单纯性肥胖儿童血浆内脂素水平与相关因素分析

目的 探讨单纯性肥胖儿童血浆内脂素水平与相关因素的关系.方法 2006年2月至2007年2月在天津医科大学总医院儿科内分泌门诊采用酶联免疫法测定50例单纯性肥胖儿童和30名正常对照的血浆内脂素.并分析血浆内脂素与收缩压、舒张压、体质量指数、体脂百分比、腰围、腰臀比及空腹血糖、空腹胰岛素水平、胰岛素抵抗指数、胰岛素敏感性指数及血脂的相关关系.结果 (1)肥胖组血浆内脂素质量浓度为(32.26±6.83)μg/L,对照组为(25.69±8.05)μg/L,肥胖组明显高于对照组(P<0.01).(2)内脂素与年龄、性别无相关关系;与体质量指数、体脂百分比、空腹血糖和胰岛素抵抗指数呈显著的正相关(相关系数r分别为0.333、0.301、0.486、0.290,P<0.01);与收缩压、舒张压、腰围、腰臀比、空腹胰岛素水平呈正相关(相关系数r分别为0.280、0.278、0.242、0.273、0.221.P<0.05);与胰岛素敏感性指数、高密度脂蛋白呈负相关(相关系数r分别为-0.269、-0.222.P<0.05);与总胆固醇、三酰甘油(甘油三酯)、低密度脂蛋白无相关关系.(3)多元逐步回归分析表明空腹血糖为影响内脂素最为显著的因素,标准化偏回归系数为0.486(P<0.01),R2=0.236.结论 血浆内脂素水平与肥胖程度、脂肪分布、糖、脂代谢密切相关.初步提示内脂素可能与儿童肥胖的发生发展密切相关.     

肥胖儿童血清瘦素水平与体格发育的关系

目的分析单纯性肥胖儿童血清瘦素、胰岛素、甲状腺素水平及其与体格发育的关系。方法对筛选出来的单纯性肥胖及体质量正常儿童各41例血清瘦素、空腹胰岛素、甲状腺素进行定量测定,并进行骨龄评定和体格测量。结果肥胖组血清瘦素、胰岛素、FT3含量均显著高于对照组;两组身高无显著差异;肥胖组坐高、足长、骨龄、血压等指标显著高于体质量正常儿童。结论肥胖儿童血清瘦素、胰岛素、FT3水平较高,瘦素可能对胰岛素、甲状腺素的分泌有正向调节作用;肥胖儿童体格发育较对照组早、快;可能与其血胰岛素及FT3水平较高有直接关系,而与瘦素水平较高可能是间接关系。     

瘦素/脂联素值与肥胖儿童体质量指数及糖脂代谢的关系

目的 探讨瘦素/脂联素(L/A)值与单纯性肥胖儿童体质量指数(BMI)、糖脂代谢及肥胖症发病的关系.方法 单纯性肥胖60例和57例健康儿童,采用放射免疫分析(RIA)法测定其血清瘦素水平;ELISA法测定其血清脂联素、空腹胰岛素(FINS)水平;免疫比浊法测定其血脂各成分.分析并比较血清瘦素、脂联素及L/A值与肥胖儿童BMI、糖脂代谢的相关性.结果 1.肥胖儿童血清瘦素、FINS和三酰甘油(TG)水平与健康对照组相比明显增加;脂联素水平降低,差异均有显著性(Pa＜0.05,0.01).2.单纯性肥胖儿童瘦素与BMI、FINS、TG水平均呈显著正相关(r=0.408,0.301,0.301 Pa＜0.05,＜0.01);脂联素水平与BMI、FINS、TG均呈显著负相关(r=-0.360,-0.413,-0.258 Pa＜0.01,＜0.05).3.L/A值与BMI、FINS、TG呈显著正相关(r=0.780,0.764,0.601 Pa＜0.001).结论 血清瘦素和脂联素与肥胖儿童的发病有关,可作为儿童肥胖的监控指标;L/A值较单独瘦素、脂联素更能反映肥胖症儿童的代谢状况,可为肥胖症儿童糖脂代谢提供更为有效的监测指标.     

