Información de la revista
Vol. 60. Núm. 2.
Páginas 142-147 (febrero 2004)
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 60. Núm. 2.
Páginas 142-147 (febrero 2004)
Acceso a texto completo
Alteraciones relacionadas con el síndrome X y bajos niveles de vitamina E en niños con obesidad y acantosis nigricans
Metabolic alterations related to syndrome x and low vitamin e levels in obese children with acanthosis nigricans
Visitas
9973
B. Bonet Serraa,b,
Autor para correspondencia
bbjbonet@fhalcorcon.es

Correspondencia: Servicio de Pediatría. Fundación Hospital Alcorcón. Budapest, 1. Alcorcón. 28922 Madrid. España
, I. Sánchez-Verab, P. Cocho Gómezc, A. Quintanar Riojaa, M. Bueno Campañaa, M. Espino Hernándeza
a Área de Pediatría y Neonatología. Fundación Hospital Alcorcón
b Universidad San Pablo-CEU
c Centro de Salud Parque Coimbra. Madrid. España
Este artículo ha recibido
Información del artículo
Antecedentes

En adultos, tanto las alteraciones metabólicas asociadas al síndrome X, como la disminución en las concentraciones plasmáticas de vitamina E, se han asociado a un mayor riesgo de desarrollar enfermedades cardiovasculares

Objetivos

Estudiar en niños obesos con acantosis nigricans la presencia de alteraciones metabólicas relacionadas con el síndrome X y determinar las concentraciones plasmáticas de vitamina E

Métodos

Se llevó a cabo un estudio prospectivo en 42 niños obesos, 15 con acantosis nigricans (OB + AN) y 27 sin ella (OB − AN), y 13 niños sanos sin obesidad. En todos ellos, y tras 12 h de ayuno, se determinaron las concentraciones plasmáticas de glucosa, insulina, vitamina E, triglicéridos, colesterol y colesterol HDL. Se calculó el índice de resistencia a la insulina. Las diferencias entre grupos se determinaron mediante el análisis de la varianza

Resultados

Los niños obesos con acantosis nigricans presentaron mayores concentraciones de insulina plasmática y de triglicéridos, menores niveles de colesterol HDL (lipoproteínas de alta densidad) y de vitamina E en plasma, así como un índice de resistencia a la insulina más elevado que los niños obesos sin acantosis nigricans o que los valores observados en un grupo de niños sin obesidad

Conclusiones

La presencia de acantosis nigricans en niños obesos define a un grupo de niños con alteraciones metabólicas asociadas a un mayor riesgo de desarrollar enfermedades cardiovasculares y diabetes de tipo 2

Palabras clave:
Acantosis nigricans
Obesidad
Hiperinsulinismo
Vitamina E
Síndrome X
Background

In adults, both metabolic alterations related to syndrome X and lower plasma vitamin E levels have been associated with an increased risk of developing cardiovascular disease

Objectives

To study the presence of metabolic alterations related to syndrome X and to determine the plasma levels of vitamin E in obese children with acanthosis nigricans

Methods

We performed a prospective study in 42 obese children [15 with acanthosis nigricans (AN) and 27 without]. Thirteen healthy non-obese children were also studied. After a 12-hour fast, plasma levels of glucose, insulin, triglycerides, cholesterol, high-density lipoprotein (HDL)-cholesterol, and vitamin E were determined. The insulin resistance index was also calculated. Differences between groups were determined using ANOVA

Results

Obese children with AN showed higher plasma levels of insulin and triglycerides and lower plasma levels of HDL-cholesterol and vitamin E, as well as a higher insulin resistance index than non-obese children and obese children without AN

Conclusions

In obese children, the presence of acanthosis nigricans is linked to a group of metabolic alterations associated with a higher risk of developing cardiovascular disease and type 2 diabetes

