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Abstract
A phenotype of metabolically healthy obesity (MHO) has been described in youth with obesity, but data are still scarce in this age group. The aim of the current study was to describe and compare clinical and laboratory parameters related to obesity among three different groups of youth, namely youth with normal weight (NW), with MHO, and with metabolically unhealthy obesity (MUO). One hundred and three youngsters with obesity were divided according to 2018 consensus-based criteria into those with MHO [n = 49, age (±SD): 10.9 ± 2.9 years] and those with MUO [n = 54, 11.5 ± 2.7 years] and were compared to age-, sex- and Tanner-matched NW [n = 69, 11.3 ± 2.9 years]. Several obesity-related parameters were investigated for all three groups of children. Comparisons were made by analysis of variance (ANOVA) followed by the Fisher's PLSD test. Youth with MHO had lower systolic (p < 0.001) and diastolic (p < 0.01) blood pressure z-score and triglycerides (p < 0.01), but higher HDL-C (p < 0.001), total cholesterol (p < 0.05), and apo-A1 (p < 0.05) compared to those with MUO. Compared to controls, both children with MHO and MUO showed higher fasting insulin (p < 0.05), HOMA-IR (p < 0.05), and QUICKI (p < 0.001). Similarly, both groups had higher hsCRP, fibrinogen, uric acid, and leptin compared to controls (for all, p < 0.001), while their adiponectin was lower (p < 0.05). Visfatin was higher in children with MUO compared to controls (p < 0.01), and it showed a trend to be lower in children with MHO compared to those with MUO (p = 0.1). This study provides evidence that children identified as having MHO by the consensus-based criteria had better metabolic profiles than youth with MUO, but worse than NW. Further research is needed in pediatric populations both regarding MHO criteria and the nature of the MHO phenotype per se.
Highlights
The worldwide prevalence of pediatric overweight and obesity has plateaued at high levels in many countries and continues to rise in others [1]
This study provides evidence that children identified as having metabolically healthy obesity (MHO) by the consensus-based criteria had better metabolic profile than youth with metabolically unhealthy obesity (MUO), but worse than normal weight (NW)
Further research is needed in pediatric populations both regarding MHO criteria and the nature of the MHO phenotype per se
Summary
The worldwide prevalence of pediatric overweight and obesity has plateaued at high levels in many countries and continues to rise in others [1]. It has been shown that not all individuals with obesity exhibit complications to the same severity and extent. In adult populations for example, several reports have shown that there are men and women with obesity who, at a given time, do not demonstrate the traditional cardiometabolic risk factors linked to increased body fat. These individuals have been characterized as having metabolically healthy obesity (MHO) in contrast to those with metabolically unhealthy obesity (MUO) who exhibit obesity related complications [4]. Depending on the criteria used to define the condition and the study population, adults with MHO represent up to 35% of the adult population with obesity, with dramatic differences in the prevalence among different studies [5]
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