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Zhao M, López-Bermejo A, Caserta CA, Medeiros CCM, Kollias A, Bassols J, Romeo EL, Ramos TDA, Stergiou GS, Yang L, Xargay-Torrent S, Amante A, Gusmão TME, Grammatikos E, Zhang Y, Prats-Puig A, de Carvalho DF, Yang L, Carreras-Badosa G, Simões MDO, Hou Y, Mas-Pares B, Shui W, Guo T, Wang M, Chen H, Lou X, Zhang Q, Zhang Y, Bovet P, Magnussen CG, Xi B. Metabolically Healthy Obesity and High Carotid Intima-Media Thickness in Children and Adolescents: International Childhood Vascular Structure Evaluation Consortium. Diabetes Care 2019; 42:119-125. [PMID: 30420475 DOI: 10.2337/dc18-1536] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 09/21/2018] [Indexed: 02/03/2023]
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.
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Affiliation(s)
- Min Zhao
- Department of Nutrition and Food Hygiene, School of Public Health, Shandong University, Jinan, China
| | - Abel López-Bermejo
- Pediatric Endocrinology Group, Girona Biomedical Research Institute (IDIBGI), Salt, Spain.,Department of Pediatrics, Hospital Dr. Josep Trueta, Girona, Spain
| | - Carmelo A Caserta
- Fondazione per la Medicina Solidale, Pellaro, Reggio Calabria, Italy
| | | | - Anastasios Kollias
- Hypertension Center STRIDE-7, School of Medicine, National and Kapodistrian University of Athens, Third Department of Medicine, Sotiria Hospital, Athens, Greece
| | - Judit Bassols
- Department of Pediatrics, Hospital Dr. Josep Trueta, Girona, Spain.,Maternal-Fetal Metabolic Group, Girona Biomedical Research Institute (IDIBGI), Salt, Spain
| | | | - Thacira Dantas Almeida Ramos
- Department of Medicine, University Center of Medical Sciences of Campina Grande, Campina Grande, Brazil.,Department of Maternal and Child Health, Professor Fernando Figueira Integral Medicine Institute, Recife, Brazil
| | - George S Stergiou
- Hypertension Center STRIDE-7, School of Medicine, National and Kapodistrian University of Athens, Third Department of Medicine, Sotiria Hospital, Athens, Greece
| | - Lili Yang
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - Silvia Xargay-Torrent
- Pediatric Endocrinology Group, Girona Biomedical Research Institute (IDIBGI), Salt, Spain
| | - Angela Amante
- Associazione Calabrese di Epatologia, Pellaro, Reggio Calabria, Italy
| | - Tatianne Moura Estrela Gusmão
- Department of Maternal and Child Health, Professor Fernando Figueira Integral Medicine Institute, Recife, Brazil.,Department of Physiotherapy, University Center of Medical Sciences of Campina Grande, Campina Grande, Brazil
| | | | - Yuanyuan Zhang
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - Anna Prats-Puig
- Department of Physical Therapy, Escola Universitària de la Salut i l'Esport, Salt, Spain
| | | | - Liu Yang
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - Gemma Carreras-Badosa
- Pediatric Endocrinology Group, Girona Biomedical Research Institute (IDIBGI), Salt, Spain
| | | | - Yaping Hou
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - Berta Mas-Pares
- Maternal-Fetal Metabolic Group, Girona Biomedical Research Institute (IDIBGI), Salt, Spain
| | - Wang Shui
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - Teng Guo
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - Mingming Wang
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - Hua Chen
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - Xiaohuan Lou
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - Qian Zhang
- Zibo Disease Control and Prevention Center, Zibo, China
| | - Yanqing Zhang
- Zibo Disease Control and Prevention Center, Zibo, China
| | - Pascal Bovet
- Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Costan G Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.,Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Bo Xi
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
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