CHARACTERIZATION OF BODY COMPOSITION IN OBESE CHILDREN DEPENDING ON COMORBID PATHOLOGY

Abstract

Assessment of nutritional status in obese children is one of the key diagnostic methods that allows you to choose the optimal therapeutic strategy and monitor its effectiveness over time. The nature of the body composition in children with obesity and various comorbid pathologies has not been sufficiently studied to date. Objective of the study: to study the characteristics of the body composition in obese children, depending on the presence of an underlying comorbid pathology. Patients and methods. The study included 537 obese children aged 3 to 17 years. The median age of children was 13 [11; 15] years, among them there were 322 girls (60 %). Based on the examination results, 4 groups of patients were formed: group 1 - children without non alcoholic fatty liver disease (NAFLD), arterial hypertension (AH) and metabolic syndrome (MS) (n = 168); group 2 - children with only NAFLD (n = 147); group 3 - children with hypertension, including in combination with NAFLD (n = 98); group 4 - children with MS in the presence or absence of other comorbid diseases (n = 124). The study of body composition was carried out by the method of bioimpedance measurement on a stationary body composition analyzer “InBody 520”, the absolute and relative amounts of fat (FM) and lean mass (TM), skeletal muscle mass (MSM), total body water were determined. Results. All the studied indicators of body composition were maximum in the group of children with MS. The amount of FM significantly exceeded the norm in all groups, while in the MS group, an excess of the norm for TM was also revealed. The percentage of exceeding the individual norm for FM significantly increased with the addition of comorbid pathology in obese children, reaching a maximum in the group with MS. The percentage of MSM exceeding the individual norm increased from 5.45 [2.8; 8.0] % among children with uncomplicated obesity up to 7.2 [3.4; 11.6] % in children with NAFLD, 8.6 [4.8; 13.6] % in children with hypertension and 10.45 [4.6; 17.3] % - 3 groups (p1-3 = 0.0001, p2-3 = 0.014). Conclusion. The body composition of obese children is characterized not only by an increase in body fat, but also by an increase in fat free components as the degree of excess body weight progresses. Further study of the role of increased MSM in the progression of obesity in children will allow the development of new approaches to treatment.