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2012, Number 1

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Rev Cubana Pediatr 2012; 84 (1)

Metabolic alterations in obese patients and its association with the acanthosis nigricans

Rivero GM, Cabrera PR, Luis ÁMC, Pantoja PO

Language: Spanish
References: 41
Page: 1-10
PDF size: 60.26 Kb.


ABSTRACT

Introduction: nowadays, obesity is considered a worldwide increasing epidemic. This phenomenon involves children and adults and it is associated with the early appearance of non-communicable chronic diseases that in the past were exclusive of adults, but that may be present in early ages of life.
Objective: to identify the clinical and metabolic alterations in obese patients and its association with acanthosis nigricans.
Methods: a prospective and longitudinal study was conducted in 60 patients diagnosed with exogenous obesity with or without acanthosis nigricans from January, 2009 to January, 2010 in the endocrinology services of the "William Soler" Teaching Children Hospital. Authors also carried out anamnesis and physical examination, glucose tolerance test, with fasting glycemia and insulinemia determination and at two hours, cholesterol determination, triglycerides and liver ultrasound.
Results: the 55 % of study patients had acanthosis nigricans. In this group of patients there was predominance of high blood pressure (18.2 %), as well as the hyperinsulinism (21.2 %). Altered glucose tolerance test (6 %), lipid alterations (27.2 %) and hepatic steatosis predominated in the obese patients presenting with acanthosis nigricans.
Conclusions: obesity in pediatric age may be a high risk to suffer metabolic complications, mainly in the obese patient with acanthosis nigricans.


REFERENCES

  1. Hermoso López E. Obesidad infantil. Concepto, valoración, clasificación, etiopatogenia, bases genéticas. En: Cañete Estrada R, Fernández García JM. Universidad Internacional de Andalucía. Editores. III Curso de Endocrinología Pediátrica. Actualizaciones en Endocrinología Pediátrica. Madrid: Ed. ERGON;2009. p. 81-93.

  2. Socarrás MM, Bolet M, Licea ME. Obesidad: tratamiento no farmacológico y prevención. Rev Cubana Endocrinol. 2002:13:35-42.

  3. Zayas GM, Chiong D, Díaz Y, Tórnente A, Herrera X. Obesidad en la infancia: diagnóstico y tratamiento. Rev Cubana Pediatr. 2002;74:233-9.

  4. Mukhta Q, Cleverley G, Voorhees R, Mc Grath J. Prevalence of acanthosis nigricans and its association with hiperinsulinemia in adolescents. J Adolesc Health. 2009;28:372-6.

  5. National Heart, Lung, and Blood Institute. Update on the 1987 Task Forcé Report on High Blood pressure in children and adolescents: a working group report from the national high pressure education program. In: Beth A, Vogt MD. Hypertension in children and adolescents: definition, pathophysiology, risk factors, and long-term sequelae. Current Therapeutic Research. 2001;62:283-97.

  6. Arranz C, González R, Álvarez A, Rodríguez B, Reyes A. Criterios de referencia para los indicadores de secreción de insulina y de los parámetros lipídicos en una población mixta hospitalaria. Rev Cubana Endocrinol. 2010;21(1):1-12.

  7. Harris SB, Macaulay AC. Diabetes management: new evidence-based recommendations. Highlights of 1998 Canadian Clinical Guidelines. Canadian Diabetes Associations. Can Fam Physicians. 1998;44:2465-79.

  8. Tietz NM. Clinical Guide to Laboratory Tests. 3rd ed. Philadelphia: WB Saunders Co;1995. p. 366-7.

  9. Stuart CH, Gikinson CH, Smith M. Acantosis nigricans. Clin Pediatr. 1998;37:73-80.

  10. Srinivasan S, Waters MJ, Rowland JE, Baxter RC, Verge CF. Hyperinsulinism and overgrowth without obesity. Arch Dis Child. 2003;88:332-4.

  11. Hirschier V, Aranda C, Oneto A, González C, Jadzinsky M. Is acanthosis nigricans a marker of insulin resistance in obese children? Diabetes Care. 2002;25:2353.

  12. López-Alvarenga JC, García-Hidalgo L, Landa-Anell MV, Santos-Gómez R, González-Barranco J, Comuzzie A. Influence of skin color on the diagnostic utility of clinical acanthosis nigricans to predict insulin resistance in obese patients. Arch Med Res. 2006;37:744-8.

  13. Reeds DN, Stuart CA, Pérez O, Klein S. Adipose tissue, hepatic, and skeletal muscle insulin sensitivity in extremely obese subjects with acanthosis nigricans. Metabolism. 2006;55:1658-63.

  14. Stunkard AJ, Soresen TLA, Hanis C. An adoption study of human obesity. N Engl Med. 1986;318:461-6.

  15. Bouchard C. Heredity and regional fat distribution during growth. En: Human growth: basic and clinical aspects. Hernández M, Argente J (eds). Amsterdam: Elsevier Sci Pub;1992. p. 227-32.

  16. Stumvoll M, Golstein B Van Haeften TW. Type 2 diabetes: principies of pathogenesis and therapy. Lancet. 2005;365:1333-46.

