Salvatore Deborah, Satnick Ava, Abell Rebecca, Messina Catherine R, Chawla Anupama
Stony Brook Long Island Children's Hospital, Stony Brook, New York
Stony Brook Long Island Children's Hospital, Stony Brook, New York.
JPEN J Parenter Enteral Nutr. 2014 Sep;38(7):852-5. doi: 10.1177/0148607113496820. Epub 2013 Jul 12.
This retrospective study aimed to determine the prevalence of abnormal metabolic parameters in obese children and its correlation to the degree of obesity determined by body mass index (BMI).
In total, 101 children seen at the Pediatric Gastroenterology Obesity Clinic at Stony Brook Children's University Hospital were enrolled in the study. The degree of obesity was characterized according to the following formula: (patient's BMI/BMI at 95th percentile) × 100%, with class I obesity >100%-120%, class II obesity >120%-140%, and class III obesity >140%. A set of metabolic parameters was evaluated in these patients. Frequency distributions of all study variables were examined using the χ(2) test of independence. Mean differences among the obesity classes and continuous measures were examined using 1-way analysis of variance.
Within our study population, we found that 80% of our obese children had a low high-density lipoprotein (HDL) cholesterol level, 58% had elevated fasting insulin levels, and 32% had an elevated alanine aminotransferase (ALT) level. Class II obese children had a 2-fold higher ALT value when compared with class I children (P = .036). Fasting insulin, ALT, HDL cholesterol, and triglyceride levels trended with class of obesity.
Obese children in classes II and III are at higher risk for developing abnormal laboratory values. We recommend obese children be further classified to reflect the severity of the obesity since this has predictive significance for comorbidities. Obesity classes I, II, and III could help serve as a screening tool to help communicate risk assessment.
这项回顾性研究旨在确定肥胖儿童异常代谢参数的患病率及其与通过体重指数（BMI）确定的肥胖程度的相关性。
总共101名在石溪儿童医院儿科胃肠病肥胖门诊就诊的儿童纳入了该研究。肥胖程度根据以下公式确定：（患者BMI/第95百分位数的BMI）×100%，其中I级肥胖>100%-120%，II级肥胖>120%-140%，III级肥胖>140%。对这些患者评估了一组代谢参数。使用独立性χ(2)检验检查所有研究变量的频率分布。使用单向方差分析检查肥胖类别和连续测量值之间的平均差异。
在我们的研究人群中，我们发现80%的肥胖儿童高密度脂蛋白（HDL）胆固醇水平低，58%的儿童空腹胰岛素水平升高，32%的儿童丙氨酸转氨酶（ALT）水平升高。与I级儿童相比，II级肥胖儿童的ALT值高出2倍（P = 0.036）。空腹胰岛素、ALT、HDL胆固醇和甘油三酯水平随肥胖类别而变化。
II级和III级肥胖儿童出现异常实验室值的风险更高。我们建议对肥胖儿童进行进一步分类以反映肥胖的严重程度，因为这对合并症具有预测意义。I级、II级和III级肥胖可作为一种筛查工具，有助于传达风险评估。
