Linear growth and prevalence of the different components of the metabolic syndrome (MetS) in young obese nondiabetic children (below 5 years) in comparison to older obese children (6-12 years)

Main Article Content

Noor Hamed
Ashraf Soliman
Vincenzo De Sanctis
Mona Shaat
Nada Alaaraj
Shaymaa Ahmed
Mohammad Qusad
Khalid Siddiq
Fawzia Alyafei

Keywords

Obesity, young children, metabolic syndrome (MetS), body mass index, catch-up growth.

Abstract

Background: In Qatar, the prevalence of metabolic syndrome (MetS) in children and adults is increasing in parallel with the markedly increasing trends in obesity rates. Objective: The aim of our study was to assess the prevalence of different components of MetS, measure plasma atherogenic indexes (AIP), and to evaluate linear growth in young obese nondiabetic children (< 5 years) in comparison to older obese children (6-12 years).  Methods:  We analysed the anthropometric and biochemical profile of 135 random sample obese children who attended to the Paediatric Clinic of Hamad Medical Centre (HGH) in Doha (Qatar) from January 2018 to December 2019. Results: A large proportion of children presented with obesity, around the age of 5 years, were obese at the end of their first year of life (63.8%) and more were obese at the 2 years of age (82.6%). Significantly rapid gain in weight and linear growth occurred during the first 6 months of postnatal life. Moreover, some metabolic risk factors and high AIP occurred more frequently in older obese children compared to young obese children. Conclusions: This study documented the early occurrence of different components of the MetS in young obese children and the progressive increase of their prevalence in older prepubertal children. Most of obese children who presented at or below 5 years of age had significant obesity and rapid linear growth during the first two years (infancy). These two findings pointed out to the necessity to impose early detection and preventive measures on a national scale.

