Investigating Endocrine and Metabolic Complications in Obese Children Referred to The Endocrinology Clinic of Ali Asghar Zahedan Hospital

 Obesity, which is defined as a body mass index above the 95th percentile (according to age and sex), is a chronic disease whose prevalence in adults, adolescents and children is increasing and is currently considered a It is considered a global epidemic. In many societies, the prevalence of overweight and obesity has increased during the last 2 decades. In the United States, the lifetime risk of overweight and obesity in each person is 50% and 25%, respectively. Analysis of the results of studies in 144 countries of the world shows that in 2010, about 43 million preschool children were overweight or obese, of which 35 million are from developing countries and 92 million children are at risk of being overweight. Also, overweight and obesity in preschool children has been increasing rapidly, from 2.4% in 1990 to 6.7% in 2010, and it is expected to reach 9.1% in 2020, i.e. reach 60 million children. Obesity is a multifactorial disease that is caused by various genetic and environmental factors. As the first place where a child grows, the family is important from various dimensions. Several studies that have been conducted in the field of factors related to obesity in children have indicated the important role of parents in the occurrence of obesity in children. Heredity on the one hand and behavioral and nutritional patterns on the other hand justify this relationship. There is strong evidence that shows that the family lifestyle and eating habits formed in the family play an important role in the type of nutrition and the child's weight; In addition, the mother's obesity probably affects how she responds to the child's needs. In many studies, parental obesity, especially maternal obesity, has a direct relationship with child obesity, and in some studies, it is known to be the most important factor related to childhood obesity. Obesity in children is associated with an increase in morbidity in childhood, so that outpatient visits, hospitalizations and the need for treatment are more in obese children than in non-obese children. In addition, childhood obesity is associated with various complications. These obesity complications include metabolic complications (increased risk of type 2 diabetes, hyperlipidemia, hepatic Steatosis, gallstones, increased blood insulin, impaired glucose tolerance test), respiratory and cardiac complications (asthma, sleep apnea, cardiovascular diseases, high blood pressure, cardiac hypertrophy, sudden death), orthopedic diseases (degenerative joint disease, slipped epiphysis of the femoral head) and other complications such as proteinuria, infertility, cancer, obesity in adolescence, depression, anxiety and discrimination in the social and work environment. On the other hand, obese children who remain obese in adolescence may become severely obese in adulthood, such that 80% of adolescents who are obese remain obese in adulthood. Abdominal obesity is more common in adolescent girls than in adolescent boys, which is associated with a higher chance of diabetes. Considering the very high prevalence of obesity and the various complications caused by it, and also considering that the studies conducted in the field of metabolic and endocrine complications of obesity in Iran are few, in this study we intend to further investigate the metabolic and endocrine complications in Let's go to the endocrinology clinic of Ali Asghar Hospital in Zahedan.

 The inclusion criteria in the study population include obese children aged 5 to 18 years who were referred to the endocrinology clinic of Ali Asghar Hospital in Zahedan in 2015. Exclusion criteria are unwillingness to participate in the study, mental retardation or having Syndromic diseases, history of chronic disease, or taking medication. Descriptive statistics including mean, standard deviation, and frequency were used to describe the data. Also, to analyze the data, the statistical tests of Student's T, Chi-square, and Pearson's correlation coefficient were used.

 In this study, 60 children with obesity were investigated, 52% were boys and 48% were girls. The average age of the studied children was 9.9 ± 3.0 years (with a minimum of 5 and a maximum of 17 years). 5.8% of the children had a BMI between the 85-95th percentile for age and sex, and 94.2% of them had a BMI above the percentile. They had 95% for age and sex. In this study, 57% of children had fatty liver in ultrasound (45% grade 1 and 12% grade 2) and 43% were normal.

 Independent T-test showed that mean FBS, AST, and ALT in boys are significantly higher than in girls. Other parameters were not significantly different in boys and girls. In this study, 57% of the children had a fatty liver ultrasound and 51% of the studied children had precocious puberty. Also, the results showed that 91% of children had normal FBS, 54% normal cholesterol, 33% normal HDL, 73% normal LDL, 40% normal triglyceride, 96% normal AST, 73% normal ALT, 85% normal HbA1C, 30% They had normal insulin, 85% normal TSH, 94% normal T4 and 22% normal vitamin D. The results of the study showed that there are more metabolic complications such as fatty liver and endocrine complications such as Hyperinsulinemia and hyperlipidemia are more common in obese children. Therefore, first of all, it is recommended not to gain a lot of weight in children. If a child is overweight, the endocrine and metabolic effects of obesity should be investigated to be treated faster.