Monday, 07 August 2017

Obese Kids, Cute or Acute?

For most parents, especially mothers, having obese kids is a pride since it shows their success in taking care of the kids. Another opinion says that obese kids look fresh, funny and cute. Meanwhile, medical field states the other way round. Parents should pay attention to the kids with obesity because it tends to remain until the kids grow mature.

Obesity in children may cause various serious psychosocial and health problems. One of those which draws medical field' s attention the most is metabolic syndrome. Metabolic syndrome may increase the risks of cardiovascular diseases and type 2 diabetes mellitus which give prolonged bad impacts, i.e. handicap and death.

Complications of obesity in children

Obesity in children happens due to the imbalance between energy intake and expenditure used by children to support their growth and development process, metabolism and physical activities. It results in energy excess stored in the form of adipose tissue or fat.

What causes such energy imbalance has not been revealed precisely yet, however, it is allegedly caused by the interaction between genetic factor, behavior and environment, as well as life style changing that affects one' s food intake.

Numerous studies find that obesity in children will potentially remain until they become adults and some of obese children will suffer from metabolic syndrome. Metabolic syndrome is a set of risk or abnormality factors which are closely related to insulin resistance (insulin performance disorder) that later increases the risk of cardiovascular diseases and type 2 diabetes mellitus.

Metabolic syndrome is generally without symptom and does not cause health problem directly. Thus, early check-up is needed to prevent harmful disease due to the syndrome. Therefore, metabolic syndrome is like an alarm we should be warned of when children encounter overweight or obesity.

Diagnosis of children' s metabolic syndrome

The International Diabetes Federation (IDF) composes consensus on the diagnostic criteria of metabolic syndrome in children based on the following age groups

  • Age 6 - < 10 years old

In this age group, metabolic syndrome can not be diagnosed. However, if abdominal circumference measurement suggests abdominal obesity (excessive abdominal fat around stomach), losing weight will be recommended.

  • Age 10 - < 16 years old

In this age group, metabolic syndrome can be diagnosed by abdominal obesity which is followed by two or more clinical criteria such as increasing triglyceride and fasting glucose, hypertension, and decreasing HDL cholesterol.

  • Age > 16 years old

In this age group, diagnostic criteria of metabolic syndrome are applied as toward the adults.

Laboratory test

According to the criteria, diagnosing metabolic syndrome requires laboratory tests on blood glucose, triglyceride and HDL cholesterol, accompanied by physical and blood pressure tests. Other than those basic examinations, some additional examinations are recommended in order to be informed further on children' s health condition.

Overall, laboratory tests being recommended include the examinations of:

  1. Routine hematology and peripheral blood description, to evaluate anemia in obese children and teenagers, which is caused by double burden of malnutrition (excess of macronutrient intake, lack of micronutrient intake).
  2. Lipid profile consisting of total cholesterol, LDL cholesterol, HDL cholesterol and triglyceride as the basis of intervention or medication and monitoring as well.
  3. ApoB, to assess the risk of cardiovascular and blood vessel diseases since it causes LDL to attach to blood vessel walls.
  4. hs-CRP, to assess the risks of chronic inflammation on blood vessel walls and of cardiovascular diseases.
  5. Uric acid, to assess the risk of metabolic disorder in the form of hyperuricemia.
  6. Fasting blood glucose, to assess the risk of hyperglycemia (excessive level of blood glucose) or insulin resistance.
  7. Urea dan creatinine, to recognize kidney functions.
  8. SGOT and SGPT, to recognize liver functions and the possibility of non-alcoholic steatohepatitis.
  9. Blood pressure
  10. Abdominal circumference, body weight and body height

Detecting metabolic syndrome in children and performing proper treatment are expected to be able to push down the handicap and mortality rates in adulthood, as well as to minimize global health problems, particularly on the occurrences of cardiovascular diseases and type 2 diabetes.