Zhai Y, Wu Y, Kong L. The role of dietary factors in chronic disease control in China. Obes Rev 2008. 9Suppl 1. 100–103.

7. Chu MA, Choe BH. Obesity and metabolic syndrome among children and adolescents in Korea. J Korean Med Assoc 2010. 53(2)142–152.

8. Chun IY. Comparison of obesity rate, dietary behavior, nutrient intake and blood profile related to metabolic syndrome of adult women in rural area 2006. Chosun University; Dissertation.

9. Chung HK, Kang JH, Shin MJ. Assessment for nutrient intakes in Korean women according to obesity and metabolic syndrome. Korean J Community Nutr 2010. 15(5)694–703.

10. Cook S, Weitzman M, Auinger P, Nguyen M, Dietz WH. Prevalence of a metabolic syndrome phenotype in adolescents: findings from the third National Health and Nutrition Examination Survey, 1988-1994. Arch Pediatr Adolesc Med 2003. 157821–827.

11. Devaraj S, Wang-Polagruto J, Polagruto J, Keen CL, Jialal I. Highfat, energy-dense, fast-food-style breakfast results in an increase in oxidative stress in metabolic syndrome. Metabolism 2008. 57867–870.

12. Flegal KM, Carroll MD, Ogden CL, Curtin L. Prevalence and trends in obesity among US adults, 1999-2008. JAMA 2010. 303(3)235–241.

13. Ford ES, Giles WH. A comparison of the prevalence of the metabolic syndrome using two proposed definitions. Diabetes Care 2003. 26575–581.

14. Ford ES, Li C. Defining the metabolic syndrome in children and adolescents: will the real definition please stand up? J Pediatr 2008. 152160–164.

15. Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 1972. 18499–502.

16. Gibson RS. Evaluation of nutrient intake data. Principles of nutritional assessment 1990. New York: Oxford University Press; 137–154.

17. Guthrie HA, Scheer JC. Validity of a dietary score for assessing nutritive adequacy. J Am Diet Assoc 1981. 78(3)240–245.

18. Heymsfield SB, McManus CB, Smith J, Stevens V, Nixon DW. Anthropometric measurement of muscle mass, revised equations for calculating bone-free arm muscle area. Am J Clin Nutr 1982. 36(4)680–690.

19. Hoffmann IS, Cubeddu LX. Salt and the metabolic syndrome. Nutr Metab Cardiovasc Dis 2009. 19123–128.

20. Jang Y, Kim OY, Ryu HJ, Kim JY, Song SH, Ordovas JM, Lee JH. Visceral fat accumulation determines postprandial lipemic response, lipid peroxidation, DNA damage, and endothelial dysfunction in nonobese Korean men. J Lipid Res 2003. 442356–2364.

21. Janssen I, Katzmarzyk PT, Ross R. Waist circumference and not body mass index explains obesity-related health risk. Am J Clin Nutr 2004. 79379–384.

22. Jung GY, Lee YS, Kim SM. The study of dietary behavior, BMI and nutrient intake status in middle school students of Daegu area. J East Asian Soc Diet Life 2005. 151–10.

23. Kadowaki T, Yamauchi T, Kubota N, Hara K, Ueki K, Tobe K. Adiponectin and adiponectin receptors in insulin resistance, diabetes and the metabolic syndrome. J Clin Invest 2006. 1161784–1792.

24. Kim KH. Effects of eating habits and control of overeating of obese children on body weight control program. Korean J Food Cult 2005. 20(4)476–486.

25. Korea Centers for Disease Control and Prevention. The Korean Pediatric Society. The Committee for the Development of Growth Standard for Korean Children and Adolescents. 2007 Korean Children and Adolescents Growth Standard (commentary for the development of 2007 growth chart). Government report online 2007. 11. Seoul: Division of Chronic Disease Surveillance; Available from: http://www.cdc.go.kr/.

26. Lee EJ, Kim KH. Changes of obesity index, serum lipid profiles and nutrient intakes in obese children after the weight control program of nutrition education. Korean J Community Nutr 2010. 15(1)61–72.

27. Lee S, Bacha F, Gungor N, Arslanian SA. Waist circumference is an independent predictor of insulin resistance in black and white youths. J Pediatr 2006. 148188–194.

28. Livingstone MB, Robson PJ, Wallaoe JM. Issues in dietaryintake assessment of children and adolescents. Br J Nutr 2004. 92Suppl 2. S213–S222.

29. Maffeis C, Corciulo N, Livieri C, Rabbone I, Trifiro G, Falorni A. Waist circumference as a predictor of cardiovascular and metabolic risk factors in obese girls. Eur J Clin Nutr 2003. 57566–572.

30. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985. 28412–419.

31. Miller ER, Erlinger TP, Appel LJ. The effects of macronutrients on blood pressure and lipids an overview of the DASH and OmniHeart trials. Curr Atheroscler Rep 2006. 8460–465.

