Yang Lili, Li Menglong, Wang Huan, Shu Wen, Zhao Min, Magnussen Costan G, Hu Yifei, Xi Bo
Department of Epidemiology, School of Public Health, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing, China.
Diabetes Obes Metab. 2024 Oct;26(10):4629-4638. doi: 10.1111/dom.15826. Epub 2024 Aug 7.
To investigate the association between metabolically healthy obesity (MHO) and left ventricular geometric remodelling in Chinese children.
This cross-sectional study used data from two population-based samples in China, including 2871 children aged 6-11 years. Weight status was defined based on body mass index according to the World Health Organization growth chart. Metabolic status was defined based on the 2018 consensus-based criteria proposed by Damanhoury et al. Obes Rev 2018;19:1476-1491 (blood pressure, lipids and glucose). Left ventricular geometric remodelling was determined as concentric remodelling, eccentric hypertrophy, and concentric hypertrophy. Multinomial logistic regression analysis was used to determine odds ratios (ORs) and 95% confidence intervals (CIs) for the association between categories of weight and metabolic status and left ventricular geometric remodelling.
Compared with children with metabolically healthy normal weight, those with MHO had higher odds of left ventricular geometric remodelling, with adjusted ORs (95% CIs) of 2.01 (1.23-3.28) for concentric remodelling, 6.36 (4.03-10.04) for eccentric hypertrophy, and 17.07 (7.97-36.58) for concentric hypertrophy. Corresponding ORs (95% CIs) were 2.35 (1.47-3.75), 10.85 (7.11-16.55), and 18.56 (8.63-39.94), respectively, for children with metabolically unhealthy obesity. In contrast, metabolically unhealthy normal weight was not associated with higher odds of left ventricular geometric remodelling. Findings were consistent in sensitivity analyses that used different definitions of weight and metabolic status and left ventricular geometric remodelling.
Children with MHO had higher odds of left ventricular geometric remodelling than their metabolically healthy normal weight counterparts. Our findings suggest MHO may not be a benign condition for cardiac health in children.
探讨中国儿童代谢健康型肥胖(MHO)与左心室几何形态重塑之间的关联。
这项横断面研究使用了来自中国两个基于人群的样本的数据,包括2871名6至11岁的儿童。根据世界卫生组织生长图表,依据体重指数定义体重状况。根据达曼胡里等人于2018年提出的基于共识的标准(《肥胖综述》2018年;19:1476 - 1491,涉及血压、血脂和血糖)定义代谢状况。左心室几何形态重塑被确定为向心性重塑、离心性肥厚和向心性肥厚。采用多项逻辑回归分析来确定体重和代谢状况类别与左心室几何形态重塑之间关联的比值比(OR)和95%置信区间(CI)。
与代谢健康的正常体重儿童相比,MHO儿童发生左心室几何形态重塑的几率更高,向心性重塑的校正OR(95%CI)为2.01(1.23 - 3.28),离心性肥厚为6.36(4.03 - 10.04),向心性肥厚为17.07(7.97 - 36.58)。代谢不健康型肥胖儿童的相应OR(95%CI)分别为2.35(1.47 - 3.75)、10.85(7.11 - 16.55)和18.56(8.63 - 39.94)。相比之下,代谢不健康的正常体重与左心室几何形态重塑几率升高无关。在使用不同体重、代谢状况和左心室几何形态重塑定义的敏感性分析中,结果一致。
MHO儿童发生左心室几何形态重塑的几率高于代谢健康的正常体重儿童。我们的研究结果表明,MHO对儿童心脏健康可能并非良性状况。