METABOLIC AND ENDOCRINE CONSEQUENCES OF CHILDHOOD OBESITY: FROM INSULIN RESISTANCE TO NON-ALCOHOLIC FATTY LIVER DISEASE

Abstract

Background: Childhood obesity is associated with a complex constellation of metabolic and endocrine disturbances that, if unaddressed, predict adult chronic disease with high fidelity. Objective: This review examines the specific metabolic pathways through which excess adiposity in childhood leads to insulin resistance, type 2 diabetes mellitus (T2DM), dyslipidemia, non-alcoholic fatty liver disease (NAFLD), and reproductive endocrine disorders. Methods: Systematic narrative review of clinical studies, endocrinological investigations, and population cohort data from 2008 to 2024. Results: Adipose tissue expansion drives inflammatory cytokine production, free fatty acid spillover, and ectopic lipid deposition. These processes produce hepatic and peripheral insulin resistance, progressive β-cell dysfunction, non-alcoholic steatohepatitis, and in adolescent girls, polycystic ovarian syndrome. Conclusion: Early identification and intervention targeting metabolic comorbidities of childhood obesity are essential to preventing a generation-wide chronic disease epidemic.