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

Abstract

AbstractBackgroundObesity 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.MethodsThis 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.ResultsThe 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).ConclusionsThe 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.