Key words:
Acanthosis nigricans
Obesity
Hyperinsulinism
Vitamin E
Syndrome X
El Texto completo está disponible en PDF
Bibliografía
[1.]
C.L. Williams, L.L. Hayman, S.R. Daniles, T.N. Robinson, J. Steinberger, S. Paridon, et al.
Cardiovascular Health in Childhood. A State-ment for Health Professionals from the Committee on Atheros-clerosis, hypertension and obesity in the Young (AHOY) of the Council on Cardiovascular Disease in the Young, American Heart Association.
Circulation, 106 (2002), pp. 143-160
[2.]
M. Rosenbaum, R.L. Leibel, J. Hirsch.
Obesity.
N Engl J Med, 337 (1997), pp. 396-407
[3.]
H.O. Mossberg.
40-Year follow-up of overweight children.
Lan-cet, 8661 (1989), pp. 491-493
[4.]
A. Must, P.F. Jacques, G.E. Dallal, C.J. Bajema, W. Dietz.
Long-Term morbidity and mortality of overweight adolescents. A Follow-up of the Harvard Growth Study of 1922 to 1935.
N Engl J Med, 327 (1992), pp. 1350-1355
[5.]
J. Steinberger, S.R. Daniels.
Obesity, insulin resistance, diabetes, and cardiovascular risk in children.
Circulation, 107 (2003), pp. 1448-1453
[6.]
B.B. Kanh, J.S. Flier.
Obesity and insulin resistance.
J Clin Invest, 106 (2000), pp. 473-481
[7.]
E.E. Calle, M.J. Thum, J.M. Petrelli, C. Rodríguez, C.W. Heath.
Body-mass index and mortality in a prospective cohort of U.S. adults.
N Engl J Med, 341 (1999), pp. 1097-1105
[8.]
G.M. Reaven.
Pathophysiology of insulin resistance in human disease.
Physiol Rev, 75 (1995), pp. 473-486
[9.]
T.E. Carew.
Role of biologically modified low-density lipopro-tein in atherosclerosis.
Am J Cardiol, 64 (1989), pp. 18G-22G
[10.]
U.P. Steinbrecher, H. Zhang, M. Lougheed.
Role of oxidatively modified LDL in atherosclerosis.
Free Radic Biol Med, 9 (1990), pp. 155-168
[11.]
D. Steinberg, S. Parthasarathy, T.E. Carew, J.C. Khoo, J.L. Witztum.
Beyond cholesterol: Modifications of Low-density lipoprotein that increase its atherogenicity.
N Engl J Med, 320 (1989), pp. 915-924
[12.]
H. Esterbauer, M. Dieber-Rothereder, G. Striegl, G. Waeg.
Role of vitamin E in preventing the oxidation of low density lipopro-tein.
Am J Clin Nutr, 53 (1991), pp. 3195-3215
[13.]
H. Esterbauer, M. Dieber-Rotheneder, G. Waeg, G. Striegl, G. Jurgens.
Biochemical, Structural and Functional Properties of Oxidi-zed Low-Density Lipoprotein.
Chem Res Toxicol, 3 (1990), pp. 77-91
[14.]
K.F. Gey, P. Puska.
Plasma vitamins E and A inversely correlated to mortality from ischemic heart disease in cross-cultural epi-demiology.
Ann NY Acad Sci, 570 (1989), pp. 268-282
[15.]
M.J. Stampfer, C.H. Henneckens, J.E. Manson, G.A. Colditz, B. Rosner, W.C. Willett.
Vitamin E consumption and the risk of coronary heart disease in women.
N Engl J Med, 328 (1993), pp. 1444-1449
[16.]
E.B. Rimm, M.J. Stampfer, A. Ascherio, E. Giovannucci, G.A. Colditz, W.C. Willett.
Vitamin E consumption and the risk of coronary heart disease in men.
N Engl J Med, 328 (1993), pp. 1450-1456
[17.]
D.R. Mattews, J.P. Hosker, A.S. Rudensky, B.A. Naylor, D.F. Treacher, R.C. Turner.
