Complications Of Childhood Obesity Research Articles

Health related quality of life is associated with gastroesophageal reflux symptoms in overweight children.

The association between obesity and gastroesophageal reflux disease (GERD) is well-established in adults; however, data in pediatric population is scarce. Our study aimed to assess the association between GERD and health-related quality of life (HRQoL) in overweight children. From April to August of 2020, we included children aged 7-18 years who attended the Endocrinological Outpatient Clinic at the Paediatric Institute, University of Debrecen, Hungary. The participants completed two questionnaires: the Pediatric Gastroesophageal Reflux Disease Symptom Questionnaire (PGSQ) and the HRQoL questionnaire (PedsQL). Based on the criteria of the World Health Organization (WHO), the patients were categorized into two groups: an overweight or obese group and a group with normal weight. A total of 107 children (51 % female, mean age 13.2 years, 46 % overweight or obese) completed the questionnaires. The median PGSQ score was similar in both groups (4.0 (IQR: 1.0-7.8) vs. 3.0 (IQR: 1.0-7.0), p=0.6). However, the total PedsQL score was significantly lower in the children with overweight or obesity compared to those with normal weight (80.1 (71.1-91.0) vs. 88.0 (76.1-94.6), p=0.031). The PedsQL score was lower among overweight patients with GERD symptoms than that of normal-weight patients without GERD symptoms. Our findings highlight the importance of raising awareness about GERD to enhance the HRQoL and prevent long-term complications in obese children.

Predictors of overnight postoperative respiratory complications in obese children undergoing adenotonsillectomy for obstructive sleep apnea.

Current clinical guidelines from the American Academy of Otolaryngology Head & Neck Surgery (AAO-HNS) recommend a preoperative polysomnogram (PSG) for obese patients prior to adenotonsillectomy (T&A). An overnight admission is recommended for children with severe (AHI >10) obstructive sleep apnea (OSA), citing a higher incidence of post-operative respiratory complications (PRCs) and need for respiratory support. Routine admission of obese children based on AHI >10 alone after T&A may place undue strain on hospital resources and increase healthcare costs, especially considering that many of these children have uncomplicated postoperative courses. In this study, we sought to identify variables from the pre-operative PSG and post-anesthesia care unit (PACU) that could more accurately predict overnight PRCs and indicate the need for a post-surgical admission after T&A. A single-center retrospective chart review was performed on a cohort of 155 obese children who underwent adenotonsillectomy for OSA. Inclusion criteria included patients 17 years of age and younger who had BMI 95th percentile or greater, underwent preoperative polysomnography, and were admitted overnight after T&A. Overnight respiratory complications were defined as an O2 desaturation under 92%, the need for overnight airway support, a respiratory support regression, respiratory depression, and bronchospasm/laryngospasm. Multivariable binary logistic regression analysis, point-biserial correlation, and Chi-square tests were performed to assess relationship of BMI z-score, polysomnography parameters, and PACU events with overnight respiratory complications. Lower O2 saturation nadirs on polysomnography were an independent predictor of respiratory complications overnight (OR=0.953, 95% CI=0.91-0.99, P=0.021), as was sleep time with O2 saturation less than 90% (OR=1.04, 95% CI=1.00-1.07, P=0.048). A prediction model with preoperative and postoperative variables significant on simple logistic regression yielded a ROC curve with AUC 0.89 (95% CI 0.82, 0.96). At a cutoff point of O2 saturation nadir less than 80%, overnight PRCs were predicted with 70.8% sensitivity and 75.2% specificity. At a cutoff point of greater than 0.5% of sleep time spent with O2 < 90% on PSG, overnight PRCs were predicted with 82.6% sensitivity and 62% specificity. Obstructive apneas (OAI) was not predictive of PRCs. BMI percentile was not significantly correlated with overnight respiratory complications, but BMI z-score was significantly correlated with overnight respiratory depression and an overnight airway event. O2 saturation nadir on PSG and time spent with oxygen saturation <90% (TST90) on PSG were found to be independent predictors of overnight postoperative respiratory complications after adenotonsillectomy in obese children. In addition to reaffirming existing guidelines for postoperative admission of patients with O2 saturation nadir on PSG <80%, these findings also suggest considering postoperative admission for obese patients who experience >0.5% sleep time with O2 sat <90% during PSG due to increased risk of overnight postoperative respiratory complications.

