FRI590 Predictors Of Metabolically (Un)Healthy Obesity In Children

Abstract

Abstract Disclosure: L. Van der Veken: None. X. Chestermann: None. K. Casteels: None. J. Helsen: None. A.M. Rochtus: None. Childhood obesity is a growing problem worldwide and can lead to type 2 diabetes, hypertension, dyslipidemia, and carotid-artery atherosclerosis. This is known as “metabolically unhealthy obesity” (MUO). However, a subgroup of children who are obese have been described as “metabolically healthy” (MHO) due to the absence of these cardiometabolic risk factors. The current definition of MHO only includes cardiometabolic criteria (MHO-CR) such as systolic blood pressure, diastolic blood pressure, triglycerides, HDL-cholesterol and a measure of fasting plasma glucose. The aim of this review is to compare the current definition based on cardiometabolic risk factors with a definition that includes insulin resistance (MHO-IR). We investigated the differences between these definitions in terms of prevalence, characteristics, predictors, and the recommended way of measuring insulin and its respective cut-off value. We searched Pubmed, Embase, Web of Science and Cochrane Library for studies on prevalence and predictors of insulin resistance in pediatric MHO. The prevalence of MHO-CR, MHO-IR, MUO-CR, MUO-IR and MHO, based on combined criteria from both MHO-CR and MHO-IR, were compared and the mean-values for each group were calculated. A meta-analysis study was designed to investigate the characteristics of MHO-CR and MHO-IR. Summary effects were calculated using random effects models. The standardized mean differences (SMD) are presented together with their confidence intervals (5% significance level). The recommended way of measuring insulin resistance was investigated by a frequency-based representation of used units and cut-off values in the included studies. Eight full text articles met the eligibility criteria for inclusion. Out of 4036 participants, the mean prevalence of different groups was MHO-CR (35%), MHO-IR (44%), MUO-CR (61%) and MUO-IR (56%). After combining the cardiometabolic criteria with the factor insulin resistance, prevalence of MHO and MUO were respectively 11% and 54%. The characteristics found to be significantly different between MHO-CR and MHO-IR were fasting insulin [SMD 1.7406; CI (0.0198-3.4614); P=0.0481] and HOMA-IR [SMD 0.7202; CI (0.4414-0.9989); P=0.0007]. HOMA-IR was also significantly higher in MUO-IR than MUO-CR [SMD -0.3940; CI (-0.7471- -0.0409); P=0.0342]. Several predictors for MHO-CR and MHO-IR were defined. The most frequently used unit and cut-off value of MHO was HOMA-IR<3.16.The implementation of insulin resistance in the definition of pediatric MHO could provide a stricter way of categorizing patients as MHO and MUO, and allow earlier treatment interventions. Presentation: Friday, June 16, 2023