Children with metabolically healthy obesity have a worse metabolic profile compared to normal-weight peers: a cross-sectional study

Anastasios Serbis; Vasilieios Giapros; Stavroula A Paschou; Ekaterini Siomou

doi:10.1007/s12020-021-02762-6

Children with metabolically healthy obesity have a worse metabolic profile compared to normal-weight peers: a cross-sectional study

Endocrine. 2021 Sep;73(3):580-587. doi: 10.1007/s12020-021-02762-6. Epub 2021 May 22.

Authors

Anastasios Serbis¹, Vasilieios Giapros², Stavroula A Paschou³, Ekaterini Siomou²

Affiliations

¹ Child Health Department, School of Health Sciences, Faculty of Medicine, University of Ioannina, Ioannina, Greece. tasos_serbis@yahoo.com.
² Child Health Department, School of Health Sciences, Faculty of Medicine, University of Ioannina, Ioannina, Greece.
³ Division of Endocrinology, Diabetes and Metabolism, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

PMID: 34023981
DOI: 10.1007/s12020-021-02762-6

Abstract

Purpose: 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).

Methods: 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.

Results: 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).

Conclusion: 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.

Keywords: Adolescents; Children; Consensus-based criteria; Metabolically healthy obese.

MeSH terms

Adolescent
Aged
Body Mass Index
Child
Cross-Sectional Studies
Humans
Metabolic Syndrome* / epidemiology
Metabolome
Obesity, Metabolically Benign* / epidemiology
Pediatric Obesity* / complications