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P67 Metabolic syndrome: case report
  1. Adriana Cosmescu,
  2. Doina Felea
  1. Outpatient-clinic of the ‘Sf.Spiridon’ Hospital, Iasi, Romania

Abstract

Introduction The metabolic syndrome is a complication of obesity wich has been difficult to diagnose for a very long time, in the absence of a consensus regarding its definition criteria.Currently, IDF ( International Diabetes Federation ) criteria are used, the presence of abdominal obesity being mandatory.

Material and method We are presenting the case of the 14 year old male patient, B.C., who came for a clinical and biological revaluation. He first sought medical attention 3 years previously, when he was diagnosed with obesity and hypercholesterolemia.It was recomended that he optimise lifestyle in terms of nutrition and physical activity, a low-calorie hypolipidic diet being initiated.

For personal reasons, his parents` divorce and changing his residence, respectively, the patient declared that he did not make his appointments and did not follow the recommendations he had received.

At this consultation, we were faced with a 14 year old teenager, weighing 87 kg, having a 165 cm height, a 99 cm waist circumference and a 33,2 BMI. We are presenting some of the results of his investigations: total lipids at 783,5 mg/dl, total cholesterol=219,6 mg/dl, LDL cholesterol=122,5 mg/dl, HDL cholesterol=59,3 mg/dl, triglycerides=189 mg/dl, glycemia=107 mg/dl.

After confronting the clinical data with the paraclinical investigations, the patient B.C. was diagnosed with the metabolic syndrome due to the presence of three of the diagnostic criteria: obesity with waist circumference > the 90th percentile for age and sex, triglycerides > the 95th percentile for age and sex, glycemia>100 mg/dl.

A low-calorie hypolipidic diet of 1000 kcal/day was recommended, avoiding concentrated sweets, having 5 meals per day. Moreover, in order to increase energy consumption, gradual exercise was recommended, its duration and intensity increasing gradually. In this case, psychological counselling would also be useful, but the teenager refused tp talk to the psychologist. We intend to resume the discussion on this topic at the next consultation.

Discussion and conclusions Through its definind elements, the metabolic syndrome is a major risk for cardiovascular disease and type 2 diabetes mellitus, increasing morbidity and mortality in adult age.

Based on these considerations, preventing obesity in children and teenagers is one of the desiderata of the modern health system, the approach being manifold: at the level of the individual and his/her family, at institutional, community and public health level.

  • obesity
  • metabolic syndrome
  • adolescent

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