Comparative analyses of surrogates of metabolic syndrome in children and adolescents with metabolically healthy obesity vs. metabolically unhealthy obesity according to Damanhoury’s criteria

Riham Mohamad; Aydilek Dagdeviren Cakir; Halil İbrahim Ada; Ahmet Uçar

doi:10.1515/jpem-2022-0484

Article

Comparative analyses of surrogates of metabolic syndrome in children and adolescents with metabolically healthy obesity vs. metabolically unhealthy obesity according to Damanhoury’s criteria

Riham Mohamad , Aydilek Dagdeviren Cakir , Halil İbrahim Ada and Ahmet Uçar

Published/Copyright: April 6, 2023

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From the journal Journal of Pediatric Endocrinology and Metabolism Volume 36 Issue 5

Abstract

Objectives

Metabolically healthy obesity (MHO) has been reported with varying frequencies in children. The reasons of metabolically healthy phenotype in some obese subjects are unclear. Our aim was to identify the frequency of MHO in obese subjects, to assess the potential associations of demographic characteristics, serum uric acid, alanine transaminase (ALT), pediatric nonalcoholic fatty liver disease fibsosis score probability (PNFS p) with MHO status and to evaluate the differences between MHO and metabolically unhealthy obesity (MUO) with regard to metabolic syndrome surrogates.

Methods

251 consecutive obese subjects (125 females) aged 7–18 years were included. Subjects were classified as having MHO according to Damanhoury’s criteria. Several metabolic variables were measured, PNFS p was calculated by using the formula: z=1.1+(0.34*sqrt(ALT))+ (0.002*ALP)–(1.1*log(platelets)–(0.02*GGT).

Results

Median age of the subjects was 12.5 yr (range: 7.0–17.0 yr). The frequency of MHO was 41 %. Subjects with MHO were significantly younger, had lower waist circumference (WC) and waist height ratio (WHtR) and lower HOMA-IR than those without MHO(p<0.05 for all). Frequencies of hyperuricemia, hypertransaminasemia, hepatosteatosis and PNFS p values≥8 were similar betwen the groups. When putatively influential factors associated with MHO status were assessed with logistic regression analysis, only WC(β=1.03) and HOMA-IR(β=1.166) emerged as significant factors(Nagelkerke R2=0.142). None of the investigated demographic factors were associated with MHO status.

Conclusions

We found a remarkably high frequency of MHO status. Nevertheless, the absence of decreased frequencies of hyperuricemia, hypertransaminasemia and PNFS in subjects with MHO may suggest the need to reconsider the validity of the criteria defining MHO.

Keywords: alanine transaminase; metabolic healthy obese; PNFS; uric acid

Corresponding author: Aydilek Dağdeviren Çakır, MD, Department of Pediatric Endocrinology and Diabetes, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Türkiye, Phone: 0(535) 922 32 65, E-mail: aydi.dagdeviren@hotmail.com

Research funding: None declared.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: Authors state no conflict of interest.
Informed consent: Informed consent was obtained from all individuals included in this study.
Ethical approval: The study protocol was approved by the local Ethics Committee (number: 3109).

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Received: 2022-09-23

Accepted: 2023-03-20

Published Online: 2023-04-06

Published in Print: 2023-05-25

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Articles in the same Issue

https://doi.org/10.1515/jpem-2022-0484

Keywords for this article

alanine transaminase; metabolic healthy obese; PNFS; uric acid