Clinical and Metabolic Profile and Cognitive Functions in Children and Adolescents with Carbohydrate Metabolism Disorders Depending on Body Weight

INTRODUCTION: Hyperglycemia causes glucotoxicity of neurons via different mechanisms, and, in combination with obesity, is a strong predictor of cognitive dysfunction. Free fatty acids and circulating cytokines cross the blood-brain barrier leading to neuroinflammation and proliferation of microglia. These alterations can be detected using neuroimaging methods. Thus, evaluation of cognitive functions and glycemic profile seems relevant in children with disorders of carbohydrate metabolism and different weights.

AIM: To analyze clinical and metabolic profile and cognitive functions in children and adolescents with carbohydrate metabolism disorders depending on body weight.

MATERIALS AND METHODS: A prospective, open, controlled study was conducted in 2022–2023. The study included 53 children aged from 7 to 18 years with carbohydrate metabolism disorders with duration of the disease of 1 to 7 years: group 1 — children with excessive body weight or obesity (n=33) and group 2 (n=20) — children with normal body weight. The work included evaluation of anthropometric parameters, carbohydrate metabolism disorders (glycemia and its variability, determination of glycated hemoglobin, immunoreactive insulin, and C-peptide), lipid spectrum, verification of non-alcoholic fatty liver disease, and testing using children’s version of Wechsler questionnaire.

RESULTS: Children with carbohydrate metabolism disorders and overweight or obesity more often had relatives with overweight (p=0.04), or diabetes mellitus (p=0.03) and were more often diagnosed with lipidemia (p=0.048) and fatty hepatosis (p=0.031). Children with carbohydrate metabolism disorders, both normal and overweight, showed statistically significant differences in the immunoreactive insulin index: among boys (p=0.030, p=0.001) and girls (р=0.020, р=0.002). Glycemia before bedtime and the time of glycemia above the target range were higher in overweight children (p=0.029, p=0.002). In Wechsler test, children with overweight or obesity and normal body weight children differed in the following parameters: vocabulary (speech function), letter-digit test, Kohs Block Design Test (constructional-spatial praxis; p=0.043, p=0.008 and p=0.005 respectively).

CONCLUSIONS: Children with carbohydrate metabolism disorders in combination with excessive body weight and obesity are characterized by impairment of some cognitive functions associated with asymptomatic glycemic variability.