Kostrzeba Ewa, Bik-Multanowski Mirosław, Brandt Stephanie, Małecka-Tendera Ewa, Mazur Artur, Ranke Michael B, Wabitsch Martin, Wójcik Małgorzata, Zachurzok Agnieszka, Przestalska-Sowa Anna, Petriczko Elżbieta
Department of Pediatrics, Endocrinology, Diabetology, Metabolic Disorders and Cardiology of Developmental Age, Pomeranian Medical University, 71-252 Szczecin, Poland.
Department of Medical Genetics, Jagiellonian University Medical College, 30-663 Cracow, Poland.
J Clin Med. 2024 Sep 25;13(19):5701. doi: 10.3390/jcm13195701.
: The increasing prevalence of severe obesity among children and adolescents poses a significant challenge for pediatricians and general practitioners. This study aimed to investigate the relationships between biochemical results, anthropometry, blood pressure measurements, and bioimpedance analysis (BIA)-derived parameters to identify potential cardiometabolic complications associated with severe obesity. : This study included 347 children (162 boys, 185 girls) aged 0-19 years, meeting the criteria for severe obesity based on BMI thresholds for different age groups. The patients were recruited in four pediatric endocrinology centers in Poland (Zabrze, Cracow, Rzeszow, Szczecin). Each participant underwent anthropometric measurements, pubertal stage assessment, blood pressure measurement, biochemical and hormonal tests, and BIA. : BMI showed significant associations with fat mass percentage (FM%) and waist-to-height ratio (WHtR) but not waist-to-hip ratio (WHR). The relationship between BMI and FM% was stronger in girls and prepubertal children. The metabolic syndrome (MetS) Z-score showed a strong positive correlation with BMI in the pubertal children. A negative correlation between HDL and triglycerides was observed only in the boys. The prepubertal children exhibited more significant correlations, despite a smaller sample size and shorter duration of obesity. : Considering multiple parameters beyond BMI alone provides a better understanding of cardiometabolic risks associated with severe obesity in children. MetS Z-score was not a reliable indicator of increased cardiometabolic risk in younger children. Early-onset severe obesity was associated with a higher risk of metabolic complications. Early intervention is crucial to mitigate metabolic complications in this population.
儿童和青少年中重度肥胖的患病率不断上升，这给儿科医生和全科医生带来了重大挑战。本研究旨在调查生化结果、人体测量学、血压测量以及生物电阻抗分析（BIA）得出的参数之间的关系，以确定与重度肥胖相关的潜在心脏代谢并发症。
本研究纳入了347名年龄在0至19岁之间、符合不同年龄组BMI阈值的重度肥胖标准的儿童（162名男孩，185名女孩）。这些患者是在波兰的四个儿科内分泌中心（扎布热、克拉科夫、热舒夫、什切青）招募的。每位参与者都接受了人体测量、青春期阶段评估、血压测量、生化和激素测试以及BIA。
BMI与体脂百分比（FM%）和腰高比（WHtR）显示出显著相关性，但与腰臀比（WHR）无关。BMI与FM%之间的关系在女孩和青春期前儿童中更强。青春期儿童的代谢综合征（MetS）Z评分与BMI呈强正相关。仅在男孩中观察到高密度脂蛋白（HDL）与甘油三酯之间存在负相关。尽管青春期前儿童的样本量较小且肥胖持续时间较短，但他们表现出更显著的相关性。
仅考虑BMI以外的多个参数，能更好地了解儿童重度肥胖相关的心脏代谢风险。MetS Z评分并不是年幼儿童心脏代谢风险增加的可靠指标。早发性重度肥胖与更高的代谢并发症风险相关。早期干预对于减轻该人群的代谢并发症至关重要。
