medigraphic.com
Instituto Nacional de Salud Pública

2007, Number S3

<< Back Next >>

salud publica mex 2007; 49 (S3)

Body mass index associated with hyperglycemia and alterations of components of metabolic syndrome in Mexican adolescents

Villalpando S, Carrión C, Barquera S, Olaiz-Fernández G, Robledo R

Language: English
References: 37
Page: 324-330
PDF size: 176.54 Kb.


ABSTRACT

Objective. This research aims to describe the epidemiology of obesity and its association with alterations in some components of metabolic syndrome, such as serum concen-trations of glucose, insulin, and some lipids in a sub-sample of the Mexican Health Survey (MHS) of youth ages 10 to 19 years. Material and Methods. This analysis is based on a randomly selected sub-sample of the MHS of 20% of the youth ages 10 to19 years (n=1977), carried-out in Mexico in the year 2000 and distinguishes differences between national, rural and urban areas as well as four geographical country regions. Serum concentrations of glucose, insulin, triglycerides (TG), total cholesterol (TC) and HDL-cholesterol (HDLc) were measured. The protocol was approved by the Ethics Committee of the Mexican National Institute of Public Health. Results. Overall, 14.8% of the individuals were overweight, 6.7% were obese and 37.5% had a family history of type 2 diabetes mellitus (DM2). The overall mean concentrations of glucose, insulin, total cholesterol, and triglycerides were significantly higher and those of HDLc were significantly lower in obese subjects than in individuals with normal Body Mass Index (BMI) (p‹ 0.05-0.001). The probability ratio (PR) of being in quintile 5 for glucose distribution was significantly higher for obese males and females (RP=2.1, p‹0.001) than for their non-obese counterparts. It was also higher for females with a history of DM2 (RP=1.12, p‹0.02), but not for males. The PR of being in quintile 5 for insulin distribution was significantly higher for obese males (RP=3.51, p‹0.001) and females (RP=3.3, p‹0.001) than for non-obese counterparts. It was also higher for male (RP=1.28, p‹0.02) and female (RP=1.27, p‹0.02) subjects with a history of DM2. Finally, the PR for being in quintile 5 for TG distribution was significantly higher for obese males (RP=4.71, p‹0.001) and females (RP=1.75, p‹0.001) than for their non-obese counterparts. Discussion. A strong association between obesity and the risk of higher concentrations of glucose, insulin, TG, and TC and a lower concentration of HDLc in youth has been demonstrated. These findings stress the risk of obesity at these early ages, with alterations in some of the components of metabolic syndrome.


REFERENCES

  1. Chávez A, Ávila A, Shamah T. Cuarta Encuesta Nacional de Alimentación y Nutrición en el Medio Rural. ENAL96. México: INNSZ, 1996.

  2. Hernández B, Peterson K, Sobol A, Rivera J, Sepúlveda J, Lezana MA. Sobrepeso en mujeres de 12 a 49 años y niños menores de cinco años en México. Salud Publica Mex 1996;38:178-188.

  3. Secretaría de Salud, Dirección General de Epidemiología. Encuesta Nacional de Enfermedades Crónicas, 1993. México, DF: SSA,1993.

  4. González de Cossío T, Rivera J, Shamah T, Ramírez I, Barquera S, Morales C, et al. Mujeres. En: Encuesta Nacional de Nutrición 1999. Cuernavaca, Morelos, México: INSP, 2001:103-178.

  5. Del Río-Navarro BE, Velásquez O, Sánchez-Castillo CP, Lara A, Berber A, Fanghaenel G, et al. The high prevalence of overweight and obesity in Mexican children. Obesity Res 2004;12:215-223.

  6. Rivera J, Shamah T, Villalpando S, González T, Hernández B, Sepúlveda J, eds. Encuesta Nacional de Nutrición 1999. Estado Nutricio de Niños y Mujeres en México. Cuernavaca, Morelos, México: INSP, 2001.

  7. Sepúlveda-Amor J, Lezana MA, Tapia-Conyer R, Valdespino JL, Madrigal H, Kumate J. Estado nutricional de preescolares y mujeres en México: resultados de una encuesta probabilística nacional. Gac Med Mex 1990;126:207-224.

  8. Atherosclerosis, Hypertension, and Obesity in the young Committee: Obesity, insulin resistance, diabetes, and cardiovascular risk in Children. Circulation 2003;107:1448-1453.

  9. Dietz WH. Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics 1998;101(3 Pt 2):518-525.

  10. National Cholesterol Education Program. Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III: Full Report) .Bethesda, Md: National Institutes of Health, 2001.

  11. Pinhas-Hamiel O, Dolan LM, Daniels SR, Standiford D, Khoury PR, Zeitler P. Increased incidence of non-insulin-dependent diabetes mellitus among adolescents. J Pediatr 1996;128(5 Pt 1):608-615.

  12. Fagot-Campagna A, Pettitt DJ, Engelgau MM, Burrows NR, Geiss LS, Valdez R, et al. Type 2 diabetes among North American children and adolescents: an epidemiologic review and a public health perspective. J Pediatr 2000;136(5):664-672.

  13. Ludwig DS, Ebbeling CB. Type 2 diabetes mellitus in children: primary care and public health considerations. JAMA 2001;286(12):1427-1430.

