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2018, Número 4

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Gac Med Mex 2018; 154 (4)


Síndrome metabólico y aterosclerosis carotídea subclínica en niños y adolescentes mexicanos con acantosis nigricans

González-Villalobos CG, Guevara-Gutiérrez E, Gutiérrez-Fajardo P, Tlacuilo-Parra JA, Sánchez-Castellanos ME, García-Vargas A, Barba-Gómez JF

Idioma: Español
Referencias bibliográficas: 34
Paginas: 462-467
Archivo PDF: 174.53 Kb.


RESUMEN

Introducción: La acantosis nigricans es un marcador de resistencia a la insulina, la cual se asocia con alteraciones metabólicas y cardiovasculares. Objetivo: Investigar la frecuencia de síndrome metabólico y aterosclerosis carotídea subclínica en niños y adolescentes mexicanos con acantosis nigricans y comparar los resultados entre sexos. Método: Estudio transversal. Se incluyeron 30 sujetos masculinos y 30 femeninos con diagnóstico de acantosis nigricans, menores de 18 años. Se investigó síndrome metabólico (criterios de Cook), riesgo cardiovascular (proteína C reactiva ultrasensible [PCRus]) y aterosclerosis carotídea (grosor íntima-media). Para el análisis de datos se utilizó estadística descriptiva e inferencial. Resultados: La frecuencia de síndrome metabólico fue de 43 % (sexo masculino 42 % versus femenino 58 %, p = 0.58). Todos presentaron niveles anormales de PCRus: 67 % fue clasificado con riesgo cardiovascular moderado y 27 % con riesgo alto. Frecuencia de aterosclerosis carotídea 98 % (masculino 49 % versus femenino 51 %, p = 0.45). La severidad de la acantosis nigricans no influyó en los resultados. Conclusiones: La búsqueda intencionada de síndrome metabólico y aterosclerosis carotídea subclínica en niños y adolescentes mexicanos con acantosis nigricans, independientemente del sexo o severidad de la enfermedad, permitirá implementar medidas para disminuir la morbimortalidad en la edad adulta.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Nguyen TT, Keil MF, Russell DL, Pathomvanich A, Uwaifo GI, Sebring NG, et al. Relation of acanthosis nigricans to hyperinsulinemia and insulin sensitivity in overweight African American and white children. J Pediatr. 2001;138:474-480.

  2. Juárez-López C, Klünder-Klünder M, Medina-Bravo P, Madrigal-Azcárate A, Mass-Díaz E, Flores-Huerta S. Insulin resistance and its association with the components of the metabolic syndrome among obese children and adolescents. BMC Public Health. 2010;10:318.

  3. Sinha S, Schwartz RA. Juvenile acanthosis nigricans. J Am Acad Dermatol. 2007;57:502-508.

  4. Stoddart ML, Blevins KS, Lee ET, Wang W, Blackett PR, Cherokee Diabetes Study. Association of acanthosis nigricans with hyperinsulinemia compared with other selected risk factors for type 2 diabetes in Cherokee Indians: the Cherokee Diabetes Study. Diabetes Care. 2002;25:1009-1014.

  5. Razani B, Chakravarthy MV, Semenkovich CF. Insulin resistance and atherosclerosis. Endocrinol Metab Clin North Am. 2008;37 603-621.

  6. Organisation for Economic Co-operation and Development. [Sitio web]. Obesity Update 2014. [Consultado 2017 Jul 25]. Disponible en: http:// www.oecd.org/els/health-systems/Obesity-Update-2014.pdf

  7. Pearson TA, Mensah GA, Alexander RW, Anderson JL, Cannon RO, Criqui M, et al. Markers of inflammation and cardiovascular disease: application to clinical and public health practice. A statement for health care professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation. 2003;107:499-511.

  8. Burke JP, Hale DE, Hazuda HP, Stern MP. A quantitative scale of acanthosis nigricans. Diabetes Care. 1999;22:1655-1659.

  9. 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;157:821-827.

  10. Fernández JR, Reeden DT, Petrobielli A, Allison DB. Waist circumference percentiles in nationally representative sample of African-American, European-American and Mexican-American children and adolescent. J Pediatr. 2004;145:439-444.

  11. 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;114:555-576.

  12. Amato M, Montorsi P, Ravani A, Oldani E, Galli S, Ravagnani PM, et al. Carotid intima-media thickness by B-mode ultrasound as surrogate of coronary atherosclerosis: correlation with quantitative coronary angiography and coronary intravascular ultrasound findings. Eur Heart J. 2007;28:2094-2101.

  13. Pignoli P, Tremoli E, Poli A, Oreste P, Paoletti R. Intimal plus medial thickness of the arterial wall: a direct measurement with ultrasound imaging. Circulation. 1986;74:1399-1406.

  14. Salonen R, Salonen JT. Determinants of carotid intima-media thickness: a population-based ultrasonography study in eastern Finnish men. J Intern Med. 1991;229:225-231.