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目的观察单纯性肥胖儿童血浆瘦素及可溶性瘦素受体质量浓度的变化,探讨其相互之间及与体重指数(BMI)之间的关系。方法于2005-06北京儿童医院采用酶联免疫吸附试验(ELISA)对40例3~6岁的单纯性肥胖儿童及按性别、年龄1∶1配对的40例正常儿童进行了血浆瘦素及可溶性瘦素受体质量浓度的检测。结果肥胖儿童血浆瘦素质量浓度(22.26±2.30)μg/L较正常儿童(3.36±0.23)μg/L明显升高,可溶性瘦素受体质量浓度(100.10±24.60)μg/L较正常儿童(132.31±30.17)μg/L则明显降低(P<0.001)。相关性分析显示,瘦素与可溶性瘦素受体水平之间呈负相关;BMI与瘦素呈正相关,而与可溶性瘦素受体呈负相关(P<0.05)。结论学龄前肥胖儿童已存在明显的瘦素抵抗现象,而可溶性瘦素受体表达减少,可能参与了瘦素抵抗的发生。     

肥胖儿童血浆瘦素及可溶性瘦素受体质量浓度的变化

目的观察单纯性肥胖儿童血浆瘦素及可溶性瘦素受体质量浓度的变化,探讨其相互之间及与体重指数(BMI)之间的关系。 方法于2005-06北京儿童医院采用酶联免疫吸附试验(ELISA)对40例3~6岁的单纯性肥胖儿童及按性别、年龄1∶1配对的40例正常儿童进行了血浆瘦素及可溶性瘦素受体质量浓度的检测。 结果肥胖儿童血浆瘦素质量浓度(2226±230)μg/L较正常儿童(336±023)μg/L明显升高,可溶性瘦素受体质量浓度(10010±2460)μg/L较正常儿童(13231±3017)μg/L则明显降低(P<0001)。相关性分析显示,瘦素与可溶性瘦素受体水平之间呈负相关;BMI与瘦素呈正相关,而与可溶性瘦素受体呈负相关(P<005)。 结论学龄前肥胖儿童已存在明显的瘦素抵抗现象,而可溶性瘦素受体表达减少,可能参与了瘦素抵抗的发生。     

儿童单纯性肥胖血清瘦素水平分析

目的：比较单纯性肥胖儿童与正常健康儿童血清瘦素的水平，分析血清瘦素与空腹胰岛素之间的关系。方法：选择单纯性肥胖儿童30例，健康非肥胖儿童30例作对照组，分别测定其空腹胰岛素与瘦素水平。结果：单纯性肥胖组血清瘦素明显高于对照组（P＜0．001），瘦素与空腹胰岛素呈显著性相关（r=0.854，P＜0．001）。结论：单纯性肥胖儿童体内存在高胰岛素血症，同时存在瘦素抵抗，胰岛素与瘦素的调控是双向的。     

北京市超重肥胖儿童青少年中黑棘皮症检出率及与胰岛素抵抗的关系

目的 分析超重、肥胖儿童青少年黑棘皮症(AN)与胰岛素抵抗的关系,为诊断胰岛素抵抗提供临床线索.方法 以2004年北京市儿童青少年代谢综合征调研中筛查出的1 877例6～18岁超重和肥胖儿童青少年作为研究对象.测量体重指数、腰围,并检测空腹血糖、胰岛素和血脂水平,采用稳态模式评估(HOMA-IR)法,评价个体胰岛素抵抗状况.结果 超重、肥胖儿童中黑棘皮症检出率分别为12.7%和26.3%;合并AN者的腰围、胰岛素、甘酰甘油(甘油三酯)、血压均分别显著高于单纯超重、肥胖者,肥胖合并AN者的高密度脂蛋白-胆固醇水平显著低于单纯肥胖者;超重、肥胖组中AN阳性者的HOMA-IR指数几何均值(P25～P75)分别为2.81(2.13～4.12)mU/L和3.69(2.53～5.34)mU/L,分别显著高于两组AN阴性者[2.03(1.45～3.01)mU/L;2.45(1.72～3.61)mU/L](P＜0.001).结论 超过1/4的肥胖儿童罹患黑棘皮症;具有黑棘皮症表型特征的超重、肥胖儿童更容易出现代谢异常指标的改变,以及胰岛素抵抗程度的加重;黑棘皮症可以作为筛查胰岛素抵抗患儿的临床表型特征.     

