Abstract
Background
Childhood obesity is frequently accompanied by endocrine dysfunction and genetic susceptibility, but their combined contribution to metabolic risk remains insufficiently defined. This retrospective study evaluated hormonal, metabolic, and genetic determinants of metabolic syndrome (MetS) in children and adolescents with obesity.Methods
Electronic medical records from January 2021 to May 2025 were reviewed. A total of 429 children and adolescents with obesity were included. Clinical, biochemical, endocrine, and targeted SNP genotyping data for FTO rs9939609, MC4R rs17782313, and LEPR rs1137101 were analyzed. MetS was defined according to pediatric criteria. Multivariable logistic regression and receiver operating characteristic analysis were performed.Results
MetS was present in 187 participants (43.6%). Fasting glucose averaged 5.3 ± 0.5 mmol/L, HbA1c averaged 5.24 ± 0.22%, and median HOMA-IR was 4.4 (2.7-5.7). Insulin resistance was observed in 68.0% of Tanner stage I participants and 73.3% of Tanner stage II-V participants. Elevated HOMA-IR was strongly associated with MetS (OR = 2.89, 95% CI: 1.71-4.99, P Conclusion
Insulin resistance, adipokine imbalance, and FTO/MC4R variants were independently associated with MetS in pediatric obesity. Integrated endocrine-genetic profiling may improve early metabolic risk stratification.Clinical trial number
Not applicable.