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Determinants of childhood and adolescent obesity and it’s effect on metabolism in South Indian population

  • Sengottaiyan Palanivel ORCID logo , Egappan Subbiah EMAIL logo , KS Raghavan and Subbiah Sridhar ORCID logo
Published/Copyright: March 20, 2025
Journal of Pediatric Endocrinology and Metabolism
From the journal Journal of Pediatric Endocrinology and Metabolism Volume 38 Issue 5

Abstract

Objectives

The primary objective is to determine the risk factors underlying the development of childhood and adolescent obesity. The secondary objective is to determine the predictors of metabolic syndrome (MetS) in childhood and adolescent obesity and its metabolic alterations in the South Indian population.

Methods

This is a cross-sectional study conducted over two years. We have screened 3,195 school children and adolescents from lower and lower-middle socioeconomic groups. From this pool, by random cluster sampling technique, we have included 166 overweight and obese individuals and 38 control subjects. We have analyzed their sociodemographic, dietary, lifestyle, anthropometric, clinical, and metabolic parameters.

Results

The prevalence of overweight and obesity in rural areas was 14.2 and 7.6 %, respectively, and in urban areas, it was 16.1 and 8.8 %, respectively. The age distribution of the control and study group is 12.3 ± 1.5 and 13.0 ± 1.9 years with a male-to-female ratio of 1.4:1 and 1.6:1, respectively. Our study found a higher average consumption of energy-dense food and screen time in the obese group compared to the control group. The average outdoor play time was 1.5 h per day in the control group and less than 0.5 h per day in the obese group. In our study, the waist-to-height ratio (WHtR) optimum cutoff value of 0.56, has 95 % sensitivity and 84 % specificity, effectively identifying MetS cases. HOMA-IR optimum cutoff value of 2.25, has 96 % sensitivity and 72 % specificity. The triglyceride-glucose index (TGI) optimum cutoff value of 4.51, has 92 % sensitivity and 88 % specificity indicating a strong balance between correctly identifying positive and negative MetS cases.

Conclusions

Our study found that even in lower socioeconomic status, there is a higher prevalence of childhood and adolescent obesity due to an urbanized lifestyle in rural areas, a sedentary lifestyle, higher consumption of low-cost energy-dense foods, and higher screening time in this electronic era. We also conclude that WHtR is a simple anthropometric marker that predicts MetS more effectively than BMI and WHR among children and adolescents. HOMA-IR and TGI are effective biochemical markers to identify metabolically unhealthy obesity early.

Keywords: obesity; metabolic syndrome; children; adolescents; India
Corresponding author: Egappan Subbiah, Endocrinology and Diabetology, Madurai Medical College, Madurai, India, E-mail:

  1. Research ethics: The study protocol was approved by the Institutional Ethics Committee of Madurai Medical College (CDSCO: Reg no. ECR/1365/Inst/TN/2020 & DHR Reg no. EC/NEW/INST/2022/TN/0059).

  2. Informed consent: Written informed consent was obtained from the parents or legal guardians of all participants, and assent was obtained from participants aged 12 years and older.

  3. Author contributions: ES: Conceptualized and designed the study, analyzed the data and supervised the study. SP: Collected and analyzed data, drafted the manuscript. KSR: Managed the cases, analyzed the data. SS: Supervised the study. All authors approved the final version of manuscript and are accountable for all aspects related to the study.

  4. Use of Large Language Models, AI and Machine Learning Tools: None declared.

  5. Conflict of interest: The authors state no conflict of interest.

  6. Research funding: None declared.

  7. Data availability: Not applicable.

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Supplementary Material

This article contains supplementary material (https://doi.org/10.1515/jpem-2024-0340).

Received: 2024-07-15
Accepted: 2025-02-25
Published Online: 2025-03-20
Published in Print: 2025-05-26

© 2025 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Review
  3. A recent update on childhood obesity: aetiology, treatment and complications
  4. Original Articles
  5. Chronotype, sleep, and glycemic control in children and adolescents with type 1 diabetes: a case-control study
  6. Determinants of childhood and adolescent obesity and it’s effect on metabolism in South Indian population
  7. Evaluation of continuous glucose monitoring and nutritional status in glycogen storage diseases
  8. Retrospective assessment of hepatic involvement in patients with inherited metabolic disorders: nine-year single-center experience
  9. Relationships among biological sex, body composition, and bone mineral density in young persons with and without diabetes
  10. The clinical characteristics of 10 cases and adult height of six cases of rare familial male-limited precocious puberty
  11. Optimal timing of repeat thyroid fine-needle aspiration biopsy
  12. Medium-chain acyl-CoA dehydrogenase deficiency in North Macedonia – ten years experience
  13. The effect of antenatal steroids on metabolic bone disease of prematurity
  14. Prader-Willi syndrome gene expression profiling of obese and non-obese patients reveals transcriptional changes in CLEC4D and ANXA3
  15. Early-onset growth hormone treatment in Prader–Willi syndrome attenuates transition to severe obesity
  16. Case Reports
  17. Neonatal severe hyperparathyroidism with inactivating calcium sensing receptor (CaSR) mutation (p.I81K)
  18. Clinical manifestations and molecular genetics of seven patients with Niemann–Pick type-C: a case series with a novel variant
  19. Expanding the genotypic spectrum of 3β-hydroxy-δ5-C27-steroid dehydrogenase (HSD3B7) deficiency: novel mutations and clinical outcomes
https://doi.org/10.1515/jpem-2024-0340
Keywords for this article
obesity; metabolic syndrome; children; adolescents; India

Articles in the same Issue

  1. Frontmatter
  2. Review
  3. A recent update on childhood obesity: aetiology, treatment and complications
  4. Original Articles
  5. Chronotype, sleep, and glycemic control in children and adolescents with type 1 diabetes: a case-control study
  6. Determinants of childhood and adolescent obesity and it’s effect on metabolism in South Indian population
  7. Evaluation of continuous glucose monitoring and nutritional status in glycogen storage diseases
  8. Retrospective assessment of hepatic involvement in patients with inherited metabolic disorders: nine-year single-center experience
  9. Relationships among biological sex, body composition, and bone mineral density in young persons with and without diabetes
  10. The clinical characteristics of 10 cases and adult height of six cases of rare familial male-limited precocious puberty
  11. Optimal timing of repeat thyroid fine-needle aspiration biopsy
  12. Medium-chain acyl-CoA dehydrogenase deficiency in North Macedonia – ten years experience
  13. The effect of antenatal steroids on metabolic bone disease of prematurity
  14. Prader-Willi syndrome gene expression profiling of obese and non-obese patients reveals transcriptional changes in CLEC4D and ANXA3
  15. Early-onset growth hormone treatment in Prader–Willi syndrome attenuates transition to severe obesity
  16. Case Reports
  17. Neonatal severe hyperparathyroidism with inactivating calcium sensing receptor (CaSR) mutation (p.I81K)
  18. Clinical manifestations and molecular genetics of seven patients with Niemann–Pick type-C: a case series with a novel variant
  19. Expanding the genotypic spectrum of 3β-hydroxy-δ5-C27-steroid dehydrogenase (HSD3B7) deficiency: novel mutations and clinical outcomes
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