Endocrine Abstracts

JOINT2727

Objective: Childhood obesity is a growing public health concern worldwide, posing long-term risks such as type 2 diabetes, hypertension, dyslipidemia, and cardiovascular diseases. Effective treatment strategies primarily focus on lifestyle modifications(LSM), with pharmacological interventions considered in resistant cases. This study aims to assess the effectiveness of LSM alone vs LSM combined with metformin therapy in children diagnosed with obesity at Ankara Etlik City Hospital. By analyzing anthropometric and biochemical changes over a one-year follow-up, this study seeks to contribute to the development of optimal treatment strategies for pediatric obesity management.

Materials and Methods: This retrospective study included 162 pediatric patients between 5-18 years, diagnosed with exogenous obesity, who were followed at the Pediatric Endocrinology clinic for one year. Patients were categorized into two groups: those receiving only LSM and those receiving LSM + metformin therapy. Collected data included demographic characteristics, body mass index(BMI), fasting blood glucose(FBG), lipid profile and liver function tests. These parameters were measured at baseline and at 3, 6, 9, and 12 months, with statistical analyses conducted to evaluate intra-group and inter-group differences over time.

Results: Among 162 patients, 52.29% were male and 47.71% were female, with a mean age of 12.49±3.19 years. Both groups showed only a limited reduction in BMI, with no significant improvements in waist circumference, systolic blood pressure, or diastolic blood pressure over the study period. However, a significant decrease in BMI SDS was observed in the LSM group between baseline and the third month, but this reduction was not sustained in subsequent follow-ups. Both groups exhibited significant reductions in fasting blood glucose (FBG) and HbA1c levels, with greater reductions in the LSM + metformin group, a difference that was statistically significant. LDL cholesterol levels significantly declined only in the LSM + metformin group, while other lipid parameters showed no significant changes. The proportion of metabolically unhealthy obesity (MUO) increased in the LSM-only group, whereas in the LSM + metformin group, MUO prevalence significantly decreased from 86.67% to 67.86% over 9 months.

Conclusion: This study highlights the critical role of regular follow-ups in obesity treatment, emphasizing that adherence is essential for long-term success. While metformin therapy provided additional metabolic benefits, its effect on BMI reduction was minimal. Personalized treatment approaches, family involvement, and structured patient education programs may enhance adherence and improve long-term outcomes. Ultimately, effective obesity management requires a multifaceted approach that combines medical intervention with continuous behavioral support and patient engagement.