Department of Pediatric Endocrinology, Regency Center for Diabetes Endocrinology & Research, Regency City Clinic, The Mall, Kanpur, 208001, India.
GROW Society, Growth & Obesity Workforce, Kanpur, India.
Indian J Pediatr. 2021 Mar;88(3):252-256. doi: 10.1007/s12098-020-03515-5. Epub 2020 Oct 13.
To identify predictors of metabolic complications in obese Indian children and adolescents.
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).
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.
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.
确定印度肥胖儿童和青少年代谢并发症的预测因素。
本横断面研究纳入了 282 名肥胖儿童和青少年（188 名男性，平均（SD）年龄为 11.7（3.1）岁，体重指数标准差评分（BMI SDS）为 2.4（0.6）），他们接受了代谢检查（口服葡萄糖耐量试验、SGPT、血脂谱）和肥胖评估（腰围和双能 X 射线吸收法）。
115 名受试者（40.8%）无代谢并发症（代谢健康肥胖），BMI SDS 类别之间的患病率相似（BMI SDS 低于 2 的为 38.8%，2-3 的为 42.1%，高于 3 的为 40.4%）。正常出生体重（比值比 3.2，95%置信区间 1.0-10.1，p=0.04）、2 型糖尿病家族史阴性（比值比 1.81，95%置信区间 1.0-3.3，p=0.04）和年龄较小[11.3（3.1）岁，而 12.1（3.1）岁，p=0.03]与代谢健康肥胖相关。BMI SDS[2.4（0.6）对 2.4（0.6），p=0.7]、腰围 SDS[2.0（0.7）对 2.2（0.9），p=0.07]、腰高比[0.6（0.05）对 0.6（0.05），p=0.1]、DXA 测定的脂肪百分比[48.6%（5.4）对 47.8%（5.2），p=0.2]、男性脂肪量/女性脂肪量比[1.05（0.1）对 1.06（0.1），p=0.08]和脂肪质量指数[13.8（3.5）对 13.8（3.3），p=0.9]在两组之间无差异。
相当一部分肥胖儿童和青少年不会出现代谢并发症。出生体重和 2 型糖尿病家族史是并发症的唯一预测因素。需要进一步探索以确定干预目标。
