Bizerea-Moga Teofana Otilia, Moga Tudor Voicu, Stroescu Ramona, Chisavu Lazar, Mărginean Otilia, Chisavu Flavia
Department XI of Pediatrics-1st Pediatric Discipline, Center for Research on Growth and Developmental Disorders in Children, 'Victor Babeș' University of Medicine and Pharmacy Timișoara, Eftimie Murgu Sq No. 2, 300041 Timișoara, Romania.
1st Pediatric Clinic from 'Louis Țurcanu' Children's Clinical and Emergency Hospital, Iosif Nemoianu 2, 300011 Timișoara, Romania.
Metabolites. 2025 Feb 22;15(3):148. doi: 10.3390/metabo15030148.
Childhood obesity has seen an important rise in recent decades, in both the pediatric and adult populations. Excess weight can cause various health complications, such as the metabolic syndrome (MetS), a cluster of medical conditions linked to adverse cardiometabolic outcomes. Although MetS may be attributed mainly to adults, early life factors, such as birth characteristics and feeding practices, may influence its development in obese children. This study aims to investigate the relationships between birth metrics, early feeding practices, and the prevalence of MetS and its components among obese children. A retrospective observational study was conducted on 800 obese patients aged 0-18 years, admitted to the "Louis Țurcanu" Children's Clinical and Emergency Hospital in Timișoara, Romania, from 1 January 2013 to 31 December 2023. Patients were divided according to gestational age: small for gestational age (SGA), appropriate for gestational age (AGA), and large for gestational age (LGA). Type 2 diabetes (18.2%), hypercholesterolemia (24.6%), IR (41.3%), and MetS (39.2%) were more prevalent among oSGA patients included in the study. These patients were breastfed for longer periods but weaned at a younger age. oLGA patients had the highest BMI values (28.4 ± 4.2) and, in this study group, hypertriglyceridemia (29.4%), arterial hypertension (26.8%), and lower HDL-C (41.7 ± 6.3 mg/dL) were more prevalent. The incidence of MetS increased with age (12.6 ± 3.1 years). Among these patients, IR (52.3%) was more prevalent. The introduction of flour-based energy-dense foods before six months was more frequent in MetS patients, but not statistically significant. Logistic regression showed oSGA patients had a 4.49-fold higher MetS risk ( < 0.001). Older age at diagnosis increased the risk of developing MetS by 37%, a diagnosis of impaired glucose tolerance by 19-fold, and a family history of diabetes by 2.7-fold. ROC analysis showed strong predictability (AUC = 0.905, sensitivity = 82%, specificity = 88%). Obese children born SGA had a higher risk for developing MetS. The incidence of MetS and its components increases with age among obese patients. Monitoring growth patterns and dietary habits in early life is paramount to mitigate future metabolic complications.
近几十年来，儿童肥胖症在儿科和成人人群中均显著增加。超重会引发各种健康并发症，如代谢综合征（MetS），这是一组与不良心脏代谢结局相关的病症。尽管MetS主要归因于成年人，但早期生活因素，如出生特征和喂养方式，可能会影响肥胖儿童中MetS的发展。本研究旨在调查出生指标、早期喂养方式与肥胖儿童中MetS及其组成部分的患病率之间的关系。对2013年1月1日至2023年12月31日期间入住罗马尼亚蒂米什瓦拉“路易·图尔卡努”儿童临床急救医院的800名0至18岁肥胖患者进行了一项回顾性观察研究。患者根据胎龄进行分组：小于胎龄儿（SGA）、适于胎龄儿（AGA）和大于胎龄儿（LGA）。研究纳入的oSGA患者中，2型糖尿病（18.2%）、高胆固醇血症（24.6%）、胰岛素抵抗（IR，41.3%）和MetS（39.2%）更为普遍。这些患者母乳喂养时间更长，但断奶年龄更小。oLGA患者的BMI值最高（28.4±4.2），在该研究组中，高甘油三酯血症（29.4%）、动脉高血压（26.8%）和较低的高密度脂蛋白胆固醇（HDL-C，41.7±6.3mg/dL）更为普遍。MetS的发病率随年龄增长而增加（12.6±3.1岁）。在这些患者中，IR（52.3%）更为普遍。MetS患者在六个月前引入基于面粉的高能量密度食物的情况更为频繁，但无统计学意义。逻辑回归显示oSGA患者患MetS的风险高4.49倍（<0.001）。诊断时年龄较大使患MetS的风险增加37%，糖耐量受损的诊断风险增加19倍，糖尿病家族史使风险增加2.7倍。ROC分析显示预测能力较强（AUC = 0.905，敏感性 = 82%，特异性 = 88%）。出生时为SGA的肥胖儿童患MetS的风险更高。肥胖患者中MetS及其组成部分的发病率随年龄增长而增加。监测早期生活中的生长模式和饮食习惯对于减轻未来的代谢并发症至关重要。
