Obesity, diabetes and their metabolic correlates in middle-aged adults with Down syndrome

IF 2.1 2区 医学 Q1 EDUCATION, SPECIAL
J. A. Luchsinger, D. Pang, S. J. Krinsky-McHale, N. Schupf, J. H. Lee, W. Silverman, W. B. Zigman
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Abstract

Background

Obesity in adults without Down syndrome is associated with an adverse metabolic profile including high prevalence of pre-diabetes and diabetes, high levels of insulin, non-high-density lipoprotein (HDL) cholesterol, leptin and high-sensitivity C-reactive protein (hsCRP) and low levels of HDL and adiponectin. We examined whether obesity in middle-aged adults with Down syndrome is also related to an adverse metabolic profile.

Methods

This cross-sectional study included 143 adults with Down syndrome, with a mean age of 55.7 ± 5.7 years and 52.5% women. Body mass index (BMI) was classified as underweight (BMI < 18.5 kg/m2), normal (BMI 18.5–24.9 kg/m2), overweight (BMI 25–29.9 kg/m2) and obese (BMI ≥ 30 kg/m2). Diabetes was ascertained by history or by haemoglobin A1c (HbA1c) as normal glucose tolerance (HbA1c < 5.7%), pre-diabetes (HbA1c 5.7–6.4%) and diabetes (HbA1c ≥ 6.5%). We measured non-fasting lipids, hsCRP, insulin, adiponectin and leptin.

Results

The majority of the sample had an overweight (46.9%) or obesity (27.3%) status. However, there was a relatively low prevalence of pre-diabetes (9.8%) and diabetes (6.9%). Overweight and obesity status were not associated with lower HDL and adiponectin and higher insulin, non-HDL cholesterol and hsCRP as expected in adults without Down syndrome. However, overweight and obesity were strongly associated with higher leptin (P < 0.001).

Conclusions

The only metabolic correlate of obesity in middle-aged adults with Down syndrome was high leptin levels. Our findings are limited by non-fasting laboratory tests but suggest that middle-aged adults with Down syndrome do not have the adverse metabolic profile related to obesity found in adults without Down syndrome.

中年唐氏综合症患者的肥胖、糖尿病及其代谢相关性。
背景:非唐氏综合征成年人的肥胖与不良代谢状况有关,包括糖尿病前期和糖尿病的高患病率、高水平的胰岛素、非高密度脂蛋白(HDL)胆固醇、瘦素和高敏C反应蛋白(hsCRP)以及低水平的HDL和脂联素。我们研究了患有唐氏综合症的中年人的肥胖是否也与不良代谢状况有关。方法:这项横断面研究包括143名患有唐氏综合症的成年人,平均年龄为55.7±5.7岁,女性占52.5%。体重指数(BMI)分为体重不足(BMI 2)、正常(BMI 18.5-24.9 kg/m2)、超重(BMI 25-29.9 kg/m2)和肥胖(BMI≥30 kg/m2)。糖尿病通过病史或血红蛋白A1c(HbA1c)确定为正常糖耐量(HbA1c结果:大多数样本具有超重(46.9%)或肥胖(27.3%)状态。然而,糖尿病前期(9.8%)和糖尿病(6.9%)的患病率相对较低。在没有唐氏综合症的成年人中,超重和肥胖状态与较低的HDL和脂联素以及较高的胰岛素、非HDL胆固醇和hsCRP无关。然而超重和肥胖与瘦素水平升高密切相关(P结论:患有唐氏综合征的中年人肥胖的唯一代谢相关因素是高瘦素水平。我们的研究结果受到非禁食实验室测试的限制,但表明患有唐氏综合症的中年人没有与非唐氏综合症成年人肥胖相关的不良代谢特征。
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来源期刊
CiteScore
5.60
自引率
5.60%
发文量
81
期刊介绍: The Journal of Intellectual Disability Research is devoted exclusively to the scientific study of intellectual disability and publishes papers reporting original observations in this field. The subject matter is broad and includes, but is not restricted to, findings from biological, educational, genetic, medical, psychiatric, psychological and sociological studies, and ethical, philosophical, and legal contributions that increase knowledge on the treatment and prevention of intellectual disability and of associated impairments and disabilities, and/or inform public policy and practice. Expert reviews on themes in which recent research has produced notable advances will be included. Such reviews will normally be by invitation.
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