Warnakulasuriya Loretta S, Samaranayake Dulani L, Adikaram Adikaram V N, Fernando Manel M A, Rytter Elisabet, Ciba Iris, Bergsten Peter, Forslund Anders H, Renuka Ruchira Silva K D, Wickramasinghe Vithanage Pujitha
Postgraduate Institute of Medicine, University of Colombo, Colombo, Sri Lanka.
Department of Community Medicine, University of Colombo, Colombo, Sri Lanka.
Int J Endocrinol. 2021 Jul 5;2021:9936889. doi: 10.1155/2021/9936889. eCollection 2021.
Childhood obesity-related metabolic derangements are increasing among South Asian populations. Most of these changes persist to adulthood. This study aims to describe the distribution of metabolic abnormalities among 7- to 17-year-old overweight and obese children in the Gampaha District of Sri Lanka. Overweight children (age- and gender-adapted BMI>+1SD, WHO standards) were selected from a community survey carried out in the Negombo Education Zone of Gampaha District. After a 12-hour overnight fast, blood was drawn, and blood glucose (FBG), lipid profile, insulin, and liver transaminases were measured. Two hours after a glucose load, blood was drawn for random blood glucose (RBG) and insulin. Metabolic syndrome (MetS) was diagnosed using modified IDF criteria for children. Anthropometry, fat mass (FM), and blood pressure were measured. Hepatic fat pattern was assessed ultrasonically. The data of 403 children (210 boys) were analysed. Of the study population, 16.4% were overweight (BMI for age +1 to +2SD), 72% were obese (BMI for age >+2 to +3SD), and 11.6% were severely obese (BMI for age >+3SD). Insulin resistance was seen in 46.8%, and prevalence increased with age. Mean postprandial insulin ranged from 368 to 625 pmol/L and was elevated in 35%. Dysglycaemia was seen among 20.8%. MetS was present in 19.8%, and 84% had at least one metabolic abnormality. Different degrees of hepatic steatosis were observed in 32.5%, and elevated ALT/AST ratio was seen in 58% of the population. Overweight and obesity during childhood were associated with multiple metabolic abnormalities including MetS, and they occur from a young age. It is important to screen children for overweight/obesity early in life and intervene to prevent them from developing metabolic complications.
在南亚人群中，与儿童肥胖相关的代谢紊乱情况正在增加。其中大多数变化会持续到成年期。本研究旨在描述斯里兰卡甘帕哈区7至17岁超重和肥胖儿童中代谢异常的分布情况。超重儿童（根据年龄和性别调整的BMI>+1SD，采用世界卫生组织标准）是从在甘帕哈区尼甘布教育区进行的一项社区调查中选取的。经过12小时空腹后，采集血液，测量空腹血糖（FBG）、血脂谱、胰岛素和肝转氨酶。葡萄糖负荷后两小时，采集血液测量随机血糖（RBG）和胰岛素。采用针对儿童的改良国际糖尿病联盟（IDF）标准诊断代谢综合征（MetS）。测量人体测量学指标、脂肪量（FM）和血压。通过超声评估肝脏脂肪模式。对403名儿童（210名男孩）的数据进行了分析。在研究人群中，16.4%为超重（年龄别BMI为+1至+2SD），72%为肥胖（年龄别BMI>+2至+3SD），11.6%为重度肥胖（年龄别BMI>+3SD）。46.8%的儿童存在胰岛素抵抗，且患病率随年龄增加。餐后平均胰岛素水平在368至625 pmol/L之间，35%的儿童该水平升高。20.8%的儿童存在血糖异常。19.8%的儿童患有代谢综合征，84%的儿童至少有一种代谢异常。32.5%的儿童观察到不同程度的肝脏脂肪变性，58%的人群谷丙转氨酶/谷草转氨酶（ALT/AST）比值升高。儿童期超重和肥胖与包括代谢综合征在内的多种代谢异常相关，且这些异常在幼年时就会出现。在儿童早期对超重/肥胖进行筛查并采取干预措施以预防他们发生代谢并发症非常重要。
