Abstract
BackgroundThe potential mechanism underlying the relationship between the risk of cardiovascular diseases and metabolically healthy obese (MHO) individuals remains unclear. The aim of the study was to prospectively investigate the potential role of the adipokines in the association between the MHO phenotype and hypertension in children and adolescents.MethodsA total of 1184 participants at baseline were recruited from a cohort of the Beijing Child and Adolescent Metabolic Syndrome (BCAMS) study. The participants were classified according to their body mass index (BMI) and metabolic syndrome (MS) components. The levels of the adipokines, including leptin, adiponectin, and resistin, were measured.ResultsMHO individuals had higher leptin levels (11.58 ug/L vs 1.20 ug/L), leptin/adiponectin ratio (1.18 vs 0.07), and lower adiponectin (11.65 ug/L vs 15.64 ug/L) levels compared to metabolically healthy normal-weight individuals (all P < 0.05). Compared to metabolically healthy normal-weight individuals, the prevalence of high leptin levels (26.5% vs 0.4%), low adiponectin levels (17.9% vs 6.3%) and a high leptin/adiponectin ratio (26.0% vs 2.1%) was higher in MHO individuals (all P < 0.01). The MHO individuals with abnormal adipokines were significantly more likely to developing hypertension (high leptin, relative risk 11.04; 95% confidence interval, 1.18–103.35; and high leptin/adiponectin ratio, relative risk 9.88; 95% confidence interval, 1.11–87.97) compared to metabolically healthy normal-weight individuals with normal adipokine levels.ConclusionsThe abnormal adipokine levels contribute to the increased hypertension risk in MHO children and adolescents. The non-traditional risk factors should be highlighted in MHO children and adolescents in clinical practice and research.
Highlights
The prevalence of obesity and type 2 diabetes has rapidly increased in Asian countries as a result of the Westernization of lifestyle, and the rates of increase do not show signs of slowing over the past few decades.[1]
Studies indicate that South and East Asians have higher proportion of body fat, prominent abdominal obesity, and greater metabolic responses to obesity compared with their western counterparts with similar body mass index (BMI) values.[2,3]
metabolically unhealthy obese (MUO) individuals had higher BMI, waist circumference (WC), Fat mass percentage (FMP), blood pressure, TG, and fasting glucose levels but lower levels of high-density lipoprotein (HDL) cholesterol compared to the metabolically healthy obese (MHO) individuals
Summary
The prevalence of obesity and type 2 diabetes has rapidly increased in Asian countries as a result of the Westernization of lifestyle, and the rates of increase do not show signs of slowing over the past few decades.[1] Metabolic syndrome is growing into a significant public health problem. The potential mechanism underlying the relationship between the risk of cardiovascular diseases and metabolically healthy obese (MHO) individuals remains unclear. The aim of the study was to prospectively investigate the potential role of the adipokines in the association between the MHO phenotype and hypertension in children and adolescents
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