Clinical phenotypes of obesity comorbidity in adolescent boys

Introduction. Obesity in adolescents is a highly prevalent and clinically heterogeneous disorder. Objective. To study the clinical diversity of the most significant obesity-related complications in adolescent boys. Materials and Methods. The study included 104 adolescents aged 14–17 years with obesity (ICD-10 code E66.0). A comprehensive examination was conducted, which included assessment of medical history, anthropometry, hormonal profile (LH, FSH, testosterone, kisspeptin, etc.), blood biochemical parameters (lipids, glucose), echocardiography and abdominal ultrasound, and blood pressure measurement. Data analysis was performed using descriptive statistics and Rasch mixture modeling. Results. Three distinct clinical phenotypes with heterogeneous propensities for developing complications were identified. Patients in the first phenotype had the highest likelihood of developing disorders of glucose metabolism and cardiovascular complications. The second phenotype was characterized by a prominent degree of insulin resistance and, to a lesser extent, dyslipidemia, while the probability of arterial hypertension was minimal. The third phenotype was defined by the highest risk of dyslipidemia and non-alcoholic fatty liver disease, with a minimal risk of glucose metabolism disorders. The overall potential for developing the full spectrum of complications was highest in the first clinical phenotype, significantly exceeding the levels observed in the second and third. A strong association was found between a high propensity for arterial hypertension and more advanced stages of pubertal development according to the Tanner scale. Conclusions. Adolescent boys with obesity exhibit varying predispositions to specific types of complications. Arterial hypertension shows a tendency to associate with insulin resistance, while dyslipidemia is linked to non-alcoholic fatty liver disease. Testosterone levels and pubertal stage have prognostic value for identifying the clinical phenotype characterized by an increased susceptibility to arterial hypertension.

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