ESPE Abstracts

Introduction: The increasing prevalence of obesity has become a major global health issue. Clustering of cardiometabolic risk factors in obese adolescents is associated with reduced life expectancy and impaired quality of life. Due to serious impact of obesity on cardiometabolic health, effective treatment strategies are intensively sought after.

Objectives: The aim of this retrospective cross-sectional study was to examine cardiometabolic risk factor clustering in obese adolescents referred for diagnostic assessment and to evaluate its' association with the degree of obesity, adipose tissue distribution, and cardiorespiratory fitness (CRF).

Methods: Data from 70 apparently healtyh adolescents with BMI ≥95th percentile for age and sex were retrospecitvely analysed. Their diagnostic work-up included waist circumference measurement, bioelectrical impedance analysis (BIA) for body composition assessment, oral glucose tolerance test (OGTT), fasting lipid profile, serum liver enzyme activity measurement, 24-hour ambulatory blood pressure monitoring, and submaximal treadmill walking test for CRF estimation.

Results: Out of 70 adolescents, 45 (64.3%) were female. All the subjects were pubertal. Their mean age was 14.3±1.8 years (age range 10-17.8), BMI 36.15 ± 4.72 kg/m², BMI SDS 2.43 ± 0.35, waist to height ratio 0.66 ± 0.08, and whole-body fat percentage 41.69 ± 7.17%. In the majority (85.7%), cardiometabolic risk factors were detected. The most prevalent cardiometabolic risk factor was dyslipidemia (77.1%), followed by hypertension (27.1%), abnormal liver function tests (21.4%), prediabetes (14.3%) and type 2 diabetes (1.4%). Regarding the frequency of cardiometabolic risk factors, only one was detected in 40%, two in 38.6% and three in 7.1% of obese adolescents. Groups with different number of cardiometabolic risk factors did not differ significantly according to age, sex and puberty stage, but they differed according to BMI (P=0.038), BMI SDS (P=0.030), waist to height ratio (P=0.050) and CRF (P=0.026). After adjustment for BMI SDS, low CRF remained statistically significant independent predictor of cardiometabolic risk factor clustering (beta coefficient = -0.272, P=0.036).

Conclusion: A significant proportion of obese adolescents referred for diagnostic assessment already have associated cardiometabolic risk factors. More pronounced obesity, centripetal distribution of adipose tissue and lower CRF were associated with cardiometabolic risk factor clustering. Raising CRF should be an integral part of the therapeutic approach for obese adolescents.