瘦体合剂治疗单纯性肥胖并高胰岛素血症

目的探讨瘦体合剂对单纯性肥胖并高胰岛素血症患儿的疗效和对相关指标的影响。方法单纯性肥胖并高胰岛素血症患儿43例随机分成瘦体合剂治疗组、二甲双胍治疗对照组。观测治疗前后体脂、血脂、胰岛索抵抗指数等指标。结果治疗后两组体质量、体质量指数、体脂含量、血脂、瘦素、肿瘤坏死因子-α(TNF-α)、空腹血胰岛素、胰岛素抵抗指数均明显降低;近期疗效治疗组显效、有效及总有效率分别为22.7%、59.1%、81.8%,对照组分别为9.5%、52.4%、61.9%,治疗组显著优于对照组;瘦体合剂短期服用未出现明显不良反应。结论瘦体合剂治疗单纯性肥胖并高胰岛素血症总体疗效明显优于对照组,其机制是通过调节脂质代谢、降低TNF-α瘦素水平以改善胰岛素抵抗实现。     

肥胖儿童黑色棘皮病与脂肪因子和代谢综合征的关系

目的 了解肥胖伴黑色棘皮病(AN)患儿代谢特点及血清脂肪因子水平,探讨AN 对代谢综合征的预测价值。方法 将2012 年2 月至2013 年6 月收治的109 名肥胖儿童分为伴AN 组(n=44)和无AN 组(n=65),同期选取年龄、性别相匹配的健康儿童做为对照组(n=47)。采用ELISA 法检测血脂联素、瘦素、肿瘤坏死因子α 和视黄醇结合蛋白4 的水平,并对代谢综合征的危险因素进行多元logistic 回归分析。结果 肥胖伴AN 组腰臀比、收缩压、血甘油三酯、空腹胰岛素、胰岛素抵抗指数均较肥胖无AN 组和对照组升高(P<0.05)。肥胖伴AN 组和肥胖无AN 组脂联素水平均较对照组降低,肥胖伴AN 组瘦素水平较肥胖无AN 组和对照组明显升高(P<0.05)。Logistic 回归提示伴发AN(OR=3.469,95%CI:1.518~7.929)和高BMI(OR=7.108,95%CI:2.359~21.416)是代谢综合征的独立危险因素(P<0.05)。结论 AN 是胰岛素抵抗的皮肤标志,与脂肪因子分泌异常密切相关,降低AN 发生率和BMI 将减少代谢综合征的发生。     

减肥对单纯性肥胖儿童糖耐量及胰岛素分泌功能的影响

目的探索单纯性肥胖儿童糖耐量减低(IGT)的干预方法。方法测定14例单纯性肥胖儿童经日服葡萄糖耐量实验(OGTT),诊断为IGT,男10例,女4例;年龄8-15岁;体质量(57.7-114.0)kg,体质量指数(BMI)(30.18±1.71)。给予中医循经推拿和行为矫正及饮食、运动调整综合减重治疗2个月。结果14例IGT肥胖儿童减肥治疗2个月后9例OGTT恢复正常,体质量下降至(49-95)kg;BMI下降至(25.30±1.35)kg;治疗后空腹胰岛素、餐后2 h胰岛素、餐后2 h血糖[(14.23 ±2.35)mIU/L、(47.20±10.26)mIU/L、(5.63±0.91)mmol/L]较治疗前[(32.54±7.13)mIU/L、(164.53±33.60)mIU/ L、(8.75±1.09)mmol/L]明显下降(P<0.05,<0.01,<0.05);空腹血糖(4.80±0.52)mmol/L和治疗前(5.36±1.59) mmol/L比较无明显差异(P>0.05)。结论减肥是干预单纯性肥胖儿童IGT、改善胰岛素抵抗及预防2型糖尿病的最好方法。     

