Indices of insulin resistance and adiposity can detect obesity-related morbidity in pediatrics.

OBJECTIVES: To evaluated obesity-related morbidity prevalence among overweight/obese children and adolescents in Saudi Arabia, adiposity indicators and insulin resistance as obesity-related morbidity predictors. METHODS: We enrolled 318 overweight/obese children attending a Pediatric Endocrinology Clinic at King Abdulaziz University Hospital, Saudi Arabia, aged 2-20 years in this retrospective cross-sectional study from September 2019 to March 2021. All children had nutritional obesity, and their body mass index (BMI) standard deviation score was higher than one standard deviation score above the mean for their age and gender. Clinical adiposity indices including BMI, waist circumference (WC), waist-hip ratio (WHR), and bioimpedance analysis (BIA) of body composition were assessed. Biochemical testing of insulin resistance through homeostasis model assessment for insulin resistance and fasting insulin was performed, along with receiver operating curve analysis to obtain optimal cut-off points for obesity-related morbidity. RESULTS: Obesity related morbidity was found in 61.9%, whereas insulin resistance was detected among 64.7% of the patients. Body mass index standard deviation score, WC, BAI of body composition-derived body fat, homeostasis model assessment for insulin resistance, and fasting insulin are significant obesity-related morbidity predictors, and the cut-off points were established. CONCLUSION: Obesity-related morbidity is widely prevalent among obese children and insulin resistance is a key factor in its prediction. Clinical adiposity indices, given their accuracy and practicability, are important predictors of obesity-related morbidity.

Polycystic Ovary Syndrome Among Female Adolescents With Congenital Adrenal Hyperplasia.

OBJECTIVES: Polycystic ovary syndrome is a common endocrine disease in adolescent females that is usually diagnosed based on clinical and hormonal abnormalities. Female adolescents with poorly controlled congenital adrenal hyperplasia are at increased risk of developing polycystic ovary syndrome. This study aimed to determine the prevalence of polycystic ovary syndrome and assess its relationship with hormonal control among adolescents with congenital adrenal hyperplasia. METHODS: This retrospective descriptive study included 40 pubertal female adolescents aged between 12 and 20 years with at least two years after menarche diagnosed with classical congenital adrenal hyperplasia since birth who were screened routinely for polycystic ovary syndrome via pelvic ultrasonography between 2012 and 2020 at King Abdul-Aziz University Hospital, Jeddah, Saudi Arabia. Serum adrenocorticotropic hormone, 17-hydroxy -progesterone, testosterone, dehydroepiandrosterone sulfate, luteinizing hormone, and follicle-stimulating hormone levels were measured. RESULTS: Polycystic ovary syndrome was detected via routine pelvic ultrasonography in 12/40 (30%) females. The median age of the affected females was 16.6 years, with the youngest female aged 12.5 years. The bone age of the patients had advanced ≤3 years. Further, serum adrenocorticotropic hormone was determined to be an independent factor affecting polycystic ovary syndrome development, indicating poor hormonal control (P = 0.005). CONCLUSION: Polycystic ovary disease is likely a complication of poorly controlled congenital adrenal hyperplasia disease. Therefore, increasing the awareness of polycystic ovary disease among congenital adrenal hyperplasia females via routine ultrasonography screening is advisable to facilitate the early diagnosis and improve disease management.