prevalence du syndrome metabolique chez l’enfant tunisien en surpoids et obese
Mots-clés :
Surpoids, Obésité, Syndrome métabolique, Enfant, Leptine.Résumé
Buts : Déterminer la prévalence du syndrome métabolique (SM) et de ses composants dans une population d’enfants tunisiens obèses et en surpoids et de rechercher l’implication de la leptine, et de l’insuline dans le développement du SM via l’obésité.
Méthodes : 306 enfants âgés entre 10 et 12 ans répartis en 35 enfants obèses, 99 enfants en surpoids et 172 témoins de poids normal ont été inclus dans cette étude. Chaque enfant a bénéficié d’un examen clinique avec mesure des paramètres anthropométriques et d’un prélèvement sanguin à jeun pour le dosage de la glycémie, des triglycérides, du HDL cholestérol, de la leptine et de l’insuline. Le SM était défini selon les critères établis par la Fédération Internationale du Diabète.
Résultats : la prévalence du SM chez les enfants obèses était de 14,3% significativement plus élevée que celle des enfants en surpoids (1%) et de poids normal (0%) ; p0,001. L’obésité abdominale était le paramètre le plus fréquent (88,6%) chez l’enfant obèse, suivie de l’hypertension artérielle (25,7%). Les niveaux de leptine étaient significativement plus élevés chez les enfants atteints de SM (p0,001) et augmentaient significativement avec l’augmentation du nombre de composants de ce syndrome (p0,001). Chez les enfants obèses, une association positive de la leptine avec le tour de taille (r=0,55 ; p=0,001) et l’insuline (r=0,52 ; p=0,002) a été observée. Après ajustement par l’indice de masse corporelle, la leptinémie restait corrélée avec l’insulinémie (r=0,47 ; p0,001).
Conclusion : le SM est relativement fréquent chez l’enfant tunisien en surpoids et obèse âgé entre 10 à 12 ans. L’obésité représente un facteur de risque pour le développement du SM. Une prise en charge précoce de l’obésité infantile est nécessaire afin d’éviter les complications métaboliques redoutables.
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