Differences between Metabolically Healthy vs Unhealthy Obese Children and Adolescents
Autor: | Vatcharapan Umpaichitra, Tanni Farook, Elna Kochummen, Vivian L. Chin, Aditi Khokhar, Shipra Bansal, Sheila Perez-Colon |
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Rok vydání: | 2016 |
Předmět: |
Male
medicine.medical_specialty Pediatric Obesity Adolescent 030209 endocrinology & metabolism 030204 cardiovascular system & hematology Fasting glucose 03 medical and health sciences Young Adult 0302 clinical medicine Risk Factors Chart review Internal medicine medicine Humans Healthy Lifestyle Child Retrospective Studies Metabolic Syndrome business.industry Age Factors General Medicine medicine.disease Obesity Endocrinology Cross-Sectional Studies Logistic Models Phenotype Case-Control Studies Child Preschool Female Waist Circumference business |
Zdroj: | Journal of the National Medical Association. 109(3) |
ISSN: | 0027-9684 |
Popis: | Obesity is on the rise worldwide. An obesity subtype, metabolically healthy obese (MHO), is resilient to unfavorable metabolic and cardiovascular effects. Factors predicting MHO phenotype are not well characterized. We aimed to identify MHO and metabolically unhealthy obese (MUO) children and adolescents with respect to metabolic factors, and to find predictors of MHO subtype. A retrospective chart review was done on children, ages 4-19 years, 99% African-American/Caribbean, with BMI ≥95th %tile. MUO was defined as meeting ≥1 of the following: fasting glucose ≥100 mg/dl, HbA1c5.6%, BP ≥90th %tile, TG ≥150 mg/dl, or HDL40 mg/dl. Study included 189 subjects, 37.6% were MHO and 62.4% MUO. MHO subjects were younger (mean ± SD, 11.6 ± 3.3 vs 12.9 ± 3.2 years; p 0.009) and had lower BMI %tile (98.4 ± 1.4 vs 98.8 ± 2.1; p 0.04), smaller waist (94.2 ± 15.2 vs 101.4 ± 17 cm; p 0.003) and hip circumferences (105.3 ± 15.6 vs 113.5 ± 15.4 cm; p 0.001), lower fasting insulin (18.5 ± 10.2 vs 24.2 ± 14.3 μU/ml; p 0.022), and lower HOMA-IR (4.1 ± 2.4 vs 5.5 ± 3.6; p 0.022). Acanthosis nigricans was noted less frequently in MHO than MUO (p 0.005). In stepwise logistic regression, age and BMI %tile were significant predictors of MHO. We found that 38% of obese children are MHO. They are younger and have lower BMI %tiles. Lifestyle modification initiated at an early age may prevent metabolic abnormalities. |
Databáze: | OpenAIRE |
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