PREVALENCIA DE COMORBILIDADES METABOLICAS EN PACIENTES CON OBESIDAD EN LA EDAD ESCOLAR Y LA ADOLESCENCIA




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PREVALENCIA DE COMORBILIDADES METABOLICAS EN PACIENTES CON OBESIDAD EN LA EDAD ESCOLAR Y LA ADOLESCENCIA

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Las alteraciones clínico-metabólicas asociadas con la obesidad y relacionadas con el síndrome metabólico ya se ponen de manifiesto en la edad escolar y, especialmente, en la adolescencia. Los niveles plasmáticos de leptina, habitualemente elevados en los pacientes obesos, podrían desempeñar un papel esencial en la etiopatogenia de las comorbilidades asociadas con la obesidad.
duratrave9_82316.jpg Autor:
Teodoro Durá travé
Columnista Experto de SIIC

Institución:
Facultad de Medicina. Universidad de Navarra.


Artículos publicados por Teodoro Durá travé
Artículo comentado
Jaime Guadalupe Valle Leal
Médico Especialista en Pediatría y Nutrición, Hospital General Regional No 1 Ciudad Obregón, Sonora, México
Recepción del artículo
4 de Enero, 2016
Aprobación
19 de Mayo, 2016
Primera edición
30 de Agosto, 2016
Segunda edición, ampliada y corregida
27 de Noviembre, 2023

Resumen
Introducción: El síndrome metabólico asociado con la obesidad tiene un alto valor predictivo de enfermedad cardiovascular y diabetes tipo 2. Aunque la International Diabetes Federation hace referencia a su imposibilidad diagnóstica en la edad escolar, los datos epidemiológicos permiten intuir que el síndrome metabólico, así como sus componentes, parecen estar ya presentes en edades tempranas. Objetivo: Determinar la prevalencia de comorbilidades metabólicas y su relación con los niveles plasmáticos de leptina en un grupo de pacientes en edad escolar y adolescentes con obesidad. Material y métodos: Valoración clínica (peso y talla, índice de masa corporal, tensión arterial) y estudio metabólico (glucosa, insulina, índice HOMA, triglicéridos, colesterol total y fracciones, y leptina) a un grupo de 106 pacientes con obesidad (47 varones y 59 mujeres) en edad prepuberal (n = 56) y puberal (n = 50). Resultados: La prevalencia de resistencia a la insulina, hipertrigliceridemia, cifras bajas de colesterol asociado a lipoproteínas de alta denisdad e hipertensión arterial eran de 51%, 38%, 32% y 21%, respectivamente. En los adolescentes, la resistencia a la insulina (66% vs. 34%) y la hipertrigliceridemia (45% vs. 30%) estaban significativamente más elevados (p < 0.05) respectode los escolares. Existió una correlación positiva (p < 0.05) entre leptina e índice de masa corporal y entre el índice HOMA y los niveles de triglicéridos en ambos grupos de edad. Además, existe una correlación positiva (p < 0,05) entre leptina e índice HOMA en los adolescentes. Conclusiones: Las alteraciones clínico-metabólicas asociadas con la obesidad y relacionadas con el síndrome metabólico ya se ponen de manifiesto en la edad escolar y, especialmente, en la adolescencia. Los niveles plasmáticos de leptina podrían desempeñar un papel esencial en la etiopatogenia de las comorbilidades asociadas con la obesidad.

Palabras clave
leptina, síndrome metabólico, adolescentes, escolares, obesidad


Artículo completo

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Abstract
Introduction: Although the International Diabetes Federation refers to the impossibility of establishing a diagnosis for metabolic syndrome in school-age patients, epidemiological data seem to suggest that such metabolic syndrome and/or its components are already present at early ages. Objective: To determine the prevalence of metabolic comorbidities and their relationship with leptin plasma levels in school-age and adolescent patients with obesity. Material and methods: Clinical assessment (weight and height, body mass index, blood pressure) and metabolic assessment (serum levels of glucose, insulin, HOMA index, triglycerides, total blood cholesterol and fractions, and leptin) in a group of 106 patients with obesity (47 males and 59 females) of school-age (n = 50) and adolescents (n = 56). Results: The prevalence of insulin resistance, hypertriglyceridemia, low HDL-cholesterol levels and high blood pressure were 51%, 38%, 32% and 21%, respectively. In adolescents, insulin resistance (66% vs. 34%) and hypertriglyceridemia (45% vs. 30%) were significantly higher (p < 0.05) compared to school-age children. There was a positive correlation (p < 0.05) between leptin serum levels and body mass index, and between the HOMA index and serum triglycerides in both age groups. In addition, there was a positive correlation (p < 0.05) between leptin levels and the HOMA index in adolescents. Conclusions: Clinical and metabolic disorders associated with obesity and related to metabolic syndrome are already present in school-age children, and especially in adolescents. Plasma levels of leptin could play an essential role in the pathogenesis of the co-morbidities associated with obesity.

Key words
obesity, leptin, adolescence, metabolic syndrome, schoolchildren


Clasificación en siicsalud
Artículos originales > Expertos de Iberoamérica >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Endocrinología y Metabolismo, Pediatría
Relacionadas: Epidemiología, Nutrición, Salud Pública



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Teodoro Durá Travé, Facultad de Medicina. Universidad de Navarra, Pamplona, España
Bibliografía del artículo
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