  14. Fagot-Campagna A, Burrows NR, Williamson DF. The public health epidemiology of type 2 diabetes in children and adolescents: a case study of American Indian adolescents in the Southwestern United States. Clin Chim Acta 1999;286(1-2):81-95.

  15. Pearson TA, Blair SN, Daniels SR, Eckel RH, Fair JM, Fortmann SP, et al. AHA Guidelines for Primary Prevention of Cardiovascular Disease and Stroke: 2002. Update: Consensus Panel Guide to Comprehensive Risk Reduction for Adult Patients Without Coronary or Other Atherosclerotic Vascular Diseases. American Heart Association Science Advisory and Coordinating Committee. Circulation 2002;106(3):388-391.

  16. Executive Summary of The 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). JAMA 2001;285(19):2486-2497.

  17. Cruz M, García-Macedo R, García-Valerio Y, Gutiérrez M, Medina-Navarro R, Duran G, et al. Low adiponectin levels predict type 2 diabetes in Mexican children. Diabetes Care 2004;27(6):1451-1453.

  18. Urrutia-Rojas X, Menchaca J, Wadley W, Ahmad N, Lacko A, Bae S, et al. Cardiovascular risk factors in Mexican-American children at risk for type 2 diabetes mellitus (T2DM). J Adolesc Health 2004;34(4):290-299.

  19. Trevino RP, Marshall RM Jr, Hale DE, Rodríguez R, Baker G, Gómez J. Diabetes risk factors in low-income Mexican-American children. Diabetes Care 1999;22(2):202-207.

  20. Glaser NS, Jones KL. Non-insulin dependent diabetes mellitus in Mexican-American children. West J Med 1998;168(1):11-16.

  21. Valdespino JL, Olaiz G, López MP, Mendoza L, Palma O, Velázques O, et al. Encuesta Nacional de Salud 2000. Cuernavaca, Morelos, México: INSP, 2003.

  22. Cole T, Bellizzi M, Flegal K, Dietz W. Establishing a standard definition of child overweight and obesity worldwide: international survey. British Medical Journal 2000;320:1240-1243.

  23. Zhang J, Yu KF. What’s the relative risk? A method of correcting the odds ratio in cohort studies of common outcomes. JAMA 1998;280:1690-1691.

  24. Must A, Spadano J, Coakley EH, Field AE, Colditz G, Dietz WH. The disease burden associated with overweight and obesity. JAMA 1999;282:1523-1529.

  25. Ley de Información Estadística y Geográfica. Diario Oficial de la Federación. Estados Unidos Mexicanos, 1980.

  26. Must A, Jacques PF, Dallal G, Bajerna CD, Dietz WW. Long-term morbidity and mortality of overweight adolescents: a follow up of the Harvard Growth Study of 1922 to 1935. N Engl J Med 1992;327: 1350-1355.

  27. Vanhala MJ, Vanhala PT, Keinanen-Kiukaanniemi SM, Kumpusalo EA, Takala JK. Relative weight gain and obesity as a child predicts metabolic syndrome as an adult. Int J Obes 1999;23:656-659.

  28. Reaven G. Insulin resistance, hypertension and coronary heart disease. J Clin Hypertens 2003;5:269-274.

  29. Ball GD, McCargar LJ. Childhood obesity in Canada: a review of prevalence estimates and risk factors for cardiovascular disease and type 2 diabetes. Can J Appl Physiol 2003;28:117-140.

  30. Goran MI, Ball GD, Cruz ML. Obesity and risk of type 2 diabetes and cardiovascular disease in children and adolescents. J Clin Endocrinol Metab 2003;88:1417-1427.

  31. Swiburn B, Egger G. Preventive strategies against weight gain and obesity. Obes Rev 2002;3:289-301.

  32. Brand-Miller JC. Postprandial glycemia, glycemic index, and the prevention of type 2 diabetes. Am J Clin Nutr 2004;80:243-244.

  33. Grundy SM, Brewer SB, Cleeman JI, Smith SC, Lenfant C. Definition of metabolic syndrome: Report of the National Heart, Lung and Blood Institute, American Heart Association conference on scientific issues related to definition. Circulation 2004;109:433-438.

  34. Gómez-Pérez FJ, Ríos JT, Aguilar-Salinas CA, Lerman I, Rull JA. Posición de la SMNE sobre el manejo del Síndrome metabólico (2ª parte). Endocrinol Nutr 2005;13:9-23.

  35. Carroll MD, Lacher DA, Sorlie PD, Cleeman JI, Gordon DJ, Wolz M, et al Trends in serum lipids and lipoproteins of adults, 1960-2002. JAMA 2005;294(14):1773-1781.

  36. Kosuge K, Miida T, Takahashi A, Obayashi K, Ito M, Ito T, et al. Estimating the fasting triglyceride concentration from the postprandial HDL-cholesterol and apolipoprotein CIII concentrations. Atherosclerosis 2005;14.

  37. Desmeules S, Arcand-Bosse JF, Bergeron J, Douville P, Agharazii M. Nonfasting non-high-density lipoprotein cholesterol is adequate for lipid management in hemodialysis patients. Am J Kidney Dis 2005;45(6): 1067-1072.




2020     |     www.medigraphic.com