Di Bonito Procolo, Di Sessa Anna, Licenziati Maria Rosaria, Corica Domenico, Wasniewska Malgorzata, Miraglia Del Giudice Emanuele, Morandi Anita, Maffeis Claudio, Faienza Maria Felicia, Mozzillo Enza, Calcaterra Valeria, Franco Francesca, Maltoni Giulio, Moio Nicola, Iannuzzi Arcangelo, Valerio Giuliana
Department of Internal Medicine, "S. Maria delle Grazie" Hospital, 80078 Pozzuoli, Italy.
Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli", 80138 Napoli, Italy.
Rev Cardiovasc Med. 2024 Apr 9;25(4):141. doi: 10.31083/j.rcm2504141. eCollection 2024 Apr.
Pediatric obesity is closely associated with cardiometabolic comorbidities, but the role of sex in this relationship is less investigated. We aimed to evaluate sex-related differences on cardiometabolic risk factors and preclinical signs of target organ damage in adolescents with overweight/obesity (OW/OB).
The main cross-sectional study included 988 adolescents (510 boys and 478 girls) with OW/OB aged 10-18 years. In all youths clinical and biochemical variables were evaluated and an abdominal echography was performed. Echocardiographic data for the assessment of left ventricular mass (LVM) and relative wall thickness (RWT) were available in an independent sample of 142 youths (67 boys and 75 girls), while echographic data of carotid intima media thickness (cIMT) were available in 107 youths (59 boys and 48 girls).
The three samples did not differ for age, body mass index, and sex distribution. In the main sample, boys showed higher waist-to-height ratio (WHtR) values ( 0.0001) and fasting glucose levels ( = 0.002) than girls. Lower levels of estimates glomerular filtration rate (eGFR) were found in girls vs boys ( 0.0001). No sex-related differences for prediabetes and hyperlipidemia were observed. A higher prevalence of WHtR 0.60 (57.3% vs 49.6%, = 0.016) and fatty liver disease (FLD) (54.5% vs 38.3%, 0.0001) as well as a trend for high prevalence of hypertension (40.4 vs 34.7%, = 0.06) were observed in boys vs girls. More, a higher prevalence of mild reduced eGFR (MReGFR) ( 90 mL/min/1.73 ) was observed in girls vs boys (14.6% vs 9.6 %, 0.0001). In the sample with echocardiographic evaluation, boys showed higher levels of LVM ( = 0.046), and RWT ( = 0.003) than girls. Again, in the sample with carotid echography, boys showed higher levels of cIMT as compared to girls ( = 0.011).
Adolescent boys with OW/OB showed higher risk of abdominal adiposity, FLD, and increased cardiac and vascular impairment than girls, whereas the latter had a higher risk of MReGFR. Risk stratification by sex for cardiometabolic risk factors or preclinical signs of target organ damage should be considered in youths with OW/OB.
儿童肥胖与心血管代谢合并症密切相关，但性别在这种关系中的作用研究较少。我们旨在评估超重/肥胖（OW/OB）青少年在心血管代谢危险因素和靶器官损害临床前体征方面的性别差异。
主要的横断面研究纳入了988名10 - 18岁的OW/OB青少年（510名男孩和478名女孩）。对所有青少年评估了临床和生化变量，并进行了腹部超声检查。在一个由142名青少年（67名男孩和75名女孩）组成的独立样本中可获得用于评估左心室质量（LVM）和相对壁厚度（RWT）的超声心动图数据，而在107名青少年（59名男孩和48名女孩）中可获得颈动脉内膜中层厚度（cIMT）的超声检查数据。
这三个样本在年龄、体重指数和性别分布方面无差异。在主要样本中，男孩的腰高比（WHtR）值（P < 0.0001）和空腹血糖水平（P = 0.002）高于女孩。女孩的估算肾小球滤过率（eGFR）水平低于男孩（P < 0.0001）。未观察到糖尿病前期和高脂血症的性别差异。与女孩相比，男孩中WHtR≥0.60的患病率更高（57.3%对49.6%，P = 0.016）、脂肪肝疾病（FLD）患病率更高（54.5%对38.3%，P < 0.0001），以及高血压患病率有升高趋势（40.4对34.7%，P = 0.06）。此外，女孩中轻度降低的eGFR（MReGFR）（<90 mL/min/1.73㎡）的患病率高于男孩（14.6%对9.6%，P < 0.0001）。在进行超声心动图评估的样本中，男孩的LVM（P = 0.046）和RWT（P = 0.003）水平高于女孩。同样，在进行颈动脉超声检查的样本中，男孩的cIMT水平高于女孩（P = 0.011）。
与女孩相比，OW/OB青少年男孩腹部肥胖、FLD风险更高，心脏和血管损伤增加，而女孩MReGFR风险更高。对于OW/OB青少年，应考虑根据性别对心血管代谢危险因素或靶器官损害临床前体征进行风险分层。