Awareness of risks and complications of obesity in school going children

Introduction: Childhood obesity is increasing in Pakistan, and it mostly occurs when there is more energy-rich food intake and not enough physical activity. Not realizing the dangers, parents often encourage the children to eat as much as possible and whatever is preferred by the child.&#x0D; Objective: To assess the level of awareness of school-going children of Peshawar about the risks and complications of childhood obesity.&#x0D; Materials &amp; Methods: It was a descriptive cross-sectional study conducted in two private schools of Peshawar, Khyber Pakhtunkhwa, from April - July 2017, where data were collected through consecutive sampling of all available children of classes 7 to 10. Questionnaires contained open and closed-ended questions. Data were entered in SPSS 22 and Microsoft Excel, and analyzed for descriptive statistics.&#x0D; Results: Majority of children (83%) were aware of the meaning of obesity and 72% knew that obesity is an illness, and it can cause problems in their bodies. Most children (65%) thought obesity caused high cholesterol levels in the body, and 56% children thought that obesity could be controlled by exercise.&#x0D; Conclusion: Majority of the school children were aware of obesity and its risks and complications.

Raised intracranial pressure - an under-recognised complication of childhood obesity

Raised intracranial pressure - an under-recognised complication of childhood obesity

520 Weight-based vs. BSA-based Fluid Resuscitation Predictions in Pediatric Burn Patients

Abstract Introduction Current practice for major pediatric burns includes fluid resuscitation using formulas that estimate fluid requirements based on weight and/or body surface area (BSA) along with percent total burn surface area (TBSA). Adult studies have shown that these formulas can cause fluid overload in obese patients and increase risk of complications. These findings have not been validated in pediatric patients. This study aims to evaluate whether a weight-based resuscitation formula increases the risk of complications in obese children following burn injuries and compares fluid estimates to those that incorporate BSA. Methods A retrospective review was conducted on 110 children (≤ 18 years old) admitted to an ABA-verified urban pediatric burn center from October 2008 to May 2020. Patients had ≥15% TBSA, were resuscitated with the weight-based Parkland formula, and had fluids titrated to urine output every two hours (1 ml/kg/hr if ≤ 30kg; 0.5 ml/kg/hr if &amp;gt; 30kg). Demographics, burn type, and TBSA were collected on admission. BSA-based Galveston and BSA-incorporated Cincinnati formula resuscitation predictions were also calculated. Output and input volumes were collected at 8h and 24h post-injury. Complications were collected throughout the hospital stay. Patients were classified into CDC-defined weight groups based on percentile ranges. Statistical analysis was conducted using SPSS Statistics version 10.0. Results This study included 11 underweight, 60 normal weight, 18 overweight, and 21 obese children. Our patients had a mean age-based weight CDC percentile of 62.2%, and mean TBSA of 25.4%. Predicted resuscitation volumes increased as CDC percentile increased for all three formulas (p=0.033, 0.092, 0.038), however there were no significant differences between overweight and obese children. Total fluid administered was higher as CDC percentile increased (p=0.023). However, overweight children received more total fluid than obese children. The difference between total fluids given and Galveston predicted resuscitation volumes were significant across all groups (p=0.042); however, the difference using the Parkland and Cincinnati formulas were not statistically significant. There were more children in the normal weight group who developed complications compared to other groups, but these findings were not significant. Conclusions The Parkland formula tended to underpredict fluid needs in the underweight, normal weight, and overweight children, and it overpredicted fluid needs for the obese. Further research is needed to determine the value of weight-based vs BSA-based or incorporated formulas in terms of their risk of complications.

