Metabolic risk factors in prepubertal and pubertal patients with overweight and obesity

Objectives: Metabolic syndrome (MetS) is a cluster of conditions linked to obesity that increases cardiovascular risk. We evaluated the frequency of clinical abnormalities associated with overweight and obesity in childhood, to determine whether a diagnosis of MetS is appropriate in this population. Methods: Cross-sectional study with 116 pubertal and prepubertal children with a mean age (SD) of 10.9 (2.5) years, with overweight and obesity. We defined MetS using the International Diabetes Federation criteria, regardless of the age. Results: 45 patients met the criteria, 20 had at least one metabolic abnormality in addition to a high waist circumference (WC), and seven with WC below percentile 90th, had at least one metabolic abnormality. The prepubertal had higher zBMI [3.1 (2.6-3.8) vs. 2.8 (2.4-3.3); p=0.037], less lean body mass (kg) [27.13 (7.3) vs. 34.13 (9.8); p=0.005] and a similar frequency of non-alcoholic fatty liver disease (NAFLD) compared to the pubertal [44.7 vs. 35.9; p=0.323]. Prepubertal with NAFLD had higher zBMI, lower HDL levels, higher TG/HDL ratios and higher fat percentages; while pubertal with NAFLD had higher WC/height, aspartate aminotransferase and oxaloacetic transaminase. Conclusions: The diagnosis of MetS in childhood is not fundamental. Individualized management, focusing on the earliest age groups, in which we identified a more severe degree of obesity, should be done. We also recommend screening for NAFLD in all ages, due to the high prevalence observed.