  15. Salonen JT, Salonen R. Ultrasound B-mode imaging in observational studies of atherosclerotic progression. Circulation. 1993;87:1156-1165.

  16. Doyon A, Kracht D, Bayazit AK, Deveci M, Duzova A, Krmar RT, et al. Carotid artery intima-media thickness and distensibility in children and adolescents: reference values and role of body dimensions. Hypertension. 2013;62:550-556.

  17. Wang TJ, Gona P, Larson MG, Tofler GH, Levy D, Newton-Cheh C, et al. Multiple biomarkers for the prediction of first major cardiovascular events and death. N Engl J Med. 2006;355:2631-2639.

  18. Asher J, Houston M. Statins and C-reactive protein levels. J Clin Hypertens (Greenwich). 2007;9:622-628.

  19. DeBoer MD, Gurka MJ, Sumner AE. Diagnosis of the metabolic syndrome is associated with disproportionately high levels of high-sensitivity C-reactive protein in Non-Hispanic black adolescents: an analysis of NHANES 1999-2008. Diabetes Care. 2011;34:734-740.

  20. Kluczynik CE, Mariz LS, Souza LC, Solano GB, Albuquerque FC, Medeiros CC. Acanthosis nigricans and insulin resistance in overweight children and adolescents. An Bras Dermatol. 2012;87 531-537.

  21. Fowler SP, Puppala S, Arya R, Chittoor G, Farook VS, Schneider J, et al. Genetic epidemiology of cardiometabolic risk factors and their clustering patterns in Mexican American children and adolescents: the SAFARI Study. Hum Genet. 2013;132:1059-1071.

  22. Halley-Castillo E, Borges G, Talavera JO, Orozco R, Vargas-Alemán C, Huitrón-Bravo G, et al. Body mass index and the prevalence of metabolic syndrome among children and adolescents in two Mexican populations. J Adolesc Health. 2007;40:521-526.

  23. García-García E, De-La-Llata-Romero M, Kaufer-Horwitz M, Tusié- Luna MT, Calzada-León R, Vázquez-Velázquez V, et al. La obesidad y el síndrome metabólico como problema de salud pública. Una reflexión. Salud Publica Mex. 2008;50:530-547.

  24. Magnussen CG, Koskinen J, Chen W, Thomson R, Schmidt MD, Srinivasan SR, et al. Pediatric metabolic syndrome predicts adulthood metabolic syndrome, subclinical atherosclerosis, and type 2 diabetes mellitus but is no better than body mass index alone: the Bogalusa Heart Study and the Cardiovascular Risk in Young Finns Study. Circulation. 2010;122:1604-1611.

  25. Morrison JA, Friedman LA, Gray-McGuire C. Metabolic syndrome in childhood predicts adult cardiovascular disease 25 years later: the Princeton Lipid Research Clinics Follow-up Study. Pediatrics. 2007;120:340-345.

  26. Srinivasan SR, Myers L, Berenson GS. Predictability of childhood adiposity and insulin for developing insulin resistance syndrome (syndrome X) in young adulthood: the Bogalusa Heart Study. Diabetes. 2002;51:204-209.

  27. Raitakari OT, Porkka KV, Rönnemaa T, Knip M, Uhari M, Akerblom HK, et al. The role of insulin in clustering of serum lipids and blood pressure in children and adolescents. Diabetologia. 1995;38:1042-1050.

  28. Arroyo-Espliguero R, Avanzas P, Kaski JC. Enfermedad cardiovascular ateroesclerótica: la utilidad de la proteína C reactiva en la identificación de la placa vulnerable y del paciente “vulnerable”. Rev Esp Cardiol. 2004;57:375-378.

  29. Soriano-Guillén L, Hernández-García B, Pita J, Domínguez-Garrido N, Del-Río-Camacho G, Rovira A. High-sensitivity C-reactive protein is a good marker of cardiovascular risk in obese children and adolescents. Eur J Endocrinol. 2008;159:1-4.

  30. Berenson GS, Srinivasan SR, Bao W, Newman HP, Tracy RE, Wattigney WA. Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. The Bogalusa Heart Study. N Engl J Med. 1998;338:1650-1656.

  31. McGill HC, McMahan CA, Herderick EE, Zieske AW, Malcom GT, Tracy RE, et al. Obesity accelerates the progression of coronary atherosclerosis in young men. Circulation. 2002;105:2712-2718.

  32. Bots ML, Evans GW, Riley WA, Grobbee DE. Carotid intima-media thickness measurements in intervention studies: design options, progression rates, and sample size considerations: a point of view. Stroke. 2003;34:2985-2994.

  33. Rtveladze K, Marsh T, Barquera S, Sanchez-Romero LM, Levy D, Melendez G, et al. Obesity prevalence in Mexico: impact on health an economic burden. Public Health Nutr. 2014;17:233-239.

  34. Obesity and the economics of prevention: Fit not fat. Key facts-Mexico, update 2014. France: Organization for Economic Cooperation and Development; 2014.




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