AP39 ameliorates high fat diet-induced liver injury in young rats via alleviation of oxidative stress and mitochondrial impairment

Non-alcoholic fatty liver disease (NAFLD) is a complication of childhood obesity and an oxidative stress-related multisystem disease. A mitochondria-targeting hydrogen sulfide (H2S) donor AP39 has antioxidant property, while the mechanism underlying the function of AP39 on pediatric NAFLD remains undefined. Here, 3-week-old SD rats were received a high-fat diet (HFD) feeding and injected with AP39 (0.05 or 0.1 mg/kg/day) via the tail vein for up to 7 weeks. AP39 reduced weight gain of HFD rats and improved HFD-caused liver injury, as evidenced by reduced liver index, improved liver pathological damage, decreased NAFLD activity score, as well as low alanine transaminase (ALT) and aspartate transaminase (AST) activities. AP39 also reduced serum total cholesterol (TC), triglyceride (TG), low-density lipoprotein-cholesterol (LDL-C) concentrations but increased high-density lipoprotein-cholesterol (HDL-C). Moreover, AP39 prevented reactive oxygen species (ROS) generation, reduced MDA content and increased glutathione (GSH) level and superoxide dismutase (SOD) activity. Furthermore, AP39 increased H2S level, protected mitochondrial DNA (mtDNA), reduced mitochondrial swelling, and restored mitochondrial membrane potential (MMP) alteration. Notably, AP39 diminished HIF-1α mRNA and protein level, possibly indicating the alleviation in mitochondrial damage. In short, AP39 protects against HFD-induced liver injury in young rats probably through attenuating lipid accumulation, oxidative stress and mitochondrial dysfunction.

Randomised Clinical Trial: Calorie Restriction Regimen with Tomato Juice Supplementation Ameliorates Oxidative Stress and Preserves a Proper Immune Surveillance Modulating Mitochondrial Bioenergetics of T-Lymphocytes in Obese Children Affected by Non-Alcoholic Fatty Liver Disease (NAFLD).

Fatty liver disease is a serious complication of childhood obesity. Calorie-restricted regimen (RCR) is one of the effective therapy for this condition. Aim of the study was to evaluate the effect of lycopene-rich tomato sauce with oregano and basil extracts in obese children with fatty liver on RCR. 61 obese children with fatty liver were enrolled, 52 completed the study. A randomized cross over clinical trial was performed. Participants were assigned to RCR alone or with a supplement of lycopene-rich tomato juice for 60 days; subsequently, the groups were switched to the alternative regimen for the next 60 days. Reduction in BMI, HOMA-IR, cholesterol, triglycerides, liver size, and steatosis was more profound in tomato-supplemented group. Leptin decreased in both groups whereas adiponectin raised only after tomato supplementation. RCR is associated with the impaired engagement of T-cells glycolysis and proliferation, tomato-supplementation resulted in glycolytic metabolic activation of T-cells. Tomato juice ameliorates glucose and lipid metabolism in obese children, improve oxidative and inflammatory state and modulates the mitochondrial metabolism of T-cells contributing to a maintenance of a proper immune surveillance in children, impaired by RCR. The addition of tomato to RCR could be considered a protective and preventive support to obese child.

Association Between the Common Carotid Artery Intima-Media Thickness and Glucose Metabolism in Obese Children

Objectives: To determine the relationship between glucose metabolism and atherosclerosis assessed according to the common carotid artery intima-media thickness (CIMT) in non-diabetic obese children. Methods: We performed anthropometric measurements and laboratory tests, including the oral glucose tolerance test (OGTT). The CIMTs on both sides were measured in obesity (body mass index [BMI] ≥ 95 percentile) children by one researcher. Results: There were 44 boys and 22 girls, and the mean age was 10.73 ± 2.48 years (range, 8 - 14 years). The mean CIMT on both sides, age, BMI, blood pressure, lipid profile, OGTT results, and HbA1c level were not significantly different between the boys and girls. Simple correlation analyses showed that the fasting plasma glucose (PG) level (γ = 0.266, P = 0.034), PG at 90 min (γ = 0.318, P = 0.014), PG at 120 min (γ = 0.336, P = 0.009), HbA1c level (γ = 0.306, P = 0.015), PG increase at 90 min (PGΔ90) (γ = 0.310, P = 0.017), and PGΔ120 (γ = 0.338, P = 0.009) were significantly correlated with the left CIMT. In multiple regression analysis, the HbA1c level, PGΔ90, and PGΔ120 were significantly associated with the left CIMT (P < 0.01). Conclusions: Ultrasound-measured CIMT, especially the left CIMT, is a reasonable glucose metabolic indicator of atherosclerotic vascular complications in obese children.

