Microalbuminuria in obese children
Keywords:Obesity, BMI, Microalbuminuria, Hypertension
Background: Obesity is a global pandemic both in adults and children and many factors contribute to this pandemic. Early diagnosis and prevention of long-term complications associated with obesity is the main goal of treatment in addition to dietary control and lifestyle modifications. Microalbuminuria, a marker of impending renal insult in adults is less understood in children. The objective of this study was to determine microalbuminuria in obese children 5-18 years of age.
Methods: This study was single centre, and cross-sectional observational study. Children between 5-18 years of age with obesity (Body mass index >95th centile for sex and age) participated in the study. Microalbuminuria based on urinary albumin to creatinine ratio and relation to obesity was studied.
Results: Fifty-four children (M:F=0.9:1) were included in the study. Family history of obesity, hypertension, diabetes mellitus was present in 53.7% (n=29), 33.3% (n=18), 27.8 (n=15) children respectively. Microalbuminuria was observed in two children (3.8%). Mean BMI (38.25±7.42 kg/m2 vs 26.13±4.13 kg/m2) (p=0.009), mean waist circumference (97.50±4.95, vs 83.52±0.94 cm) (p=0.044), mean waist hip ratio (0.93±0.04 vs 0.88±0.09) was more in children with microalbuminuria when compared to without microalbuminuria. One obese child with microalbuminuria had hypertension.
Conclusions: Microalbuminuria, though a good marker of renal insult in adults, may not be prevalent in obese children. It may me more prevalent in obese children with higher BMI, truncal obesity and WHR, hence these children should be screened for the same.
Must A, Jacques PF, Dallal GE, Bajema CJ, Dietz WH. Long-term morbidity and mortality of overweight adolescents. A follow-up of the Harvard Growth Study of 1922 to 1935. N Engl J Med. 1992;327(19):1350-5.
Khadilkar VV, Khadilkar AV, Cole TJ, Chiplonkar SA, Pandit D. Overweight and obesity prevalence and body mass index trends in Indian children. Int J Pediatr Obes. 2011;6(2):216-24.
Rosenbloom AL, Joe JR, Young RS, Winter WE. Emerging epidemic of type 2 diabetes in youth. Diabetes Care. 1999;22(2):345-54.
Weiss R, Dziura J, Burgert TS, Tamborlane WV, Taksali SE, Yeckel CW, et al. Obesity and the metabolic syndrome in children and adolescents. N Engl J Med. 2004;350(23):2362-74.
Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ. 2007;85(9):660-7.
Cole TJ, Lobstein T. Extended international (IOTF) body mass index cut-offs for thinness, overweight and obesity. Pediatr Obes. 2012;7(4):284-94.
Indian Academy of Pediatrics Growth Charts Committee, Khadilkar V, Yadav S, Agrawal KK, Tamboli S, Banerjee M, et al. Revised IAP growth charts for height, weight and body mass index for 5- to 18-year-old Indian children. Indian Pediatr. 2015;52(1):47-55.
NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet. 2017;390(10113):2627-42.
Shah B, Tombeau Cost K, Fuller A, Birken CS, Anderson LN. Sex and gender differences in childhood obesity: contributing to the research agenda. BMJ Nutr Prev Health. 2020;3(2):387-90.
Corica D, Aversa T, Valenzise M, Messina MF, Alibrandi A, Luca F, et al. Does Family History of Obesity, Cardiovascular, and Metabolic Diseases Influence Onset and Severity of Childhood Obesity? Front Endocrinol. 2018;9:187.
Rosner B, Cook NR, Daniels S, Falkner B. Childhood blood pressure trends and risk factors for high blood pressure: the NHANES experience 1988-2008. Hypertension. 2013;62(2):247-54.
Herter AI, Osuna E, Sarnovska Z, Zimmermann MB. Significant Decrease in Childhood Obesity and Waist Circumference over 15 Years in Switzerland: A Repeated Cross-Sectional Study. Nutrients. 2019;11(8):1922.
Wachtell K, Ibsen H, Olsen MH, Borch JK, Lindholm LH, Mogensen CE, et al. Albuminuria and cardiovascular risk in hypertensive patients with left ventricular hypertrophy: the LIFE study. Ann Intern Med. 2003;139(11):901-6.
Sedfy HH, Toaima NN, Ahmed MA, Bahy DL. Microalbuminuria in obese children and adolescents and the metabolic syndrome. QJM. An Int J Med. 2018;111(1):138-200.
Okpere AN, Anochie IC, Eke FU. Prevalence of microalbuminuria among secondary school children. Afr Health Sci. 2012;12(2):140-7.
Sanad M, Gharib A. Evaluation of microalbuminuria in obese children and its relation to metabolic syndrome. Pediatr Nephrol. 2011;26(12):2193-9.