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Metabolic complications of obesity in children and adolescents

Clin Exp Pediatr > Accepted Articles
DOI: https://doi.org/10.3345/cep.2023.00892    [Accepted]
Published online November 16, 2023.
Metabolic complications of obesity in children and adolescents
Hyunjin Park1,2  , Jung Eun Choi3  , Seunghee Jun1,2  , Hyelim Lee1,2  , Hae Soon Kim3  , Hye Ah Lee4  , Hyesook Park1,2 
1Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
2Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea
3Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul, Korea
4Clinical Trial Center, Ewha Womans University Mokdong Hospital, Seoul, Korea
Correspondence: 
Hyesook Park, Email: hpark@ewha.ac.kr
Received: 5 July 2023   • Revised: 18 August 2023   • Accepted: 18 August 2023
Abstract
The global prevalence of childhood and adolescent obesity, exacerbated by the COVID-19 pandemic, is affecting not only school-aged children but also preschoolers. Early-onset obesity, along with a higher risk of metabolic complications, may contribute to a lower age of onset of cardiovascular disease (CVD). As metabolic diseases such as diabetes, dyslipidemia, and non-alcoholic fatty liver disease (NAFLD) observed in adulthood are increasingly recognized in the pediatric population, there is an emphasis on moving disease susceptibility assessment from adulthood to childhood for early detection. Unlike adults, there is a lack of consensus in the definition of metabolic diseases in children. In response to this, various indicators such as pediatric simple metabolic syndrome score (PsiMS), continuous metabolic syndrome score (cMetS), single point insulin sensitivity estimator (SPISE), and fatty liver index (FLI) have been proposed in several studies. These indicators may help explain and early detect metabolic complications associated with pediatric obesity, although more validity studies are needed. Meanwhile, obesity assessment is shifting its perspective from visual obesity to metabolic health and body composition considerations to fill the gap in health impact assessment. Sarcopenic obesity, defined as muscle-to-fat ratio (MFR), has been proposed in pediatric populations and has also been found to be associated with metabolic health in children and adolescents. The National health screening program for children in Korea has expanded but still faces limitations in laboratory testing. These tests facilitate timely intervention by identifying high-risk groups for metabolic complications. Early detection and intervention through comprehensive health screening are critical to mitigate long-term complications of childhood obesity.
Key Words: Health Services, Insulin resistance, Metabolic syndrome, Non-alcoholic Fatty Liver Disease, Pediatric obesity


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