Background: Pediatric obesity is the most common nutritional disorder that affects more than a third of the young population and predisposed individuals to greater future morbidity and mortality. Therefore, rising obesity epidemics becomes is becoming one the most important healthcare problems.
Methods: In the period of 2017-2018, 62 consecutive pediatric patients referred to the University Pediatric clinic were recruited. Demographic and clinical information for both the patients and their parents were collected using in-person interview and standardized questionnaires. Specific data regarding weight, height, systolc (SP) and diastolic (DP) blood pressure, lipid metabolic profile, thyroid and adrenal hormone levels, and glucose and insulin levels before and after oral glucose tolerance test (OGTT with 75g glucose dose) were collected. Body mass index was determined and patients were classified based on the International Obesity Task Form (IOTF) criteria. Appropriate descriptive, comparative parametric and non-parametric tests and Spearmans's ranked correlations were used for statistical analysis.
Results: The population was consisted of 34 males and 27 females with respective age of 11.3 and 11.7 years old (P=0.781) were recruited. The mean BMI was 30.5 (SD 5.5), of which 8 were with normal weight (£25 BMI), 22 were overweight (25-30 BMI) and 32 were obese (³30 BMI). Patients BMI was significantly associated with the BMI of their parents (Spearman's ranked r=0.293, P=0.033). Both SP and DP were significantly different between the BMI subgroups (one-way ANOVA P=0.005 and P=0.001, respectably) with the obese group having the highest BP values (post-hoc Benjamini P=0.004). The obese group had a trend of lower T4 when compared to overweight and normal pediatric patients (7.0mg/dL vs. 9.4mg/dL vs. 10.4mg/dL, one-way ANOVA P=0.061). The obese group had lowest baseline glucose (4.0mmol/L vs. 4.9mmol/L vs. 4.5mmol/L, one-way ANOVA P<0.001) but largest numerical increase during the OGTT (D3.5mmol/L vs. D2.6mmol/L vs. D2.0mmol/L, one-way ANOVA P=0.137). Along those lines, the obese group had the greatest levels of insulin at rest (21.8mgU/mL vs. 12.9mgU/mL vs. 13.6mgU/mL, one-way ANOVA P=0.008). Furthermore, the obese group had numerically the smallest insulin response after oral glucose tolerance test (D86.1mgU/mL vs. D125.7mgU/mL, P=0.08).
Conclusion: Pediatric patients in our clinic demonstrate familial type of obesity which is characterized with premorbid asymptomatic endocrine impairments. In order to maintain normal glucose levels, obese pediatric patients demonstrate high levels of resting insulin levels and diminished response after OGTT load. Failure of these compensatory mechanisms may lead to early development of diabetes type 2.
19 - 21 Sep 2019
European Society for Paediatric Endocrinology