Min Zhao1, Abel López-Bermejo2,3, Carmelo A Caserta4, Carla Campos Muniz Medeiros5, Anastasios Kollias6, Judit Bassols3,7, Elisabetta L Romeo4, Thacira Dantas Almeida Ramos8,9, George S Stergiou6, Lili Yang10, Silvia Xargay-Torrent2, Angela Amante11, Tatianne Moura Estrela Gusmão9,12, Evangelos Grammatikos13, Yuanyuan Zhang10, Anna Prats-Puig14, Danielle Franklin de Carvalho5, Liu Yang10, Gemma Carreras-Badosa2, Mônica de Oliveira Simões5, Yaping Hou10, Berta Mas-Pares7, Wang Shui10, Teng Guo10, Mingming Wang10, Hua Chen10, Xiaohuan Lou10, Qian Zhang15, Yanqing Zhang15, Pascal Bovet16, Costan G Magnussen17,18, Bo Xi19. 1. Department of Nutrition and Food Hygiene, School of Public Health, Shandong University, Jinan, China. 2. Pediatric Endocrinology Group, Girona Biomedical Research Institute (IDIBGI), Salt, Spain. 3. Department of Pediatrics, Hospital Dr. Josep Trueta, Girona, Spain. 4. Fondazione per la Medicina Solidale, Pellaro, Reggio Calabria, Italy. 5. Department of Public Health, State University of Paraiba, Campina Grande, Brazil. 6. Hypertension Center STRIDE-7, School of Medicine, National and Kapodistrian University of Athens, Third Department of Medicine, Sotiria Hospital, Athens, Greece. 7. Maternal-Fetal Metabolic Group, Girona Biomedical Research Institute (IDIBGI), Salt, Spain. 8. Department of Medicine, University Center of Medical Sciences of Campina Grande, Campina Grande, Brazil. 9. Department of Maternal and Child Health, Professor Fernando Figueira Integral Medicine Institute, Recife, Brazil. 10. Department of Epidemiology, School of Public Health, Shandong University, Jinan, China. 11. Associazione Calabrese di Epatologia, Pellaro, Reggio Calabria, Italy. 12. Department of Physiotherapy, University Center of Medical Sciences of Campina Grande, Campina Grande, Brazil. 13. Pediatric Department, General Hospital of Samos, Vathi, Greece. 14. Department of Physical Therapy, Escola Universitària de la Salut i l'Esport, Salt, Spain. 15. Zibo Disease Control and Prevention Center, Zibo, China. 16. Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland. 17. Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia. 18. Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland. 19. Department of Epidemiology, School of Public Health, Shandong University, Jinan, China xibo2007@126.com xibo2010@sdu.edu.cn.
Abstract
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.
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.
Authors: Scott T Chiesa; Marietta Charakida; Georgios Georgiopoulos; Frida Dangardt; Kaitlin H Wade; Alicja Rapala; Devina J Bhowruth; Helen C Nguyen; Vivek Muthurangu; Rukshana Shroff; George Davey Smith; Debbie A Lawlor; Naveed Sattar; Nicholas J Timpson; Alun D Hughes; John E Deanfield Journal: JACC Cardiovasc Imaging Date: 2019-10-11
Authors: Giulietta S Monasso; Carolina C V Silva; Susana Santos; Romy Goncalvez; Romy Gaillard; Janine F Felix; Vincent W V Jaddoe Journal: Obesity (Silver Spring) Date: 2022-02-10 Impact factor: 9.298