Follow-up Evaluation of Association between Weight Changes, Metabolic, and Hormonal Outcomes in Children – a Single-center Pilot Study

Folia Medica(2020)

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摘要
Introduction: Fasting blood glucose, insulin level, and lipid profile are the minimal tests according to the Romanian guidelines to evaluate obese children. Cross-sectional studies for pediatric obesity in Romania focused only on epidemiology and management. Aim: Our study aimed to evaluate the metabolic and hormonal changes in association with follow-up bodyweight modifications.Materials and methods: Medical charts of overweight or obese children presenting at the First Paediatric Hospital, Cluj-Napoca from January 2017 to March 2019 were retrospectively evaluated. Anthropometric measures [e.g., body mass index (BMI), and waist circumference] and blood tests such as inflammatory markers (e.g., white blood cell and neutrophil absolute/relative counts, C-reactive protein), metabolic parameters (e.g., liver enzymes, uric acid, fasting blood glucose, triglycerides, high-density lipoprotein-cholesterol), fasting blood insulin, and cortisol levels were evaluated.Results: Twenty-two overweight or obese children (17 girls, median age of 13 years) monitored on median for 7.5 months were in-cluded in the study. Blood glucose level significantly decreased (p=0.010) and fasting insulin levels increased (p=0.051) at follow-up evaluation, independently of BMI-for-age z-score. Fasting insulin levels were associated with waist circumference (Spearman’s rank cor-relation coefficient) ρ=0.58, p=0.030). BMI-for-age z-score proved to be associated with the C-reactive protein level at baseline (ρ=0.70, p=0.036, n=9) and high-density lipoprotein cholesterol at follow-up (ρ=-0.52, p=0.033, n=17).Conclusions: Present analysis found changes in fasting insulin levels in relation to the abdominal circumference and high-density lipoprotein cholesterol and C-reactive protein levels in relation to BMI-for-age z-score in obese children. 
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关键词
follow-up study,pediatric obesity,practice guide
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