Abnormal Metabolic Phenotypes Among Urban Chinese Children: Epidemiology and the Impact of DXA‐Measured Body Composition

Chen, Fangfang; Liu, Junting; Yan, Yinkun; Mi, Jie; Child, China

doi:10.1002/oby.22426

Cited by 33 publications

(29 citation statements)

References 38 publications

(40 reference statements)

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“…Secondly, blood pressure was similar in both normal weight children with metabolic abnormalities typical of metabolic syndrome (normal weight metabolically unhealthy [NWMU]) and obese children with metabolic abnormalities (metabolically unhealthy obese [MUHO]), but it was significantly higher than in children with normal body weight who did not suffer from any metabolic abnormalities (normal weight metabolically healthy [NWMH]) and in obese children without metabolic abnormalities (metabolically healthy obese [MHO]). These studies indicate that it is not only adiposity, but disturbed relations between fat mass and lean mass and fat distribution with visceral fatness and metabolic abnormalities that is typical for PH [30,[32][33][34][35]. It also means that even in patients with normal BMI but lower lean mass and relatively greater amount of fat mass with visceral distribution (NWMU), blood pressure was elevated and was accompanied by typical metabolic abnormalities [34].…”

Section: Body Compositionmentioning

confidence: 87%

“…Analysis of body composition with the use of dual X-ray densitometry (DXA) showed that the relation between adipose mass and lean body mass is disturbed in hypertensive adolescents [30]. Chen et al, who analyzed body composition in a population sample of Chinese children and adolescents, observed that metabolic abnormalities typical for metabolic syndrome (Table 2) were present in both obese and normal weight children and were associated with VAT rather than BMI [32]. Secondly, blood pressure was similar in both normal weight children with metabolic abnormalities typical of metabolic syndrome (normal weight metabolically unhealthy [NWMU]) and obese children with metabolic abnormalities (metabolically unhealthy obese [MUHO]), but it was significantly higher than in children with normal body weight who did not suffer from any metabolic abnormalities (normal weight metabolically healthy [NWMH]) and in obese children without metabolic abnormalities (metabolically healthy obese [MHO]).…”

Section: Body Compositionmentioning

confidence: 99%

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Obesity, metabolic syndrome, and primary hypertension

2020

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Primary hypertension is the dominant form of arterial hypertension in adolescents. Disturbed body composition with, among other things, increased visceral fat deposition, accelerated biological maturation, metabolic abnormalities typical for metabolic syndrome, and increased adrenergic drive constitutes the intermediary phenotype of primary hypertension. Metabolic syndrome is observed in 15–20% of adolescents with primary hypertension. These features are also typical of obesity-related hypertension. Metabolic abnormalities and metabolic syndrome are closely associated with both the severity of hypertension and the risk of target organ damage. However, even though increased body mass index is the main determinant of blood pressure in the general population, not every hypertensive adolescent is obese and not every obese patient suffers from hypertension or metabolic abnormalities typical for metabolic syndrome. Thus, the concepts of metabolically healthy obesity, normal weight metabolically unhealthy, and metabolically unhealthy obese phenotypes have been developed. The risk of hypertension and hypertensive target organ damage increases with exposure to metabolic risk factors which are determined by disturbed body composition and visceral obesity. Due to the fact that both primary hypertension and obesity-related hypertension present similar pathogenesis, the principles of treatment are the same and are focused not only on lowering blood pressure, but also on normalizing body composition and metabolic abnormalities.

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Section: Body Compositionmentioning

confidence: 87%

Section: Body Compositionmentioning

confidence: 99%

Obesity, metabolic syndrome, and primary hypertension

2020

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“…The body fat mass of boys increases year by year from the age of 6 to 12, and begins to decrease at the age of 13. However, the increased body fat of girls occurs early in life and is maintained during adolescence, which may be related to the increase of estrogen during puberty [18,19].…”

Section: Discussionmentioning

confidence: 99%

Gender-specific differences in related indicators of blood pressure in Chinese school-age children with overweight and obesity

He¹,

Yang²,

Qiu³

et al. 2020

Preprint

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Background The effects of overweight and obesity on blood pressure in children may differ by sex. Previous studies have only shown the association between overweight and obesity and elevated blood pressure (EBP). The objective of this study is to further explore the association between elevated pulse pressure (EPP) and elevated mean arterial pressure (EMAP) and obesity in Chinese school-age children by gender. Methods We performed a cross-sectional study of 935 children between seven and twelve years old. Overweight and obesity were defined by body mass index and body composition. The adjusted population attributable risk was used to assess the effects of obesity on EBP, EPP and EMAP. Results The interaction of height or age and obesity was used to identify the effect of obesity on blood pressure independent of age and height. Boys with overweight and obesity had higher EBP, EPP and EMAP (P < 0.05). The multivariate logistic regression analysis showed that overweight and obesity had a greater impact on BP and MAP than PP, especially in boys [Odds ratio (OR) > 1]. EBP in 79% of boys and 76% of girls could be attributable to the visceral fat level. The interaction between blood pressure and height or age was modestly increased in children with overweight and obesity, especially in boys. Conclusions Independent of age and height, the effect of obesity on blood pressure was greater in boys than girls. Moreover, the effect was mainly on small arteries rather than large arteries.

