Clinical and laboratory findings in adolescents in 'Cigotica' programme from 2008 to 2012

Abstract

INTRODUCTION: Obesity is becoming an increasingly important public health problem due to a drastic increase in its frequency, not only in adult but also at the pediatric and adolescent age, which directly and indirectly influences population morbidity, life expectancy and mortality. In response to the obesity epidemic in Serbia in 2008, the Center for the prevention, treatment and rehabilitation of obesity in children and adolescents was formed as well as 'CIGOTICA' Programme at the Special Hospital 'Zlatibor'. The characteristics of programs 'CIGOTICA' Programme is a multidisciplinary approach to the treatment of obese children, which includes specific training, dietary intervention with the reduction of total daily caloric intake, physical activity, clinical control and psychological support, change in behaviour and lifestyle. OBJECTIVE: To identify the complications of obesity and metabolic risk factors in adolescents participating in CIGOTICA Programme. METHOD: Anthropometric, clinical and biochemical parameters were analyzed in 1,000 adolescents (468 girls and 532 boys), of average 15.30 years of age (range 12 to 18) with primary obesity. The research was conducted at the Center for the Prevention and treatment of obesity in children and adolescents at the Special Hospital 'Cigota' from 27 July, 2008 to 1January, 2012. Hospitalization lasts 21 days. The criterion for obesity is the body mass index (BMI)> +2 SD. In addition to clinical examination, blood pressure was measured. Triglycerides, total, HDL and LDL cholesterol, uric acid and glucose were measured on the second day of hospitalization after 12 hours of fasting. RESULTS: Abdominal obesity defined as OS> P90 was diagnosed in all examinees (100%). 28% of adolescents had hypertension. Acanthosis nigricans was present in 51.4% of adolescents. Triglyceride values were high in 7.8% of patients, lower levels of HDL h were observed in 22.9% of the examinees, and high cholesterol was present in 5.8% of patients. Two risk factors for metabolic syndrome were observed in 27.6%, and metabolic syndrome was present in 18.3% of patients. 8.9% examinees had a glucose disorder (0.3%). Orthopedic complications were observed in 82% of the examinees. Polycyistic ovary syndrome were observed in 12% of adolescents. CONCLUSION: Complications occur in a large number of obese adolescents, which indicates the seriousness of the problem of obesity and the need for more effective prevention programmes. Short-term effects of Cigotica programme are encouraging, and the effectiveness of the multidisciplinary approach to obesity treatment will be evaluated by the current research which analyses sustainability of the achieved results.