ESPE Abstracts (2014) 82 P-D-1-2-116

Characterizing the Metabolically Obese Normal Weight Phenotype in Youth

Melanie Hendersona, Marie-Eve Mathieua, Andrea Benedettic & Tracie Barnettb


aUniversity of Montreal, Montreal, Quebec, Canada; bConcordia University, Montreal, Quebec, Canada; cMcGill University, Montreal, Quebec, Canada


Background: Although metabolically obese normal weight (MONW) adults are at increased risk of type 2 diabetes and cardiovascular disease (CVD), little is known regarding MONW children.

Objective and hypotheses: To characterize lifestyle habits and insulin dynamics of MONW children.

Method: Caucasian youth (n=630) aged 8–10 years, with at least one obese biological parent, were studied (QUALITY cohort). We defined MONW children as having normal weight and at least one of: triglycerides >1.2 mmol/l, fasting glucose >6.1, HDL-cholesterol <1.04, blood pressure (BP) >95th percentile for age and sex and height, or waist circumference >90th percentile for age and sex (n=53). Fitness was measured by VO2peak, moderate to vigorous physical activity (MVPA) using accelerometry. Sedentary behavior indicators included average hours daily of self-reported screen time (SBST), and average minutes daily at <100 counts/min from accelerometry (SBacc). Insulin sensitivity and secretion were measured with Matsuda-insulin sensitivity index (ISI) and the ratio of the area under the curve of insulin to glucose (AUC I/G 30 min) over the first 30 min of an OGTT respectively. We compared MONW children to normal weight youth with no risk factors (n=182) using t-tests.

Results: No normal weight youth (n=235) met criteria for metabolic syndrome, while 47/235 children had one CVD risk factor, and 6/235 had two risk factors. Children with at least one risk factor (22.6%) vs those without had: i) lower MVPA (57 vs 48 min/day, P=0.03); ii) higher SBST (3.1 vs 2.3 h/day, P=0.006). There were no differences between the groups in terms of age, sex, fitness, SBacc, Matsuda-ISI or AUC I/G 30 min.

Conclusion: Further research is warranted to better understand what characteristics distinguish normal weight youth without CVD risk factors from MONW youth, towards the development of early CVD prevention strategies.

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