Usefulness of the metabolic syndrome diagnosis in obese children in clinical practice.

In the light of recent studies, the usefulness of the metabolic syndrome diagnosis in obese pediatric patients seems to be controversial. It leads to the pressing questions, if the metabolic syndrome diagnosis is reflecting risk of the cardiovascular complications in obese chil-dren. To evaluate the incidence of metabolic syndrome in obese children, asses the role of insulin resistance in the metabolic complications and investigate if the diagnosis of MS has a clinical value in that group of patients. After the retrospective analysis of 588 records of obese children treated in metabolic outpatient clinic, 289 children (145 boys) in the mean age of 11 years, was qualified to the study. Diagnosis of metabolic syndrome was based on IDF 2009 criteria and HOMA-IR was used in the assessment of insulin resistance. Metabolic syndrome was diagnosed in 69 children (24%) including 42 girls (61%, p < 0.05). Mean age was higher (12.4 vs. 10.9, p < 0.05) in patients with metabolic syndrome. Initial BMI Z-score was similar in the both groups (2.93 SD vs. 2.92 SD). However, further follow-up showed significantly (p < 0.001) less effective BMI z-score reduction in patients with metabolic syndrome. Insulin resistance was observed significantly more often in children with metabolic syndrome (77% vs. 35%, p < 0.0001). Moreover, ami-notransferases were significantly higher in boys with metabolic syndrome (AST = 35 vs. 28 U/l, ALT = 38 vs. 23 U/l, p < 0.0001). The diagnosis of metabolic syndrome in obese children seems to have a predictive value for the clinical practice. Affected children are older and their criteria are present more often in girls. Insulin resistance seems to be an important factor associated with metabolic syn-drome in obese children. The outcomes of behavioral therapy are less effective in children with metabolic syndrome. Affected boys are at higher risk of non-alcoholic fatty liver disease (NAFLD) in the future.

The Prevalence of Vitamin D Deficiency and its Correlation to Obesity- Related Complications in Obese Children from West Virginia

Obesity is significantly associated with Vitamin D (Vit D) deficiency in children, and normalization of Vit D levels in children has been shown to improve obesity related complications including insulin resistance (IR). WV has been recognized with one of the highest obesity rates in the nation. In a retrospective study, the charts of obese children were reviewed. Fasting blood levels for Vit D, insulin, glucose, aminotransferases, and lipid profiles were collected and analyzed. Results showed that over 50% of our population were Vit D deficient (&lt; 20 ng/ml) and over 80% were insufficient (&lt;30 ng/ml). Vit D deficiency/insufficiency was associated with IR but not with triglycerides, insulin, or lipid profiles. We report for the first time that Caucasian WV children have a higher rate of Vit D deficiency than the reported national levels. Moreover, Vit D deficiency/ insufficiency was significantly associated with IR. We suggest that in each obese child, Vit D and metabolic syndrome should be assessed in order to prevent obesity related complications.

Lifestyle Habits, Dietary Factors, and the Metabolically Unhealthy Obese Phenotype in Youth

To determine whether lifestyle habits and dietary factors at age 8-10 years predict the development of metabolically unhealthy obesity 2 years later among children who were previously metabolically healthy obese. The QUebec Adipose and Lifestyle InvesTigation in Youth cohort comprises 630 youth with a parental history of obesity. Metabolically healthy obesity and metabolically unhealthy obesity were defined using cut-offs for the components of pediatric metabolic syndrome. Dietary factors, physical activity, fitness, sedentary behavior, screen time, and sleep duration were measured. Multivariable logistic regressions were used to examine associations. At baseline, 48 participants with metabolically healthy obesity were identified; 2 years later, 19 became metabolically unhealthy obese and 29 remained metabolically healthy obese. Every additional daily portion of fruits and vegetables decreased the risk of converting to metabolically unhealthy obesity by 39% (OR 0.61, 95% CI 0.40-0.94). Cumulating more hours of screen time and diets high in saturated fat and sugar-sweetened beverages and low in protein were associated with a tendency to develop metabolically unhealthy obesity. Fruit and vegetable intake and possibly screen time, saturated fat, sugar-sweetened beverages, and protein intake may be important targets for the prevention of cardiometabolic complications in obese children. ClinicalTrials.gov: NCT03356262.

