Abstract

BackgroundThe cardiovascular disease risk was assessed in metabolically healthy obese (MHO) children, obese children with metabolic disorders (MUO), and to a control group of normal-weight children using carotid intima-media thickness (CIMT).MethodsParticipants were 204 obese children (114 M, 90 F), including 162 MUO (74 M, 88 F) and 42 MHO (24 M, 18 F), and 99 gender- and age-matched controls (45 M, 54 F). Glucose, triglycerides, total cholesterol, high-density and low-density lipoprotein cholesterol, and other serum values were determined in peripheral blood. Anthropometric parameters, blood pressure, and a carotid Doppler ultrasound scan were also acquired. The mean CIMT of obese subjects and controls was compared by analysis of variance. Abnormality of even one of the metabolic parameters assessed involved assignation to the MUO group. Mean CIMT was compared in MHO and MUO children.ResultsMean CIMT in control children was 402.97 ± 53.18 μm (left carotid artery) and 377.85 ± 52.47 μm (right carotid artery). In MHO and MUO patients CIMT was respectively 453.29 ± 62.04 and 460.17 ± 92.22 μm (left carotid artery) and 446.36 ± 49.21 and 456.30 ± 85.7 μm (right carotid artery). The mean CIMT was not significantly different in MUO and MHO children, whereas it showed a significant difference between both groups of obese children and controls (p < 0.01).ConclusionCIMT was significantly greater in obese patients, also in those without metabolic alterations, than in normal-weight children. Obesity is therefore an important risk factor for cardiovascular disease in itself, also in the absence of metabolic abnormalities.

Highlights

  • The cardiovascular disease risk was assessed in metabolically healthy obese (MHO) children, obese children with metabolic disorders (MUO), and to a control group of normal-weight children using carotid intima-media thickness (CIMT)

  • CIMT was significantly greater in obese patients, in those without metabolic alterations, than in normalweight children

  • In order to investigate the presence of a cardiovascular risk, demonstrated through the increase of CIMT in the metabolically healthy obese subjects, we have studied this parameter in a population of metabolically healthy obese, metabolically unhealthy obese compared to a control group

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Summary

Introduction

The cardiovascular disease risk was assessed in metabolically healthy obese (MHO) children, obese children with metabolic disorders (MUO), and to a control group of normal-weight children using carotid intima-media thickness (CIMT). In 2013, 42 million children aged less than 5 years were overweight or obese [1]. Obesity plays a key role in the development of metabolic syndrome (MS) [2, 3], which in the past few decades has significantly increased among obese children [4]. Not all the severely obese suffer from MS; 10–25% of severely obese adults are “metabolically healthy” (MHO) [5,6,7,8]. The prevalence of “obesity without metabolic alterations” ranges from 4.2 to 68% according to the classification used and the reference population. A predominance of the MHO phenotype is found in females and is inversely related to age [9]

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