Abstract:

Objective: This study aimed at investigating the frequency of endocrine-metabolic disorders accompanying obesity in children and to identify the factors related to these disorders.Material and Methods: A total of 642 children with a diagnosis of obesity among the endocrinology clinic patients were included in the study. Obesity was accepted as a body mass index over the 95th percentile. All patients were evaluated in terms of age, waist circumference, body mass index, body mass index standard deviation score, systolic and diastolic hypertension, homeostasis model of assessment for insulin resistance (HOMA-IR) index, stria, hirsutismus, acantosis nigricans, cushingoid appearance, early puberty, dyslipidemia, hypertension, insulin resistance, impaired fasting glucose, impaired glucose tolerance, type 2 DM, subclinical hypothyroidism and Hashimato thyroiditis, retrospectively.Results: The average age of the patients with a diagnosis of obesity was 11.1 ± 3.2 years and the male/female ratio was 1.01. The most common accompanying endocrine problem was insulin resistance (44.4%), and the most common clinical sign was acantosis nigricans (31.9%). Striae and precocious puberty were seen significantly more commonly in female than male patients (p < 0.05). Obesity-related clinical symptoms including hypertension, hirsutism, stria and acantosis nigricans were significantly more common in pubertal patients but buried penis was more commonly seen in pre-pubertals than pubertal cases (p< 0.05). We found the frequency of dyslipidemia, autoimmune thyroiditis and subclinical hypothyroidism in obese children and adolescents to be 23.2%, 4% and 1.2% respectively. The frequencies of IGT and type 2 DM were 7.5% and 0.9% respectively. This group of patients were found to be older, to have higher BMI and abdominal circumference, and to suffer more commonly from dyslipidemia, hypertension, acantosis nigricans and stria compared to the patients without insulin resistance (p=0.001). Obesity is a significant health problem of childhood. The incidence of endocrine and metabolic disorders is increased in obese children with age-induced obesity. These children should be screened for the possible presence of endocrine and metabolic disorders taking into account the age, puberal status and gender. Determining children at metabolic risk and decreasing morbidity and mortality in adulthood requires prevention of obesity in childhood and careful follow-up of obese children with lifestyle modification.

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