Relationship between plasma leptin, insulin and tumor necrosis factor alpha in obese children

OBJECTIVES: 1. To evaluate the relationship between plasma leptin and TNFalpha concentrations in obese children and to assess the differences between hyperinsulinemic and normoinsulinemic groups. 2. To evaluate the relationship between plasma leptin and insulin levels in obese children. 3. To investigate the TNFalpha G308A mutation in obese children. METHODS: Body mass index (BMI), fasting plasma glucose and insulin levels, oral glucose tolerance test results, homeostasis model assessment of insulin resistance (HOMA-IR) results, and plasma leptin and TNFalpha concentrations were evaluated in obese children (n = 45) and age- and gender-matched, lean healthy controls (n = 40). RESULTS: In obese children the fasting insulin, HOMA-IR results, plasma leptin and TNFalpha concentrations were significantly higher than in controls (p <0.05). Furthermore, obese females showed higher plasma leptin and insulin resistance compared to obese males. While plasma leptin, TNFalpha levels and HOMA-IR results were similar in the prepubertal and pubertal groups, insulin levels were significantly higher in the pubertal group. Plasma leptin and TNFalpha concentrations were similar in hyperinsulinemic and normoinsulinemic obese children. In control children, plasma leptin concentrations showed a positive correlation with BMI, age, fasting insulin and HOMA-IR results. In obese children, plasma leptin levels did not correlate with BMI, fasting insulin or TNFalpha. CONCLUSION: Plasma leptin concentrations did not show any correlation with TNFalpha levels in obese children. Furthermore, plasma leptin and TNFalpha concentrations were similar in hyperinsulinemic and normoinsulinemic obese children.     

Acanthosis nigricans is a reliable cutaneous marker of insulin resistance in obese Japanese children

BACKGROUND: Acanthosis nigricans (AN) is a skin condition characterized by darkening and thickening of skin with formation of irregular folds, usually limited to a few specific areas of the body. Recently, AN has been reported to be linked to hyperinsulinemia and obesity. The aim of the present study was to determine whether or not the presence of AN in obese Japanese children is a reliable cutaneous marker. METHODS: The authors analyzed the clinical characteristics of 439 obese Japanese children (260 boys, 179 girls; mean age 10.1 years; mean percentage overweight 51.9%), who had visited Tsuruoka City Shonai Hospital in 1990-2000. Eighty-two of the 439 children were examined using an oral glucose tolerance test (OGTT). Of these children, the authors retrospectively studied 16 subjects: eight with AN and eight without AN (age range: 10.8-13.9 years; percentage overweight range: 54.3-97.0%). They were age and percentage obesity-matched males with normal glucose tolerance during OGTT. Females with normal glucose tolerance during OGTT were excluded from the 16 subjects because the number was too small and children with impaired glucose tolerance or type 2 diabetes during OGTT were also excluded because of glucose toxicity. Eighty-two children including the 16 subjects were analyzed at their first visit for the presence or absence of AN on the posterior of the neck, and for characteristics including age, birthweight, body height, bodyweight, percentage overweight, blood pressure, liver function markers serum lipid concentrations, fasting plasma glucose concentrations and insulin concentrations shown by the results of OGTT. RESULTS: (1) Children with AN showed significantly more glucose intolerance including impaired glucose tolerance and type 2 diabetes compared with those children without AN, and fasting plasma insulin concentrations were most significantly correlated with the presence of AN. (2) Insulin resistance based on fasting plasma insulin concentrations was seen in significantly more children with AN than in children without AN, even in age and percentage obesity-matched subjects with normal glucose tolerance during OGTT. CONCLUSIONS: Acanthosis nigricans could be a reliable cutaneous marker of insulin resistance in obese Japanese children.     

