Distribution of obesity-related metabolic markers among 5–15 year old children from an urban area of Sri Lanka

BACKGROUND: Obesity-associated metabolic consequences are commonly seen among young South Asians. OBJECTIVE: To assess the nutritional status, prevalence of metabolic derangements and to identify the validity of different obesity diagnostic criteria in the detection of metabolic derangements among 5-15 year old school children in the Colombo district of Sri Lanka. MATERIALS AND PROCEDURES: After a 12-hour overnight fast, blood was drawn for glucose, lipid profile and alanine amino transferase (ALT) enzyme. Oral glucose tolerance test (OGTT) was done with blood taken for random blood sugar 2 hours after glucose load. Height, weight, waist circumference (WC) and blood pressure were measured. RESULTS: Nine hundred and twenty children were studied (boys, n = 547). Thirty-two (3.5%) were obese according to IOTF classification. Five (0.5%) and 57 (6.2%) children had systolic and diastolic hypertension. Twelve (1.3%) and three (0.3%) had impaired fasting glucose and 2-hour OGTT, respectively. One hundred and thirty-nine (15.1%) had hypercholesterolemia and 36 (3.9%) hypertriglyceridaemia. Two hundred and fifteen (23.3%) had low HDL. Fifteen (1.6%) had metabolic syndrome according to IDF definition. Two hundred and eighty-three (30.7%) had one metabolic derangement; 95 (10.3%) had two metabolic derangements; and 16 (1.7%) had three or more metabolic derangements. Sri Lankan BMI and WC obesity cut-offs had a higher sensitivity in detecting metabolic abnormalities than international cut-offs. CONCLUSION: Metabolic derangements are prevalent in children who were detected to be non-obese by anthropometric measures, and clinicians should actively look and correct them. New research is needed to study the long-term effects on health.