Obesity, plasma high sensitivity C-reactive protein levels and insulin resistance status among school children in Taiwan

Abstract

Objective: To evaluate the degree of obesity and plasma high sensitivity C-reactive protein (hs-CRP) levels in relation to insulin resistance status among school children in Taiwan.

Methods: After multistage sampling, we randomly selected 1438 children (701 boys and 737 girls) with the mean age of 13.4 years (from 12 to 16) in Taipei in 2003. Anthropometric measures and plasma biochemical variables (including lipid profiles, glucose and insulin) were measured using standard methods. Plasma hs-CRP levels were measured using nephelometric methods. We calculated insulin resistance (IR) index using HOMA methods and further calculated a gender-specific insulin resistance syndrome (IRS) summary score by adding the quartile ranks from the distribution of systolic blood pressure (SBP), triglyceride (TG), high density lipoprotein-cholesterol (HDL-C) and insulin levels of each children. A high IRS summary score corresponds to higher levels of SBP, TG and insulin levels and lower levels of HDL-C.

Results: Boys were taller, heavier, had larger BMI, glucose, IRS summary score and hs-CRP than girls; however, there is no difference in plasma TG, insulin levels, and IR index between genders. Plasma hs-CRP levels were positively correlated with anthropometric measures, TG, insulin levels, IR index, and IRS summary score and negatively correlated with HDL-C. Anthropometric measures, plasma TG, insulin levels, IR index and IRS summary score were significantly higher in children with higher plasma hs-CRP levels (test for trend p<0.05). After adjustment for age, heart rate, smoking and drinking, hs-CRP continued to be positively associated with anthropometric variables (weight and BMI), insulin levels, and IR index and negatively correlated with HDL-C in both genders. Plasma hs-CRP levels were also positively associated with TG and IRS summary score in boys and glucose in girls. However, after further adjusting for BMI, the association of hs-CRP on TG, insulin levels, IR index and IRS summary score disappeared in boys and on body weight, HDL-C, insulin level and IR index disappeared in girls.

Conclusion: Plasma hs-CRP levels are positively related to anthropometric variables, such as body weight and BMI, insulin levels, IR index and IRS summary score and negatively related to HDL-C in Taiwanese children. Moreover, the degree of body fat status (as measured by BMI) plays a more significantly role on insulin resistance status than hs-CRP levels among Taiwanese children.