Correlation of body mass index <i>Z</i>-scores with glucose and lipid profiles among overweight and obese children and adolescents

Nogueira-de-Almeida, Carlos Alberto; Mello, Elza Daniel de

doi:10.1016/j.jped.2017.06.012

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Original articles • J. Pediatr. (Rio J.) 94 (3) • May-Jun 2018 • https://doi.org/10.1016/j.jped.2017.06.012 copy

Correlation of body mass index Z-scores with glucose and lipid profiles among overweight and obese children and adolescents^☆ ☆ Please cite this article as: Nogueira-de-Almeida CA, Mello ED. Correlation of BMI Z-scores with glucose and lipid profiles among overweight and obese children and adolescents. J Pediatr (Rio J). 2018;94:308-12. , ^☆☆ ☆☆ Study conducted at Universidade Federal de São Carlos (UFSCAR), São Carlos, SP; and Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

To evaluate the prevalence of abnormalities in plasma lipid and glucose profiles among overweight and obese children and adolescents, and to assess the presence of a correlation between body mass index Z-scores and indicators of comorbidities related to both profiles.

Methods

This was a multicenter cross-sectional study conducted at two outpatient clinics. The study included all 417 comers for the first visit from 2008 to 2012, aged between 7 and 18 years, with BMI above the Z-score +1. Anthropometry and blood sampling were obtained. The prevalence of dyslipidemias, hyperglycemia, and insulin resistance were evaluated, together with the correlations of these variables with the increase of Z-BMI.

Results

Dyslipidemia was observed in 43.4% of the boys and 66.1% of the girls, with no difference between genders. High glucose levels were detected in 6.2% of the individuals. Insulin resistance was present in 32.3% and 41.7% of the cases, with no statistical significance between boys and girls. Correlations between the Z-BMI were noted for triglycerides in the entire group and among girls; for HDL-c, only among girls; for glucose, a correlation was observed for the entire group, but not when stratified by gender. The indicators of insulin resistance were all correlated with Z-BMI, even when corrected for age.

Conclusions

Overweight and obesity give origin to a high prevalence of dyslipidemia and insulin resistance. BMI Z-scores showed a weak positive correlation with glucose and triglyceride, and negative with HDL-c. In turn, the strongest positive correlation was found with insulin resistance indicators.

KEYWORDS
Obesity; Overweight; Dyslipidemias; Insulin resistance; Child; Adolescent

	Boys + girls (n = 417) n (%)	Boys (n = 189) n (% among boys)	Girls (n = 228) n (% among Girls)	Boys vs. girls p^a a Fisher exact test.
Total cholesterol > 150 mg/dL	273 (65.5)	125 (66.1)	148 (64.9)	0.8364
LDL-c > 100 mg/dL	189 (45.3)	83 (43.9)	106 (46.5)	0.6221
HDL-c < 45 mg/dL	199 (47.7)	82 (43.4)	117 (51.3)	0.1157
Triglycerides > 100 mg/dL	189 (45.3)	84 (44.4)	105 (46.1)	0.7675
Glucose > 100 mg/dL	26 (6.2)	14 (7.4)	12 (5.3)	0.4187
Plasma insulin > 15 µU/mL	156 (37.4)	61 (32.3)	95 (41.7)	0.0537
HOMA > 3.16	161 (38.6)	69 (36.5)	92 (40.4)	0.4795

	Boys + Girls R (p)	Boys R (p)	Girls R (p)
Total cholesterol	−0.01388 (0.7865)	0.05364 (0.4847)	−0.1031 (0.1354)
LDL-c	−0.01994 (0.6973)	0.05797 (0.4500)	−0.08481 (0.2199)
HDL-c	−0.08400 (0.1007)	−0.04759 (0.5353)	−0.1677 (0.0147)
Triglycerides	0.1184 (0.0204)	0.07521 (0.3268)	0.1592 (0.0207)
Glucose	0.1249 (0.0144)	0.1482 (0.0523)	0.06200 (0.3702)
Plasma insulin	0.3228 (<0.0001)	0.3076 (<0.0001)	0.4297 (<0.0001)
HOMA	0.3292 (<0.0001)	0.3139 (<0.0001)	0.4233 (<0.0001)
Age-adjusted insulin	0.1578 (<0.0001)	0.2627 (<0.0001)	0.1078 (<0.0001)
Age-adjusted HOMA	0.1510 (<0.0001)	0.2543 (<0.0001)	0.0926 (<0.0001)

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[1] * Corresponding author. E-mail:dr.nogueira@me.com (C.A. Nogueira-de-Almeida).