C Dave1,2, N Agarwal1,2, R Patel1,2, R Shukla1, Anurag Bajpai3,4. 1. Department of Pediatric Endocrinology, Regency Center for Diabetes Endocrinology & Research, Regency City Clinic, The Mall, Kanpur, 208001, India. 2. GROW Society, Growth & Obesity Workforce, Kanpur, India. 3. Department of Pediatric Endocrinology, Regency Center for Diabetes Endocrinology & Research, Regency City Clinic, The Mall, Kanpur, 208001, India. dr_anuragbajpai@yahoo.com. 4. GROW Society, Growth & Obesity Workforce, Kanpur, India. dr_anuragbajpai@yahoo.com.
Abstract
OBJECTIVE: To identify predictors of metabolic complications in obese Indian children and adolescents. METHODS: This cross-sectional study included 282 obese children and adolescents [188 boys, mean (SD) age of 11.7 (3.1) y, body mass index standard deviation score (BMI SDS) 2.4 (0.6)] who underwent metabolic work-up (oral glucose tolerance test, SGPT, lipid profile) and adiposity assessment (waist circumference and Dual energy X-ray absorptiometry). RESULTS: One hundred and fifteen subjects (40.8%) had no metabolic complication (metabolic healthy obesity) with similar prevalence across BMI SDS categories (38.8% for BMI SDS below 2, 42.1% for 2-3 and 40.4% for those above 3). Normal birth weight (odds ratio 3.2, 95% confidence interval 1.0-10.1, p = 0.04), negative family history of type 2 diabetes (odds ratio 1.81, 95% confidence interval 1.0-3.3, p = 0.04) and younger age [11.3 (3.1) y as against 12.1 (3.1) y, p = 0.03] were associated with metabolically healthy obesity. No difference in BMI SDS [2.4 (0.6) as against 2.4 (0.6), p = 0.7], waist circumference SDS [2.0 (0.7) as against 2.2 (0.9), p = 0.07], waist to height ratio [0.6 (0.05) as against 0.6 (0.05), p = 0.1], DXA derived fat percentage [48.6 (5.4)% as against 47.8% (5.2), p = 0.2], android to gynoid ratio [1.05 (0.1) as against 1.06 (0.1), p = 0.08] and fat mass index [13.8 (3.5) as against 13.8 (3.3), p = 0.9] was observed in the two groups. CONCLUSIONS: A substantial proportion of obese children and adolescents do not develop metabolic complications. Birth weight and family history of type 2 diabetes are the only predictors of complications. Further exploration is needed to identify interventional targets.
OBJECTIVE: To identify predictors of metabolic complications in obese Indian children and adolescents. METHODS: This cross-sectional study included 282 obesechildren and adolescents [188 boys, mean (SD) age of 11.7 (3.1) y, body mass index standard deviation score (BMI SDS) 2.4 (0.6)] who underwent metabolic work-up (oral glucose tolerance test, SGPT, lipid profile) and adiposity assessment (waist circumference and Dual energy X-ray absorptiometry). RESULTS: One hundred and fifteen subjects (40.8%) had no metabolic complication (metabolic healthy obesity) with similar prevalence across BMI SDS categories (38.8% for BMI SDS below 2, 42.1% for 2-3 and 40.4% for those above 3). Normal birth weight (odds ratio 3.2, 95% confidence interval 1.0-10.1, p = 0.04), negative family history of type 2 diabetes (odds ratio 1.81, 95% confidence interval 1.0-3.3, p = 0.04) and younger age [11.3 (3.1) y as against 12.1 (3.1) y, p = 0.03] were associated with metabolically healthy obesity. No difference in BMI SDS [2.4 (0.6) as against 2.4 (0.6), p = 0.7], waist circumference SDS [2.0 (0.7) as against 2.2 (0.9), p = 0.07], waist to height ratio [0.6 (0.05) as against 0.6 (0.05), p = 0.1], DXA derived fat percentage [48.6 (5.4)% as against 47.8% (5.2), p = 0.2], android to gynoid ratio [1.05 (0.1) as against 1.06 (0.1), p = 0.08] and fat mass index [13.8 (3.5) as against 13.8 (3.3), p = 0.9] was observed in the two groups. CONCLUSIONS: A substantial proportion of obesechildren and adolescents do not develop metabolic complications. Birth weight and family history of type 2 diabetes are the only predictors of complications. Further exploration is needed to identify interventional targets.
Entities:
Keywords:
Body composition; Childhood obesity; Metabolically healthy obesity
Authors: Sunil V Pawar; Vinay G Zanwar; Ajay S Choksey; Ashok R Mohite; Samit S Jain; Ravindra G Surude; Qais Q Contractor; Pravin M Rathi; Ravi U Verma; Premlata K Varthakavi Journal: Ann Hepatol Date: 2016 Nov-Dec 2016 Impact factor: 2.400