OBEZ ERGENLERDE METABOLİK SENDROM SIKLIĞI VE METABOLİK SENDROM İÇİN RİSK FAKTÖRLERİNİN BELİRLENMESİ

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Thesis Type: Expertise In Medicine

Institution Of The Thesis: Sivas Cumhuriyet University, Tıp Fakültesi, ÇOCUK SAĞLIĞI VE HASTALIKLARI ANABİLİM DALI, Turkey

Approval Date: 2021

Thesis Language: Turkish

Student: PERİHAN BEYSEL

Supervisor: Nurullah Çelik

Open Archive Collection: AVESIS Open Access Collection

Abstract:

There has not been a common consensus for the definition of Metabolic Syndrome (MS) in childhood, but the most widely accepted criteria were established by International Diabetes Federation (IDF) and World Health Organization (WHO). As the epidemic global obesity increases, the need for research on MS prevalence and risk factors in childhood and adolescent obesity has been increasing. In this retrospective single-center observational study, it was aimed to examine the demographic and laboratory findings of 957 patients in the 6-18 age group, consisting of 291 males and 380 females, who applied to Pediatric Endocrinology Polyclinic of Faculty of Medicine Hospital of Sivas Cumhuriyet University between September 2017 and January 2020, and to compare the anthropometric and basal metabolic parameters of the groups with and without MS diagnosis, and also to determine the prevalence and risk factors of MS in obese children and adolescents. All cases were classified byo MS diagnosis according to the criteria of IDF, Cook et al. and De Ferranti et al., the prevalence of MS was determined as 6.37% (n = 61) according to the IDF criteria, 21.8% (n = 209) according to the Cook criteria and 32.4% (n = 310) according to the De Ferranti criteria. The prevalence of MS among children under 12 and over 12 years old was 7.7% and 12.5% according to the IDF criteria; 12.9% and 26.4% according to Cook criteria; 25% and 37.4% according to de Ferranti criteria, respectively. Regardless of age, it was determined that the rates of MS diagnosis according to both IDF and De Ferranti criteria were higher among girls than boys, without a statistically significant difference (P> 0.05). However, the logistic regression analysis showed that the risk of MS diagnosis according to Cook criteria was expected to increase as the age increased (OR: 2.752; P = 0.016). The changes in the bone age, triglyceride, hemoglobin, thrombocyte and free T4 levels determined by IDF criteria (P = 0.017, 0.011, 0.039, 0.009 and 0.039, respectively); the changes in the bone age, gestational week, birth weight, cesarean delivery, insulin, cholesterol, LDL and triglyceride levels determined by Cook criteria (P = 0.006, 0.012, 0.032, 0.02, 0.001, 0.003, <0.001, 0.041, respectively); the changes in insulin, cholesterol, LDL, triglyceride levels and MPV values determined by De Ferranti criteria (P = 0.029, 0.002, <0.001, <0.001, 0.038, respectively) significantly increased the probability of MS diagnosis. In conclusion, we suggest that the variations in age groups, bone age, insulin metabolism, lipid metabolism and some hematological parameters in children and adolescents may increase the risk of MS diagnosis. For other examined criteria, all demographic, anthropometric and metabolic indices should be compared, and the criteria determined for diagnosis should be revealed at national and international level by using different analyzes. Keywords: Obesity, Metabolic Syndrome, Children, Adolescents