Metabolically Healthy Obesity and High Carotid Intima-Media Thickness in Children and Adolescents: International Childhood Vascular Structure Evaluation Consortium

Zhao, Min; López‐Bermejo, Abel; Caserta, Carmelo Antonio; Medeiros, Carla Campos Muniz; Κόλλιας, Αναστάσιος; Bassols, Judit; Romeo, Elisabetta L.; Ramos, Talytta Menezes; Stergiou, George S.; Yang, Lili; Xargay-Torrent, Sílvia; Amante, Angela; Gusmão, Tatianne Moura Estrela; Grammatikos, Evangelos; Zhang, Yuanyuan; Prats‐Puig, Anna; Carvalho, Danielle Franklin de; Yang, Liu; Carreras‐Badosa, Gemma; Simões, Mônica de Oliveira; Hou, Yaping; Mas-Parés, Berta; Wang, Shui; Guo, Teng; Wang, Mingming; Chen, Hua; Lou, Xiaohuan; Zhang, Qian; Zhang, Yanqing; Bovet, Pascal; Magnussen, Costan G.; Xi, Bo; Lizárraga-Mollinedo, Esther; Díaz-Roldán, Ferran; Costa, Ivelise Fhrideraid Alves Furtado da; Farias, Camilla Ribeiro Lima de; Oliveira, Renata Cardoso; Medeiros, Camila Muniz; Lira, Jessica; Psilopatis, Isidoros; Karagiaouri, Eirini; Glaraki, Maria; Grammatikos, Emmanouel E.; Dantas, Rafaela Ramos; Aires, Yggo Ramos de Farias; Melo, Priscilla Yevelin Barros de; Melo, Elayne Maria Cordeiro de; Ramalho, Milena Cavalcanti

doi:10.2337/dc18-1536

Cited by 58 publications

(42 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…42,44 In a recent study including results from 5 countries (Brazil, China, Greece, Italy, and Spain), metabolically healthy obese/overweight children and adolescents (n = 158/388) had an increased cIMT compared with metabolically healthy normal weight ones (n = 1393). 45 Moreover, obese children were shown to have a higher cIMT as adults. 46…”

Section: Discussionmentioning

confidence: 99%

The Effect of Long-Term Atorvastatin Therapy on Carotid Intima-Media Thickness of Children With Dyslipidemia

et al. 2020

View full text Add to dashboard Cite

Carotid intima-media thickness (cIMT) has been proposed as an early marker of subclinical atherosclerosis in high risk children. Children with heterozygous familial hypercholesterolemia have greater cIMT than matched healthy controls or their unaffected siblings. Statin therapy may delay the progression of cIMT, although long-term studies in children are scarce. We evaluated the effect of atorvastatin treatment on cIMT in children with dyslipidemia. We studied 81 children/adolescents, 27 with severe dyslipidemia (low-density lipoprotein cholesterol [LDL-C] ≥190 mg/dL) and 54 sex- and age-matched healthy controls; LDL-C ≤ 130 mg/dL and lipoprotein (a), Lp(a), ≤30 mg/dL. In the children with dyslipidemia, cIMT was measured twice, before and on treatment (18.2 ± 7.7 months). Anthropometric data, a full lipid profile, liver, kidney, and thyroid function were evaluated. Males with dyslipidemia had a greater cIMT than male controls after adjustment for other factors ( P = .049). In addition, a nonstatistically significant decrease in cIMT was observed after treatment ( P = .261). Treatment with atorvastatin resulted in a significantly improved lipid profile. Females with dyslipidemia had a significantly thinner cIMT than males. Children with normal and high Lp(a) levels had similar cIMT values. In conclusion, treatment with atorvastatin had a beneficial effect on the lipid profile and cIMT progression in children with severe dyslipidemia.

show abstract

Section: Discussionmentioning

confidence: 99%

The Effect of Long-Term Atorvastatin Therapy on Carotid Intima-Media Thickness of Children With Dyslipidemia

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Although children with MHO are usually defined as being without traditional cardiometabolic risk factors within the MS definition, several studies have detected the presence of other features among this population, such as: hepatic steatosis, increased carotid intima-media thickness, and inflammatory biomarkers, as well as higher degree of visceral fat accumulation, higher birth weight, adipose cell size, and different gene expression-encoding markers in adipose tissue (4,8,(130)(131)(132)(133)(134). The diverse characteristics found in children with MHO may indicate they pursue a different metabolic phenotype compared to their peers of normal weight (7,18).…”

Section: Treatment and Outcomes Of Mho In Childhoodmentioning

confidence: 99%

Children With Metabolically Healthy Obesity: A Review

Vuković

Ybarra

et al. 2019

Front. Endocrinol.

