ESPE2016 Poster Presentations Fat Metabolism and Obesity P2 (56 abstracts)
Arbitrary Cutoffs Lead to Underestimation of Metabolic Abnormalities in Obese Children: The Value of Age- and Sex-adjusted Normative Values
Adele Carlier Gonod a, , Ahlam Azar b , Nathalie Lecomte b , Melanie Amouyal Perrod b , Manon Prevot b , Adeline Jacques b , Sophie Guilmin Crepon b & Jean Claude Carel b
aHopital Intercommunal Creteil, Creteil, France; bHopital Robert Debré, Paris, France
Background: Metabolic syndrome and insulin resistance are well recognized in adult obesity. Their criteria and prevalence and are still controversial in children.
Objective and hypotheses: To evaluate the prevalence and natural history of clinical and biological parameters of the metabolic syndrome in a pediatric cohort of obese subjects. To identify metabolically healthy subjects and the persistence of this phenotype over time.
Method: Prospective longitudinal, observational, single-center study on children monitored for overweight or obesity. Data collection was done yearly from 2007. Metabolic syndrome parameters were expressed in SDS for age and sex, using reference curves obtained from an independent representative healthy cohort of children in France, using the the same biological assays (Mellerio et al, Pediatrics 2012). Results are expressed as median (IQR).
Results: 533 children and pre-teens were enrolled between 2007 and 2015. They ranged in age from 5 to 13 years at baseline (9.2, 8–10.2), had a BMI of +3.8 SDS (3.1–4.3). The results are shown on the table. Metabolic abnormalities were detected in 90% of children initially and during follow up, and only 10% could be considered metabolically healthy.
| Waist circumference | Fasting plasma glucose | Fasting plasma insulin | Triglycerides | HDL cholesterol | |
| Median (IQR) | +2.8 | +1.5 | +0.7 | +0.7 | −0.7 |
| %>+2 S.D. | 85% | 24% | 11% | 13% | 11% |
Conclusion: The prevalence of metabolic abnormalities is higher than expected in obese children and early adolescents when appropriate reference values are used.
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