ESPE Abstracts (2018) 89 P-P2-140

Sex-related Differences and Effect of Puberty on Metabolic Syndrome in Obese Children and Adolescents

Chiara Guzzetti, Anastasia Ibba, Letizia Casula, Sabrina Pilia & Sandro Loche


SSD Endocrinologia Pediatrica e Centro Screening Neonatale, Ospedale Pediatrico Microcitemico “A. Cao”, AO Brotzu, Cagliari, Italy


Introduction: Metabolic syndrome (MS) is a known complication of obesity. It is still unclear whether gender and puberty influence the prevalence of MS in children and adolescents.

Objective: Aim of the study was to evaluate the effect of gender and puberty on the prevalence of MS and on cardiovascular risk factors (CVRF) in obese children and adolescents.

Patients and Methods: 1437 obese patients (age 9.7 (2.2–17.9) ys; 660 Male) were included in this retrospective analysis. Subjects were stratified according to Tanner pubertal staging (prepubertal (PREP), pubertal stage 2–3 (PS2-3), pubertal stage 4–5 (PS4-5)). Waist circumference (WC), systolic and diastolic blood pressure (SP, DP), fasting plasma glucose (GLU) and insulin (INS), post Oral Glucose Tolerance Test glucose (post-OGTT GLU) and insulin (post-OGTT INS), and lipids were evaluated in all subjects. HOMA index (GLU(mmol/L) x INS(mU/L) / 22.5) was calculated as insulin resistance index. MS was defined according to the IDEFICS criteria in 2–10 ys patients (Group 1) and IDF criteria in patients ≥10 ys (10–16 ys=Group 2, ≥16 ys=Group 3).

Results: The overall prevalence of MS was 10.9%. BMI-SDS (PREP, PS4-5), WC (All, PREP, PS4-5), SP (All, PREP, PS2-3, PS4-5), DP (PREP, PS2-3), GLU (All, PREP, PS4-5) and triglycerides (All, PS4-5) were higher in males. Mean INS and post-OGTT INS were higher in All, PREP and PS2-3 females.The CVRF more frequently abnormal in males were WC (All, PREP, PS4-5), SP (All, PS2-3, PS4-5) and GLU (All), while HOMA was more frequently abnormal in All and PS2-3 females. WC was more frequently abnormal in PREP, while SP was more frequently abnormal in pubertal patients, regardless of sex. PS2-3 males showed more frequent abnormalities of GLU and less frequent abnormalities of HOMA. HDL was more frequently abnormal in PS2-3 female. The prevalence of MS was higher in PREP and PS4-5 males of group 2 and in group 3.

Conclusions: Sex and pubertal status influence the prevalence of MS and the frequency of abnormalities of CVRF in obese children and adolescents. CVRF are already present in prepubertal age, and their prevalence is higher in male. Identifying patients with higher risk of metabolic complications and cardiovascular risk factors is important to design targeted and effective prevention strategies.

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