Profiles of Obese Children Presenting for Metabolic Evaluation

BACKGROUND: Obesity, increasingly prevalent among children, causes major morbidities, among which is earlier onset of type 2 diabetes mellitus (DM). METHODS: We reviewed charts of children aged 3 to 18 years (n=106). The population was divided into four age groups. Anthropomorphic measurements, family history, diet and exercise patterns, and selected endocrine/metabolic measurements were recorded, and descriptive statistics were calculated. RESULTS: Obesity in one or both parents correlated with a higher percent of ideal body weight (IBW) (p = 0.01). Fifty-eight percent of the children had first- or second-degree relatives with a history of type 2 DM; 9% had relatives with type 1 DM. Fifty-four percent had dieted and exercised regularly. Mean onset of obesity was at 4.2 +/- 0.9 years. Mean cholesterol was elevated at 176 mg/dl. Average BMI was 26.6 in the youngest children (Group 1; normal mean for this age approximately 15.5), and increased to 37.8 in adolescents (Group 4; normal mean approximately 21). Elevated TSH was present in <1% of the population. The number of patients with an abnormal insulin: glucose ratio (>1:4) increased with age. CONCLUSIONS: Childhood obesity in children is correlated with family histories of obesity and DM. Thyroid dysfunction is seldom found, although mild hypercholesterolemia and insulin insensitivity are prevalent, especially among adolescents.