Kilolu Çocuklarda Metabolik Sendrom Sıklığı ve Özelliklerinin Araştırılması

Yıl 2022, Cilt: 44 Sayı: 4, 525 - 532, 19.07.2022

Akan Yaman , İbrahim Kandemir , Fügen Pekün

https://doi.org/10.20515/otd.1023692

Öz

Amaç: Fazla kilolu ve obez çocuklarda metabolik sendrom (MS) sıklığını ve özelliklerinin belirtilmesi
Yöntem: Çalışmaya İstanbul Okmeydanı Eğitim ve Araştırma Hastanesi Çocuk Sağlığı ve Hastalıkları polikliniğine başvuran sistemik, endokrin veya nörolojik hastalığı olmayan 102 fazla kilolu ve obez vaka alındı. Vakalar MS klinik bulguları, antropometrik ölçümler ve laboratuvar sonuçları (insülin direnci, kan şekeri, ‘high density lipoptorein’ (HDL) kolesterol (HDL-C), ‘low density lipoprotein’ (LDL) kolesterol (LDL-C), ‘very low density lipoprotein’ VLDL kolesterol (VLDL-C), trigliserit, C-reaktif protein (CRP), aspartat transaminaz (AST), alanin transaminaz (ALT), üre ve kreatinin düzeyleri) açısından araştırıldı, aile öyküleri sorgulandı. MS tanısını koymak için modifiye “National Cholesterol Education Program Adult Treatment Panel III” (NCEP/ATP III) kriterleri kullanıldı.
Bulgular: Vakaların ortalama yaşı 10.14±2.56 yıl (min:4 maks:15 yıl), %52.9’u (n=54) kız, %47.1’i (n=48) erkek idi. Çalışmaya alınan çocuk ve adolesanların %28.4’ü (n:29) fazla ağırlıklı ve %71.6’sı (n:73) obezdi. Obez ve fazla kilolu hastalarda hastalarda MS sıklığı sırasıyla %50,6 (n:37) ve %37,9 (n=11) idi. MS(+) olan grupta MS(-) olan gruba kıyasla aile öyküsünde MS olması (p=0,021), insülin direnci (p<0,001), açlık kan şekeri yüksekliği (p=0,008), akantozis nigrikans saptanması (p=0,021), hipertansiyon (p=0,001), bel çevresinde artış (p=0,014), CRP yüksekliği (p=0,048), trigliserit yüksekliği (p=0,008), VLDL-C yüksekliği (p=0,002) ve HDL-C düşüklüğü (p=0,047) istatistiksel olarak anlamlıydı.
Sonuç: Fazla ağırlıklı hastaların da obez vakalar gibi MS açısından tetkik ve takibi gereklidir. Ülkemizde MS sıklığının tespiti için çok merkezli prospektif çalışmalar gerekmektedir.

Anahtar Kelimeler

Metabolik sendrom, Obez çocuk, Fazla kilolu çocuk, NCEP/ATP III

Destekleyen Kurum

Yoktur

Investigation of Metabolic Syndrome Frequency and Characteristics in Overweight Children

Öz

To investigate the frequency and characteristics of metabolic syndrome (MS) in overweight and obese children. We included 102 overweight and obese cases without systemic, endocrine, or neurological diseases who applied to Istanbul Okmeydanı Training and Research Hospital Pediatrics Outpatient Clinic in the study. We investigated the patients in terms of MS clinical findings, anthropometric measurements, laboratory results (insulin resistance, blood glucose, 'high-density lipoprotein (HDL) cholesterol (HDL-C), 'low-density lipoprotein' (LDL) cholesterol (LDL-C), 'very low' Density lipoprotein (CLDL) cholesterol (VLDL-C), triglyceride, C-reactive protein (CRP), aspartate transaminase (AST), alanine transaminase (ALT), urea and creatinine levels), and family histories. Modified "National Cholesterol Education Program Adult Treatment Panel III" (NCEP ATP III) criteria were used to diagnose MS. The mean age of the cases was 10.14±2.56 years (min:4 max:15 years), 52.9% (n=54) were female, 47.1% (n=48) were male. Of the children and adolescents included in the study, 28.4% (n: 29) were overweight and 71.6% (n: 73) were obese. The prevalence of MS in obese and overweight patients was 50.6% (n:37) and 37.9% (n=11), respectively. In the MS(+) group compared to the MS(-) group, having MS in the family history (p=0.021), insulin resistance (p<0.001), high fasting blood glucose (p=0.008), acanthosis nigricans (p=0.021), hypertension (p=0.001), increase in waist circumference (p=0.014), high CRP (p=0.048), high triglyceride (p=0.008), high VLDL-C (p=0.002) and low HDL-C (p=0.047) ) was statistically significant. Examination and follow-up of overweight patients in terms of Metabolic syndrome is required, just like obese patients. Multicenter prospective studies are needed to determine the frequency of MS in our country.

Anahtar Kelimeler

Metabolic syndrome, Pediatric obesity, Pediatric overweight, NCEP ATP III

Kaynakça

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