Evaluation of follow-up results of pediatric cases with obesity and metabolic syndrome

Aim: Obesity is a chronic inflammatory condition that impairs quality of life in many ways with abnormal accumulation of adipose tissue that can cause various health problems. Metabolic syndrome (MS) is one of the most important complications of obesity. We aimed to evaluate the frequency of MS and its components, and the variability in the presence and components of MS during the follow-up period by examining the follow-up results of pediatric patients with obesity and/or MS diagnosis. Method: A total of 207 patients aged 10-18 years with obesity and/or MS, followed up in the Pediatric Endocrinology Department of our hospital between December 2012 and December 2021, along with patients who were overweight and had at least one MS component and were diagnosed with obesity and/or MS during the follow-up period were included. The files of the patients were scanned retrospectively and their demographic, clinical and laboratory characteristics were recorded. The definition of MS was made according to the International Diabetes Federation (IDF) criteria. Patients were grouped as never MS, variable MS, incidental MS and persistent MS. Results: In the study group, the prevalence of obesity increased from 77.3% to 89.7%, and the frequency of MS increased from 9.2% to 17.4% (72.4% non-MS, 12.5% variable MS, 9.7% incidental MS, 5.4% persistent MS) during the follow-up period. The median age was higher in the persistent MS group than in the other groups (p=0.005). The follow-up period was longer in the variable MS group than in the other groups (p<0.001). BMI SDS at the third and fourth follow-up was found to be higher in the persistent MS group than the other groups (p=0.019, p=0.01). At the first follow up, high-density lipoprotein (HDL) level was the lowest in the persistent MS group, and HDL level was found to be higher in the non-MS group than the other groups in the second follow-up (p=0.049, p<0.001). The frequency of HT was found to be higher in the persistent MS group, and the frequency of glucose intolerance was higher in both variable and persistent MS groups (p<0.001, p<0.001). Dyslipidemia was seen in all patients in the persistent MS group. The incidence of HT in the incidental MS group increased dramatically during the follow-up period. Conclusion: To our knowledge, in our country for the first time in our study, children with MS were evaluated in terms of MS subgroups and the variability in MS status and components during the follow-up period was examined. Our findings show that significant instability can be observed in MS and its components in the childhood age group. Although there is a relationship between follow-up time and MS instability, it can be said that hypertension is a reliable parameter when evaluating the course of MS.