Non-alcoholic fatty liver disease severity and metabolic complications in obese children: impact of omega-3 fatty acids

Although n-3 polyunsaturated fatty acids (PUFA) revealed promising therapeutic results in non-alcoholic fatty liver disease (NAFLD), which is considered as the most prevalent cause of chronic hepatic disease, inconsistencies are calling for further confirmatory trials to demonstrate therapeutic efficacy and safety. The study, registered as NCT02201160 on www.clinicaltrials.gov, was designed to compare two groups of NAFLD with a different severity, and to evaluate the efficacy of n-3 PUFA supplementation. Twenty young male participants of French Canadian origin with NAFLD were enrolled and classified into moderate (mNAFLD) and severe (sNAFLD) fatty liver groups, according to transaminase levels, ultrasonography, NAFLD Activity Score and Fatty Liver Index (FLI). The sNAFLD patients were assigned to consume 2 g of n-3 PUFA for 6 months. sNAFLD patients displayed higher insulinemia, insulin resistance (IR), oxidative stress (OxS), systolic blood pressure and the risk lipid indicators of cardiovascular diseases. Supplementation of n-3 PUFA for 6 months resulted in a significant increase in concentrations of eicosapentaenoic and docosahexaenoic acids in red blood cells along with an attenuation of hepatic steatosis as reflected by the reduction of the FLI, ALT and ALT/AST ratio. Moreover, the n-3 PUFA improved the lipid profile and carotid intima-media thickness, while reducing metabolic and OxS markers as well as raising adiponectin. In conclusion, NAFLD severity was essentially related to IR. Treatment with n-3 PUFA has an evidently beneficial effect on liver steatosis and related metabolic abnormalities. Furthermore, the cross association of omega-3 index with cardiometabolic markers may serve as a predictor for cardiovascular risk disorders in NAFLD.

Sleep and Breathing the First Night After Adenotonsillectomy in Obese Children With Obstructive Sleep Apnea.

There are few studies measuring postoperative respiratory complications in obese children with obstructive sleep apnea (OSA) undergoing adenotonsillectomy (AT). These complications are further compounded by perioperative medications. Our objective was to study obese children with OSA for their respiratory characteristics and sleep architecture on the night of AT. This was a prospective study at a tertiary pediatric hospital between January 2009-February 2012. Twenty obese children between 8-17 years of age with OSA and adenotonsillar hypertrophy were recruited. Patients underwent baseline polysomnography (PSG) and AT with or without additional debulking procedures, followed by a second PSG on the night of surgery. Demographic and clinical variables, surgical details, perioperative anesthetics and analgesics, and PSG respiratory and sleep architecture parameters were recorded. Statistical tests included Pearson correlation coefficient for correlation between continuous variables and chi-square and Wilcoxon rank-sum tests for differences between groups. Baseline PSG showed OSA with mean obstructive apnea-hypopnea index (oAHI) 27.1 ± 22.9, SpO2 nadir 80.1 ± 7.9%, and sleep fragmentation-arousal index 25.5 ± 22.0. Postoperatively, 85% of patients had abnormal sleep studies similar to baseline, with postoperative oAHI 27.0 ± 34.3 (P = .204), SpO2 nadir, 82.0 ± 8.7% (P = .462), and arousal index, 24.3 ± 24.0 (P = .295). Sleep architecture was abnormal after surgery, showing a significant decrease in REM sleep (P = .003), and a corresponding increase in N2 (P = .017). Obese children undergoing AT for OSA are at increased risk for residual OSA on the night of surgery. Special considerations should be taken for postoperative monitoring and treatment of these children. A commentary on this article appears in this issue on page 775.

121: THE COMPARISON OF THE EFFECTS OF PIOGLITAZONE AND METFORMIN ON REDUCING INSULIN RESISTANCE IN 8 TO 15 YEARS OLD CHILDREN WITH OBESITY IN GORGAN BETWEEN 2012–2013

Background and aims:Insulin resistance is one of the metabolic complications of obesity in childhood. Metformin and pioglitazone are medications that have beneficial effects in improving insulin sensitivity via different mechanisms....

