Insulin Resistance in Pre-Pubertal Obese Children

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Illustration by Klik Dokter

The incidence of insulin resistance at an early age is increasing along with the increasing prevalence of childhood obesity in the world. Insulin resistance is one of the complications of obesity often found in obese children and adolescents. Obesity correlates with leptin production and high plasma leptin levels. Several studies suggest that hyperleptinemia or leptin resistance plays an important role in conditions of insulin resistance. In animal studies, leptin also affects the regulation of energy balance and insulin sensitivity.

The results showed a relationship between obesity and the HOMA index as an indicator of insulin resistance. The positive correlation between obesity and insulin resistance shows that the higher the BMI value, the higher the HOMA index. Leptin is one of the adipocytokines produced by adipose tissue. Leptin plays a role in regulating food intake and weight loss by signaling the central nervous system to reduce food intake and increase energy expenditure. The results also showed that leptin levels were positively correlated with IR (insulin resistance). In other studies, leptin was positively correlated with insulin resistance in prepubertal children, even though in cases of obesity and non-obesity.

Low levels of leptin (reduced leptin receptors) lead to hyperphagia and obesity. If the energy intake exceeds what is needed, the adipose tissue increases along with an increase in leptin levels in the bloodstream. Then in obese patients, there is leptin resistance, so that high leptin levels do not cause decreased appetite. There is a positive correlation between obesity and insulin resistance in prepubertal children. Therefore, it is advisable to make efforts to reduce insulin resistance by adjusting the diet and increasing physical exercise as obesity in prepubertal children is still in the early stages of obesity, where insulin resistance is reversible.

Author: Prof Bambang Wirjatmadi

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