Comorbidities of Childhood Obesity

Abstract

Obesity in urban children both in India and across the world, shows a rising trend and, hence it is necessary to continue surveillance. Obese children experience immediate health consequences and comorbities like metabolic syndrome- insulin resistance including hypertension, hyperinsulinemia, hyperlipidemia; pre diabetes, Type II diabetes (T2DM), polycystic ovary syndrome (PCOS), sleep apnea and asthma, joint inflammation, joint pain, back pain, skin changes like acanthosis nigricans, gastroesophageal reflux, non alcoholic fatty liver, dental problems and psychological problems. Cardiovascular complications include high blood pressure which may be associated with left ventricular hypertrophy and higher intima thickness of carotid arteries. Screening for lipids should start at around 8 years in high risk children (obese or with adverse family history etc). Asian Indians have higher prevalence of upper body visceral fat distribution, PCOS, higher insulin resistance family history of T2 DM. Obesity was significantly related to current asthma among children and adolescents. Obstructive sleep apnoea produces night time hypoxic episodes affecting children snoring, morning headache, daytime sleepiness with difficulty in learning and memory. Acne, skinfold fungal infection and hyperpigmentation including acanthosis nigricans are common manifestations and may be associated with PCOS. Obesity is also associated with Attention Deficit Hyperactive Disorder psychological disorders and depression. Sometimes complications may also present as medical emergencies in severe obesity. Early diagnosis and detailed knowledge of these comorbities lead to effective treatment and prevent complications in adulthood.