Strong Effect of Pubertal Status on Metabolic Health in Obese Children: A Longitudinal Study

Reinehr, Thomas; Wolters, Barbara; Knop, Caroline; Lass, Nina; Holl, Reinhard W.

doi:10.1210/jc.2014-2674

Cited by 117 publications

(147 citation statements)

References 38 publications

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“…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]. Using the same MHO criteria as in the present study, a recently published German study on the effect of pubertal status revealed that a large proportion of obese children (49.3%) exhibited a MHO status [38]. It is likely that the high variability in reported MHO prevalence could be explained by the lack of a standard definition of MHO, specific cutoff values, small sample sizes, different age ranges, as well as behavioral differences between populations [39-41].…”

Section: Discussionmentioning

confidence: 57%

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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: 57%

“…Reinehr et al [38] showed that entering puberty doubles the risk of switching from MHO to MUO. The difference between pubertal stage and cardiometabolic alterations may be attributable to the physiological changes of body composition and the influence of sex hormones during puberty development [51].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2018

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“…However, even in childhood, BMI has been shown to be associated with cardiovascular risk factors similarly as directly determined fat mass (43). A strong association between puberty and MUO status has been found (44). Due to the initial design of COPAT project from which our cohorts were recruited we do not have data on pubertal stage being unable to analyze its impact on health risk.…”

Section: Discussionmentioning

confidence: 99%

Cardiometabolic Health in Obese Adolescents Is Related to Length of Obesity Exposure: A Pilot Study

Zamrazilová

Weiss

Hainer

et al. 2016

The Journal of Clinical Endocrinology &Amp; Metabolism

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“…Additionally, overweight and obese children enter puberty usually earlier than thin or normal weight children [57, 58]. As BP increases with puberty [59, 60] and early puberty has shown to be a risk factor for later high BP [57], this may have also contributed to higher BP in overweight/obese children. Also, inflammatory cytokines and adipocytokines from adipose tissue in overweight and obese subjects were shown to increase blood pressure [61, 62] such that obesity-related effects on BP may have overlaid the BP lowering effects of n-3 PUFA observed in thin/normal weight children.…”

Section: Discussionmentioning

confidence: 99%

Associations of Whole Blood n-3 and n-6 Polyunsaturated Fatty Acids with Blood Pressure in Children and Adolescents – Results from the IDEFICS/I.Family Cohort

et al. 2016

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BackgroundPolyunsaturated n-3 and n-6 polyunsaturated fatty acids (PUFA) are precursors of biologically active metabolites that affect blood pressure (BP) regulation. This study investigated the association of n-3 and n-6 PUFA and BP in children and adolescents.MethodsIn a subsample of 1267 children aged 2–9 years at baseline of the European IDEFICS (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants) cohort whole blood fatty acids were measured by a validated gas chromatographic method. Systolic and diastolic BP was measured at baseline and after two and six years. Mixed-effects models were used to assess the associations between fatty acids at baseline and BP z-scores over time adjusting for relevant covariables. Models were further estimated stratified by sex and weight status.ResultsThe baseline level of arachidonic acid was positively associated with subsequent systolic BP (β = 0.08, P = 0.002) and diastolic BP (β = 0.07, P<0.001). In thin/normal weight children, baseline alpha-linolenic (β = -1.13, P = 0.003) and eicosapentaenoic acid (β = -0.85, P = 0.003) levels were inversely related to baseline and also to subsequent systolic BP and alpha-linolenic acid to subsequent diastolic BP. In overweight/obese children, baseline eicosapentaenoic acid level was positively associated with baseline diastolic BP (β = 0.54, P = 0.005).ConclusionsLow blood arachidonic acid levels in the whole sample and high n-3 PUFA levels in thin/normal weight children are associated with lower and therefore healthier BP. The beneficial effects of high n-3 PUFA on BP were not observed in overweight/obese children, suggesting that they may have been overlaid by the unfavorable effects of excess weight.

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Strong Effect of Pubertal Status on Metabolic Health in Obese Children: A Longitudinal Study

Abstract: MHO is a stable status in childhood obesity as long as pubertal status remains stable. Due to the strong association between puberty and MUO status, the concept of MHO is questionable, at least in pubertal children.

Cited by 117 publications

References 38 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

Cardiometabolic Health in Obese Adolescents Is Related to Length of Obesity Exposure: A Pilot Study

Associations of Whole Blood n-3 and n-6 Polyunsaturated Fatty Acids with Blood Pressure in Children and Adolescents – Results from the IDEFICS/I.Family Cohort

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