Homeostasis model assessment: Insulin resistance and b-cell function from fasting plasma glucose and insulin concentrations in man.
Diabetologia, 28 (1985), pp. 412-419
[18.]
J. Radziuk.
Insulin Sensitivity and its measurement: Structural commonalities among the methods.
J Clin Endocrinol Metab, 85 (2000), pp. 4426-4433
[19.]
C. Barbas, M. Castro, B. Bonet, M. Viana, E. Herrera.
Simultaneous determination of vitamin A and E in rat tissues by HPLC.
J Chro-matography, 778 (1997), pp. 415-420
[20.]
T.T. Nguyen, M.F. Keil, D.L. Russell, A. Pathomvanich, G.I. Uwaifo, N.G. Sebring, et al.
Relation of acanthosis nigricans to hyperin-sulinemia and insulin senstitivity in overweigh African Ameri-can and white children.
J Pediatr, 138 (2001), pp. 474-480
[21.]
C.R. Kahn, J.S. Flier, R.S. Bar, J.A. Archer, P. Gorden, M.M. Martin, et al.
The syndromes of insulin resistance and acanthosis nigri-cans: Insulin receptor disorders in man.
N Engl J Med, 294 (1976), pp. 739-745
[22.]
I. Zavaroni, E. Bonora, M. Pagliara, E. DallÁgio, L. Luchetti, G. Bui-nanno, et al.
Risk factors for coronary artery disease in healthy persons with hyperinsulinemia and normal glucose tolerance.
N Engl J Med, 320 (1989), pp. 702-706
[23.]
T.K. Young, H.J. Dean, B. Flett, P. Wood-Steiman.
Childhood obe-sity in a population at high risk for type 2 diabetes.
J Pediatr, 136 (2000), pp. 365-369
[24.]
R. Sinha, G. Fisch, B. Teague, W.V. Tamborlane, B. Banya, K. Allen, et al.
Prevalence of impaired glucose tolerance among children and adolescents with marked obesity.
N Engl J Med, 346 (2002), pp. 802-810
[25.]
C. Rubenstein, D. Romhilt, P. Segal, G. Heiss, L.E. Chambless, K.E. Boyle, et al.
Dyslipoproteinemias and manifestations of coronary heart disease. The Lipid Research Clinics Program Prevalence Study.
Circulation, 73 (1986), pp. 1-91
[26.]
NIH Consensus Development Panel on Triglyceride, High-Density Lipoprotein, and Coronary Heart Disease.
Triglyceride, High-Density Lipoprotein and Coronary Heart Disease.
Jama, 269 (1993), pp. 505-510
[27.]
L. Welin, H. Eriksson, B. Larsson, O.L. Ohlson, K. Svardsudd, G. Tib-blin.
Triglycerides, a major coronay risk factor in elderly men. A study of men born in 1913.
Eur Heart J, 12 (1991), pp. 700-704
[28.]
M.J. Stampfer, R.M. Krauss, J. Ma, P.J. Blanche, L.G. Holl, F.M. Sacks, et al.
A prospective study of triglyceride level, low-density lipo-protein particle diameter, and risk of myocardial infarction.
Jama, 276 (1996), pp. 882-888
[29.]
M.A. Austin, J.L. Breslow, C.H. Hennekens, J.E. Buring, W.C. Willet, R.M. Krauss.
Low density lipoprotein subclass patterns and the risk of myocardial infarction.
J Am Med Assoc, 260 (1988), pp. 1917-1921
[30.]
B. Bonet, A. Quintanar, M. Alavés, J. Martínez, M. Espino, J. Pérez-Lescure.
Presencia de genu valgo en niños obesos: causa o efecto.
An Pediatr (Barc), 58 (2003), pp. 232-235
Copyright © 2004. Asociación Española de Pediatría
Descargar PDF
Idiomas
Anales de Pediatría
Opciones de artículo
Herramientas
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?