Health Care : Current Reviews

Evaluation of the impact of abdominal obesity on glucose and lipid metabolism disorders in adults with Down syndrome

Global Healthcare & Fitness Summit

July 20-22, 2015 San Francisco, USA

Pedro Parra Caballero, Diego Real de Asua, Ramon Costa, Fernando Moldenhauer and Carmen Suarez

Posters-Accepted Abstracts: Health Care: Current Reviews

Abstract:

Background & Objectives: We aimed to describe anthropometric differences in weight-related disorders between adults with
Down syndrome (DS) and healthy controls, as well as their disparate impact on glucose and lipid metabolism disorders.
Material & Methods: We underwent a cross-sectional study of 49 consecutively selected, community-residing adults with
DS and 49 healthy controls in an outpatient clinic of a tertiary care hospital in Madrid, Spain. Siblings of adults with DS were
studied as controls in 42 cases. Epidemiological,anthropometric, clinical and laboratory data were measured and compared
between the groups, using SPSS software.
Results: Adults with DS were significantly younger and more often male, with a higher prevalence of overweight and obesity
than controls. Adults with DS also had a higher waist-to-height ratio (WHR), and more frequently presented abdominal
obesity, but total body fat percentage was similar between the groups and lipid profiles were similar between groups. The kappa
correlation index for the diagnosis of abdominal obesity between waist circumference and WHR was 0.24 (95%CI: 0.13–
0.34). Thyroid-related disorders were more frequent in adults with DS. Adults with DS had a significantly higher daily fruit
and fiber consumption than controls, and more often received antidepressants (all of them being selective serotonin uptake
inhibitors) and neuroleptic drugs than controls; no other relevant differences in medication were found between the groups.
A new diagnosis of diabetes mellitus was reached in two adults with DS. Both HOMA indexes were higher in adults with DS,
indicating that insulin resistance, measured using the homeostatic model assessment, was more prevalent among adults with
DS – and specially in those presenting abdominal obesity; however, this difference did not remain after adjustment for age
and gender. Subjects were then classified according to the presence of abdominal obesity, as determined by WHR. Adults with
DS and abdominal obesity had higher BMI values, and both HOMA indexes were also significantly higher in adults with DS
and abdominal obesity than in those without abdominal obesity (HOMA-IR 3.48 vs. 1.41; HOMA-b 164.4 vs. 82.3; p < 0.05
for both comparisons). Total cholesterol, triglycerides, cholesterol fractions, and blood pressure values were similar between
groups. Adults with DS who were newly diagnosed with impaired fasting glucose, insulin resistance, diabetes mellitus, and/or
metabolic syndrome were in the abdominal obesity group.
Discussion & Conclusions: Weight-related disorders were highly prevalent among adults with DS. Adults with DS and
abdominal obesity showed the highest insulin resistance indexes, which were higher than those of adults with DS but no
abdominal obesity and than those of controls with abdominal obesity. We found a significant relationship between abdominal
obesity and insulin resistance in adults with DS; this finding has been extensively studied in the general population, but had
not been previously described in DS. We observed a relatively low prevalence of metabolic syndrome among adults with
DS and abdominal obesity (10%), probably explained by low pressure valules and normal lipid profile. Dietary differences
could have partially accounted for the lower prevalence of overweight and obesity than observed in cohorts from outside the
Mediterraneanarea.WHR was a useful tool for the evaluation of abdominal obesity in this population, with a poor correlation
with waist circumference and excess body fat due to differences in body build in adults with DS. Favorable leptin/adiponectin
balance and sustained arterial hypotension in adults with DS could account for a beneficial effect on both adipose tissue
metabolism and on endothelial function, and thus cardiovascular protection. Hypothyroidism did not play a major role in
explaining their results.