Journal of Metabolic Syndrome

Objective: The purpose of the current preliminary study was to estimate the nature and occurrence of metabolic abnormalities among adolescent inpatients receiving psychiatric treatment and to pilot a health promotion and life style intervention program.

Method: A total of 107 adolescents admitted over a 12-month period were evaluated for physical, clinical and metabolic parameters in two inpatient psychiatric units in Sydney, Australia, where a health promotion and life style intervention program was provided under the leadership of a Sports Psychologist.

Results: 46% of subjects were found to be “at risk for adverse health outcome” with one or more metabolic abnormalities and 4.6% qualified for a diagnosis of Metabolic Syndrome meeting 3 or more of the modified criteria for Metabolic Syndrome in young people. 13% of the sample was overweight with abnormal Body Mass Index (BMI). While two thirds recognized the importance of staying physically active, only a quarter were maintaining adequate level of physical activity. Regarding quality of life, only 30 to 40% reported good life and health satisfaction.

Conclusion: Our findings suggest that metabolic abnormalities are not uncommon among young psychiatric patients and that they are often missed. Regular monitoring for the presence of metabolic abnormalities and clinical risk factors should be part of the comprehensive management with special focus on preventative programs.

Objective: To investigate Nonalcoholic Fatty Liver Disease (NAFLD), the Left Ventricle Mass Index (LVMI), and the relationship between NAFLD and LVMI in obese children.

Material and methods: Systolic (SBP) and Diastolic (DBP) Blood Pressure and waist and hip circumferences were measured. Fasting blood glucose and insulin concentrations, total cholesterol, and Triglycerides (TG) were assayed. The diagnosis of NAFLD was based on sonographic evidence of a fatty liver. The Left Ventricle Mass (LVM) was calculated from two-dimensionally guided M-mode echocardiographic measurements of the left ventricle. LVMI was calculated as LVM (g)/height (m)2.7 and Left Ventricular Hypertrophy (LVH) was defined as LVMI ≥ 95th percentile for age and gender

Results: Forty-three obese children with NAFLD, 55 obese children without NAFLD, and 48 non-obese controls were studied. Fasting insulin, homeostasis model assessment-estimated insulin resistance (HOMA-IR) index, TG, and total cholesterol levels in the obese children were significantly higher than in the controls (all p < 0.001); SBP and DBP in the obese children were also higher than in the controls. LVMI was higher in the obese children (p < 0.001), although the mean LVMI did not differ significantly between obese children with and without NAFLD (p > 0.05). The prevalence of LVH differed significantly between the obese groups and controls (all p < 0.001), while there was no significant difference between the obese subjects with and without NAFLD. LVH was present in 5 of 48 (10.4%) control subjects, 25 of 79 (31.6%) obese subjects with normotensive subjects, and 6 of 19 (36.8%) obese subjects with hypertension. The prevalence of LVH differed significantly between the obese groups and controls (all p < 0.001), whereas no significant difference was observed between obese subjects with or without hypertension (p > 0.05). In a multiple linear regression analysis, NAFLD, SBP, and DBP were not correlated with LVMI. The LVMI was closely related to the Body Mass Index-Standard Deviation Score (BMI-SDS), and Liver Longitudinal Dimension (LLD) percentile. The BMI-SDS was the only independent predictor of NAFLD and LVMI.

Conclusions: LVH and NAFLD are two important and independent covariates in obese children. Obese children with or without hypertension have significant LVH as compared with non-obese control subjects. NAFLD and casual blood pressure measurements are not predictors of LVMI in obese children.