Background: The theory of Metabolically healthy obese individuals is become very popular in researchers across the world. Nevertheless, obese persons are at increased risk for adverse long-term outcomes compared with metabolically healthy normal-weight individuals.
Objective: To determine the obesity-related cardiovascular comorbidities in metabolically healthy obese adolescents comparatively to lean and metabolically unhealthy ones.
Methods: 208 obese adolescents aged 1017 were examined with an analysis of body composition, lipid and carb parameters, evaluation left ventricular (LV) geometry and function, 24-h BP monitoring, carotid intima-media thickness (CIMT). IDF criteria were used for grouping for metabolically healthy (MH) and metabolically unhealthy (MUH). Control group 27 lean healthy (LH) subjects. Standard statistical methods were used for the data analysis.
Results: BMI in MUH group was greater than in MH (P=0.019) due to fat mass (P=0.020), despite of the same values of waist to height ratio (P=0.071) and lean mass (P=0.124). Interestingly the upper arm circumference to lean mass ratio was greater in MUH vs MH (P=0.031). Clearly lipid parameters (TC, TG, HDL, FFA) were higher in MUH vs MH (P<0.001 for all) and in MH vs LH (P<0.001 for all). Fasting insulin levels and HOMA-IR were similar (P=0.431; P=0.364), but greater vs LH. LV mass indexed was increased in all obese subjects: LH vs MH and MUH (P=0.013; 0.002), but without difference MH vs MUH (P=0.469). CIMT higher in obese (P<0.001) and no distinction MH vs MUH (P=0.199). SBP gradually growing from lean to MUH (LH vs MH P<0.001; MH vs MUH P=0.014). DPB didnt reveal any difference with a lean group.
Conclusion: Our data suggests the presence of independent cardiovascular risk markers such as myocardial hypertrophy, thickening carotid vessels and systolic hypertension in both metabolically healthy and unhealthy individuals. Considered the lipid flux between fat and lean body compartments at the insulin resistance background plays the key role in risk development.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology