RESUMO
INTRODUCTION: a relationship has been observed between elevated levels of liver enzymes and uric acid with the presence of metabolic syndrome (MS) in the pediatric population. OBJECTIVE: to compare serum liver enzyme and uric acid levels between adolescents with and without MS. METHODS: a cross-sectional study was carried out in adolescents with obesity between 10 and 18 years old. Somatometric data, serum insulin, lipid profile, uric acid levels and liver enzymes (aspartate aminotransferase [AST], alanine aminotransferase [ALT] and gamma-glutamyl transferase [GGT]) were analyzed. STATISTICAL ANALYSIS: Student's t test or the Chi-square test was used to evaluate differences between groups. RESULTS: a total of 1095 adolescents with obesity were included (444 with MS and 651 without MS). The group with MS had a higher BMI (with MS 2.28 vs without MS 2.11 p < 0.001), with no difference in body fat (42.9 % vs 42.9 %, p = 0.978). The MS group had significantly higher levels of AST (34.4 vs. 29.5, p = 0.013), ALT (42.2 vs. 34.6, p = 0.003), and uric acid (6.17 vs. 5.74, p = 0.002). comparison to the group without MS. The proportion of ALT (40.5 % vs 29.5 %, p = 0.029) and altered uric acid (58.1 % vs. 45.6 %, p = 0.019) was higher in the MS group. CONCLUSIONS: serum levels of ALT, AST and uric acid in adolescents with obesity and MS were higher compared to those without MS. Altered ALT was a risk factor for SM.
RESUMO
Introducción: la obesidad en la población pediátrica es un problema de salud pública. Se ha demostrado la correlación del ácido úrico y el grosor de la íntima media de la carótida en adultos. Objetivo: identificar la correlación del ácido úrico y el grosor de la íntima media de la carótida en adolescentes con obesidad. Material y métodos: se realizó un estudio observacional, transversal. Se incluyeron pacientes de diez a 16 años con diagnóstico de obesidad. Se determinó ácido úrico, perfil de lípidos y grosor de la íntima media carotidea. En el análisis estadístico, se correlacionó el grosor de la íntima media carotídea con los niveles de ácido úrico a través del coeficiente de correlación de Spearman. Resultados: se incluyeron 169 adolescentes con una mediana para la edad de 13 años, sin predominio de sexo. Se identificó una correlación positiva del ácido úrico con el grosor de la íntima media carotídea (r = 0,242, p = 0,001). Al estratificarse de acuerdo con el sexo, no hubo correlación en las mujeres (r = -0,187, p = 0,074), mientras que en los hombres aumentó (r = 0,36, p = 0,001) y por estadio puberal, los adolescentes varones púberes tuvieron una correlación positiva (p = 0,384, p = 0,002). Conclusión: se identificó una correlación positiva débil entre el grosor de la íntima de la carótida y el ácido úrico en adolescentes con obesidad. (AU)
Introduction: obesity in the pediatric population is a public health problem. The correlation of uric acid and carotid intima media thickness in adults has been demonstrated.Objective: to identify the correlation of uric acid and carotid intima media thickness in adolescents with obesity.Material and methods: an observational, cross-sectional study was carried out. Patients aged ten to 16 years with a diagnosis of obesity were included. Uric acid, lipid profile and carotid intima media thickness were determined. In relation to the statistical analysis, carotid intima media thickness was correlated with uric acid levels through Spearman's correlation coefficient. Results: one hundred and sixty-nine adolescents were included with a median age of 13 years, without predominance of sex. A positive correlation of uric acid with carotid intima media thickness was identified (r = 0.242, p = 0.001). When stratified according to sex, there was no correlation in women (r = -0.187, p = 0.074), while in men it increased (r = 0.36, p = 0.001) and by pubertal stage, pubertal male adolescents had a positive correlation (p = 0.384, p = 0.002).Conclusion: a weak positive correlation was identified between carotid intimal thickness and uric acid in obese adolescents. (AU)
