ESPE Abstracts (2016) 86 P-P2-527

Arbitrary Cutoffs Lead to Underestimation of Metabolic Abnormalities in Obese Children: The Value of Age- and Sex-adjusted Normative Values

Adele Carlier Gonoda,b, Ahlam Azarb, Nathalie Lecomteb, Melanie Amouyal Perrodb, Manon Prevotb, Adeline Jacquesb, Sophie Guilmin Creponb & Jean Claude Carelb


aHopital Intercommunal Creteil, Creteil, France; bHopital Robert Debré, Paris, France


Background: Metabolic syndrome and insulin resistance are well recognized in adult obesity. Their criteria and prevalence and are still controversial in children.

Objective and hypotheses: To evaluate the prevalence and natural history of clinical and biological parameters of the metabolic syndrome in a pediatric cohort of obese subjects. To identify metabolically healthy subjects and the persistence of this phenotype over time.

Method: Prospective longitudinal, observational, single-center study on children monitored for overweight or obesity. Data collection was done yearly from 2007. Metabolic syndrome parameters were expressed in SDS for age and sex, using reference curves obtained from an independent representative healthy cohort of children in France, using the the same biological assays (Mellerio et al, Pediatrics 2012). Results are expressed as median (IQR).

Results: 533 children and pre-teens were enrolled between 2007 and 2015. They ranged in age from 5 to 13 years at baseline (9.2, 8–10.2), had a BMI of +3.8 SDS (3.1–4.3). The results are shown on the table. Metabolic abnormalities were detected in 90% of children initially and during follow up, and only 10% could be considered metabolically healthy.

Table 1.
Waist circumferenceFasting plasma glucoseFasting plasma insulinTriglyceridesHDL cholesterol
Median (IQR)+2.8+1.5+0.7+0.7−0.7
%>+2 S.D.85%24%11%13%11%

Conclusion: The prevalence of metabolic abnormalities is higher than expected in obese children and early adolescents when appropriate reference values are used.