ESPE Abstracts

Background: Childhood obesity has emerged as a global pandemic, posing significant health challenges and necessitating urgent action to address its widespread prevalence and associated metabolic consequences. Understanding the link between childhood obesity, being born large for gestational age (LGA), and insulin resistance (IR) in children is crucial for developing targeted interventions and sustainable preventive measures against long-term health risks associated with cardiovascular disease, and metabolic syndrome (MetS).

Objective: A retrospective observational study was conducted at "Louis Țurcanu" Children's Clinical and Emergency Hospital in Timișoara - Departments of Endocrinology, Diabetes, and Metabolic Diseases. The study involved a cohort of 278 patients aged 2 to 18 years, who were diagnosed with obesity, admitted over a 1-year period (March 25. 2022, to April 25. 2023). The aim was to determine the prevalence of LGA among obese children and to compare the metabolic profile of LGA obese children to their appropriate for gestational age (AGA) counterparts.

Methods and Results: Obesity was diagnosed as body mass index (BMI) values exceeding the 95th percentile, using age-specific BMI reference guidelines outlined in the 2000 Centers for Disease Control and Prevention Child Growth Charts. Fasting glucose and insulin levels were determined and used to quantify the homeostasis model assessment for IR index (HOMA – IR). According to age, patients were divided into 3 groups: pre-pubertal group: < 8 years (6.83%), pubertal group: 8 -14 years (58.63%), and adolescent group: > 14 years (34.53%). The 3 main groups were further divided into six subgroups, based on their birth weight (AGA or LGA). Overall, the prevalence of LGA among obese children was 21.22%. IR had a prevalence of 79.49% in the studied population, with the highest percentage observed in the pubertal group at 51.43%, followed by the adolescent group at 28.05% and the pre-pubertal group at 20.52%. In relation to birth weight, the highest percentage of IR in LGA children was noted in the adolescent group (17.94%) followed by the pubertal group (16.78%).

Conclusions: The relatively high prevalence of LGA among obese children as well as that of IR, that increases around puberty and adolescence, emphasises the need of continuous monitoring of LGA-born obese children, for an early detection and management of metabolic and cardiovascular disease.