Colasante AM, Bartiromo M, Nardolillo M, Guarino S, Marzuillo P, Mangoni di S Stefano GSRC, Miraglia del Giudice E, Di Sessa A. Tangled relationship between insulin resistance and microalbuminuria in children with obesity. World J Clin Pediatr 2022; 11(6): 455-462 [PMID: 36439903 DOI: 10.5409/wjcp.v11.i6.455]
Corresponding Author of This Article
Anna Di Sessa, MD, PhD, Research Fellow, Department of Woman, Child, and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Via De Crecchio, Naples 80138, Italy. anna.disessa@libero.it
Research Domain of This Article
Pediatrics
Article-Type of This Article
Opinion Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Pediatr. Nov 9, 2022; 11(6): 455-462 Published online Nov 9, 2022. doi: 10.5409/wjcp.v11.i6.455
Tangled relationship between insulin resistance and microalbuminuria in children with obesity
Alberto Maria Colasante, Mario Bartiromo, Michele Nardolillo, Stefano Guarino, Pierluigi Marzuillo, Giuseppe Salvatore R C Mangoni di S Stefano, Emanuele Miraglia del Giudice, Anna Di Sessa
Alberto Maria Colasante, Mario Bartiromo, Michele Nardolillo, Stefano Guarino, Pierluigi Marzuillo, Giuseppe Salvatore R C Mangoni di S Stefano, Emanuele Miraglia del Giudice, Anna Di Sessa, Department of Woman, Child, and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples 80138, Italy
Author contributions: Colasante AM and Di Sessa A wrote the manuscript; Miraglia del Giudice E, Di Sessa A and Marzuillo P conceived the manuscript; Miraglia del Giudice E, Di Sessa A, and Marzuillo P supervised the manuscript drafting; Nardolillo M, Bartiromo M, Guarino S and Mangoni di S Stefano GSRC reviewed the literature data; Colasante AM and Nardolillo M prepared the table and the figure; each author contributed important intellectual content during manuscript drafting or revision.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Anna Di Sessa, MD, PhD, Research Fellow, Department of Woman, Child, and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Via De Crecchio, Naples 80138, Italy. anna.disessa@libero.it
Received: July 31, 2022 Peer-review started: July 31, 2022 First decision: September 5, 2022 Revised: September 19, 2022 Accepted: October 27, 2022 Article in press: October 27, 2022 Published online: November 9, 2022 Processing time: 99 Days and 6.6 Hours
Abstract
Childhood obesity represents a complex disease with a well-known cardiometabolic burden including fatty liver, type 2 diabetes, metabolic syndrome, and cardiovascular disease. From a pathogenic point of view, insulin resistance (IR) represents the key factor underlying the spectrum of these obesity consequences. As observed in adults, recent data supported the occurrence of microalbuminuria (MA) as marker of early kidney dysfunction and its potential link with cardiometabolic factors also in children with obesity. In fact, a well-documented pathophysiological hypothesis both in adults and children supported an intimate correlation with the major feature of obesity such as IR through the influence of insulin on renal hemodynamics. Based on the clinical and prognostic relevance of this relationship in daily practice (including an increased risk of chronic kidney disease development overtime), more scientific attention needs to be paid to the evaluation of early kidney damage in children with obesity. In this paper, we attempt to address three debated questions regarding the intriguing liaison between IR and MA in children with obesity: (1) What is the prevalence of pediatric MA? (2) What is the state of art of MA in children with obesity? and (3) Is there a link between IR and MA in children with obesity?
Core Tip: In addition to the well-known cardiometabolic consequences of obesity (including fatty liver, type 2 diabetes, metabolic syndrome, and cardiovascular disease), early kidney damage has been also demonstrated in children with obesity. As a consequence of the dysmetabolism, the occurrence of microalbuminuria as an early marker of kidney dysfunction has been widely described in these subjects and closely linked to insulin resistance. Given the lack of extensive pediatric data and the prognostic implications of this intriguing association, a better knowledge in this field is needed to counteract the intrinsic increased cardiometabolic risk of children with obesity.
