Child Health Department, School of Health Sciences, Faculty of Medicine, University of Ioannina, Ioannina, Greece.
Division of Endocrinology, Diabetes and Metabolism, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
Endocrine. 2021 Sep;73(3):580-587. doi: 10.1007/s12020-021-02762-6. Epub 2021 May 22.
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.
代谢健康肥胖（MHO）表型在肥胖青少年中已有描述，但该表型在该年龄段的数据仍然有限。本研究旨在描述和比较三组不同肥胖青少年人群的相关临床和实验室参数，即体重正常（NW）、MHO 和代谢不健康肥胖（MUO）。
根据 2018 年基于共识的标准，将 103 名肥胖青少年分为 MHO 组（n=49，年龄（±SD）：10.9±2.9 岁）和 MUO 组（n=54，11.5±2.7 岁），并与年龄、性别和 Tanner 匹配的 NW 组（n=69，11.3±2.9 岁）进行比较。对三组儿童的所有肥胖相关参数进行了调查。通过方差分析（ANOVA）进行比较，然后进行 Fisher's PLSD 检验。
MHO 组的收缩压（p<0.001）和舒张压（p<0.01）血压 z 评分以及甘油三酯（p<0.01）较低，但高密度脂蛋白胆固醇（p<0.001）、总胆固醇（p<0.05）和载脂蛋白 A1（p<0.05）较高。与 MUO 组相比，MHO 组的空腹胰岛素（p<0.05）、HOMA-IR（p<0.05）和 QUICKI（p<0.001）更高。同样，两组的 hsCRP、纤维蛋白原、尿酸和瘦素均高于对照组（均为 p<0.001），而脂联素较低（p<0.05）。与对照组相比，MUO 组的内脂素水平更高（p<0.01），而 MHO 组的内脂素水平低于 MUO 组（p=0.1），呈下降趋势。
本研究表明，根据共识标准确定的 MHO 儿童的代谢特征优于 MUO 儿童，但不如 NW 儿童。在儿科人群中，无论是 MHO 标准还是 MHO 表型本身的性质，都需要进一步研究。
