PC1155: Alterations in the Metabolic Profile of Overweight and Obese Youth During the COVID-19 Pandemic

Background: During the COVID-19 pandemic, the time spent in non-sedentary activities significantly dropped, especially in children and adolescents living in the US. The sedentary lifestyle may have exacerbated the risk of metabolic comorbidities in overweight and obese youth. The metabolic profile in overweight and obese youth during the COVID-19 pandemic has not been well investigated.

The primary objective is to analyze the metabolic profile progression of overweight and obese youth during the COVID-19 pandemic, determine relationships between metabolic profile values, and examine any underlying sociodemographic data.

Methods: A retrospective chart review of patients < 18 years followed in a Pediatric Endocrinology Clinic for overweight and obesity related comorbidities (i.e Type 2 Diabetes) was conducted.

Demographic data and metabolic profile variables (HbA1c, triglycerides, HDL, LDL, ALT) were collected before the COVID-19 pandemic (June 2019 to May 2020) and during the COVID-19 pandemic (June 2020 to May 2021). Progression in the metabolic profile values was defined as an increase from one category to another except for HDL values being a decrease in categories (Table 1).

The statistical significance was determined with t-tests, Chi-square, and Fisher’s exact tests.

Results: A total of 57 patients with a BMI ≥ 85th percentile (mean pre-pandemic age of 12.8 years, 59.6% females, 38.6% white, and 58.2% publicly insured) were analyzed. Regarding progression in metabolic lab values, 19.3% (11 of 57) patients had HbA1c progression, 12.2% (5 of 41) patients had HDL progression, 17.1% (7 of 41) patients had triglyceride progression, and 16% (8 of 50) had ALT progression.

There were 25.6% (10 of 39) patients with LDL progression. There were 62.5% of Hispanics (62.5%) with LDL progression compared to 16.1% of non-Hispanics (p=0.016) and compared to other races (p=0.034) as shown in Table 2. There was no significant difference in sociodemographic data between those with progression and without progression of HbA1c, HDL, triglyceride, and ALT.

A significant difference regarding HbA1c and LDL was found. A higher proportion (66.7%) of patients who had progressed HbA1c had progressed LDL compared to those who did not have progressed HbA1c (16.7%) (p = 0.025).

Conclusion: It was found that a higher proportion of Hispanic youth had progressed LDL compared to Non-Hispanic youth considering both race and ethnicity. Thus, overweight and obese Hispanic youth may be at higher risk for cardiovascular comorbidities during the pandemic.

Furthermore, 19.3% of overweight/obese youth had HbA1c progression and 25.6% had LDL progression during the COVID-19 pandemic. Patients with HbA1c progression were more likely to progress in LDL values during the COVID-19 pandemic, suggesting a strong association between T2DM and cardiovascular comorbidities during the COVID-19 pandemic.