Microalbuminuria in Obese Children and Adolescents and the Metabolic Syndrome
Insulin resistance is a common feature of childhood obesity and is considered to be an important link between adiposity and development of type 2 diabetes mellitus and cardiovascular disease. It is also a major contributing factor to renal injury. Microalbuminuria (albumin excretion 20-200 mg∕min or 30-300 mg∕gram creatinine) is now considered an early marker of renal damage in non-diabetic patients.
Objectives: to evaluate the association of obesity and microalbuminuria among obese subjects and its relation to metabolic syndrome components.
Methods: This cross-sectional study was conducted on sixty two obese children and adolescents randomly recruited from the Obesity Clinic, Pediatric Hospital, Ain-Shams University. Anthropometric data were collected, fasting serum insulin, glucose and serum lipid profile were measured. The homeostasis model assessment of insulin resistance (HOMA-IR) was used to calculate in vivo insulin resistance. Oral glucose tolerance test and urinary albumin concentrations were done.
Results: Microalbuminuria was detected in 18 cases (29%) , metabolic syndrome in 4 cases (6.4%), impaired OGTT in 9.6%. Impaired fasting insulin and high serum insulin after 2 hours in OGTT in 3.2% of cases. Abnormal lipid profile was significantly associated with microalbuminuria.
Conclusion: Microalbuminuria is strongly associated with impaired fasting insulin, and abnormal lipid profile.