Differences between Metabolically Healthy vs Unhealthy Obese Children and Adolescents

Khokhar, Aditi; Chin, Vivian; Perez-Colon, Sheila; Farook, Tanni; Bansal, Shipra; Kochummen, Elna; Umpaichitra, Vatcharapan

doi:10.1016/j.jnma.2017.02.008

Cited by 24 publications

(23 citation statements)

References 62 publications

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“…(ii) Another point of interest is that there were higher proportions of MHO (38.5%) in overweight/obese children and adolescents than described by other authors who evaluated obesity in the pediatric age [35, 36]. For instance, a recent study examining Chinese children and adolescents aged 6–18 years found that prevalence rates were 3.9 and 36.7% using 2 different MHO criteria defined by insulin resistance and cardiometabolic parameters, respectively [37].…”

Section: Discussionmentioning

confidence: 95%

Serum Uric Acid Levels as an Indicator for Metabolically Unhealthy Obesity in Children and Adolescents

et al. 2018

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Background: Metabolically healthy obesity (MHO) refers to those individuals who do not show cardiometabolic abnormalities. Our aim was to identify potential clinical and metabolic indicators that may help to distinguish between metabolically healthy and unhealthy individuals amongst overweight and obese children and adolescents. Methods: The study involved 246 overweight/obese and 212 normal-weight individuals enrolled in the LIFE Child study, aged between 6 and 18 years. Overweight/obese individuals without cardiovascular risk factors (fasting serum lipids, blood pressure, and glucose) were classified as MHO. Individuals meeting 1 or more criteria of cardiovascular risk factors were classified as metabolically unhealthy obesity (MUO). Results: Among the 246 overweight/obese individuals, 173 (70%) were MHO and 73 (30%) were MUO. The MHO individuals were younger, more likely to be male, and had lower BMI SDS. In the logistic regression models, uric acid (UA) SDS (OR 1.61, 95% CI 1.1–2.6, p = 0.004), waist circumference SDS (OR 2.50, 95% CI 1.2–6.4, p = 0.017), and C-peptide (OR 4.05, 95% CI 3.5–91, p = 0.003) were significant indicators of MUO. Conclusion: Our results suggest that nearly one-third of overweight/obese children are already identified as MUO. Serum levels of UA can be used as an indicator of unhealthy obesity in youth, where lower levels of UA indicate a lower risk and higher levels suggest a higher risk of MUO. We note that the relevance of identifying potential indicators remains the first most important step in future clinical research.

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Section: Discussionmentioning

confidence: 95%

Serum Uric Acid Levels as an Indicator for Metabolically Unhealthy Obesity in Children and Adolescents

et al. 2018

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“…First, there is no fixed set of risk factors to define MHO in children. For instance, some studies used a combination of cardiometabolic risk factors plus a measure of insulin , while others used either insulin alone or cardiometabolic risk factors alone . Although there were several combinations of risk factors, most of the criteria used to define MHO were based on definitions that have been applied to define the metabolic syndrome .…”

Section: Discussionmentioning

confidence: 99%

“…Last, the diversity in the demographic characteristics ( e.g., age, sex) of different study samples added to the variability in the prevalence estimates of MHO in children. Several studies found that MHO was more common in younger and pre‐pubertal individuals in relation to their older and pubertal peers. These differences may be explained by the physiological and body composition changes children undergo during puberty, which includes an increase in insulin resistance .…”

Section: Discussionmentioning

confidence: 99%

Defining metabolically healthy obesity in children: a scoping review

et al. 2018

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We conducted a scoping review to identify definitions of metabolically healthy obesity (MHO), describe gaps in the literature, and establish a universal definition of MHO in children. We searched electronic databases from January 1980 to June 2017 and grey literature. Experimental, quasi-experimental, or observational studies were eligible for inclusion if they (i) included a definition of MHO that identified risk factors, cut-off values, and the number of criteria used to define MHO, and (ii) classified 2-18 year olds as overweight or obese. Two reviewers independently screened 1,711 papers for relevance and quality; we extracted data from 39 individual reports that met inclusion criteria. Most (31/39; 79%) definitions of MHO included an absence of cardiometabolic risk factors. Heterogeneity across MHO definitions, obesity criteria, and sample sizes/characteristics resulted in variable prevalence estimates (3-80%). Finally, we convened an international panel of 46 experts to complete a 4-round Delphi process to generate a consensus-based definition of MHO. Based on consensus (≥ 80% agreement), our definition of MHO included: high density lipoprotein-cholesterol > 40 mg/dl (or > 1.03 mmol/l), triglycerides ≤ 150 mg/dl (or ≤ 1.7 mmol/l), systolic and diastolic blood pressure ≤ 90th percentile, and a measure of glycemia. This definition of MHO holds potential universal value to enable comparisons between studies and inform clinical decision-making for children with obesity.

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“…For the purposes of the study, MHO participants were obese children (waist circumference ≥ 90th percentile by age and sex) without abnormal glucose/insulin ratio (HOMA – IR) or lipid metabolism compared to the reference values for age and gender and without blood pressure alterations based on the percentiles for age, gender, and height (Table 1 ). Obese children (waist circumference ≥ 90th percentile by age and sex) with, at least, one parameter of metabolic syndrome not in the normal range were assigned to the MUO group as established by the previous literature [ 22 , 23 ].…”

Section: Methodsmentioning

confidence: 99%

Metabolically healthy and metabolically unhealthy obese children both have increased carotid intima-media thickness: a case control study

Farello

Antenucci

Stagi

et al. 2018

BMC Cardiovasc Disord

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BackgroundThe cardiovascular disease risk was assessed in metabolically healthy obese (MHO) children, obese children with metabolic disorders (MUO), and to a control group of normal-weight children using carotid intima-media thickness (CIMT).MethodsParticipants were 204 obese children (114 M, 90 F), including 162 MUO (74 M, 88 F) and 42 MHO (24 M, 18 F), and 99 gender- and age-matched controls (45 M, 54 F). Glucose, triglycerides, total cholesterol, high-density and low-density lipoprotein cholesterol, and other serum values were determined in peripheral blood. Anthropometric parameters, blood pressure, and a carotid Doppler ultrasound scan were also acquired. The mean CIMT of obese subjects and controls was compared by analysis of variance. Abnormality of even one of the metabolic parameters assessed involved assignation to the MUO group. Mean CIMT was compared in MHO and MUO children.ResultsMean CIMT in control children was 402.97 ± 53.18 μm (left carotid artery) and 377.85 ± 52.47 μm (right carotid artery). In MHO and MUO patients CIMT was respectively 453.29 ± 62.04 and 460.17 ± 92.22 μm (left carotid artery) and 446.36 ± 49.21 and 456.30 ± 85.7 μm (right carotid artery). The mean CIMT was not significantly different in MUO and MHO children, whereas it showed a significant difference between both groups of obese children and controls (p < 0.01).ConclusionCIMT was significantly greater in obese patients, also in those without metabolic alterations, than in normal-weight children. Obesity is therefore an important risk factor for cardiovascular disease in itself, also in the absence of metabolic abnormalities.

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Differences between Metabolically Healthy vs Unhealthy Obese Children and Adolescents

Cited by 24 publications

References 62 publications

Serum Uric Acid Levels as an Indicator for Metabolically Unhealthy Obesity in Children and Adolescents

Serum Uric Acid Levels as an Indicator for Metabolically Unhealthy Obesity in Children and Adolescents

Defining metabolically healthy obesity in children: a scoping review

Metabolically healthy and metabolically unhealthy obese children both have increased carotid intima-media thickness: a case control study

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