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“…За нашими даними, діти з МЗО є достовірно молодшими, ніж з МС, що також підтверджено іншими дослідженнями [31]. Зокрема, китайські дослідники, які обстежили 7926 дітей віком 6-17 років різної тілобудови, показали, що діти з МЗО були молодшими, мали нижчий ІМТ та менші стандартні відхилення ІМТ, менший ОТ [32].…”

Section: вступunclassified

“…Співвідношення ОТС, як маркер ожиріння, був затверджений експертами ВООЗ для дорослих без вікових обмежень і з високою чутливістю у молодих [25]. Ведуться ще дискусії про оцінку цих параметрів у дітей, зокрема більшість досліджень підтримують використання коефіцієнту ОТР менше 0,5 у здорових пропорційних дітей, як і у дорослих [27,40,41], хоча частина дослідників аргументують доцільність використання нижчих значень, задля уникнення хибно-негативних результатів [28,32,39,43]. Чисельними дослідженнями у дітей було протестовано індекс ОТС >0,9 для хлопців шкільного віку, як достовірний критерій ожиріння у дитячому віці [39,43,44] [47,48,49] і були достовірно відмінними між групами обстежених нами пацієнтів.…”

Section: вступunclassified

Metabolically Healthy and Unhealthy Obesity in Children From the Point of View of Evidence-Based Medicine

Furdela

Smiian

Furdela

2020

EUMJ

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Introduction. Childhood obesity and associated metabolic comorbidities is a major global health concern. Metabolic syndrome (MS) is a cluster of metabolic abnormalities that confers a substantial increase in cardiovascular disease risk. In the context of the childhood obesity pandemic, a distinct subgroup of youth with obesity less prone to the development of metabolic disturbances, called “metabolically healthy obese” (MHO), recently has come into focus. However, the diagnostic criteria of both conditions are still controversial in children. Therefore, the purpose of our research is to estimate the prevalence of metabolic syndrome and metabolically healthy obesity in school-age boys using international reference standards and to recognize the most sensitive metabolic markers. Materials and methods. This study was carried out at the Ternopil regional hospital (Western Ukraine) and involved randomly chosen 112 boys from rural and urban population; aged 10–17 years (mean ± SD, 14.6 ± 0.25). Height, weight and waist and hip circumferences were measured by standard methods in each patient. Body mass index (BMI, kg/m2), waist-to-height ratio (WtHR), waist-to-hip ratio (WHR) were calculated by common formulas. Obesity was defined as a BMI ≥ 2SD for age and gender. Blood pressure was measured and estimated according to European Society of Hypertension guidelines (2016). Biomarkers of carbohydrate and lipid metabolism were tested. Discussion. The study identified prominent physical and metabolic differences in groups of patients with MHO and manifested MS, as well as in the high-risk group for the realization of MS. As a result of this project, MHO and MS were confirmed in 49.11 % and 9.82 % surveyed boys, respectively. The rest of teenagers (32.14 %) based on metabolic disturbances, formed a cluster of the high-risk realization of MS. Moreover, fasting hyperglycemia and glucose intolerance were identified only in patients with manifested MS in 10.91 % and 5.45 % cases, respectively. It was found that the waist-to-height ratio > 0.5 is an informative test of obesity in general, and the waist-to-hip ratio > 0.9 is a sensitive screening tool for abdominal obesity in boys in our population. Based on the results, the triglyceride index is the most sensitive biomarker of insulin resistance compared to triglyceride-to-high density lipids cholesterol ratio and atherogenic coefficient in school-age boys. The results can be applied in pediatric practice for early identification of patients with metabolically unhealthy obesity with WHR and the triglyceride index at the early preclinical stage of MS manifestation. Keywords children, metabolically healthy obesity, metabolic syndrome, triglyceride index.

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Abnormal Metabolic Phenotypes Among Urban Chinese Children: Epidemiology and the Impact of DXA‐Measured Body Composition

Cited by 33 publications

References 38 publications

Obesity, metabolic syndrome, and primary hypertension

Obesity, metabolic syndrome, and primary hypertension

Gender-specific differences in related indicators of blood pressure in Chinese school-age children with overweight and obesity

Metabolically Healthy and Unhealthy Obesity in Children From the Point of View of Evidence-Based Medicine

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