Puberty has a strong effect on the metabolic health of obese children, according to a study published in the Journal of Clinical Endocrinology & Metabolism.
Obesity is often associated with many cardiovascular (CV) risk factors, but not all obese individuals have these risk factors. In these cases, the status of metabolic healthy obese (MHO) has been proposed for both adults and children.
However, the stability of this status during childhood remains unclear. Researchers sought to analyze changes in MHO status in children over time.
The study included 2,017 obese children (mean age, 11.6 years; mean BMI, 28.5) from the outpatient obesity clinic of the Vestische Children’s Hospital; each child underwent follow-up 1 year later.
Researchers analyzed baseline and follow-up parameters including weight, height, waist and hip circumferences, fasting insulin, blood pressure (BP), fasting glucose, HDL cholesterol and triglyceride levels.
At baseline, 49% of the children were MHO. The MHO children were significantly younger, more frequently prepubertal and less overweight compared with the metabolic unhealthy obese (MUO) children (P<.05 for all).
Pubertal children had a 100% higher risk of being MUO than prepubertal or late pubertal children, according to the data.
After 1 year, 68% of the MHO children and 62% of the MUO children maintained their status, supporting the idea of MHO in children. Increasing weight was associated with switching from MHO to MUO, and decreasing weight was associated with switching from MUO to MHO.
However, the study questions the concept of MHO around puberty. The strongest predictor for MUO was pubertal stage, with the risk for switching from MHO to MUO doubling as children entered puberty.
In contrast, moving from mid- to late puberty tripled the odds of switching from MUO to MHO.
Entering puberty was also associated with deteriorations in BP, lipids, glucose levels and an increase in insulin resistance; transitioning from mid- to late puberty was associated with an improvement of those factors.
The results of this study suggest that while MHO remained stable in children not experiencing puberty, its status is questionable in pubertal children.
Metabolically healthy obesity is a concept that has been proposed in both children and adults. Whether children retain this status, however, is questioned in this study. Researchers examined more than 2,000 obese children, some of whom were metabolically unhealthy and some of whom were metabolically healthy. Study results delineated a potential link between puberty and metabolic health, including clinical parameters like lipid levels, blood pressure and insulin resistance.