Effects of metabolic syndrome and its components on pulmonary function and functional capacity in children and
Lertluksana Limkul1, Kanokporn Udomittipong2, Pawinee Charoensittisup1
1Division of Pulmonology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok Noi, Bangkok, 10700, Thailand.
Insights
Metabolic syndrome (MetS) in obese children and adolescents significantly reduces functional capacity, impacting six-minute walk test (6-MWT) performance. Increased abdominal circumference and elevated fasting blood sugar are key predictors of this decline.
Area of Science:
- Pediatric Endocrinology
- Pulmonary Medicine
- Metabolic Health
Background:
- Obesity is a global health concern linked to metabolic syndrome (MetS).
- The impact of MetS and its components on pulmonary function in obese children is not well-defined.
Purpose of the Study:
- To investigate the relationship between MetS and lung function in obese pediatric populations.
- To identify specific MetS components that negatively affect pulmonary outcomes and exercise capacity.
Main Methods:
- Enrolled obese children and adolescents (7-18 years) for anthropometric and metabolic assessments.
- Conducted spirometry and the six-minute walk test (6-MWT).
- Classified participants into MetS or non-MetS groups and performed regression analyses.
Main Results:
- Participants with MetS showed significantly lower 6-MWT distance z-scores compared to non-MetS.
- No significant differences in spirometric parameters were observed between groups.
- Abdominal circumference and elevated fasting blood sugar (>100 mg/dL) predicted reduced 6-MWT and FEV1% predicted.
Conclusions:
- Obese children and adolescents with MetS exhibit diminished functional capacity, evidenced by poorer 6-MWT performance.
- Increased abdominal circumference and elevated fasting blood sugar are critical predictors of reduced functional capacity in this population.
Abstract:
Obesity is a pervasive global health issue frequently associated with metabolic syndrome (MetS). Limited data exist regarding the impact of MetS and its individual components on pulmonary function in obese pediatric populations. This study investigated the relationship between MetS and lung function, and further identified specific MetS components that adversely affect pulmonary outcomes. We enrolled obese children and adolescents aged 7‒18 years. Anthropometric measurements and metabolic assessments were performed. All participants underwent spirometry and the six-minute walk test (6-MWT). Based on MetS criteria, participants were classified into MetS or non-MetS groups. Between-group comparisons were conducted, and regression analyses were used to identify MetS components predictive of lung function and exercise capacity. A total of 155 participants were evaluated (37 [23.9%] with MetS; 118 [76.1%] without). Those with MetS demonstrated a significantly lower 6-MWT distance z-score (‒0.61 ± 1.1 vs ‒0.07 ± 0.99; P = 0.006). No significant group differences were found in spirometric parameters. Obesity indices exerted a stronger negative effect on lung function than MetS status. Abdominal circumference (b = ‒0.03, P < 0.001) and elevated FBS (> 100 mg/dL; b = ‒0.50, P = 0.04) were associated with reduced 6-MWT distance z-scores; they also negatively influenced FEV1% predicted (abdominal circumference: b = ‒0.15, P < 0.04; elevated FBS: b = ‒9.04, P = 0.02).
Conclusions:
Obese children and adolescents with MetS show significantly diminished functional capacity as evidenced by lower 6-MWT performance. Among MetS components, increased abdominal circumference and elevated FBS (> 100 mg/dL) emerged as critical predictors of decreased functional capacity.
What Is Known:
• Obesity is associated with metabolic syndrome (MetS) and is known to impair lung function. • MetS is linked to metabolic and cardiovascular complications, but its impact on pulmonary function in obese pediatric populations remains unclear.
What Is New:
• Obese children and adolescents with MetS have significantly lower functional capacity, as demonstrated by reduced six-minute walk test (6-MWT) performance. • Among MetS components, increased abdominal circumference and elevated fasting blood sugar > 100 mg/dL were identified as key predictors of reduced functional capacity and lung function.
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