Assuntos
Humanos , Masculino , Feminino , Adolescente , Obesidade , Ácido Úrico , Espessura Intima-Media Carotídea , Estudos Transversais , México , Correlação de DadosRESUMO
Introducción: El síndrome metabólico (SM) consiste en conjunto de alteraciones metabólicas y cardiovasculares relacionadas con resistencia insulínica y la grasa visceral. Los índices antropométricos de adiposidad visceral son herramientas útiles que pudieran detectar complicaciones metabólicas en niños obesos. Objetivos: Determinar correlación entre índices de adiposidad visceral y componentes del SM en pacientes pediátricos obesos. Métodos: Estudio transversal, pacientes de 6-16 años. Inclusión: IMC ≥ 85p, exclusión: obesidad endógena, genopatías, uso de esteroides, silla de ruedas y yesos. Variables: CC (circunferencia de cintura), ICE (índice cintura-estatura), ICC (índice de cintura-cadera), TAS, TAD (tensión arterial sistólica y diastólica), triglicéridos, colesterol total, HDL (lipoproteína alta densidad), LDL (lipoproteína de baja densidad), VLDL (lipoproteína de muy baja densidad), ácido úrico sérico, insulina, índice de HOMA. Estándares internacionales para variables. Estadística: Frecuencias, porcentajes, medias/medianas, DS/rango, correlación Pearson. Resultados: 83 pacientes, mediana 11 años. 49 (51%) masculinos. Media IMC 31.4 (DS 6.3). Diagnóstico de obesidad visceral por ICE= 96.3%; por CC =80.7% y por ICC= 57.8%. Correlaciones: CC con TAS= r 0.35, p 0.001; TAD =r 0.29, p= 0.008; ácido úrico r =0.25, p 0.02 y con LDL-C = r 0.23, p 0.029. ICE con LDL r = 0.29, p 0.009. ICC con HDL r 0.34, p 0.002. Conclusiones: El ICE fue el que más detectó adiposidad visceral y el ICC fue el que menos diagnosticó. Las correlaciones significativas fueron: ICE con LDL; ICC con HDL y CC con TAS, TAD, LDL y ácido úrico sérico. La CC correlacionó con más componentes del SM (AU)
Metabolic syndrome (MS) consisting of set of metabolic and cardiovascular disorders related to insulin resistance and visceral fat. Anthropometric visceral adiposity indices are useful tools that could detect metabolic complications in obese children. Objective to determine correlation between visceral adiposity indices and components of MS in obese pediatric patients. Transversal, patients 6-16 years. Inclusion: BMI ≥ 85p, exclusion endogenous obesity, genopathies, steroid use, wheelchair and plasters. Variables: WC (waist circumference), WHtI (waist-height index), WHR (waist-hip ratio), SBP, DBP (systolic and diastolic blood pressure), triglycerides, total cholesterol, HDL (high lipoprotein density), LDL (low density lipoprotein) VLDL (very low-density lipoprotein), serum uric acid, insulin, HOMA index. international standards for variables. Statistics: frequencies, percentages, means / medium, DS / range, Pearson correlation. Results: 83 patients, median 11 years. 49 (51%) male. Average BMI 31.4 (SD 6.3). Diagnosis of visceral obesity = 96.3% by WHI; WC = 80.7% and 57.8% WHR. Correlations WC with SBP, r = 0.35, p 0.001; DBP, r = 0.29, p = 0.008; Uric acid r = 0.25, p 0.02 and LDL-C r= 0.23, p 0.029. WHI with LDL, r = 0.29, p 0.009. WHR with HDL, r 0.34, p 0.002. The WHtI was the most detected visceral adiposity and the WHR was the least diagnosed. We concluded the WC correlated with more components of MS. Significant correlations: WHtI with LDL; WHR with HDL and WC with SBP, DBP, LDL and serum uric acid (AU)