ASSOCIATION OF FASTING INSULIN WITH SERUM-LIPIDS AND BLOOD-PRESSURE IN KUWAITI CHILDREN

To examine the association of hyperinsulinemia with the atherogenic ri sk profile in children, we studied the relationships of the fasting pl asma insulin level with indices of obesity (body mass index [BMI] and sum of triceps and subscapular skinfold thickness [SFT]), body fat dis tribution (waist to hip ratio [WHR]), serum lipid, lipoprotein, and ap olipoprotein levels, and blood pressure in a case-control study of 460 Kuwaiti prepubertal obese children aged 6 to 13 years matched by age and sex to 460 prepubertal non-obese controls. Obese children were asc ertained in a representative cross-sectional study of 2,400 school chi ldren. Fasting insulin levels were positively correlated (P <.001) wit h serum triglyceride (TG) and very-low-density lipoprotein (VLDL) chol esterol levels and negatively correlated with high-density lipoprotein (HDL) cholesterol levels. No significant associations were observed b etween insulin and total cholesterol (TC), cholesterol, low-density li poprotein (LDL) or apolipoprotein A-l (ape A-l). Stronger associations of insulin levels with lipoprotein fractions were observed in obese v ersus non-obese controls, Obese children had a higher concentration of apo B and a lower apo A-l:B ratio (P <.001). Insulin and the insulin to glucose ratio increased with age in obese children, whereas there w ere slight changes in non-obese children, TG and HDL cholesterol level s and systolic blood pressure (SEP) were significantly different acros s insulin quartiles in boys and girls. We conclude that the fasting pl asma insulin level may be used as a marker for the development of obes ity-associated metabolic disorders and elevated blood pressure in chil dren. Copyright (C) 1998 by W.B. Saunders Company.