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References

1. de Onis M, Blössner M, Borghi B. Global prevalence and trends of overweight and obesity among preschool children. Am J Clin Nutr 2010; 92:1257–64.
2. Sun SS, Liang R, Huang TT, et al. Childhood obesity predicts adult metabolic syndrome: the Fels longitudinal study. J Pediatr 2008;152:191–200.
3.Daniels SR, Arnett DK, Eckel RH, et al. Overweight in children and adolescents: pathophysiology, consequences, prevention, and treatment. Circulation 2005;111:1999-2012.
4. Hadjiyannakis S. The metabolic syndrome in children and adolescents. Paediatr Child Health 2005; 10:41–7.
5. Weiss R, Dziura J, Burgert TS, et al. Obesity and the metabolic syndrome in children and adolescents. N Engl J Med 2004;350:2362-74.
6. Martínez-Costa C, Núñez F, Montal A, Brines J. Relationship between childhood obesity cut-offs and metabolic and vascular comorbidities: comparative analysis of three growth standards. J Hum Nutr Diet 2014;27 (Suppl 2):75-83.
7. de Onis M, Martínez-Costa C, Núñez F, Nguefack-Tsague G, Montal A, Brines J. Association between WHO cut-offs for childhood overweight and obesity and cardiometabolic risk. Public Health Nutr 2013;16:625-30.
8. Alyafei F, Soliman A, Alkhalaf F, et al. Incidence of type 1 and type 2 diabetes, between 2012-2016, among children and adolescents in Qatar. Acta Biomed 2018;89:7–10.
9. Hamed N, Soliman A, De Sanctis V, et al. The Prevalence of the Different Components of the Metabolic Syndrome (MetS) in Obese Nondiabetic Children and Young Adolescents and their Anthropometric Data in Relation to Parents. Acta Biomed 2021;92(4):e2021321.
10. Zhu X, Yu L, Zhou H, et al. Atherogenic index of plasma is a novel and better biomarker associated with obesity: a population-based cross-sectional study in China. Lipids Health Dis 2018;17(1):37.
11.NGHS Coordinating Center. NHLBI Growth and Health Study (NGHS) data monitoring report. Baltimore: Maryland Medical Research, 1998.
12.The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 1999;22 (Suppl 1):S5-S19
13. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985;28:412-19.
14. de Onis M, Onyango AW, Borghi E, et al.Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ 2007;85:660–7.
15. 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 2004:114: 555–76.
16. NCEP Expert Panel on Blood Cholesterol Levels in Children and Adolescents. National Cholesterol Education Program (NCEP): highlights of the report of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents. Pediatrics 1992;89:495–501.
17. Cook S, Weitzman M, Auinger P, et al. Prevalence of a metabolic syndrome phenotype in adolescents: findings from the third National Health and Nutrition Examination Survey, 1988–1994. Arch Pediatr Adolesc Med 2003;157:821–7.
18. Skelton JA, Rudolph CD. Overweight and obesity. In: Nelson Textbook of Pediatrics, RM Kliegman, RE Behrman, HB Jenson et al., Eds. Philadelphia, PA: Elsevier. 2009; pp. 232–42.
19. Martınez Costa C, Nunez Gomez F, Montal Navarro MA, et al. Alteraciones vasculares en nin˜os obesos con y sin resistencia a la insulina. Rev Esp Pediatr 2011;67 (Suppl.2): 20.
20. Bokor S, Frelut ML, Vania A, et al. Prevalence of metabolic syndrome in European obese children. Int J Pediatr Obes 2008;3 (Suppl. 2);3–8.
21. Ministry of Health – Qatar https://phs.moph.gov.qa/data/healthy-lifestyle.
22. Reilly JJ, Kelly J. Long-term impact of overweight and obesity in childhood and adolescence on morbidity and premature mortality in adulthood: systematic review. Int J Obes (Lond) 2011;35:891–8.
23. Ali FM, Nikoloski Z, Reka H, Gjebrea O, Mossialos E. The diabetes-obesity-hypertension nexus in Qatar: evidence from the World Health Survey. Popul Health Metr 2014;12:18.
24. Taveras EM, Rifas-Shiman SL, Belfort MB, Kleinman KP, Oken E, Gillman MW. Weight status in the first 6 months of life and obesity at 3 years of age. Pediatrics 2009; 123:1177-83.
25. Wang, G., Johnson, S., Gong, Y. et al. Weight Gain in Infancy and Overweight or Obesity in Childhood across the Gestational Spectrum: a Prospective Birth Cohort Study. Sci Rep 2016;6:29867.
26. Ambrosini GL. Childhood dietary patterns and later obesity: a review of the evidence. Proc Nutr Soc 2014;73:137–46.
27. Smithers LG, Golley RK, Brazionis L, Lynch JW. Characterizing whole diets of young children from developed countries and the association between diet and health: a systematic review. Nutr Rev 2011;69:449–67.
28. Ambrosini GL, Emmett PM, Northstone K, Howe LD, Tilling K, Jebb SA. Identification of a dietary pattern prospectively associated with increased adiposity during childhood and adolescence. Int J Obes (Lond) 2012;36:1299–1305.
29. Jennings A, Welch A, van Sluijs EM, Griffin SJ, Cassidy A. Diet quality is independently associated with weight status in children aged 9–10 years. J Nutr 2011;141:453–9.
30.Shroff MR, Perng W, Baylin A, Mora-Plazas M, Marin C, Villamor E. Adherence to a snacking dietary pattern and soda intake are related to the development of adiposity: a prospective study in school-age children. Public Health Nutr 2014;17:1507–13.
31. Tapsell LC, Neale EP, Satija A, Hu FB. Foods, nutrients, and dietary patterns: interconnections and implications for dietary guidelines. Adv Nutr 2016;7:445–54.
32.Smithers LG, Golley RK, Brazionis L, Lynch JW. Characterizing whole diets of young children from developed countries and the association between diet and health: a systematic review. Nutr Rev 2011;69:449–67.
33. Cañete R, Gil-Campos M, Aguilera CM, Gil A. Development of insulin resistance and its relation to diet in the obese child. Eur J Nutr 2007;46:181-7.
34. Voortman T, Leermakers ET, Franco OH, et al. A priori and a posteriori dietary pattern at the age of 1 year and body composition at the age of 6 years: the Generation R Study. Eur J Epidemiol 2016; 31:775-83.
35. Friedemann C, Heneghan C, Mahtani K, Thompson M, Perera R, Ward AM. Cardiovascular disease risk in healthy children and its association with body mass index: systematic review and meta-analysis. BMJ 2012 ;345:e4759.
36. Matthaei S, Stumvoll M, Kellerer M, Haring HU. Pathophysiology and pharmacological treatment of insulin resistance. Endocr Rev 2000 ;21:585–618.

