Introduction. Dyslipidemia is one of the major complications of obesity; vitamin D deficiency and insulin resistance are attending metabolic complications in dyslipidemic obese children. Objective. To determine if vitamin D deficiency and insulin resistance are risk factors for dyslipidemia in obese children. Materials and Methods. This study was conducted in the Department of Pediatrics at Bagcilar Training and Research Hospital in Istanbul, Turkey between 2014 and 2015. Obese patients whose age range was 8-14 were included in the study. The serum triglyceride, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, fasting glucose, insulin, alanine aminotransferase, vitamin D levels were measured; a liver ultrasonography was performed. Homeostatic model assessment (HOMA-IR), was used to calculate insulin resistance. Results. 108 obese children were included; 39 (36.11%) had dyslipidemia. The average fasting blood glucose (88.74 ± 7.58 vs. 95.31 ± 6.82; p= 0.0001), insulin level (14.71 ± 12.44 vs. 24.39 ± 15.02; p= 0.0001) and alanine aminotransferase level (23.45 ± 11.18 vs. 30.4 ± 18.95; p= 0.018) were significantly higher in the children with dyslipidemia. In the dyslipidemic obese children, the average hepatosteatosis rate and HOMA-IR level were higher; 28 (71.9%) had hepatosteatosis, 37 (94.87%) had insulin resistance; the vitamin D levels were <20 ng/ml in 69.3%. Vitamin D deficiency was significantly more common (p= 0.033). The multivariate regression analysis confirmed that the increase in the HOMA-IR level (p= 0.015) and the low vitamin D level (p= 0.04) were important risk factors for dyslipidemia. Conclusion. Obese children in our region exhibit low vitamin D and increased HOMA-IR levels, which are efficient risk factors of dyslipidemia.

Introducción. La dislipidemia es una de las mayores complicaciones de la obesidad; la deficiencia de vitamina D y la resistencia a la insulina son complicaciones metabólicas que se presentan en niños obesos con dislipidemia. Objetivo. Determinar si la deficiencia de vitamina D y la resistencia a la insulina son factores de riesgo de dislipidemia en niños obesos. Materiales y métodos. Este estudio se llevó a cabo en el Departamento de Pediatría del Hospital Universitario y de Investigación Bagcilar en Estambul, Turquía, entre 2014 y 2015. Se incluyeron en el estudio pacientes obesos de 8 a 14 años de edad. Se midió la concentración sérica de triglicéridos, colesterol total, colesterol de las LDL, colesterol de las HDL, glucemia en ayunas, insulina, alanina aminotransferasa y vitamina D; también se hicieron ecografías hepáticas. La resistencia a la insulina se calculó utilizando el índice de la evaluación del modelo homeostático (HOMA-IR). Resultados. Se incluyeron en el estudio 108 niños obesos, de los cuales 39 (36,11%) padecían dislipidemia. Los valores promedio de glucemia en ayunas (88,74 ± 7,58 frente a 95,31 ± 6,82; p= 0,0001), insulina (14,71 ± 12,44 frente a 24,39 ± 15,02; p= 0,0001) y alanina aminotransferasa (23,45 ± 11,18 frente a 30,4 ± 18,95; p= 0,018) fueron significativamente más altos en los niños con dislipidemia. En los niños obesos con dislipidemia, la tasa promedio de esteatosis hepática y el índice HOMA-IR fueron más altos: 28 niños (71,9%) tuvieron esteatosis hepática y 37 (94,87%), presentaron resistencia a la insulina; las concentraciones de vitamina D fueron <20 ng/ml en el 69,3% de los niños. La deficiencia de vitamina D fue notablemente más frecuente (p= 0,033). El análisis de regresión multivariante confirmó que el aumento del índice HOMA-IR (p= 0,015) y el bajo nivel de vitamina D (p= 0,04) fueron factores importantes de riesgo de dislipidemia. Conclusión. En los niños obesos de nuestra región se observanbajas concentraciones de vitamina D y aumento del índice HOMA-IR, ambos factores de riesgo significativos para la dislipidemia.

OBJETIVO: Embora a obesidade tenha sido associada ao comprometimento grave da ventilação, a maior parte da população estudada constitui-se de adultos com obesidade mórbida. Nosso objetivo foi investigar os efeitos da obesidade leve na função ventilatória de pacientes pediátricos. MÉTODOS: Estudo transversal controlado que analisou 80 pacientes (M/F: 35/45) avaliados em nosso ambulatório, com queixa de sobrepeso, sem histórico de asma ou de outras atopias, comparando-os a um grupo controle com 50 crianças de peso normal controladas para a idade e para o sexo. A média de idade dos pacientes foi de 9,7±2,5 anos (7 a 15 anos). Todos os indivíduos foram submetidos a medições antropométricas e à espirometria. A capacidade vital forçada (CVF) e o volume expiratório forçado no primeiro segundo (VEF1) foram usados como medidas da função ventilatória. RESULTADOS: Não houve diferenças significativas nas VEF1%, CVF% e VEF1%/CVF% por grupo de estudo (p > 0,05). Apenas três pacientes tiveram alterações obstrutivas relatadas em seus testes de função pulmonar (dois tiveram alterações moderadamente graves e um teve alterações obstrutivas leves). Não houve correlação entre os parâmetros da função pulmonar e as medidas antropométricas. CONCLUSÃO: Esses dados mostram que os parâmetros do teste da função pulmonar em crianças com obesidade leve foram semelhantes àqueles das crianças com peso normal. As medidas antropométricas não mostraram nenhum efeito significativo nas medições espirométricas das crianças, como ocorreu nos adultos.

OBJECTIVE: Although obesity was found to be associated with severe impairment of ventilation, most of the study population has been morbidly obese adults. We aimed to explore the effects of mild obesity on ventilatory function in the pediatric age group. METHODS: In a cross-sectional controlled study, 80 patients (M/F: 35/45), who were evaluated in our outpatient clinic with the complaint of excess body weight, with no history of asthma or other atopic diseases were studied and compared to a control group of 50 normal weight children controlled for age and sex. The mean age of patients was 9.7±2.5 years (7 to 15 years). Anthropometric measurements and spirometry were performed in all subjects. Forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) were used as measures of ventilatory function. RESULTS: There were no significant differences in FEV1%, FVC% and FEV1%/FVC% by study group (p > 0.05). Only three patients had obstructive abnormalities documented on their pulmonary function tests (two had moderately severe and one had mild obstructive abnormalities). No correlation was observed between pulmonary function parameters and anthropometric measurements. CONCLUSION: These data demonstrate that pulmonary function test parameters of the mildly obese children were similar to those of the normal weight children. Anthropometric measurements had no significant effect on spirometric measurements in children as they did on adults.