Classification and clinical characterization of metabolically “healthy” obese children and adolescents

Abstract

Less than 20% obese children and adolescents are identified as MHO and show a healthier cardiometabolic profile as compared to MUO. Implementation of the proposed classifications in future clinical research could contribute towards the standardization of the MHO definition and offer new insights into the manifestation of the pediatric MHO phenotype.

Which predictors differentiate between obese children and adolescents with cardiometabolic complications and those with metabolically healthy obesity?

“…The prevalence of MHO in our cohort of obese patients (20.9%) was similar to that reported by previous pediatric studies, but significantly lower than that reported by Reinehr et al of 49% MHO in the German pediatric population. The reasons for this difference may reside in differences in ethnicity, socioeconomic status, and environment, and the interactions among these variables.…”

Fasting insulin resistance affects the prevalence of metabolically healthy obesity in Brazilian adolescents

“…Although self‐reporting bias may not be ruled out, it was unlikely that this substantially affected our results, considering that it is not expected that MHO and MUO adolescents reported differently. Finally, even though our sample size was larger than most previous studies based on treatment‐seeking youths with obesity , it may not have been sufficient to detect differences between MHO and MUO. Despite these limitations, we were able to examine the association of important risk factors with metabolic phenotypes in a Brazilian sample of well‐characterised adolescents attending a highly specialised multidisciplinary obesity health service.…”

“…Earlier reports based on children and adolescent attendees of obesity outpatient clinics, and which had defined MHO as non CMRF, showed a MHO prevalence range of 18.6-21.7% (10)(11)(12). Studies, which selected adolescents with obesity from national surveys (9,13,14) or school (15) samples, found higher MHO prevalence estimates, between 36.8 and 74%.…”

“…Bervoets et al. have also compared the CMRF criteria with CMRF combined with insulin resistance. MHO prevalence dropped from 18.6 to 6.4%.…”

“…To the best of our knowledge, no study had investigated the prevalence of MHO in adolescents in Latin‐American countries. Most studies have been performed on North‐American , European and Asian paediatric populations . Another strength of the present study is that it relied on the assessment of a relatively large sample of treatment‐seeking adolescents with HOMA‐IR index, as compared to four other smaller studies .…”