  17. Kahn CR. Banting lecture: insulin action, diabetogenes, and the cause of type II diabetes. Diabetes. 1994;43:1066-84.

  18. Poulsen P, Kyvik KO, Vaag A, Beck-Nielsen H. Heritability of type II (noninsulin-dependent) diabetes mellitus and abnormal glucose tolerance: a populationbased twin study. Diabetologia. 1999;42:139-45.

  19. Medici F, Hawa M, lanari A, Pyke DA, Leslie RD. Concordance rate for type II diabetes mellitus in monozygotic twins: actuarial analysis. Diabetologia. 1999;42:146-60.

  20. Amigo H. Obesidad en el niño en América Latina: situación, criterios de diagnóstico y desafio. Cad Saúde Pública, Río de Janeiro. 2003;19(supl):S163-70.

  21. Graupner C, Rodríguez L, García de Castro A. Síndrome metabólico e hipertensión arterial. Monocardio. 2003;V:167-76.

  22. 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 [serie en internet]. 2004 [citado 10 de mayo de 2011];114(2). Disponible en: http://pediatrics.aappublications.org/content/114/Supplement_2/555.full.pdf+html

  23. Güell González R, Carvajal Martínez F. Obesidad en el niño y en el adolescente. Tomo VII. La Habana: Editorial Ciencias Médicas;2004. p. 97-109.

  24. Williams CL, Hayman LL, Daniels SR, Robinson TN, Steinberger J. Cardiovascular health in childhood: a statement for health professionals from Committee on Atherosclerosis, Hypertension, and Obesity in the Young of the Council on Cardiovascular Disease in the Young. American Heart Association. Circulation. 2002;106:143-60.

  25. Lurbe E, Cifkova R, Cruickshank JK, Dillon MJ, Ferreira I, Kuznetsova T, et al. Manejo de la hipertensión arterial en niños y adolescentes: recomendaciones de la Sociedad Europea de Hipertensión. An Pediatr (Barc). 2010;73(1):51.e1-51.e28.

  26. Daniels SR, Arnett DK, Eckel RH, Gidding SS, Hayman LL. Overwight in children and adolescents: pathophysiology, consequences, prevention and treatment. Circulation. 2005;111:1999-2012.

  27. Bueno M. Obesidad. Tratado de Pediatría. 8va. edición. Barcelona: Ergón;2000. p. 635-42.

  28. National Cholesterol Education Panel (NCEP). Adult treatment Panel III (ATPIII). JAMA. 2001;285:2486.

  29. American Diabetes Association. Standards of Medical Care in Diabetes-2007. Diabetes Care. 2007;30:S4-S41.

  30. Arslanian A. Type 2 Diabetes in children: clinical aspects and riskfactors. Horm Res. 2008;57(Suppl 1):19-28.

  31. Gungor N, Hannon T, Libman I, Bacha F, Arsianian A. Type 2 Diabetes Mellitus in youth: the complete picture to date. Pediatr Clin North Am. 2005;52:1579-609.

  32. Hahier B. An overview of dermatological conditions commonly associated with the obese patient. Ostomy Wound Manage. 2006;52:34-6.

  33. Ehtisham S, Barrett TG, Shaw NJ. Type 2 diabetes metlitus in UK children: an emerging problem. Diabet Med. 2000;17:867-71.

  34. Kitagawa T, Owada M, Urakami T, Yamauchi K. Increased incidence of noninsulin dependent diabetes mellitus among Japanese school children correlates with an increased intake of animal protein and fat. Clin Pediatr. 1998;37:111-5.

  35. Kadiki O, Reddy M, Marzouk A. Incidence of insulin-dependent Diabetes (IDDM) and non insulin-dependent diabetes (NIDDM) (0-34 years at onset) in Benghazi, Lybia. Diabetes Res Clin Pract. 1996;32:165-73.

  36. Braun B, Zimmermann MB, Kretchner N, Spargo RM, Smith RM, Gracey M. Risk factors for diabetes and cardiovascular disease in young Australian 108 aborigens: a 5 years follow-up study. Diabetes Care. 1996;19:472-9.

  37. Arslain S. Type 2 Diabetes Mellitus in children. Clinical aspects and risk factor. Horm Res. 2002;57:19-28.

  38. Freedman DS, Khan LK, Dietz WH. Relation ship of childhood obesity to coronary heart disease risk factors in adulthood: The Bogalusa Heart Study. Pediatrics. 2001;108:712-8.

  39. Lauer RM, Lee J, Clarke WR. Factors affecting the relations between childhood and adult cholesterol levels: the Muscatine Study. Pediatrics. 2006;82:309-18.

  40. Fishbein Mh, Mogren C, Gleason T. Relationship of hepatic steatosis to adipose tissue distribution in pediatric non-alcoholic fatty liver disease. J Pediatr Gastroenterol Nutr. 2007;42:83-8.

  41. Kaechele V, Wabitsch M, Thiere D, Kessler AL, Haenle MM, Mayer H, et al. Prevalence of gallblader stone disease in obese children and adolescents: influence of the degree of obesity, sex, and pubertal development. J Pediatr Gastroenterol Nutr. 2006;42:66-70.




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