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.

中文翻译：

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斯里兰卡城市中一群超重和肥胖儿童的代谢异常


南亚人群中与儿童肥胖相关的代谢紊乱正在增加。大多数这些变化会持续到成年。本研究旨在描述斯里兰卡加姆珀哈区 7 至 17 岁超重和肥胖儿童代谢异常的分布情况。超重儿童（年龄和性别适应的BMI>+1SD，世界卫生组织标准）是从加姆珀哈区尼甘布教育区进行的社区调查中选出的。禁食 12 小时过夜后，抽血并测量血糖 (FBG)、血脂、胰岛素和肝转氨酶。葡萄糖负荷后两小时，抽血测定随机血糖（RBG）和胰岛素。使用修改后的 IDF 儿童标准诊断代谢综合征 (MetS)。测量了人体测量学、脂肪量（FM）和血压。通过超声评估肝脂肪模式。对 403 名儿童（210 名男孩）的数据进行了分析。在研究人群中，16.4% 超重（年龄 BMI +1 至 +2SD），72% 肥胖（年龄 BMI >+2 至 +3SD），11.6% 严重肥胖（年龄 BMI >+3SD） 。 46.8% 的人存在胰岛素抵抗，且患病率随着年龄的增长而增加。平均餐后胰岛素范围为 368 至 625 pmol/L，升高了 35%。 20.8% 的人出现血糖异常。 19.8% 的人存在 MetS，84% 的人至少有一种代谢异常。 32.5%的人群出现不同程度的肝脏脂肪变性，58%的人群出现ALT/AST比值升高。儿童时期的超重和肥胖与包括 MetS 在内的多种代谢异常有关，并且这些异常从年轻时就发生。在生命早期筛查儿童是否超重/肥胖并进行干预以防止他们出现代谢并发症非常重要。