Genetic factors and clinical significance of acanthosis nigricans in obese Japanese children and adolescents

AIM: To clarify the clinical significance of acanthosis nigricans (AN) and the association of gene polymorphisms in the ss2- and ss3-adrenergic receptors (B2ADR and B3ADR) in Japanese obese children and adolescents. METHODS: Seventy obese subjects (56 boys, 14 girls) from 5 to 19 y of age were examined as to clinical features. Genetic analyses were performed in 83 obese subjects (61 boys, 22 girls), 2 to 17 y of age. Typing of gene polymorphisms in B2ADR and B3ADR was achieved by polymerase chain reaction (PCR) of genomic DNA and restriction fragment-length polymorphism analysis (PCR-RFLP). RESULTS: The group with AN (n = 30) had higher values for percent overweight, BMI, waist circumference, fasting insulin, HOMA-R, leptin and PAI-1 than the AN-negative group (n = 40), but there were no significant differences in age, sex or percent body fat between the two groups. The prevalences of B2ADR Gly16 and B3ADR Arg64 were significantly higher in AN-positive (n = 26) than in AN-negative (n = 57) subjects. In addition, the AN frequency was significantly higher in the group with both Gly16 and Arg64 than in the group with neither of these alleles (55.6% vs 12.5%, p < 0.05). CONCLUSION: We demonstrate that AN is a useful clinical marker for the severity of obesity associated with a high BMI, and that B2ADR Gly16 and B3ADR Arg64 are associated synergistically with AN in obese children and adolescents.     

Are C‐reactive protein and homocysteine cardiovascular risk factors in obese children and adolescents?

Background: Several prospective epidemiological studies have demonstrated that high-sensitivity C-reactive protein (hsCRP) and plasma homocysteine (hcy) are predictors of future coronary events among healthy men and women. The aim of the present study was therefore to investigate a possible relationship between hsCRP, hcy levels and body mass index (BMI), relative weight (RW), serum leptin levels, and cardiovascular risk factors in obese children and adolescents.
Methods: The study involved 28 obese children and adolescents (13 girls, 15 boys; BMI>95‰ for age and sex), 4.5–15 years of age (mean 10.7 ± 0.6 years), who attended hospital for a basic obesity check-up. The association between hsCRP, hcy levels and BMI, RW, serum leptin levels, and cardiovascular risk factors such as blood pressure (BP), lipid profile, serum fasting insulin levels, and insulin resistance indexes, was investigated.
Results: Serum hsCRP level was positively correlated with BMI ( r = 0.512, P  < 0.01), RW ( r = 0.438, P  < 0.05), systolic and diastolic BP ( r = 0.498, P  < 0.01), serum leptin levels ( r = 0.457, P  < 0.05), but not with serum lipid, glucose, fasting insulin, plasma hcy levels or insulin resistance indexes. For hcy level, in contrast, no correlation was found with BMI, RW, systolic and diastolic BP, serum lipid levels, leptin, hsCRP, glucose, fasting insulin levels, or insulin resistance indexes.
Conclusions: hsCRP is correlated with BMI, RW, BP and leptin, which are risk factors for coronary heart disease, which supports the relationship between obesity, inflammation and atherosclerosis. hsCRP in childhood obesity might be a useful index to predict possible atherosclerotic events.     

