ESPE Abstracts

Background: Some obese children are metabolically healthy obese (MHO), while some are metabolically unhealthy obese (MUO) having dyslipidemia and/or insulin resistance which increase mortality and morbidity related to cardiovascular diseases during adulthood.

Objective and hypotheses: This study is designed to assess factors affecting metabolic condition in obesity and compare clinical and laboratory findings between MHO and MUO children.

Method: In total 1085 obese individuals aged 6–18 years (mean 11.1±2.9 years, 57.6% females, and 59.7% pubertal) with age- and sex-matched BMI above 95th percentile were included in the study. Cases without dyslipidemia, insulin resistance, hepatosteatosis, and hypertension were considered as MHO. Dyslipidemia was defined as total cholesterol >200 mg/dl, triglycerides >150 mg/dl, LDL >130 mg/dl, or HDL >40 mg/dl. Insulin resistance was evaluated using HOMA-IR index. Obesity duration, physical activity, eating habits, screen time, parental obesity, serum levels of TSH, free T₄, ALT, AST, and hepatosteatosis in ultrasonography were also assessed retrospectively.

Results: Six hundred forty-two (59.2%) cases were MHO. Older age, sedentary life style, male gender, and higher BMI SDS was associated with being MHO. Rare/non consumption of junk food was predictive for good metabolic condition only in prepubertal obese cases. In MUO group serum free T₄ levels were lower; TSH was higher.

Conclusion: Active life style and restriction of junk-food consumption are the major parameters to prevent metabolic disorders in obesity.