Objective and hypotheses: The work was initiated to perform integral assessment of metabolic syndrome (MS) risk factors in obese children and adolescents.
Method: We examined Uzbek 100 children and adolescents with exogenous-constitutional obesity (ECO) aged from 6 to 16 years (mean age 11.7±0.25); 54 (54.0%) boys and 46 (46.0%) girls among them. To develop prediction scale we used a modification of Bayesian probability, method for standardization of intensive parameters.
Results: MS risk is 8.5 times higher with triglycerides (TG) ≧1.7 mmol/l; it is 5.3 times higher with HDL <1.03 mmol/l, 3.1 times higher with BMI>97th percentile and 2.6 times higher with HbA1c>6.7%. MS risk increases by 2.7 times with early onset of obesity (under 10 years), by 3.4 times with ECO duration >5 year, and by 2.9 times with SHBG<70 nmol/l for boys and <100 nmol/l for girls. Analysis of relative risk (RR) and etiological fraction (EF) of MS risk factors demonstrated that TG≧1.7 mmol/l (RR=8.47; EF=88.19%) and HDL <1.03 mmol/l (RR=5.30; EF=81.15%) almost completely precondition MS. Very high and high precondition of MS could be seen with BMI>97th percentile (RR=3.07; EF=67.44%), and HbA1c>6.7% (RR=2.60; EF=61.54%) and IA >3.0 (RR=2.16; EF=53.64%), respectively. MS is moderately preconditioned by obesity duration ranging from 5 to 10 years, obesity onset age >10 years, MAU ranging from 30 to 100, fasting glycemia (≧5.0), diastolic blood pressure ≧85 Hg mm, SHBG<20 for boys and <30 for girls.
Conclusion: Children and adolescents aged under 16 years with high TG, low HDL, BMI>97th percentile, high HbA1c and obesity duration >5 years are at MS high risk. TG≧1.7 mmol/l and HDL<1.03 mmol/l almost completely precondition MS. BMI>97th percentile, and HbA1c>6.7% and IA>3.0 are associated with very and high MS precondition.
01 - 03 Oct 2015
European Society for Paediatric Endocrinology