Pedro Parra Caballero, Diego Real de Asúa, Ramón Costa, Fernando Moldenhauer and Carmen Suárez
Hospital Universitario La Princesa, Spain
ScientificTracks Abstracts-Workshop: J Diabetes Metab
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: 0.13â??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 â?? and specially in those presenting abdominal obesity; however, this difference did not remain after adjustment for age and gender. 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 then 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. 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.
Pedro Parra Caballero is a part of the specific Unit for Adults with Down’s syndrome of our hospital, which provides specialized care for more than 350 individuals affected by the trisomy. He is also specialized in cardiovascular disease and subclinical vascular damage disease evaluation.
Email: pedroatletico@hotmail.com
