Whole-Body and Hepatic Insulin Resistance in Obese Children

<div><p>Background</p><p>Insulin resistance may be assessed as whole body or hepatic.</p><p>Objective</p><p>To study factors associated with both types of insulin resistance.</p><p>Methods</p><p>Cross-sectional study of 182 obese children. Somatometric measurements were registered, and the following three adiposity indexes were compared: BMI, waist-to-height ratio and visceral adiposity. Whole-body insulin resistance was evaluated using HOMA-IR, with 2.5 as the cut-off point. Hepatic insulin resistance was considered for IGFBP-1 level quartiles 1 to 3 (<6.67 ng/ml). We determined metabolite and hormone levels and performed a liver ultrasound.</p><p>Results</p><p>The majority, 73.1%, of obese children had whole-body insulin resistance and hepatic insulin resistance, while 7% did not have either type. HOMA-IR was negatively associated with IGFBP-1 and positively associated with BMI, triglycerides, leptin and mother's BMI. Girls had increased HOMA-IR. IGFBP-1 was negatively associated with waist-to-height ratio, age, leptin, HOMA-IR and IGF-I. We did not find HOMA-IR or IGFBP-1 associated with fatty liver.</p><p>Conclusion</p><p>In school-aged children, BMI is the best metric to predict whole-body insulin resistance, and waist-to-height ratio is the best predictor of hepatic insulin resistance, indicating that central obesity is important for hepatic insulin resistance. The reciprocal negative association of IGFBP-1 and HOMA-IR may represent a strong interaction of the physiological processes of both whole-body and hepatic insulin resistance.</p></div

Factors associated with HOMA-IR.

<p>Factors associated with HOMA-IR were analyzed by means of the generalized linear model, testing three different types of adiposity index. Body mass index (BMI), visceral adiposity index (VAI), insulin-like growth factor binding protein-1 (IGFBP-1).</p><p>Factors associated with HOMA-IR.</p

Characteristics of the obese children with or without whole body IR (HOMA-IR cut off point 2.5).

<p>Characteristics of obese children with or without whole-body IR (HOMA-IR cut off point 2.5). Body mass index (BMI), visceral adiposity index (VAI), insulin-like growth factor binding protein-1 (IGFBP-1), insulin-like growth factor I (IGF-I).</p><p>Characteristics of the obese children with or without whole body IR (HOMA-IR cut off point 2.5).</p

Factors associated with IGFBP-1.

<p>Factors associated with IGFBP-1 analyzed by means of the generalized linear model, testing three different types of adiposity index. Body mass index (BMI), visceral adiposity index (VAI), insulin-like growth factor binding protein-1 (IGFBP-1), insulin-like growth factor I (IGF-I).</p><p>Factors associated with IGFBP-1.</p

Self-medication practice in pregnant women from central Mexico

Self-medication during pregnancy represents a serious threat for mother and child health. The objective of this study was to evaluate the prevalence and the factors associated with self-medication among Mexican women living in the central region of Mexico. This is a descriptive interview-study of 1798 pregnant women or women who were pregnant no more than 3 years ago, when the interview was carried out. Data analysis was carried out with chi-square analysis and odds ratio. The prevalence of self-medication (allopathic drugs, medicinal plants, and other products, including vitamins, food supplements, among others) was 21.9%. The factors associated (p < 0.05) with self-medication were: higher education (college and postgraduate), smoking, and consumption of alcohol. Smoking was the strongest factor (OR: 2.536; 1.46–4.42) associated to self-medication during pregnancy, followed by consumption of alcohol (OR: 2.06; 1.38–3.08), and higher education (OR: 1.607; 1.18–2.19). Medicinal plant consumption was associated with nausea, constipation, migraine, and cold (p < 0.05), whereas he self-medication of allopathy was associated with gastritis and migraine (p < 0.05). Self-medication was influenced mainly by a relative or friend, who recommended the use of herbal medicine/allopathic medication. Two of the most common medicinal plants (arnica and ruda) here informed are reported to induce abortion or toxicity during pregnancy. The findings showed that self-medication (medicinal plants and allopathic medication) is a common practice among pregnant women from central Mexico. Adequate counselling of pregnant women by healthcare professionals about the potential risks of self-medication with herbal medicine and allopathic drugs during pregnancy is strongly warranted. Keywords: Self-medication, Pregnancy, Allopathy, Medicinal plan