非酒精性脂肪肝病儿童、青少年的肝内脂肪定量评价

目的：量化评估非酒精性脂肪肝病(NAFLD)儿童、青少年肝内脂肪的临床意义。方法：对93例肥胖儿童、青少年进行形体学参数、肝功能、血脂、血糖及胰岛素释放试验和肝脏B超等检查,采用氢质子磁共振波谱定量测定肝内脂肪（IHF）含量,并按传统诊断标准将其分为单纯性肥胖组（31例）、非酒精性脂肪肝病-1组（NAFLD-1,33例）（B超示脂肪肝,但不伴有肝损）和NAFLD-2组（B超示脂肪肝,且伴有肝损,29例）。20例健康儿童、青少年作为正常对照组。观察IHF含量在组间的变化情况,分析IHF含量与各临床生化指标的相关关系以及探寻IHF量化改变的影响因素。结果：正常对照组、单纯性肥胖组、NAFLD-1组和NAFLD-2组IHF含量分别为0.80%（0.4%～1.0%）、2.9%（1.7%～4.3%）、14.0%（7.2%～17.5%）、18.8%（14.0%~29.1%）,组间两两比较差异均有统计学意义（P<0.05）。单因素相关分析表明IHF含量与腰围、臀围、腰臀比、体重指数、收缩压、舒张压、丙氨酸氨基转移酶、门冬氨酸氨基转移酶、γ-谷氨酰转肽酶、空腹甘油三酯、低密度脂蛋白、口服葡萄糖耐量试验（OGTT）2 h血糖、空腹胰岛素、2 h胰岛素和胰岛素抵抗指数呈显著正相关,与高密度脂蛋白呈显著负相关。进一步的多元线性回归分析发现增加的腰围、降低的高密度脂蛋白水平和增高的OGTT 2 h血糖是IHF含量升高的独立危险因素。结论：IHF量化改变非常敏感,早期已增高于单纯性肥胖儿童、青少年,并随NAFLD的发生、发展进程而显著升高。量化的IHF与诸多临床生化指标相关,其中腰围、高密度脂蛋白和OGTT 2 h血糖是IHF含量的独立影响因素。     

Abdominal obesity is an independent risk factor for increased carotid intima- media thickness in obese children

We aimed in this study to investigate carotid intima-media thickness (IMT) in obese children and evaluate the relationship of IMT to various cardiovascular risk factors. One-hundred four obese children (9.3 +/- 2.5 years) and 30 healthy age-matched control subjects were enrolled in the study. All children were assessed for fasting levels of glucose, insulin, lipid profile, skinfold thickness (SFT), waist circumference (WC), and blood pressure (BP). Insulin resistance was estimated by the homeostasis model assessment (HOMA) index. Carotid IMT measurements and non-alcoholic fatty liver disease (NAFLD) were diagnosed with ultrasonographic findings. IMT was significantly higher in obese children compared to controls (0.49 +/- 0.05 vs. 0.40 +/- 0.02 mm, p < 0.001). Significant positive correlations were found between increased carotid IMT and body fat percentage (BFP), body mass index (BMI), age, height, systolic BP, WC, SFT, triglyceride and insulin levels, and insulin resistance index. In a linear logistic regression analysis, the only parameter affecting the increase in carotid IMT was WC (beta: 0.589, p < 0.001). Furthermore, IMT was increased significantly in obese children with NAFLD when compared to obese children without NAFLD (0.54 +/- 0.04 vs. 0.48 +/- 0.05 mm, p < 0.001). Children with abdominal obesity are at increased risk for atherosclerosis, and WC can be used to determine the atherosclerosis risk in obese children.     

Leptin receptor gene Gln223Arg polymorphism is not associated with obesity and metabolic syndrome in Turkish children

The aim of the study was to investigate the relationship between leptin receptor gene (LEPR) Gln223Arg polymorphism and obesity in Turkish children. Ninety-two obese and 99 lean children (between 5-15 years) were included in the study. Twenty-three of the obese children were diagnosed with metabolic syndrome. Blood samples were collected for morning fasting blood glucose, insulin, leptin, and lipid level measurements. LEPR Gln223Arg polymorphism was analyzed by restriction fragment length polymorphism. Significant differences were observed in anthropometric measurements, fasting blood glucose, insulin, leptin, and lipid levels between obese and lean children. Serum leptin levels were markedly higher in obese children. No significant association was noted between Gln223Arg polymorphism and serum leptin, insulin and lipid levels. There were no differences in the genotype frequencies or allele distribution for Gln223Arg polymorphism among obese, obese with metabolic syndrome and lean children. Our findings suggest that there is no association between Gln223Arg polymorphism and obesity in Turkish children.     

