School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.
Cardiologic Unit, Istituto Auxologico Italiano, IRCCS, Milan, Italy.
Front Endocrinol (Lausanne). 2020 Feb 7;11:27. doi: 10.3389/fendo.2020.00027. eCollection 2020.
In pediatric age the prevalence of obesity is high. Obese children who do not have other risk factors than excess weight have been defined as "metabolically healthy obese" (MHO). The aim of this study is to evaluate, in a population of obese children, the prevalence of the MHO and "metabolically unhealthy obese" (MUO) phenotype. Furthermore, we evaluated the distribution of Uric Acid, HOMA index and Waist-Height ratio (W-Hr) in the MHO and MUO sub-groups and the impact of these non-traditional risk factors on the probability to be MUO. In 1201 obese children and adolescents [54% males, age (±SD) 11.9 (±3.0) years] weight, height, waist circumference, systolic (SBP) and diastolic (DBP) blood pressure, pubertal status, glucose, insulin, HDL cholesterol, triglycerides and Uric Acid serum values were assessed. MUO phenotype was defined as the presence of at least one of the following risk factors: SBP or DBP ≥ 90th percentile, glycaemia ≥ 100 mg/dl, HDL cholesterol <40 mg/dl, triglycerides ≥100 mg/dl (children <10 years) or ≥130 mg/dl (children ≥10 years). A multivariate logistic regression analysis was used to estimate the association between MUO phenotype and non-traditional cardiovascular risk factors. The prevalence of the MUO status was high (61%). MUO subjects were more often male, older and pubertal ( < 0.001). The levels of the three non-traditional risk factors were significantly higher in MUO children compared to MHO children ( < 0.001) and all of them were independent predictors of the fact of being MUO [OR 1.41 (95% CI 1.24-1.69); 1.15 (95% CI 1.06-1.23) and 1.03 (95% CI1.01-1.05) for Uric Acid, HOMA index and W-Hr, respectively]. About 15% of MHO subjects had serum Uric Acid, HOMA index and W-Hr values within the highest quartile of the study population. The prevalence of MUO subjects in a large pediatric population is high and serum Uric Acid, HOMA index and W-Hr values are independent predictors of the probability of being MUO. A non-negligible percentage of subjects MHO has high values of all three non-traditional risk factors.
在儿科中，肥胖的患病率很高。没有超重以外的其他危险因素的肥胖儿童被定义为“代谢健康型肥胖”（MHO）。本研究旨在评估肥胖儿童中 MHO 和“代谢不健康型肥胖”（MUO）表型的患病率。此外，我们评估了尿酸、HOMA 指数和腰围身高比（W-Hr）在 MHO 和 MUO 亚组中的分布，以及这些非传统危险因素对 MUO 发生概率的影响。在 1201 名肥胖儿童和青少年中（54%为男性，年龄（±SD）为 11.9（±3.0）岁），评估了体重、身高、腰围、收缩压（SBP）和舒张压（DBP）、青春期状态、血糖、胰岛素、高密度脂蛋白胆固醇、甘油三酯和尿酸血清值。MUO 表型的定义为存在以下至少一个危险因素：SBP 或 DBP≥第 90 百分位数，血糖≥100mg/dl，HDL 胆固醇<40mg/dl，甘油三酯≥100mg/dl（<10 岁儿童）或≥130mg/dl（≥10 岁儿童）。采用多变量逻辑回归分析估计 MUO 表型与非传统心血管危险因素之间的关联。MUO 状态的患病率较高（61%）。MUO 受试者更多为男性、年龄较大且处于青春期（<0.001）。与 MHO 儿童相比，MUO 儿童的三种非传统危险因素水平明显更高（<0.001），并且它们都是 MUO 发生的独立预测因素[比值比 1.41（95%可信区间 1.24-1.69）；1.15（95%可信区间 1.06-1.23）和 1.03（95%可信区间 1.01-1.05），尿酸、HOMA 指数和 W-Hr]。约 15%的 MHO 受试者的尿酸、HOMA 指数和 W-Hr 值在研究人群的最高四分位数内。在大型儿科人群中，MUO 受试者的患病率较高，血清尿酸、HOMA 指数和 W-Hr 值是 MUO 发生概率的独立预测因素。有相当比例的 MHO 受试者的所有三种非传统危险因素值都很高。
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