BSPED2023 Poster Presentations Obesity 1 (9 abstracts)
Clinical characteristics and complications of excess weight (CEW) seen in multi-disciplinary tier-3 paediatric weight management services: a two centre experience
Katherine Hawton 1,2 , Louise Apperley 3 , Jennifer Parkinson 3 , Meghan Owens 3 , Claire Semple 1 , Amy Fitzgerald 1 , Shelley Easter 1 , Kate Clark 3 , Kim Lund 3 , Ellie Clarke 3 , Dinesh Giri 1,2 , Senthil Senniappan 3 & Julian Hamilton-Shield 4
1Bristol Royal Hospital for Children, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK; 2University of Bristol, Bristol, UK; 3Alder Hey Children’s NHS Foundation Trust, Liverpool, UK; 4NIHR Biomedical Research Centre (Nutrition), University of Bristol, Bristol, UK
Background: Children and young people living with severe obesity experience wide ranging complications of excess weight (CEW), however their prevalence is not well defined. We have evaluated baseline clinical characteristics and complications in two multi-disciplinary tier-3 paediatric weight management services in different regions of the UK.
Methods: All new patients (n=185) aged 2–17 years seen in a 12-month period from March 2022 to February 2023 were included. Baseline demographic data was collected, and patients were screened for a range of CEW. PedsQL-4.0 Generic Core Scales questionnaire was used to assess quality of life (QoL).
Results: The mean age was 13.04 years (range 3.33–17.95) and 50.8% were female. The majority of patients were white British (73.8%) and a significant excess living in the most deprived decile (41.4%). The mean BMI was 36.47 kg/m2 (+8.37 S.D.) and BMI SDS was +3.54 (+0.70 S.D.). Mean body fat (n=77) was 48.6% (+8.44 S.D.). Neurodevelopmental problems were common; 27% had autistic spectrum disorder, 10.3% had attention deficit hyperactivity disorder (with 7.0% having both diagnoses), and 14.1% had learning difficulties. Dyslipidaemia (defined by total cholesterol >5.17 mmol/l, LDL > 3.36 mmol/l, HDL < 1.02 mmol/l or triglycerides >1.5 mmol/l) was the most common (51.6%) complication identified, followed by hypertension (29.7%), evidence of non-alcoholic fatty liver disease on ultrasound (17.8%), obstructive sleep apnoea (9.0%) and idiopathic intracranial hypertension (4.9%). Mean HbA1c was 39.0 mmol/mol (+15.18 S.D.; NR <42). Sixteen (8.6%) patients had type 2 diabetes mellitus, with two cases diagnosed through screening in the CEW clinics.
QoL scores were low with a mean child-reported questionnaire (n=82) total score of 49.51/100 (+19.19 S.D.) and a mean parent-reported questionnaire (n=87) total score of 45.81/100 (+19.35 S.D.). Mean scores from a healthy UK paediatric reference population were 82.25 and 81.12 respectively. Mental health problems were common, with 26.2% and 7.7% having diagnoses of anxiety and depression respectively.
Conclusions: We believe we have demonstrated the significant and profound pathology resulting from severe paediatric obesity, highlighting the clinical necessity for CEW clinics. A rigorous approach to identify and manage these physical and mental health complications at an early stage is essential to improve long-term health outcomes.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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