ESPE Abstracts

Introduction: Pediatric obesity (PO) if not adequately identified and addressed, leads to significant chronic diseases in adulthood. The anthropometric methods for the evaluation of PO have limitations well described in the literature. Neck circumference (NC) is recently proposed as parameter for better identification and evaluation of PO. We verified the relationship between NC, body mass index (BMI), waist circumference (WC) and some laboratory parameters of a chidren and adolescents obese group, with the aim of defining the validity of NC as a clinical marker of PO and its hepato-cardio-metabolic (HCM) complications.

Materials and Methods: A retrospective study was conducted on 48 children (20M, 28F, age 5-16 years) with obesity (BMI z-score 2.86 ± 0.27) assessed at the pediatric endocrinology service of the Pediatric Unit - PO di Battipaglia - ASL Salerno from January 2016 to January 2020. All of them practiced: weight, height, BMI z-score, WC, NC and blood pressure measurement; glucose, insulin (for calculating HOMA index), c-peptide, ALT, AST, gamma GT, uric acid (UA), total cholesterol, HDl, LDl, triglycerides (TG), ESR, PCR blood dosages. They also followed the oral glucose tolerance test (OGTT). The correlation coefficient was calculated between NC and clinical/laboratory values identified.

Results: NC is always higher than the 95th percentile for sex and age (cut off: 30.5 - 46.5 cm) with mean values 35.97 ± 4.2 cm. NC is significantly correlated with weight (r=0.86140 P=0.00000), BMI (r=0.80831 P=0.00000) and CV (r=0.85164 P=0.000005). The correlations between NC and HDL (r=-0.34139 P=0.02692), AST (r=-0.33223 P=0.02951), GGT (r=0.34778 P=0.02230) and UA (r=0.54632 P=0.00047) are also significant. The relationship between NC and the main laboratory indicators of insulin resistance is also significant. In particular, NC correlates with c-peptide (r=0.53912 P=0.01167), insulinemia (r=0.36661 P=0.01694) and HOMA index (r =0.32932 P=0.03551).

Conclusion: Despite the small sample of patients, this study shows that NC could be used as an alternative to BMI and WC to evaluate PO. In particular, it is clear that NC can represent a clinical index of insulin resistance and HCM risk in obese adolescents and children. Therefore, it is advisable to measure NC in all obese children, especially those who show clinical and laboratory signs of hyperinsulinism.