The prevalence of metabolic syndrome and presumed non-alcoholic fatty liver disease in obese children at Tygerberg Hospital

Hough, Wayne (2016-12)

Thesis (MMed)--Stellenbosch University, 2016.

Thesis

ENGLISH SUMMARY: Introduction: The prevalence of obesity in children and adolescents is increasing worldwide, including in low and middle income countries (LMIC). Childhood obesity is also associated with conditions like metabolic syndrome (MS) and non-alcoholic fatty liver disease (NAFLD).This study looks at the prevalence of these complications and the factors that predict for them in obese children. Finally the effectiveness of the interventions implemented is assessed. Methods: This is a retrospective cohort study with cross-sectional elements performed at Tygerberg Children’s Hospital. Obese and morbidly obese children (under 18years) attending the endocrinology clinic over a 7year period (2008 to 2014) were included in the study. Demographic data, severity of obesity and data on possible predictive factors for MS and NAFLD were collected. Results: Obese (n=18) and morbidly obese (n=65) children were studied. MS occurred in 45.5 % of the study population. MS was significantly more common in the morbidly obese group (p = <0.001). Possible NAFLD occurred in 63% with no significant difference in incidence between obese and morbidly obese children. No factors predicted the presence of MS or NAFLD in this group of obese children. Factors predicting a decrease in BMI SDS were: BMI at presentation (p = 0.01), duration of follow-up (p = 0.01) and age at presentation (p = 0.08). Conclusion: MS and NAFLD are as prevalent in obese children seen at Tygerberg Children’s Hospital as demonstrated internationally. The follow-up BMI findings suggest that in order to successfully manage childhood obesity in our setting, long-term follow up and early intervention is required. Weight loss after dietary and lifestyle advice occurs more often in patients with a higher BMI.

AFRIKAANSE OPSOMMING: Inleiding: Die voorkoms van obesiteit in kinders en tieners is wêreldwydaan die toeneem, insluitende in die lae-en middel-inkomste lande. Obesiteit in kinders word geassosieer met toestande soos metaboliese sindroom en nie-alkoholiese vetterige lewersiekte. Hierdie studie kyk na die voorkoms van die komplikasies en die faktore wat hierdie komplikasies sal voorspel in vetsugtige kinders. Ten slotte word die doeltreffendheid van die intervensies wat geïmplementeer word beoordeel. Metodes: Dit is 'n terugwerkende kohort studie met deursnee-elemente wat by Tygerberg hospitaal gedoen is. Vetsugtige kinders (onder 18 jaar) wat die endokrinologie kliniek bygewoon het oor 'n tydperk van 7 jaar (2008-2014) is ingesluit in die studie. Demografiese data, graad van vetsug en data oor moontlike voorspellende faktore vir metaboliese sindroom en nie-alkoholiese vetterige lewer siekte is ingesamel. Resultate: Vetsugtige (n = 18) en morbied vetsugtige (n = 65) kinders is bestudeer. Metaboliese sindroom is gevind in 45.5% van die studiepopulasie en is aansienlik meer algemeen in die morbied vetsugtige groep (p = <0.001). Moontlike nie-alkoholiese vetterige lewersiekteis gevind in 63% met geen beduidende verskil in voorkoms tussen vetsugtige en morbied vetsugtige kinders nie. Voorspellende faktore vir 'n suksesvolle uitkoms na intervensie was: liggaamsmassa-indeks by eerste besoek (p = 0.01), tydperk van opvolg (p = 0.01) en ouderdom by eerste besoek (p = 0.08). Geen voorspellende faktore vir die ontwikkeling van metaboliese sindroom of nie-alkoholiese vetterige lewersiekte is in die groep vetsugtige kinders gedemonstreer nie. Gevolgtrekking: Metaboliese sindroom en nie-alkoholiese vetterige lewer siekte is net so algemeen in vetsugtigekinders gesien by die Tygerberg hospitaal as wat internasionaal gedemonstreer word. Die bevindings dui daarop dat om vetsugtige kinders suksesvol te behandel daar vroeë intervensie moet plaasvind en dat hulle vir lang termyn opgevolg moet word. Kinders met ‘n hoër liggaamsmassa-indeks was meer geneig tot ‘n suksessvolle uitkoms na intervensie.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/100405
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