Endocrine Abstracts

Introduction: Visceral body fat has been shown to correlate with complications related to obesity. Body mass index (BMI) is widely used to define obesity in the adolescent population; however, it does not take the overall body composition into account. We present body composition data in a group of UK adolescents attending the tertiary MDT weight management service.

Methods: Data was collected on 31 patients (M:F = 15:16) attending the MDT service over a 6-month period. Body composition was evaluated by bioelectrical impedance analysis using TANITA RD-545 body composition scale.

Result: The mean (±SD) age was 14.56 years (range between 12-18 years) and the average weight was 123.12 kg (±25.15). The mean BMI and BMI SDS were 43.15(±7.67) and 3.67(±0.48) respectively. The mean fasting insulin and C-peptide were 338 pmol/l and 1617 pmol/l respectively. The OGTT did not reveal evidence of diabetes or pre-diabetes in the group. 7/31 (23%) patients had abnormal liver function and 39% (11/37) had dyslipidaemia. The mean fat mass (FM) was 57.05 kg (±16.06SD) and fat free mass (FFM) was 63.33 kg (±12.6SD) in males. In females, the mean fat mass (FM) was 68.19 kg (±22.096SD) and fat free mass (FFM) was 56.8 kg (±8.6SD) which were significantly elevated. Body fat percentage was 46.15% in males and 53.64% in females. There was a positive corelation between BMI SDS and body fat percentage in both males [r=0.773, P=0.0019] and females [r=0.785, P=0.0015] which was statistically significant (P<0.01). 19 (61%) patients were managed with lifestyle modification and behavioural intervention. 11(34%) patients were started on GLP1 analogue therapy after a period of lifestyle intervention.

Discussion: Our data provides insights into the baseline body fat composition in a group of adolescents with significant obesity. Assessment of fat mass and fat free mass could help providing targeted interventions in achieving weight loss. Serial assessment of body composition and FFM/FM ratio could help monitor the response to lifestyle intervention and medical therapy for weight management. Improving muscle mass and reducing fat mass will have positive impact on metabolic parameters and long-term cardiovascular outcomes in adolescents with severe obesity.