Fasting glucose: a cardiometabolic indicator for subclinical atherosclerosis on excess weight adolescents.

OBJECTIVE: To build a model based on cardiometabolic indicators that allow the identification of overweight adolescents at higher risk of subclinical atherosclerotic disease (SAD). METHODS: Cross-sectional study involving 161 adolescents with a body mass index ≥ +1 z-Score, aged 10 to 19 years. Carotid intima-media complex thickness (IMT) was evaluated using ultrasound to assess subclinical atherosclerotic disease. Cardiometabolic indicators evaluated included nutritional status, central adiposity, blood pressure, lipidic profile, glycemic profile, as well as age and sex. Data was presented using measures of central tendency and dispersion, as well as absolute and relative frequency. The relationship between IMT measurement (outcome variable) and other variables (independent variables) was assessed using Pearson or Spearman correlation, followed by multiple regression modeling with Gamma distribution to analyze predictors of IMT. Statistical analysis was performed using SPSS and R software, considering a significance level of 5 %. RESULTS: It was observed that 23.7 % had Carotid thickening, and the prevalence of abnormal fasting glucose was the lowest. Age and fasting glucose were identified as predictors of IMT increase, with IMT decreasing with age by approximately 1 % per year and increasing with glucose by around 0.24 % per mg/dL. CONCLUSION: The adolescent at higher risk is younger with higher fasting glycemia levels.

Leptin and cardiometabolic risk factors in obese children and adolescents.

AIM: To verify the relationship between leptin and cardiometabolic risk factors in obese children and adolescents. METHODS: A cross-sectional study evaluated 200 children and adolescents treated in Campina Grande, Brazil, from April 2009 to March 2010. Leptin, fasting glucose, insulin, homeostasis model assessment of insulin resistance (HOMA-IR), total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides were determined. The t-test was used to compare leptin means of two groups and analysis of variance to compare means of three groups. Multiple comparisons of pairs of group means were performed with Tukey's test. In all tests, a significance level of 0.05 was adopted. RESULTS: The leptin sample mean was 22.7 ± 10.0 µg/L (95% confidence interval: 21.3 µg/L to 24.1 µg/L). Leptin was significantly higher in the following groups: female, teenager, increased waist circumference, high systolic blood pressure, elevated triglycerides hyperinsulinemia, insulin resistance and metabolic syndrome. Most cardiometabolic risk factors had higher means in the last quartile of leptin, except total-cholesterol, LDL-C and triglycerides levels. HDL-C was reduced in the last quartile of leptin. Simple linear regression analysis showed a significant negative correlation between leptin and HDL-C and a positive correlation between leptin and triglycerides, insulin, HOMA-IR, body mass index, waist circumference, and systolic and diastolic blood pressure. Multiple linear regression models showed an independent association between leptin and HDL-C, triglycerides, insulin, HOMA-IR, body mass index, waist circumference, systolic and diastolic blood pressure, after age and gender control. CONCLUSION: Leptin may be a useful marker of metabolic syndrome and insulin resistance in obese adolescents.