Prevalence and clinical characteristics of metabolically healthy obese versus metabolically unhealthy obese school children
Document Type
Article
Publication Date
8-1-2022
Abstract
IntroductionChildren with obesity in the absence of traditional cardiometabolic risk factors (CRF) have been described as metabolically healthy obese (MHO). Children with MHO phenotype has a favorable metabolic profile with normal glucose metabolism, lipids, and blood pressure compared to children with metabolically unhealthy obese (MUO) phenotype. This study aimed to compare several parameters related to obesity between these two groups and to examine the predictors associated with the MHO phenotype. MethodsThis study included a cross-sectional baseline data of 193 children with obesity (BMI z-score > +2 SD) aged 8-16 years enrolled in MyBFF@school program, a school-based intervention study conducted between January and December 2014. Metabolic status was defined based on the 2018 consensus-based criteria with MHO children had no CRF (HDL-cholesterol > 1.03 mmol/L, triglycerides <= 1.7 mmol/L, systolic and diastolic blood pressure <= 90(th) percentile, and fasting plasma glucose <= 5.6 mmol/L). Those that did not meet one or more of the above criteria were classified as children with MUO phenotype. ResultsThe prevalence of MHO was 30.1% (95% CI 23.7 - 37.1) among schoolchildren with obesity and more common in younger and prepubertal children. Compared to MUO, children with MHO phenotype had significantly lower BMI, lower waist circumference, lower uric acid, higher adiponectin, and higher apolipoprotein A-1 levels (p < 0.01). Multivariate logistic regression showed that adiponectin (OR: 1.33, 95% CI 1.05 - 1.68) and apolipoprotein A-1 (OR: 1.02, 95% CI 1.01 - 1.03) were independent predictors for MHO phenotype in this population. ConclusionsMHO phenotype was more common in younger and prepubertal children with obesity. Higher serum levels of adiponectin and apolipoprotein A-1 increased the possibility of schoolchildren with obesity to be classified into MHO phenotype.
Keywords
Obesity, Children, Metabolically healthy obese, Metabolically unhealthy obese, Cardiometabolic risk
Divisions
fac_med
Funders
Ministry of Health Malaysia [NMRR-13-439-16563]
Publication Title
Frontiers in Endocrinology
Volume
13
Publisher
Frontiers Media
Publisher Location
AVENUE DU TRIBUNAL FEDERAL 34, LAUSANNE, CH-1015, SWITZERLAND