Büyükyılmaz Gönül, Özdemir Şahan Yasemin
Department of Pediatric Endocrinology, Ankara Bilkent City Hospital, Ankara, Türkiye.
Department of Pediatric Cardiology, Ankara Bilkent City Hospital, Ankara, Türkiye.
Turk J Pediatr. 2024 Dec 30;66(6):690-702. doi: 10.24953/turkjpediatr.2024.4558.
We aimed to evaluate how the parameters used in the diagnosis of metabolic syndrome (MetS) and parameters such as epicardial adipose tissue (EAT) thickness, insulin resistance (IR), and serum uric acid (SUA) are affected according to the severity of obesity.
A total of 120 obese patients aged 10-18 years were classified as class 1-2-3 according to their body mass index (BMI) score. SUA was measured and oral glucose tolerance tests were performed on all patients. MetS components were determined according to the International Diabetes Federation 2007 criteria. IR was calculated using homeostatic model assessment for insulin resistance (HOMA-IR) and whole body insulin sensitivity index (WBISI).
HOMA-IR was higher in the class 3 group than in the class 1 (p<0.001) and class 2 groups (p<0.01). WBISI was lower in the class 3 group than in the class 1 (p=0.015) and class 2 groups (p<0.01). EAT thickness was higher in the class 3 group than in the class 1 (p<0.01) and class 2 groups (p<0.01). No significant difference was found between class 1 and 2 groups for HOMA-IR, WBISI, and EAT thickness variables. The frequency of the MetS components was similar between the class of obesity groups (p=0.702). SUA and EAT thickness were significantly higher in the group with 2 and/or more MetS components than in the group with no MetS component. EAT thickness was positively and moderately correlated with SUA levels (Rho=0.319, p<0.001).
A more significant increase in cardiovascular disease risk factors, especially after class 2 obesity suggests that obese people should be followed closely and necessary interventions made for the prevention and progression of obesity. SUA and EAT thickness, an important risk factor affecting the obesity-related comorbidities, are positively correlated with each other and can be used in the follow-up of obese children.
我们旨在评估肥胖严重程度如何影响用于诊断代谢综合征（MetS）的参数以及诸如心外膜脂肪组织（EAT）厚度、胰岛素抵抗（IR）和血清尿酸（SUA）等参数。
总共120名年龄在10至18岁的肥胖患者根据其体重指数（BMI）评分分为1 - 2 - 3级。对所有患者测量SUA并进行口服葡萄糖耐量试验。根据国际糖尿病联盟2007年标准确定MetS组分。使用胰岛素抵抗稳态模型评估（HOMA - IR）和全身胰岛素敏感性指数（WBISI）计算IR。
3级组的HOMA - IR高于1级组（p<0.001）和2级组（p<0.01）。3级组的WBISI低于1级组（p = 0.015）和2级组（p<0.01）。3级组的EAT厚度高于1级组（p<0.01）和2级组（p<0.01）。1级和2级组在HOMA - IR、WBISI和EAT厚度变量方面未发现显著差异。肥胖组类别之间MetS组分的频率相似（p = 0.702）。有2种和/或更多MetS组分的组中的SUA和EAT厚度显著高于无MetS组分的组。EAT厚度与SUA水平呈正相关且具有中等相关性（Rho = 0.319，p<0.001）。
心血管疾病危险因素有更显著增加，尤其是在2级肥胖之后，这表明应对肥胖者进行密切随访，并采取必要干预措施以预防肥胖及其进展。SUA和EAT厚度作为影响肥胖相关合并症的重要危险因素，彼此呈正相关，可用于肥胖儿童的随访。
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