400 Section - Correlation of musculoskeletal performance and body composition with metabolic markers in paediatric obesity

Socio-economic changes in Europe reshaped dietary habits rising childhood obesity. Italy ranks fourth in Europe for overweight prevalence among children. Traditional assessments focus on anthropometry, yet few studies adopt a multidimensional approach including body composition, musculoskeletal function, and psycho-physical well-being. This study investigated these parameters to provide a comprehensive evaluation in overweight and obese children.

Design:

Children aged 9–16 years with overweight/obesity were enrolled. Anthropometric data were collected. Clinical assessment included physical examination, goniometry, Manual Muscle Testing, Hand-Grip Strength Test, Ultrasound of rectus femoris and vastus intermedius. Functional/psychosocial tools included Fatigue Severity Scale, Timed Up and Go, Jump Test, 10-m walk, PBS, and PedsQL. Whole-body DXA assessed fat and lean mass distribution. Biochemical and metabolic parameters  were measured like glycated hemoglobin and cholesterol value.

Results:

71 patients were recruited. The population was subsequently stratified according to the median value of the dominant hand Hand Grip Strength/BMI-ds ratio (4.93), analyzing differences in body composition, functional, and biochemical parameters. Subjects with lower values of this ratio showed greater fat mass, particularly in total fat-to-lean (p=0.03), truncal (p=0.04), and upper limb (p=0.002) parameters. Furthermore, they exhibited a higher waist-to-height ratio (p=0.01), increased non-HDL cholesterol (p=0.006). The HGS/BMI-ds ratio was significantly correlated with glycated hemoglobin (r=-0.35, p=0.02), and non-HDL cholesterol (r=-0.40, p=0.01). A positive correlation was observed between HGS and PBS (r=0.44, p=0.0002), while the latter was inversely correlated with trunk fat mass (r= -0.37, p=0.005), upper limb fat mass (r=-0.42, p=0.001), and lower limb fat mass (r =-0.37, p=0.005).

Conclusion: Children with reduced hand grip strength showed higher fat mass and less favorable metabolic profiles. The HGS/BMI-ds ratio correlated with insulin resistance and body composition, suggesting its potential as an integrated indicator of metabolic and musculoskeletal status. Muscle strength was positively associated with functional balance, underscoring the importance of multidimensional assessments in managing pediatric obesity.