ESPE2023 Poster Category 1 Fat, Metabolism and Obesity (97 abstracts)
Occurrence of cardiovascular risk factors in Polish children and adolescents with severe obesity. Preliminary results of the Polish-German study project on severe early-onset obesity
Anna Stępniewska 1 , Ewa Szczudlik 1 , Mirosław Bik-Multanowski 2 , Stephanie Brandt 3 , Bertram Flehmig 4 , Ewa Małecka-Tendera 5 , Artur Mazur 6 , Elżbieta Petriczko 7 , Michael B. Ranke 8 , Agnieszka Zachurzok 9 & Małgorzata Wójcik 1
1Department of Pediatric and Adolescent Endocrinology, Pediatric Institute, Jagiellonian University Medical College, Cracow, Poland. 2Department of Medical Genetics, Faculty of Medicine, Jagiellonian University Medical College, Cracow, Poland. 3Center for Rare Endocrine Diseases, Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, Ulm, Germany. 4Mediagnost GmbH, Reutlingen, Germany. 5Department of Pediatrics and Pediatric Endocrinology, Medical University of Silesia, School of Medicine in Katowice, Katowice, Poland. 6Department of Pediatrics, Pediatric Endocrinology and Diabetes, Medical Faculty, University of Rzeszów, Rzeszów, Poland. 7Department of Pediatrics, Endocrinology, Diabetology, Metabolic Disorders and Cardiology of Developmental Age, Pomeranian Medical University, Szczecin, Poland. 8Children’s Hospital, University of Tübingen, Tübingen, Germany. 9Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Zabrze, Poland
It is estimated that 1-5% of children and adolescents in Europe suffer from severe obesity (corresponding to an adult BMI > 40 kg/m2). However, in risk stratification, the occurrence of metabolic complications is more important than BMI itself. The study aimed to assess the occurrence of cardiovascular risk factors in a cohort of children and adolescents with severe obesity.
Patients and Methods: The analysis included 140 patients (75 female) with severe obesity at the mean age of 14 (range 10-18) years (all recruited in 4 regional reference centers in Poland). Severe obesity was defined as BMI>35 kg/m2 (children in the age 6-14 years) and BMI>40 kg/m2 (in older). Cardiovascular risk factors – high blood pressure (>90percentile), dyslipidemia (HDL cholesterol <1.03 mmol/L, triglycerides ≥1.7 mmol/L), and glucose metabolism disorders (fasting and 120 min. after OGTT; > 5.5 mmol/L and > 7.8 mmol/L respectively were assessed in all patients.
Results: 89% (n= 124) patients had elevated blood pressure, 83% (n=117) with abnormal lipid profile (16 % with isolated low HDL, 23% isolated high TG, and 44% with both disorders), 19% (n=26) with the hyperglycemic state (3% impaired fasting glucose, 14% impaired glucose tolerance, 2% diabetes mellitus). Only 1.4% (n=2) was free of cardiometabolic risk factors. A single cardiometabolic risk factor was noticed in 24% (n=33) participants, two were present in 61% (n=85), and three in 7% (n=10) participants. Female patients presented with significantly lower BMI z-score (3.5 vs. 3.8, p <0.001), but higher fat mass percent (48.3 vs. 44.6, P<0.001). They had also lower mean fasting glucose levels (4.8 vs. 5.0 mmol/L, P<0.008) and higher mean HDL cholesterol levels (43.7 vs. 40.1 mg/dL, P=0.01) compared to male patients.
Conclusions: The most common cardiovascular risk factor in children and adolescents with severe obesity was elevated blood pressure. More than 60% of patients had more than one cardiovascular risk factor. This calls for an early intervention in severe obesity.
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