Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Division of Paediatric Endocrinology, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore.
Pediatr Res. 2022 Nov;92(5):1374-1380. doi: 10.1038/s41390-022-01941-z. Epub 2022 Feb 7.
Obese individuals who have little or no metabolic syndrome components are proposed to be "metabolically healthy obese (MHO)". This study aim to evaluate the prevalence of MHO and examine the predictors associated with MHO in a multi-ethnic Asian cohort of severely obese children.
This study included a cross-sectional cohort of 406 Chinese, Malay and Indian children aged 5-20 years old with BMI for age ≥ 97th percentile. Metabolic syndrome (MS) and metabolic health (MH) definitions based on the presence or absence of metabolic abnormalities (High triglycerides, low HDL cholesterol, elevated blood pressure and high glucose) were used to define MHO in the cohort.
The prevalence of MHO is 63.5% by MS definition and 22.4% by MH definition. Maternal healthy metabolic status (OR: 2.47), age (OR: 0.83, 0.80), paternal obesity (OR: 0.48, 0.53), Malay (OR: 1.97) and Indian ethnicity (OR: 6.38, 3.21) (compared to Chinese ethnicity) are independent predictors for MHO phenotype based on different MHO definitions.
Adiposity measures are not associated with MHO phenotype, but instead younger age, maternal healthy metabolic status, absence of paternal obesity, Malay and Indian ethnicity are independent predictors for MHO phenotype in a multi-ethnic Asian cohort of severely obese children.
The prevalence of metabolically healthy obese (MHO) in our multi-ethnic Asian cohort of severely obese children is 63.5% and 22.4%, respectively, based on different MHO definitions. Adiposity measures are not associated with the MHO phenotype. There are other factors that contribute to the metabolic phenotype in obese individuals. Younger age, maternal healthy metabolic status, absence of paternal obesity, Malay and Indian ethnicity are independent predictors for MHO phenotype. Parental influence is important in predicting metabolic health in obese individuals.
肥胖个体如果几乎没有或没有任何代谢综合征成分，则被认为是“代谢健康肥胖（MHO）”。本研究旨在评估多民族亚洲重度肥胖儿童队列中 MHO 的患病率，并研究与 MHO 相关的预测因素。
本研究纳入了一个横断面队列，共纳入 406 名年龄在 5-20 岁、年龄别 BMI 大于等于第 97 百分位数的中、马来和印度裔儿童。采用代谢综合征（MS）和代谢健康（MH）的定义（即存在或不存在代谢异常，包括高甘油三酯、低高密度脂蛋白胆固醇、血压升高和高血糖）来定义队列中的 MHO。
根据 MS 定义，MHO 的患病率为 63.5%，根据 MH 定义，MHO 的患病率为 22.4%。母亲健康的代谢状态（OR：2.47）、年龄（OR：0.83、0.80）、父亲肥胖（OR：0.48、0.53）、马来裔（OR：1.97）和印度裔（OR：6.38、3.21）（与华裔相比）是基于不同 MHO 定义的 MHO 表型的独立预测因素。
肥胖程度指标与 MHO 表型无关，而年轻年龄、母亲健康的代谢状态、父亲不肥胖、马来裔和印度裔是多民族亚洲重度肥胖儿童队列中 MHO 表型的独立预测因素。
我们在多民族亚洲重度肥胖儿童队列中，根据不同的 MHO 定义，MHO 的患病率分别为 63.5%和 22.4%。肥胖程度指标与 MHO 表型无关。还有其他因素会导致肥胖个体的代谢表型。年轻年龄、母亲健康的代谢状态、父亲不肥胖、马来裔和印度裔是 MHO 表型的独立预测因素。父母的影响在预测肥胖个体的代谢健康方面很重要。
