Metabolically Healthy Obese Children, Adolescents at Higher Risk for CVD
Some obese individuals do not develop metabolic disorders at a certain point in time, and these individuals have been described as “metabolically healthy obese.”
Children and adolescents with metabolically healthy obesity had higher carotid intima-media thickness (cIMT), which is a proxy for cardiovascular disease risk, compared with metabolically healthy individuals who were a normal weight, according to study findings published in Diabetes Care.
Research has demonstrated that childhood obesity is associated with several cardiometabolic disorders. Conversely, several earlier studies in adults have suggested that metabolically healthy obesity was not associated with a higher risk for cardiovascular disease when compared with individuals who were a metabolically healthy normal weight. However, more recent data suggest that this may not be true. To better understand the association between metabolically healthy obesity and high cIMT in young people, this study examined 3497 children and adolescents ages 6 to 17 using population-based data from Brazil, China, Greece, Italy, and Spain.
Measurements of cIMT were higher in participants with metabolically healthy obesity and metabolically healthy overweight compared with participants with metabolically healthy normal weight. The odds ratios for high cIMT were 2.29 (95% CI, 1.58-3.32) for metabolically healthy overweight and 3.91 (95% CI, 2.46-6.21) for metabolically healthy overweight. In addition, the odds ratios for high cIMT were 1.44 (95% CI, 1.03-2.02) for metabolically unhealthy normal weight, 3.49 (95% CI, 2.51-4.85) for metabolically unhealthy overweight, and 6.96 (95% CI, 5.05-9.61) for metabolically unhealthy obesity, compared with participants with metabolically healthy normal weight.
“Our ﬁndings provide pediatric evidence that [metabolically healthy obesity] is not a harmless condition, and this reinforces the need for weight control in children and adolescents regardless of their metabolic status,” concluded the researchers.
Zhao M, López-Bermejo A, Caserta CA, et al. Metabolically healthy obesity and high carotid intima-media thickness in children and adolescents: International Childhood Vascular Structure Evaluation Consortium [published online November 12, 2018]. Diabetes Care. doi:10.2337/dc18-1536