37. Liu L, Hironaka K, Pihoker C. Type 2 diabetes in youth. Curr Probl Pediatr Adolesc Health Care 2004;34:254-72.

38. Caprio S. Insulin resistance in childhood obesity. J Pediatr Endocrinol Metab. 2002;15 (Suppl 1):487-92.

39. Matsuzawa Y. The role of fat topology in the risk of disease. Int J Obes (Lond) 2008; 32 (Suppl 7) :S83-92.
40. Griffin ME, Marcucci MJ, Cline GW, et al . Free fatty acid-induced insulin resistance is associated with activation of protein kinase C theta and alterations in the insulin signaling cascade. Diabetes 1999 ;48:1270–4.
41. Despres JP. Is visceral obesity the cause of the metabolic syndrome? Ann Med 2006; 38:52–63.
42. Lee S, Bacha F, Gungor N, Arslanian SA. Racial differences in adiponectin in youth: relationship to visceral fat and insulin sensitivity. Diabetes Care 2006; 29:51–6.
43. Kern L, Mittenbühler MJ, Vesting AJ, Ostermann AL, Wunderlich CM, Wunderlich FT. Obesity-Induced TNFα and IL-6 Signaling: The Missing Link between Obesity and Inflammation-Driven Liver and Colorectal Cancers. Cancers (Basel) 2018;11(1):24.
44. López-Jaramillo P, Gómez-Arbeláez D, López-López J, et al.. The role of leptin/adiponectin ratio in metabolic syndrome and diabetes. Hormone Mol Biol Clin Invest 2014;18:37-45.
45. Chu NF, Wang DJ, Shieh SM, Rimm EB. Plasma leptin concentrations and obesity in relation to insulin resistance syndrome components among school children in Taiwan – the Taipei Children Heart Study. Int J Obes Relat Metab Disord 2000;24:1265–71.
46. Cottrell EC, Ozanne SE. Early life programming of obesity and metabolic disease. Physiol Behav 2008;94:17–28.
47. Ibanez L, Ong K, Dunger DB, de Zegher F. Early development of adiposity and insulin resistance after catch-up weight gain in small-for-gestational-age children. J Clin Endocrinol Metab 2006; 91: 2153–8.
48. Deivanayagam S, Mohammed BS, Vitola BE, et al. Nonalcoholic fatty liver disease is associated with hepatic and skeletal muscle insulin resistance in overweight adolescents. Am J Clin Nutr 2008;88:257–62.
49. Perseghin G, Bonfanti R, Magni S, et al. Insulin resistance and whole-body energy homeostasis in obese adolescents with fatty liver disease. Am J Physiol Endocrinol Metab 2006;291:E 697–703.
50. Woo Baidal JA, Elbel EE, Lavine JE, et al. Associations of Early to Mid-Childhood Adiposity with Elevated Mid-Childhood Alanine Aminotransferase Levels in the Project Viva Cohort. J Pediatr 2018;197:121-7.
51. Vajro P, Lenta S, Socha P, et al. Diagnosis of nonalcoholic fatty liver disease in children and adolescents: position paper of the ESPGHAN Hepatology Committee. J Pediatr Gastroenterol Nutr 2012;54:700-13.
52. Barlow SE. Expert Committee: Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics 2007;120:S164-92.