Abstract
Childhood obesity-related metabolic derangements are increasing among South Asian populations. Most of these changes persist to adulthood. This study aims to describe the distribution of metabolic abnormalities among 7- to 17-year-old overweight and obese children in the Gampaha District of Sri Lanka. Overweight children (age- and gender-adapted BMI>+1SD, WHO standards) were selected from a community survey carried out in the Negombo Education Zone of Gampaha District. After a 12-hour overnight fast, blood was drawn, and blood glucose (FBG), lipid profile, insulin, and liver transaminases were measured. Two hours after a glucose load, blood was drawn for random blood glucose (RBG) and insulin. Metabolic syndrome (MetS) was diagnosed using modified IDF criteria for children. Anthropometry, fat mass (FM), and blood pressure were measured. Hepatic fat pattern was assessed ultrasonically. The data of 403 children (210 boys) were analysed. Of the study population, 16.4% were overweight (BMI for age +1 to +2SD), 72% were obese (BMI for age >+2 to +3SD), and 11.6% were severely obese (BMI for age >+3SD). Insulin resistance was seen in 46.8%, and prevalence increased with age. Mean postprandial insulin ranged from 368 to 625 pmol/L and was elevated in 35%. Dysglycaemia was seen among 20.8%. MetS was present in 19.8%, and 84% had at least one metabolic abnormality. Different degrees of hepatic steatosis were observed in 32.5%, and elevated ALT/AST ratio was seen in 58% of the population. Overweight and obesity during childhood were associated with multiple metabolic abnormalities including MetS, and they occur from a young age. It is important to screen children for overweight/obesity early in life and intervene to prevent them from developing metabolic complications.
Highlights
Obesity, one of the primary risk factors for noncommunicable diseases (NCDs), is spreading in epidemic proportions all over the world, penetrating rapidly into the paediatric population [1]. e prevalence of obesity has doubled in many countries since 1980 [1]
Mean alanine transaminase (ALT) was higher than the mean aspartate transaminase (AST) levels and both were significantly higher in boys than girls in the older age group. e mean fasting and random insulin levels were very high with high HOMA-IR levels, with no significant difference between the sexes
In a majority, is an illness caused by energy imbalance, where excess energy intake and low energy expenditure leads to energy surplus, which is deposited as fat for later use
Summary
One of the primary risk factors for noncommunicable diseases (NCDs), is spreading in epidemic proportions all over the world, penetrating rapidly into the paediatric population [1]. e prevalence of obesity has doubled in many countries since 1980 [1]. E prevalence of obesity has doubled in many countries since 1980 [1]. The prevalence of childhood obesity is lower than that of adults, the rate of increase is very high among children compared to adults. Between 1980 and 2015, there was a significant relative increase of 20.0% in the prevalence of obesity in countries with a low socio-demographic index and the highest rates of increase were observed in countries with a middle socio-demographic index [2]. The national rates of childhood obesity are still low in Sri Lanka, there are certain geographical areas, which show increased prevalence. Data from Colombo municipal area showed overweight and obesity to be about 14% among 8- to 12-year-old school children [3] and in Colombo district about 13% among 5- to 15-year-old children [4]. In the Negombo education zone, overnutrition was shown to vary between 10 and 18% across 5–15 year age group with the prevalence increasing with age [5]
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