The Correlation Study Of Childhood Obesity, Insulin Resistance And Androgens

Objective:To investigate the levels of insulin and androgens in obese children, analysis the correlation between insulin resistance and androgens, and the characteristics of androgens altercation in obese children.Methods:(1) One hundred and ten obese children and seventy normal weight children were recruited in the outpatient department of endocrinology of Children’s Hospital of Chongqing Medical University from Jul.2011 to Mar.2015.Weight, height, waist circumference of all children and blood pressure of obese children were measured, then body mass index(BMI) were calculated. Fasting plasma glucose (FPG),fasting insulin (FINS), dehydroepiandrosterone sulfate(DHEAS), androstenedione(A4), testosterone(T), luteinizing hormone(LH), follicle stimulating hormone(FSH), and estradiol(E2) were measured in all children. Triglyceride(TG), total cholesterol(TC), low-density lipoprotein cholesterol(LDL-C), high-density lipoprotein cholesterol(HDL-C) were measured in obese group. And then, non-high-density lipoprotein cholesterol(non-HDL-C) were calculated.2-hour postprandial glucose(2hPG) and 2-hour postprandial insulin(2hINS) were measured in obese children who attended the oral glucose tolerance test (OGTT) and insulin release test. Homeostatic model assessment of insulin resistance (HOMA-IR) were calculated.(2)The basic characteristics and FPG, FINS, HOMA-IR were compared between obese and normal group.(3) The levels of serum sex hormones were compared between obese and normal group. Compared the differences in serum levels of androgens between obese boys and girls, and between prepubertal and pubertal children. Then analyzed the correlation between androgens, anthropometric characteristics and the indices of insulin resistance.(4)Obese children were divided into metabolic syndrome(MS) group and non-metabolic syndrome(non-MS) group. The differences of androgens distribution were compared, and the correlation between serum androgens levels and indicators of MS were analyzed.Results:(1) There was no significant difference in gender, ages, height, FPG levels between obese and control group. But weight, BMI, WC, FINS, HOMA-IR were significantly higher in obese group than normal group.(2)Serum DHEAS in obese and normal group were 3.08±2.52umol/L, 2.40±1.67umol/L respectively. Serum A4 in obese and normal group were 6.27±7.42nmol/L,4.10±3.08nmol/L respectively. Serum DHEAS and A4 in obese children were higher than normol children. There was no significant difference in T,LH,FSH,LH/FSH,E2 between the obese group and the normal group(P>0.05). Serum testosterone levels were higher in 6 boys and 17 girls in obese group. The distribution of high and normal testosterone levels were found significantly different in boys and girls. Serum A4 in obese boys and girls were 4.10±3.18nmol/L,6.27±7.42nmo/L respectively. The difference between the two groups was significant(P< 0.05),but there was no obvious difference in serum DHEAS levels(P> 0.05).Serum T, DHEAS, A4, LH, FSH, LH/FSH in pubertal children were higher than prepubertal children(P<0.05).(3) Correlation analysis showed that both DHEAS and A4 had apositive relationship with BMI, WC, FINS,2hINS, HOMA-IR.(4)One hundred and two obese children were measured the indicators of MS, and twenty five children were diagnosed with MS. In MS group,7 children(16.28%) had higher DHEAS concentrations and 14 children(35.00%) had higher A4 concentrations. There was significant difference in A4 distribution between MS and non-MS group. Correlation analysis showed that both DHEAS and A4 had a positive relationship with blood pressure, A4 had a negative relationship with HDL-C. There was no significant relationship between DHEAS,A4 and FPG,2hPG, non-HDL,TG.Conclusions:(1)The secretion of androgens are increasing in obese children, and A4 is more prominent.(2) Compared with obese boys, obese girls have higher androgen levels.(3) Compared with prepubertal children, pubertal children have higher androgen levels.(4)Hyperandrogenism is associated with insulin resistance in obese children.(5) The androgen levels in obese children have some correlation with the abnormity of metabolic indices.