ESPE Abstracts

Introduction: Pediatric obesity is associated with an increased risk of serious long-term complications. Therapeutic failure is influenced by several factors, such as the high dropout rate. A retrospective study was conducted on a cohort of children and adolescents with essential obesity, in order to evalute (1)the average duration of a correct follow-up and the percentage of weight loss at the end of it, (2)the rate of drop-out, researching related factors.

Materials and Methods: The retrospective, single-center study, involved 489 patients, followed for essential obesity at our Pediatric Endocrinology in the period 2016-2020. The auxological patients' data were collected during the first(V1) and the last visit(V2). Each patient during V1 were subjected to a blood sampling in order to evaluate the metabolic structure (triglycerides, total cholesterol, LDl, HDl, glycemia and insulin). Drop-out was defined as a follow-up of less than 12 months and/or including less than 1 visit every 6 months. To assess the drop-out rate and associated factors, patients were divided into 2 groups: Group A of drop-out (297 patients) and Group B of non-drop-out (192 patients). The difference between the BMI DS at V1 and V2 was considered to evaluate the percentage of weight loss and the associated factors.

Results: The median duration of follow-up was 20.8 ± 23.2 months. In the observed period, drop-out rate was 60.7%. The remaining patients completed follow-up in 12 or 24 months. In group A, the SD BMI and patients with BMI ≥3 SD at V2 were significantly higher than in group B (P=0.002 and P=0.027, respectively). In Group B, the percentage of patients with pathological HOMA-IR was significantly higher than in Group A (51.1% vs 41.3%; P=0.036), as well as was that of subjects with fasting glucose> 100 mg/dL (16.5% vs 8.9%; P=0.012). The likelihood of drop-out was positively associated with pubertal stage at V1 (OR 1.39) and negatively with a fasting blood glucose > 100 mg/dl and insulinemia> 15 uI / ml at V1(respectively OR 0.52 and OR 0.64). A negative association was found between weight loss and age > 10 years and a positive association between weight loss and non-pathological HOMA-IR.

Conclusion: The study demonstrated a high drop-out rate during follow-up, mainly among adolescents and patients with no glucometabolic alterations. These patients will need closer monitoring and possible counseling to avoid early abandonment and the development of complications in adulthood.