Year 2017 / Volume 109 / Number 11
Original
Insulin resistance and the metabolic syndrome are related to the severity of steatosis in the pediatric population with obesity

772-777

DOI: 10.17235/reed.2017.4898/2017

Esther Ubiña-Aznar, Leopoldo Tapia-Ceballos, José Miguel Rosales-Zabal, Rocío Porcel-Chacón, Francisco Poveda-Gómez, Carmen Lozano-Calero, Carmen Ortiz-Cuevas, Francisco Rivas-Ruiz, Andrés Sánchez Cantos, José María Navarro Jarabo,

Abstract
Background: To determine the factors associated with an increased risk for severe steatosis (SS) and establish the Homeostatic Model Assessment-Insulin Resistance (HOMA-IR) as a screening tool. Methods: A cross-sectional study was performed in obese children to assess the relationship between the metabolic syndrome (MetS) and glucose metabolism alterations (GMA) and the risk for severe steatosis. Results: A total of 94 children (51 males) aged from six to 14 years were included. Thirteen children (14.8%) had severe steatosis (SS). The anthropometric variables associated with SS included body mass index (BMI) (SS 34.1 vs non-SS 29.7, p = 0.005), waist circumference (cm) (100 vs 92.5, p = 0.015) and hip circumference (cm) (108 vs 100, p = 0.018). The blood parameters included alanine aminotransferase (ALT) (UI/dl) (27 vs 21, p = 0.002), gamma-glutamil transpeptidase (GGT) (UI/dl) (16 vs 15, p = 0.017), fasting glycemia (mg/dl) (96 vs 88, p = 0.006), fasting insulin (UI/dl) (25 vs 15.3, p < 0.001) and HOMA-IR score (7.1 vs 3.7, p < 0.001). Eighteen children with MetS were found to be at an increased risk for severe steatosis (odds ratio [OR] 11.36, p < 0.001). After receiver operating characteristic (ROC) curve analysis, the best area under the curve (AUC) was obtained for HOMA-R of 0.862. The HOMA-R 4.9 cut-off value had a 100% sensitivity (CI 95%: 96.2-100) and 67.9% specificity (CI 95%: 57.1-78.7) for severe steatosis. Conclusions: The presence of MetS and glucose metabolism alterations are risk factors for severe steatosis. The 4.9 cut-off value for HOMA-IR may be a risk factor for severe steatosis in obese children.
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Ubiña-Aznar E, Tapia-Ceballos L, Rosales-Zabal J, Porcel-Chacón R, Poveda-Gómez F, Lozano-Calero C, et all. Insulin resistance and the metabolic syndrome are related to the severity of steatosis in the pediatric population with obesity. 4898/2017


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Publication history

Received: 12/02/2017

Accepted: 14/07/2017

Online First: 04/08/2017

Published: 02/11/2017

Article revision time: 151 days

Article Online First time: 173 days

Article editing time: 263 days


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