Характеристика коморбидной патологии при саркопеническом ожирении у детей

Abstract

Objective. To study the frequency and structure of comorbid pathology in children with sarcopenic obesity. Patients and methods. This retrospective study included 726 children aged 10 to 17 (13 [12; 15]) years, among whom 54.9% were girls. Anthropometric, laboratory and instrumental examinations were performed to diagnose non-alcoholic fatty liver disease (NAFLD), arterial hypertension (AH), and metabolic syndrome (MS). Body fat mass and skeletal muscle mass were determined by bioelectrical impedance analysis. Sarcopenic obesity was diagnosed when the muscle-to-fat ratio (MFR) fell below the reference range. Results. The frequency of sarcopenic obesity in the total group of children was 83.3%, 71.2% in girls and 98.2% in boys. MFR was negatively correlated with the body mass index standard deviation score (BMI SDS) (R = -0.66, p < 0.05). Sarcopenic obesity was associated with an increase in the frequency of comorbidities: in children with decreased MFR, NAFLD was detected in 74.7%, AH in 35.9%, and MS in 29.6%; with normal MFR values, the frequency of comorbidities was 52.9%, 14.0%, and 14.9%, respectively (p < 0.001). Median MFR in children with uncomplicated obesity (0.78 [0.67; 0.92]) was significantly higher than in patients with NAFLD (0.67 [0.58; 0.82]), AH (0.66 [0.52; 0.78]), and MS (0.68 [0.56; 0.83]), p < 0.001. Absolute values of skeletal muscle mass in most of the children remained within or exceeded the reference range. Conclusion. Most children with exogenous constitutional obesity were diagnosed with sarcopenic obesity. Sarcopenic obesity in children was accompanied by an increase in the frequency of non-alcoholic fatty liver disease, arterial hypertension, and metabolic syndrome. MFR can be used to assess the risk of obesity complications in children. Key words: obesity, skeletal muscle mass, sarcopenic obesity, children, metabolic syndrome, non-alcoholic fatty liver disease