ESPE Abstracts

Background: Significant aspects of metabolic homeostasis are regulated differently in males and females and sex differences can influence diagnostic approach and therapeutic responses. The underlying mechanisms accounting for gender difference remain to be established and may involve genetic and hormonal factors.

Aim: This study aimed at evaluating gender differences in anthropometric and metabolic parameters in a large cohort of obese children.

Methods and Results: We conducted a retrospective study in 581 children and adolescents referred to our Hospital for obesity (BMI>95°pc). All patients underwent anthropometric, biochemical and hormonal evaluation. All patients underwent OGTT. Subjects were subdivided according to Tanner stage in 269 pre-pubertal (103 F/142 M) and 370 pubertal subjects (204 F/132 M). In pre-pubertal subjects, basal glycaemia was higher in males than females (83.99 ± 7.7 vs 80.94 ± 8.3, P<0.05). Basaline c-peptide (1.54 ± 0.8 vs 1.77 ± 0.8, P<0.05) and insulin at 120’ (110.1 ± 115.9 vs 158.3 ± 108.1, P<0.05) resulted higher in females. In pubertal subjects, obese males showed higher BMI SDS (3.08 ± 0.98 vs 2.84 ± 0.98, P<0.05), basal C-peptide levels (3.14 ± 0.17 vs 2.34 ± 0.86, P<0.05), triglycerides levels (105.7 ± 57.3 vs 92.32 ± 47.35, P<0.05), AST (29.7 ± 11.5 vs 25.8 ± 11.7, P<0.001) and ALT levels (28.5 ± 17.9 vs 28.1 ± 8.3, P<0.001). Pubertal males and females showed no differences in prevalence of impaired fasting glycaemia (3% vs 3.9%), impaired glucose tolerance (16.6% vs 16%). Pubertal males had a higher prevalence of abnormal HbA1c than females (7.5% vs 3.9%).

Conclusion: In pubertt, males show a more severe degree of obesity and a worse metabolic profile than females. A role of androgens could be hypothesized. These results suggest that pubertal obese males need a more intensive management to reduce long-term cardiometabolic risk.