IMPE Abstracts

Bariatric surgery is becoming a modality of treatment for severe obesity in adolescents. Referral to surgery is governed by certain policies which mandates presence of certain comorbidities. Family history of bariatric surgery might encourage families to seek surgery referral for adolescents with severe obesity as anti-obesity medications are not widely available and lifestyle modifications are challenging. The study design is observational retrospective inclusive of patients between the age of 12 and 19 years referred to bariatric surgery. The study was between Jan 2020 to June 2022, where patients are recruited from the paediatric endocrine clinic. Medical notes are examined for age, sex, family history, clinical and biochemical profiles. 58 patients (33 females) were enrolled. Mean (range) age was 15.9 (12.2-19). Fifty-one patients (86.4%) had a family history of obesity and 41 (69.4%) had a family history of bariatric surgery in a first degree relative. Nine patients (15%) tried Metforin with or without Liraglutide. Twenty-nine patients (49%) had history of obstructive sleep apnoea. Average weight was 128.7 kg with an average weight Z score of 3.1. Average BMI Z score of 2.8 with an average BMI centile of 99.6. 21 patients (36%) had normal blood pressure, 8 (15%) had elevated blood pressure. Twenty-three patients (39%) and 6 (10%) had stage 1 and stage 2 hypertension respectively. 2 subjects (3.4%) had type 2 diabetes, 12 (20.6%) were in pre-diabetes stage and 34 (58.6%) had normal HbA1c. 11 (20.75%) had an elevated ALT. Four had a level of more than 2 folds upper limit of normal. Fifty-three patients had fasting lipid profile. 39 (73.58%) had normal total cholesterol levels, 12 (22.64%) and 2 (3.77% had borderline and high levels respectively. 51 (96.22%), 1(1.88%), 1 (1.88%) had normal, borderline high and high LDL levels respectively. HDL levels showed normal levels in 31 patients (58.49%), borderline low levels in 7 (13.2%) and low levels in 15 (28.3%). Thirty (56.6%) patients had normal triglyceride levels, 12 (22.64%) and 11 (20.75%) had borderline high and high levels respectively. Referral of adolescents with severe obesity to bariatric surgery is becoming a common practice particularly in families with history of obesity and bariatric surgery. Sleep apnea is a common comorbidity amongst adolescents with severe obesity whereas hypertension, elevated liver transaminases, dyslipidemia and glucose intolerance might not be present at the time of referral to bariatric surgery.