32. Ministry of Health and Welfare. National health and nutrition survey: overview 2011. Seoul, South Korea: Ministry of Health and Welfare;

33. Moreno LA, Pineda I, Rodriguez G, Fleta J, Sarria A, Bueno M. Waist circumference for the screening of the metabolic syndrome in children. Acta Paediatr 2002. 911307–1312.

34. Morrison JA, Friedman LA, Gray-McGuire C. Metabolic syndrome in childhood predicts adult cardiovascular disease 25 years later: the Princeton Lipid Research Clinic Followup Study. Pediatrics 2007. 120340–345.

35. Park JS, Park ES. Prevalence of metabolic syndrome and nutrient intakes of obese middle school students in Korea. J Korean Living Sci Assoc 2008. 17(1)159–170.

36. Park YS, Lee DH, Choi JM, Kang YJ, Kim CH. Trend of obesity in school age children in Seoul over the past 23 years. Korean J Pediatr 2004. 47247–257.

37. Park YS, Son SM, Lim WJ, Kim SB, Chung YS. Comparison of dietary behaviors related to sodium intake by gender and age. Korean J Community Nutr 2008. 131–12.

38. Popkin BM, Conde W, Hou N, Monteiro C. Is there a lag globally in overweight trends for children compared with adults? Obesity 2006. 141846–1853.

39. Reaven GM. Do high carbohydrate diets prevent the development or attenuate the manifestations (or both) of syndrome X? A viewpoint strongly against. Curr Opin Lipidol 1997. 823–27.

40. Pi-Sunyer X. The metabolic syndrome: how to approach differing definitions. Med Clin North Am 2007. 911025–1040.

41. Riccardi G, Giacco R, Rivellese AA. Dietary fat, insulin sensitivity and the MS. Clin Nutr 2004. 23447–456.

42. Saito I, Mori M, Shibata H, Hirose H, Tsujioka M, Kawabe H. Prevalence of metabolic syndrome in young men in Japan. J Atheroscler Thromb 2007. 1427–30.

43. Seo JW, Jung JA, Park HS, Ko JS, Kim YJ, Kim JY, Ryoo E, Bae SH, Sim JG, Yang HR, Choe BH, Cho KY. Assessment of modifiable lifestyle factors for obese children and adolescents through questionnaires. Korean J Pediatr 2008. 51576–583.

44. Seong EJ. Metabolic syndrome of Korean children and adolescents 2006. Seoul National University; 43–44. Dissertation.

45. Shai I, Schwarzfuchs D, Henkin Y, Shahar DR, Witkow S, Greenberg I, Golan R, Fraser D, Bolotin A, Vardi H, Tangi-Rozental O, Zuk-Ramot R, Sarusi B, Brickner D, Schwartz Z, Sheiner E, Marko R, Katorza E, Thiery J, Fiedler GM, Blher M, Stumvoll M, Stampfer MJ. Dietary Intervention Randomized Controlled Trial (DIRECT) Group. Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. N Engl J Med 2008. 359(3)229–241.

46. Srinivasan SR, Bao W, Watt igney WA, Berenson GS. Adolescent overweight is associated with adult overweight and related multiple cardiovascular risk factors: the Bogalusa Heart Study. Metabolism 1996. 45235–240.

47. Styne DM. Childhood and adolescent obesity. Prevalence and significance. Pediatr Clin North Am 2001. 48823–854.

48. The Korea Health Industry Development Institute. National food and nutrition statitics 2010.

49. The Korean Society of Nutrition. Dietary reference intake for Koreans 2010.

50. Yang SF, Tzang BS, Yang KT, Hsiao YC, Chang YY, Chan CH, Fu SG, Chen YC. Taurine alleviates dyslipidemia and liver damage induced by a high-fat/cholesterol-dietary habit. Food Chemisty 2010. 120156–162.

51. Yoo HJ, Kim YH. A study on the characteristics of nutrient intake in metabolic syndrome subjects. Korean J Nutr 2008. 41(6)510–517.

52. Abe Y, Kikuchi T, Nagasaki K, Hiura M, Tanaka Y, Ogawa Y, Uchiyama M. Usefulness of GPT for diagnosis of metabolic syndrome in obese Japanese children. J Atheroscler Thromb 2009. 16902–909.

53. Warensjo C, Sundstrom J, Lind L, Vessby B. Factor analysis of fatty acids in serum lipids as a measure of dietary fat quality in relation to the metabolic syndrome in men. Am J Clin Nutr 2006. 84442–448.

54. Webber LS, Srinivasan SR, Wattigney WA, Berenson GS. Tracking of serum lipids and lipoproteins from childhood to adulthood. The Bogalusa Heart Study. Am J Epidemiol 1991. 133884–899.

55. Zhu S, Heshka S, Wang Z, Shen W, Allison DB, Ross R. Combination of BMI and waist circumference for identifying cardiovascular risk factors in whites. Obes Res 2004. 12633–645.