Awareness of Complications of Obesity in Young Individuals

Obesity is a leading cause of morbidity worldwide. As per WHO data in 2008, 1.4 billion persons aged 20 years and above were obese. Type 2 diabetes mellitus, hypertension, dyslipidemia, ischemic heart disease, stroke, gall bladder stones, osteoarthritis and nonalcoholic fatty liver disease are some of the common complications of obesity. Awareness of these complications is very essential among young individuals. The study included a 100 individuals attending out-patient services of Father Muller Medical College Hospital by convenience sampling. Most participants were aware about complications of obesity such as joint pains, risk of developing diabetes, hypertension, hypercholesterolemia, coronary artery disease, asthma, obstructive sleep apnea and depression. There was no significant body image misperception among the participants in this study. Many participants in our study felt that obesity has a genetic factor because of which obesity cannot be prevented. Community wide efforts to increase awareness and promote environments that encourage physical activity and healthy nutrition are needed. These measures could probably reduce this misperception. (2) There are various factors that play a role in causing obesity. Obesity itself can lead to multiple complications. Type 2 diabetes mellitus, hypertension, dyslipidemia, ischemic heart disease, stroke, gall bladder stones, osteoarthritis and nonalcoholic fatty liver disease are some of the common complications of obesity. (3) Awareness of these complications is very essential among young individuals. Very few studies have been done on awareness of obesity and its complications in young individuals in Mangalore. Hence this study attempts to study the awareness of complications of obesity in young individuals. II. Review of Literature Obesity is known to be associated with multiple diseases affecting multiple organ systems. The major diseases associated with obesity are diabetes mellitus, hypertension, dyslipidemias, atherosclerotic disease and cancers. These complications are fairly well known among the general public. Other complications such as cholelithiasis, impairment of pulmonary function, sleep disorders, endocrine abnormalities, joint disorders, dermatologic disorders and immunologic impairment are not so well known among people not associated with health care. (3) Complications of obesity in childhood include psychosocial problems, learning impairment, abnormal glucose tolerance, hypertension and significant risk of obesity during adulthood and beyond. (4)

Insulin resistance in prepubertal obese children correlates with sex-dependent early onset metabolomic alterations

Background:Insulin resistance (IR) is usually the first metabolic alteration diagnosed in obese children and the key risk factor for development of comorbidities. The factors determining whether or not IR develops as a result of excess body mass index (BMI) are still not completely understood.Objectives:This study aimed to elucidate the mechanisms underpinning the predisposition toward hyperinsulinemia-related complications in obese children by using a metabolomic strategy that allows a profound interpretation of metabolic profiles potentially affected by IR.Methods:Serum from 60 prepubertal obese children (30 girls/30 boys, 50% IR and 50% non-IR in each group, but with similar BMIs) were analyzed by using liquid chromatography–mass spectrometry, gas chromatography–mass spectrometry and capillary electrophoresis–mass spectrometry following an untargeted metabolomics approach. Validation was then performed on a group of 100 additional children with the same characteristics.Results:When obese children with and without IR were compared, 47 metabolites out of 818 compounds (P<0.05) obtained after data pre-processing were found to be significantly different. Bile acids exhibit the greatest changes (that is, approximately a 90% increase in IR). The majority of metabolites differing between groups were lysophospholipids (15) and amino acids (17), indicating inflammation and central carbon metabolism as the most altered processes in impaired insulin signaling. Multivariate analysis (OPLS-DA models) showed subtle differences between groups that were magnified when females were analyzed alone.Conclusions:Inflammation and central carbon metabolism, together with the contribution of the gut microbiota, are the most altered processes in obese children with impaired insulin signaling in a sex-specific fashion despite their prepubertal status.

