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Metabolically healthy obesity and high carotid intima-media thickness in children and adolescents: International Childhood Vascular Structure Evaluation Consortium

Zhao, M, Lopez-Bermejo, A, Caserta, CA, Medeiros, CCM, Kollias, A, Bassols, J, Romeo, EL, Ramos, TDA, Stergiou, GS, Yang, L, Xargay-Torrent, S, Amante, A, Gusmao, TME, Grammatikos, E, Zhang, Yuanyuan, Prats-Puig, A, de Carvalho, DF, Yang, L, Carreras-Badosa, G, de Oliveira Simoes, M, Hou, Y, Mas-Pares, B, Shui, W, Guo, T, Wang, M, Chen, H, Lou, X, Zhang, Q, Zhang, Yanqing, Bovet, P, Magnussen, CG ORCID: 0000-0002-6238-5730 and Xi, B 2019 , 'Metabolically healthy obesity and high carotid intima-media thickness in children and adolescents: International Childhood Vascular Structure Evaluation Consortium' , Diabetes Care, vol. 42, no. 1 , pp. 119-125 , doi: 10.2337/dc18-1536.

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Objective: It has been argued that metabolically healthy obesity (MHO) does not increase cardiovascular disease (CVD) risk. This study examines the association of MHO with carotid intima-media thickness (cIMT), a proxy of CVD risk, in children and adolescents.Research Design and Methods: Data were available for 3,497 children and adolescents aged 6-17 years from five population-based cross-sectional studies in Brazil, China, Greece, Italy, and Spain. Weight status categories (normal, overweight, and obese) were defined using BMI cutoffs from the International Obesity Task Force. Metabolic status (defined as "healthy" [no risk factors] or "unhealthy" [one or more risk factors]) was based on four CVD risk factors: elevated blood pressure, elevated triglyceride levels, reduced HDL cholesterol, and elevated fasting glucose. High cIMT was defined as cIMT ≥90th percentile for sex, age, and study population. Logistic regression model was used to examine the association of weight and metabolic status with high cIMT, with adjustment for sex, age, race/ethnicity, and study center.Results: In comparison with metabolically healthy normal weight, odds ratios (ORs) for high cIMT were 2.29 (95% CI 1.58-3.32) for metabolically healthy overweight and 3.91 (2.46-6.21) for MHO. ORs for high cIMT were 1.44 (1.03-2.02) for unhealthy normal weight, 3.49 (2.51-4.85) for unhealthy overweight, and 6.96 (5.05-9.61) for unhealthy obesity.Conclusions: Among children and adolescents, cIMT was higher for both MHO and metabolically healthy overweight compared with metabolically healthy normal weight. Our findings reinforce the need for weight control in children and adolescents irrespective of their metabolic status.

Item Type: Article
Authors/Creators:Zhao, M and Lopez-Bermejo, A and Caserta, CA and Medeiros, CCM and Kollias, A and Bassols, J and Romeo, EL and Ramos, TDA and Stergiou, GS and Yang, L and Xargay-Torrent, S and Amante, A and Gusmao, TME and Grammatikos, E and Zhang, Yuanyuan and Prats-Puig, A and de Carvalho, DF and Yang, L and Carreras-Badosa, G and de Oliveira Simoes, M and Hou, Y and Mas-Pares, B and Shui, W and Guo, T and Wang, M and Chen, H and Lou, X and Zhang, Q and Zhang, Yanqing and Bovet, P and Magnussen, CG and Xi, B
Journal or Publication Title: Diabetes Care
Publisher: Amer Diabetes Assoc
ISSN: 0149-5992
DOI / ID Number: 10.2337/dc18-1536
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Copyright 2019 American Diabetes Association

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