View full text Add to dashboard Cite

Children with "metabolically healthy obesity" (MHO) are a distinct subgroup of youth with obesity, who are less prone to the clustering of cardiometabolic risk factors. Although this phenotype, frequently defined by the absence of metabolic syndrome components or insulin resistance, was first described during the early 1980s, a consensus-based definition of pediatric MHO was introduced only recently, in 2018. The purpose of this review was to concisely summarize current knowledge regarding the MHO phenomenon in youth. The prevalence of MHO in children varies from 3 to 87%, depending on the definition used and the parameters evaluated, as well as the ethnicity and the pubertal status of the sample. The most consistent predictors of MHO in youth include younger age, lower body mass index, lower waist circumference, and lower body fat measurements. Various hypotheses have been proposed to elucidate the underlying factors maintaining the favorable MHO phenotype. While preserved insulin sensitivity and lack of inflammation were previously considered to be the main etiological factors, the most recent findings have implicated adipokine levels, the number of inflammatory immune cells in the adipose tissue, and the reduction of visceral adiposity due to adipose tissue expandability. Physical activity and genetic factors also contribute to the MHO phenotype. Obesity constitutes a continuum-increased risk for cardiometabolic complications, which is less evident in children with MHO. However, some findings have highlighted the emergence of hepatic steatosis, increased carotid intima-media thickness and inflammatory biomarkers in the MHO group compared to peers without obesity. Screening should be directed at those more likely to develop clustering of cardiometabolic risk factors. Lifestyle modifications should include behavioral changes focusing on sleep duration, screen time, diet, physical activity, and tobacco smoke exposure. Weight loss has also been associated with the improvement of insulin sensitivity and inflammation. Further investigative efforts are needed in order to elucidate the mechanisms which protect against the clustering of cardiometabolic risk factors in pediatric obesity, to provide more efficient, targeted treatment approaches for children with obesity, and to identify the protective factors preserving the MHO profile, avoiding the crossover of MHO to the phenotype with metabolically unhealthy obesity.

show abstract

“…These individuals seem to be less prone to the traditional metabolic abnormalities that often accompany excess body fat (e.g., insulin resistance, dyslipidemia, hypertension), showing a reduced incidence of several obesity-related comorbidities [9], such as a 50% decreased risk of developing type 2 diabetes (T2D) compared with metabolically unhealthy obese (MUO) subjects [12]. Conversely, a significantly higher cardiovascular risk has been reported, compared to lean subjects [13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Clinical Characteristics of Children and Adolescents with Metabolically Healthy Obesity: Role of Insulin Sensitivity

Vinciguerra

Tumminia

Baratta

et al. 2020

Life

View full text Add to dashboard Cite

Obesity represents a major risk factor for metabolic disorders, but some individuals, “metabolically healthy” (MHO), show less clinical evidence of these complications, in contrast to “metabolically unhealthy” (MUO) individuals. The aim of this cross-sectional study is to assess the prevalence of the MHO phenotype in a cohort of 246 overweight/obese Italian children and adolescents, and to evaluate their characteristics and the role of insulin resistance. Homeostasis model assessment–insulin resistance (HOMA-IR), insulin sensitivity index (ISI), insulinogenic index (IGI) and disposition index (DI) were all calculated from the Oral Glucose Tolerance Test (OGTT). MHO was defined by either: (1) HOMA-IR < 2.5 (MHO-IRes), or (2) absence of the criteria for metabolic syndrome (MHO-MetS). The MHO prevalence, according to MHO-MetS or MHO-IRes criteria, was 37.4% and 15.8%, respectively. ISI was the strongest predictor of the MHO phenotype, independently associated with both MHO-IRes and MHO-MetS. The MHO-MetS group was further subdivided into insulin sensitive or insulin resistant on the basis of HOMA-IR (either < or ≥ 2.5). Insulin sensitive MHO-MetS patients had a better metabolic profile compared to both insulin resistant MHO-MetS and MUO-MetS individuals. These data underscore the relevance of insulin sensitivity to identifying, among young individuals with overweight/obesity, the ones who have a more favorable metabolic phenotype.

show abstract

Metabolically Healthy Obesity and High Carotid Intima-Media Thickness in Children and Adolescents: International Childhood Vascular Structure Evaluation Consortium

Cited by 58 publications

References 41 publications

The Effect of Long-Term Atorvastatin Therapy on Carotid Intima-Media Thickness of Children With Dyslipidemia

The Effect of Long-Term Atorvastatin Therapy on Carotid Intima-Media Thickness of Children With Dyslipidemia

Children With Metabolically Healthy Obesity: A Review

Prevalence and Clinical Characteristics of Children and Adolescents with Metabolically Healthy Obesity: Role of Insulin Sensitivity

Contact Info

Product

Resources

About