Complications of Childhood Obesity Appear Early

Because severe childhood obesity is a growing public health problem, understanding obesity-associated cardiovascular risk factors has importance for

Neck circumference as a novel screening method for estimating fat distribution and metabolic complications in obese children

BackgroundNeck circumference (NC) has been shown to be an indicator of upper-body subcutaneous adipose tissue distribution. The aim of this study was to investigate the association between NC with pattern of fat distribution of obese children, hypertension, abnormal lipid profile and presence of insulin resistance. MethodsA cross sectional case-control study was conducted on 50 obese subjects (27 male, 23 female), body mass index (BMI) ⩾95th percentile for age and sex, aged 7–12years and 50 healthy children (25 male, 25 female), BMI 15th to <85th percentile, age and sex matched as a control group. All children were subjected to history taking, complete clinical examination, blood pressure (BP), and anthropometric assessment (weight, height, BMI, NC, waist circumference (WC) and hip circumference (HC), biceps; triceps and sub scapular skin fold thickness); and fasting blood glucose, insulin and lipid profile estimation. ResultsAll studied anthropometric parameters; including NC, were significantly higher in obese than control for total sample, males and females separately. The obese subjects also, showed statistically significantly higher low density lipoproteins (LDL), cholesterol, triglycerides (TG), glucose, insulin and homeostatic model assessment-insulin resistance (HOMA-IR). A significant positive correlation was recorded between NC and weight, height, BMI, WC, HC, triceps skin fold and diastolic blood pressure. ConclusionNC is a valuable predictor for body fat distribution among obese children either central (WC and HC) or peripheral (triceps skin fold). It should be used as a screening tool in population-based studies.

Postoperative complications in obese children undergoing adenotonsillectomy

ObjectiveThe incidence of obesity in the pediatric population is increasing. To date, data are limited regarding safety of adenotonsillectomy in this patient population. The purpose of this study is to assess perioperative outcomes of adenotonsillectomy in the obese pediatric patient. MethodsA review of the 2012 Kids’ Inpatient Database (KID) was conducted to compare patients with clinical modification codes for adenotonsillectomy plus obesity to patients with clinical modification codes for adenotonsillectomy alone.Elements for comparison included patient demographics and concurrent discharge. An in depth review of risk factors associated with respiratory complications in obese patients was also conducted. ResultsA weighted total of 899 obese and 20,535 non-obese patients admitted after adenotonsillectomy were identified. When these two groups were compared, respiratory complications were found in 16.2% of obese and 9.6% of non-obese patients (p<0.0001). A diagnosis of respiratory failure or pulmonary insufficiency was statistically more common in obese patients when compared to non-obese patients (5.0% versus 3.0%, p=0.007). In obese patients, respiratory complications were associated with male gender, low income, and concomitant asthma on multivariate analysis (p=0.01, 0.004, and 0.007 respectively). ConclusionPerforming adenotonsillectomy on the obese pediatric patient is safe. When performing adenotonsillectomy on this patient population, one must be aware that respiratory events are the most common type of complication and risk of respiratory complications is higher in males, patients of low socioeconomic status, and patients with comorbid asthma, regardless of race or insurance status.

Prevalence of Obesity and Its Associated Complications Among Suburban School Children of Navi Mumbai, India

Childhood obesity is a complex, multifactorial, challenging problem that has been escalating at an alarming rate in the western world and also paradoxically in the developing nations like India, due to changes in lifestyle and physical activity attributed to the phenomena of westernization and rapid urbanization. To determine anthropometric measurements of school-going children and estimate the prevalence of overweight and obesity among them. To assess the dietary habits, lifestyle patterns and prevalence of associated complications in obese children. Cross sectional study. Tertiary care centre. Students from government school in the age group of 5 to 15 years. The anthropometric measurements, blood pressure, dietary history, duration of physical activity, and TV viewing were recorded on a predesigned proforma. Blood investigations were done in overweight and obese children. Prevalence of obesity and associated complications. Prevalence of obesity is 9.3% with male predominance. Prevalence of obesity was higher as per waist hip ratio (WHR) as compared to body mass index (BMI) with strong correlation between WHR and BMI for the measurement of obesity. Obese children had a higher caloric intake, a heavy dinner, and more junk food. No significant association between the duration of physical activity and obesity. Obese children viewed TV for longer periods. Fasting RBS did not have a significant association with obesity, however fasting serum insulin levels may be a more reliable marker. Lipid profile seemed to be significantly deranged in obese and overweight children. Subclinical hypothyroidism was associated with obesity in 10.6% of obese children. CRP was non-reactive in all the children who were obese. Obesity is prevalent in school going children in India. Obese children had a higher caloric intake and sedentary life style. There is increased association of obesity with dyslipidemia and subclinical hypothyroidism.