ESPE Abstracts (2019) 92 P3-126

Metabolic Risk Assessment in Obese Children Using Hypertriglyceridemic Waist (HTGW) Phenotype. Can it be a Useful Screening Marker?

Eirni Dikaiakou1, Elpis-Athina Vlachopapadopoulou1, Fani Athanasouli1, Stefanos Stergiotis1, Maria Kafetzi2, Aspasia Fotinou2, Stefanos Michalacos1


1Dept. of Endocrinology-Growth and Development, Children's Hospital P. & A. Kyriakou, Athens, Greece. 2Biochemistry Dept.-Hormones Laboratory, Children's Hospital P. & A. Kyriakou, Athens, Greece


Background: The prevalence of childhood obesity is dramatically increasing worldwide. Overweight and obesity are well known risk factors for metabolic disorders such as Insulin Resistance, Type II Diabetes, Arterial Hypertension and Non Alcoholic Fatty Liver Disease (NAFLD).

Aims: This study was conducted to assess the prevalence of Hypertriglyceridemic Waist phenotype (HTGW) among overweight and obese Greek children. Furthermore, to investigate whether HTGW phenotype could be used as a screening marker to detect children in risk of Insulin Resistance, Hypertension and NAFLD.

Methods: Data from 172 children (83 males) with mean age 9.7 years (SD=2.5 years) were analyzed. Triglycerides-Glucose (TyG) and Homeostasis Model Assessment for insulin resistance (HOMA-IR) indices were used as predictors of insulin resistance. TyG index was calculated as ln [triglycerides (mg/dl) × fasting glucose (mg/dl)/2]. HTGW phenotype was defined as Waist Circumference (WC) ≥ 90th CDC percentile and triglyceride levels ≥100 mg/dl for children 0 to 9 years of age and ≥ 130 mg/dl for 10 to 19 years old. Elevated arterial pressure was defined as Systolic Arterial Pressure (SAP) or Diastolic Arterial Pressure (DAP) ≥ 90th percentile. Alanine aminotransferase (ALT) ≥25.8 U/L (boys) and 22.1 U/L (girls), was defined as abnormal. Chi-square tests were used for the comparison of proportions and Student's t-tests for the comparison of means.

Results: 43.2% of the children had waist circumference above the 90th percentile and 20.9% had elevated triglycerides. HTGW was present at 16.3% of the sample. No gender or age differences were found among children with HTGW. Significantly lower levels of HDL were found in cases with HTGW (P<0.001). WHtR ratio was significantly greater in cases with HTGW (P=0.007). Mean TyG was 8.79 (SD=0.32) for those with HTGW and 8.0 (SD=0.37) for those without HTGW (P<0.001), while subjects with HOMA-IR ≥2.5 had a greater proportion of HTGW (23.4% vs. 8.8%, P=0.030). SAP and DAP did not differ in the presence of HTGW, while subjects with and without elevated blood pressure where not different in the presence of HTGW (P=0.596). NAFLD risk was not found to be associated with the presence of HTGW (P=0.316).

Conclusions: High prevalence of HTGW phenotype was detected among overweight and obese children and it was significantly and positively correlated with insulin resistance and lower HDL levels. Therefore, it could be a useful and cost effective marker for early detection of children in risk of developing metabolic disorders.

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