Prevalence of Metabolic Syndrome in Obese Prepubertal and Pubertal Children

Year 2015, Volume: 6 Issue: 2, 54 - 59, 14.09.2015

Ayça Törel Ergür

Abstract

Aim: Obesity associated with metabolic syndrome is characterized by glucose intolerance, insulin resistance, type 2 diabetes mellitus, dyslipidemia and other hormonal disorders in childhood. Unfortunately, if the preventive measures are not taken in time they become obese in the adult age. The prevalence of metabolic syndrome in the pediatric age group is still not well known in our country. The purpose of our study is to evaluate the prevalence of metabolic syndrome and other metabolic characteristics in the obese prepubertal and pubertal children.

Material and methods: We studied 70 obese children and adolescents. Each child was subjected to detailed examination including anthropometric measures, blood testing (biochemistry, blood fasting glucose, renal and hepatic function tests, lipids, electrolytes, hormonal testing including free T3, free T4, TSH, thyroid autoantibodies, fasting insulin levels and oral glucose tolerance test). The criteria of metabolic syndrome were defined according to modified WHO criteria. Homeostasis model assessment of insulin resistance (HOMA-IR) parameters were used as index of insulin resistance.

Results: Metabolic syndrome was found in 18.8% of cases. Metabolic syndrome was found in a significantly higher rate in the pubertal prepubertal group (P > 0.05). The data related with glucose homeostasis; fasting hyperinsulinemia, impaired glucose tolerance were 33.3% and 5.5% in the prepubertal group, where it was 64.7% and 23.5% in the pubertal group, respectively. Hypertension was observed in four pubertal cases (11.7%). Dyslipidemia were identified in 41.6% and 41.1% in prepubertal and pubertal groups, respectively, with no significant differences (P < 0.05).

Conclusion: Metabolic syndrome prevalence especially abnormal glucose homoeostasis among the obese pediatric age group was quite high. We suggested that, early diagnosis, regularly follow-up and if needed, treatment will prevent beta-cell destruction and development of type 2 diabetes mellitus in these cases.

Key words: Childhood obesity, obesity prevalence, metabolic syndrome, diabetes mellitus

Keywords

Childhood obesity, obesity prevalence, metabolic syndrome, diabetes mellitus

Obez Prepubertal ve Pubertal Çocuklarda Metabolik Sendrom Prevalansı

Abstract

Amaç: Çocukluk çağında Metabolik Sendrom (MS), ilişkili obezite glukoz intoleransı, insülin direnci, tip 2 diabet, dislipidemi ve diğer hormonal bozukluklarla karakterizedir. Ne yazık ki Maalesef bu olgular koruyucu önlemler alınmadığı taktirde erişkin yaşamda obez hale gelecektirler. Pediatrik yaşta MS prevelansı ülkemizde halen iyi bilinmemektedir. Bu amaçla çalışmamızda prepubertal ve pubertal çocuklarda MS ve diğer metabolik özelliklere ait prevelansın değerlendirilmesi amaçlandı.

Gereç ve Yöntemler: 70 obez çocuk çalışmaya alındı. Antropometrik ölçümleri içeren detaylı muayenesi yapılan herbir çocuğa, kan biyokimyası; kan şekeri, renal ve hepatik fonksiyon testleri, lipidler, elektrolitler, hormonal değerlendirme için fT3, fT4, TSH tiroid otoantikorları, açlık insülin seviyeleri ve OGTT uygulandı. Metabolik sendrom kriterleri modifiye WHO kriterlerine göre tanımlandı. “Homeostasis model assessment of insulin resistance” (HOMA-IR) parametresi insülin rezistans indeksi olarak kullanıldı.

Bulgular: Tüm olgularda MS prevalansı %18,8 olarak saptandı. MS prepubertal gruba göre pubertal grupta anlamlı derecede yüksekti (P > 0,05). Glukoz homeostazına ilişkin bulgular, prepubertal grupta açlık hiperinsülinemisi, bozulmuş glukoz toleransı olup sırasıyla %33,3 ve %5,5 idi. Aynı bulgular pubertal grupta sırasıyla %64,7 ve %23,5 idi. Hipertansiyon 4 (%11,7) pubertal vakada gözlendi. Prepubertal ve pubertal grupta dislipidemi sırasıyla %41,6 ve %41,1 olarak saptandı. Bu yönü ile anlamlı farklılık yoktu (P < 0,05).

Sonuçlar: Obez pediatrik yaş grubunda özellikle anormal glukoz homeostazını içeren MS prevelansı belirgin yüksek saptandı. Sonuç olarak bu olgularda erken tanı, düzenli izlem ve gerekirse tedaviyle, beta hücre yıkımının ve tip 2 diabet gelişiminin önlenebileceği düşünülebilir.

Anahtar kelimeler: Çocukluk çağı obezitesi,obezite prevelansı, metabolik sendrom, diabetes mellitus.

Keywords

Çocukluk çağı obezitesi, obezite prevelansı, metabolik sendrom, diabetes mellitus

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