Characterisation of morbidity in a UK, hospital based, obesity clinic. Issue 2 (24th October 2005)

• Record Type: Journal Article
• Authors: Sabin, M A; Ford, A L; Holly, J M P; Hunt, L P; Crowne, E C; Shield, J P H
• Is Part Of: Archives of disease in childhood. Volume 91:Issue 2(2006)
• Page Start: 126
• Page End: 130
• Publication Date: 2005-10-24
• Subjects: IGT, impaired glucose tolerance -- OGTT, oral glucose tolerance test -- MS, metabolic syndrome; obesity -- impaired glucose tolerance -- metabolic syndrome; Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/adc.2005.083485
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Aim: To identify clinical features which predict those most at risk of co-morbidities within an obesity clinic. Methods: Children attending an obesity clinic had fasting glucose, insulin, and lipids measured prior to a standard oral glucose tolerance test (OGTT). History and examination established birth weight, family history of type 2 diabetes/obesity, pubertal status, and presence of acanthosis nigricans. Central and total fat mass was estimated by bio-impedance. Results: Of the 126 children evaluated, 10.3% (n = 13) had impaired glucose tolerance (IGT); the majority (n = 11) of these would not have been identified on fasting glucose alone. Those with IGT were more likely to have a parental history of type 2 diabetes (relative risk 3.5). IGT was not associated with acanthosis nigricans. Twenty five per cent (n = 19) of those evaluated (n = 75) had evidence of the "metabolic syndrome" (MS). HDL cholesterol and triglyceride levels were related to insulin sensitivity (HOMA-R); HDL cholesterol was also related to birth weight SDS. We observed a trend for those with MS to have a lower birth weight SDS. The severity of obesity did not influence the likelihood of IGT or MS. Conclusions: Significant numbers of obese children have associated co-morbidities. Analysis of fasting blood glucose samples alone is not satisfactory to adequately evaluate glucose homoeostasis. The overall level of obesity does not predict co-morbidities. Special attention should be given to those with parental diabetes and a history of low birth weight who are more likely to have IGT and abnormal lipid profiles respectively.