肥胖症儿童血清抵抗素水平与胰岛素抵抗关系的研究

目的探讨肥胖症儿童血清抵抗素水平与高胰岛素血症和(或)胰岛素抵抗的关系。方法采用酶联免疫法测定34例肥胖儿童,31例正常对照的血清抵抗素水平。分析血清抵抗素与体重指数、体脂百分比、腰臀比及空腹血糖、空腹胰岛素水平、胰岛素抵抗指数、胰岛β细胞功能指数的相关关系。结果(1)肥胖组及对照组抵抗素浓度(对数转换值3.1±0.5)高于对照组(对数转换值2.7±0.8)(P<0.05)。(2)抵抗素与性别、年龄、收缩压、舒张压无相关关系;与体重指数、体脂百分比、腰臀比呈正相关(相关系数分别为r=0.299、0.304、0.322,P<0.01);与空腹血糖及空腹胰岛素水平呈正相关(相关系数为r=0.299和r=0.303,P<0.05);与胰岛素抵抗指数呈正相关(r=0.324,P<0.01),与胰岛β细胞功能指数无相关关系。(3)多元逐步回归分析表明,胰岛素抵抗指数为影响抵抗素最为显著的因素(R2=0.105);标准化偏回归系数0.279(P<0.01)。结论肥胖症儿童血清抵抗素水平较正常儿童增高,并与肥胖程度,脂肪分布密切相关。抵抗素可能与肥胖症儿童发生高胰岛素血症和(或)胰岛素抵抗有关。     

Significance of acanthosis nigricans in childhood obesity

Aim: Acanthosis nigricans (AN) is among the most common dermatologic manifestations of obesity and hyperinsulinism. In this study, we aimed to find the clinical and laboratory differences in obese children with AN and without AN (non‐AN). Methods: In total, 160 obese children were included in the study. The duration of obesity, body mass index (BMI), BMI z‐scores, birth weight, parental BMI, lipid profile, fasting and post‐meal (PM) glucose and insulin levels were compared in 67 obese with AN and 93 obese without AN. Results: Age was similar in both groups. AN group had higher male to female ratio (42/25 in AN, 43/50 in non‐AN; P = 0.03), higher BMI (30.3 ± 6.1 in AN, 26.4 ± 3.6 in non‐AN; P < 0.001) and weight for height (162.6 ± 28.8 in AN, 144.6 ± 15.8 in non‐AN; P < 0.001) than non‐AN group. There were no significant differences between the groups in birth weight, parental BMI and blood pressure. AN group had higher fasting (19.9 ± 16.2 mU/L in AN, 10.4 ± 7.6 mU/L in non‐AN; P < 0.001) and PM insulin (88.6 ± 87.3 mU/L in AN, 51.1 ± 42.0 mU/L in non‐AN; P = 0.01) and homeostasis model assessment for insulin resistance (HOMA‐IR) (4.0 ± 2.5 in AN, 2.2 ± 1.8 in non‐AN; P < 0.001) than non‐AN group. However, fasting and PM glucose, triglyceride, low‐density lipoprotein‐, high‐density lipoprotein‐ and total cholesterol levels were similar in both groups. BMI was correlated with HOMA‐IR in both groups (r = 0.40 for AN, r = 0.28 for non‐AN). PM glucose and PM insulin were correlated in both groups (r = 0.56 for AN, r = 0.39 for non‐AN). However, fasting glucose and fasting insulin were correlated in only non‐AN (r = 0.25), but not in AN group. Conclusions: Obese children with AN show higher insulin levels and HOMA‐IR. AN is an important predictor of the insulin resistance in childhood obesity. Insulin secretory dynamics seem to be disrupted in fasting state initially, which is reflected as the loss of fasting insulin–glucose correlation in AN group.