Context: The unified approach for obese children can result in therapeutic failure as obesity is a symptom of several conditions. It was previously suggested that only children with obesity onset beyond age 6 years will develop the metabolic syndrome and T2D. In turn, early childhood obesity carries a few times less risk of adult obesity comparing to that with the onset during juvenility.
Aim: We determine the clinical and biochemical profile of early-(E-Ob, up to 3 yrs) and late-onset (L-Ob; after 3 yrs) obesity.
Methods: We analysed detailed clinical and laboratory profiles of 240 non-syndromic obese children (116 girls; BMI >97%) aged 6.0˗17.0 from 3 countries in the prospective 'multi-OMICS' study granted by ESPE Research Unit. E-Ob and L-Ob was found in 55 and 185 subjects, respectively.
Results: E-Ob and L-Ob children had comparable mean age (11.8±2.2 vs. 12.4±2.3 yrs resp.), sex distribution, BMI (30.7±5.7 vs. 31.0±4.7), z-score BMI (2.8±0.5 vs. 2.8±0.4), waist-to-hip ratio (0.88±0.1 vs. 0.88±0.1), waist-to-height ratio (0.59±0.1 vs 0.58±0.01), systolic and diastolic blood pressure, acanthosis nigricans frequency as well as body composition parameters (P>0.05). Family economic status, gestational age, birth weight, type of delivery, mother's obesity before or during pregnancy, weaning time, antibiotic therapy in the 1st year of life and parents' BMI have not influenced the age of obesity onset.
Glucose, insulin (both in OGTT), insulin/glucose ratio, HOMA-IR, total cholesterol, HDL-chol, triglycerides, TSH, fT4, cortisol, ferritin, uric acid, creatinine as well the frequency of liver steatosis (by ultrasonography) were not different between E-Ob and L-Ob groups. L-Ob was characterized by higher values of HbA1c (P=0.007) as well as higher ALT (P=0.009), AST (P=0.019) and GGTP activity (P=0.007).
Conclusions: Higher activity of liver enzymes and higher value of hyperglycemia marker in children with late-onset obesity could reflect the influence of previously suggested enhanced adrenal steroidogenesis and indicate their tendency to develop the metabolic syndrome and T2D.
19 - 21 Sep 2019
European Society for Paediatric Endocrinology