Serum Phosphate Level and Insulin Resistance in Obese Non-diabetic Children

Abstract

The aim of the present study was to evaluate the relationship between serum phosphate levels with obesity and insulin resistance in obese non-diabetic children. In order to achieve these objectives, this work was conducted on 40 obese children and 40 apparently healthy. Aged 6 to 16 years. Age and sex matched recruited randomly from outpatient clinic of Children's Hospital, Ain Shams University. All cases underwent clinical examination, anthropometric measurements (wt, Ht, WC, W/H ratio, BMI and also blood pressure was calculated. Laboratory assessment was done to the study group including lipid profile, ca, phosphate, alkalin phosphatase, insulin, blood glucose. Insulin resistance was evaluated using HOMA. The results of this study revealed that: Obese children recorded highly significant statistical increase in weight, weight-SDs, height-SDs, BMI, BMI-SDs, triceps skin fold thickness, subscapular skin fold thickness, hip circumference, waist circumference compared to control group. While non-significant statistical difference as regard height, Waist/hip ratio. Moreover there was an increase in the level of all anthropometric data in males but did not reach statistically significant difference. Systolic blood pressure centile and diastolic blood pressure centile showed a highly statistical significance among obese group compared to control group. Moreover there was non-significant statistical difference between males and females in the obese group regarding blood pressure and blood pressure centiles. Obese children showed statistically significant increased in cholesterol, TG and decreased in Ca and phosphate compared to control group. Whereas non-significant statistical difference with other remaining parameters although increased more in obese group. On comparing between males and females in the obese group regarding laboratory data there was non-significant statistical difference. In this study there was a highly significant correlation between BMI and waist circumference, weight, triceps, subscapular skinfold thickness and hip circumference. While significant correlation with waist/hip ratio. A correlation analysis was done between BMI and biochemical profile and it was found that there was a highly significant correlation between the BMI and 2hp.p blood glucose and negative correlation with phosphate. That means presence of low serum phosphate level in obese children. Also, It was found that there was a highly significant correlation between waist circumference and weight, height, triceps, subscapular skinfold thickness, hip circumference and waist/hip ratio. There were highly significant correlations between glucose, 2hp.p, ALP, insulin and HOMA-IR. While significant negative correlation with weight-SDs. Insulin was highly significantly negatively correlated with 2hp.p blood glucose and highly significantly correlated with HOMA-IR. HOMA-IR was highly significantly correlated with ALP, glucose and Insulin. While highly significantly negatively correlated with 2hp.p blood glucose and significantly negatively correlated with height-SDs. In our study, we found 2 obese children with border line high cholesterol, 4 with border line high TG, 1 with border line high LDL, 31 with low HDL, 12 hypertensive and 16 with hypophosphatemia.