Corica Domenico, Aversa Tommaso, Valenzise Mariella, Messina Maria Francesca, Alibrandi Angela, De Luca Filippo, Wasniewska Malgorzata
Department of Human Pathology of Adulthood and Childhood, Unit of Pediatrics, University of Messina, Messina, Italy.
Department of Economics, Unit of Statistical and Mathematical Science, University of Messina, Messina, Italy.
Front Endocrinol (Lausanne). 2018 May 2;9:187. doi: 10.3389/fendo.2018.00187. eCollection 2018.
The objectives were to evaluate (1) the metabolic profile and cardiometabolic risk in overweight/obese children at first assessment, stratifying patients according to severity of overweight and age; and (2) to investigate the relationship between family history (FH) for obesity and cardiometabolic diseases and severity of childhood obesity.
In this cross-sectional, retrospective, observational study, 260 children (139 female), aged between 2.4 and 17.2 years, with overweight and obesity were recruited. Data regarding FH for obesity and cardiometabolic diseases were collected. Each patient underwent clinical and auxological examination and fasting blood sampling for metabolic profile. Homeostasis model assessment of insulin resistance (HOMA-IR), triglyceride-to-high-density lipoprotein cholesterol ratio, and atherogenic index of plasma were calculated. To evaluate the severity of obesity, children were divided into two groups for BMI standard deviation (SD) ≤2.5 and BMI SD >2.5. Moreover, study population was analyzed, dividing it into three groups based on the chronological age of patient (<8, 8-11, >11 years).
BMI SD was negatively correlated with chronological age ( < 0.005) and significantly higher in the group of children <8 years. BMI SD was positively associated with FH for obesity. Patients with more severe obesity (BMI SD >2.5) were younger ( < 0.005), mostly prepubertal, presented a significantly higher HOMA-IR ( = 0.04), and had a significantly higher prevalence of FH for arterial hypertension, type 2 diabetes mellitus, and coronary heart disease than the other group.
(1) Family history of obesity and cardiometabolic diseases are important risk factors for precocious obesity onset in childhood and are related to the severity of obesity. (2) Metabolic profile, especially HOMA-IR, is altered even among the youngest obese children at first evaluation. (3) Stratification of obesity severity, using BMI SD, is effective to estimate the cardiometabolic risk of patients.
本研究旨在评估:(1)首次评估时超重/肥胖儿童的代谢特征和心血管代谢风险,根据超重严重程度和年龄对患者进行分层;(2)调查肥胖家族史(FH)与心血管代谢疾病以及儿童肥胖严重程度之间的关系。
在这项横断面、回顾性观察研究中,招募了260名年龄在2.4至17.2岁之间的超重和肥胖儿童(139名女性)。收集了有关肥胖和心血管代谢疾病家族史的数据。每位患者均接受了临床和体格检查,并进行空腹采血以检测代谢特征。计算胰岛素抵抗的稳态模型评估(HOMA-IR)、甘油三酯与高密度脂蛋白胆固醇比值以及血浆致动脉粥样硬化指数。为评估肥胖的严重程度,将儿童分为两组,BMI标准差(SD)≤2.5和BMI SD>2.5。此外,根据患者的实际年龄(<8岁、8-11岁、>11岁)将研究人群分为三组进行分析。
BMI SD与实际年龄呈负相关(<0.005),在<8岁儿童组中显著更高。BMI SD与肥胖家族史呈正相关。肥胖程度更严重(BMI SD>2.5)的患者年龄更小(<0.005),大多为青春期前儿童,HOMA-IR显著更高(=0.04),且动脉高血压、2型糖尿病和冠心病家族史的患病率显著高于另一组。
(1)肥胖和心血管代谢疾病家族史是儿童早熟肥胖发病的重要危险因素,且与肥胖严重程度相关。(2)即使在首次评估时,最年幼的肥胖儿童的代谢特征,尤其是HOMA-IR也会发生改变。(3)使用BMI SD对肥胖严重程度进行分层,可有效估计患者的心血管代谢风险。