Abstract
Objectives
The association between metabolically healthy overweight/obesity (MHO) and inflammatory markers remains controversial. The aim of the present study was to describe the prevalence of different metabolic phenotypes and to examine the relationship of different metabolic phenotypes with inflammatory markers among Chinese children and adolescents.
Methods
The study included 1,125 children and adolescents aged 10–18 years using a cross-sectional survey, and all subjects were classified into four groups based on a combination of BMI and metabolic status. In addition, the inflammatory markers we measured were high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6).
Results
The prevalence of metabolically healthy with normal-weight (MHNW), MHO, metabolically unhealthy with normal-weight (MUNW), and metabolically unhealthy overweight/obesity (MUO) phenotypes was 38.76, 7.11, 38.67 and 15.47%, respectively. The results of logistic regression analysis showed that the MHO was associated with the z scores of hs-CRP in Chinese children and adolescents (OR=0.57, 95% CI: 0.39–0.83). Meanwhile, multivariate adjusted regression analysis showed that the relationship between hs-CRP and MHO among the overweight/obese was consistent with the results above, but among the normal-weight, only the highest quartile of TNF-α could increase the risk of MUNW (OR=1.65, 95% CI: 1.09–2.52).
Conclusions
MHO phenotypes were not common in Chinese children and adolescents. Individuals with MHO had a more beneficial hs-CRP profile than those with MUO.
Funding source: Ningxia Medical University scientific research project
Funding source: The National Natural Science Foundation of China
Award Identifier / Grant number: 82160641
-
Research funding: Project supported by Ningxia Medical University scientific research project, and the National Science Foundation of China (Grant No. 82160641).
-
Author contribution: ZJY, DYY, and DWQ designed, planned, and interpreted the study. BL and CRR collected the data and performed the statistical analysis. ZJY wrote the initial paper, and DWQ revised the paper and led the study. All authors read and approved the final manuscript. DWQ is the corresponding author to this paper.
-
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication. The authors declare that there are no conflicts of interest regarding the publication of this paper.
-
Ethics approval: This study was approved by the ethics committee of the Ningxia Medical University (approval number: 2021-G053). All the subjects agreed to participate in this study and provided written informed consent.
References
1. Mika, KK, Kuosma, E, Ferrie, JE, Luukkonen, R, Nyberg, ST, Alfredsson, L, et al.. Overweight, obesity, and risk of cardiometabolic multimorbidity: pooled analysis of individual-level data for 120,813 adults from 16 cohort studies from the USA and Europe. Lancet Public Health 2017;2:277–85. https://doi.org/10.1016/S2468-2667(17)30074-9.Search in Google Scholar PubMed PubMed Central
2. McPherson, K. Reducing the global prevalence of overweight and obesity. Lancet 2014;384:728–30. https://doi.org/10.1016/s0140-6736(14)60767-4.Search in Google Scholar
3. Jaacks, LM, Vandevijvere, S, Pan, A, McGowan, CJ, Wallace, C, Imamura, F, et al.. The obesity transition: stages of the global epidemic. Lancet Diabetes Endocrinol 2019;7:231–40. https://doi.org/10.1016/s2213-8587(19)30026-9.Search in Google Scholar
4. Skinner, AC, Perrin, EM, Moss, LA, Skelton, JA. Cardiometabolic risks and severity of obesity in children and young adults. N Engl J Med 2015;373:1307–17. https://doi.org/10.1056/nejmoa1502821.Search in Google Scholar
5. Kumar, S, Kelly, AS. Review of childhood obesity: from epidemiology, etiology, and comorbidities to clinical assessment and treatment. Mayo Clin Proc 2017;92:251. https://doi.org/10.1016/j.mayocp.2016.09.017.Search in Google Scholar PubMed
6. Matthias, B. The distinction of metabolically ‘healthy’ from ‘unhealthy’ obese individuals. Curr Opin Lipidol 2010;21:38–43.10.1097/MOL.0b013e3283346cccSearch in Google Scholar PubMed
7. Hotamisligil, GS. Inflammation and metabolic disorders. Nature 2006;444:860–7. https://doi.org/10.1038/nature05485.Search in Google Scholar PubMed
8. Phillips, CM, Perry, IJ. Does inflammation determine metabolic health status in obese and nonobese adults? J Clin Endocrinol Metab 2013;98:E1610–9. https://doi.org/10.1210/jc.2013-2038.Search in Google Scholar PubMed
9. Doumatey, AP, Bentley, AR, Zhou, J, Huang, H, Adeyemo, A, Rotimi, CN. Paradoxical hyperadiponectinemia is associated with the metabolically healthy obese (MHO) phenotype in African Americans. J Endocrinol Metab 2012;2:51–65. https://doi.org/10.4021/jem95W.Search in Google Scholar PubMed PubMed Central
10. Wildman, RP, Kaplan, R, Manson, JE, Rajkovic, A, Connelly, SA, Mackey, RH, et al.. Body size phenotypes and inflammation in the women’s health initiative observational study. Obesity 2011;19:1482–91. https://doi.org/10.1038/oby.2010.332.Search in Google Scholar PubMed PubMed Central
11. Cole, TJ, Bellizzi, MC, Flegal, KM, Dietz, WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000;320:1240–3. https://doi.org/10.1136/bmj.320.7244.1240.Search in Google Scholar PubMed PubMed Central
12. Damanhoury, S, Newton, AS, Rashid, M, Hartling, L, Byrne, JLS, Ball, GDC. Defining metabolically healthy obesity in children: a scoping review. Obes Rev 2018;19:1476–91. https://doi.org/10.1111/obr.12721.Search in Google Scholar PubMed
13. Vukovic, R, Dos Santos, TJ, Ybarra, M, Atar, M. Children with metabolically healthy obesity: a review. Front Endocrinol 2019;10:865. https://doi.org/10.3389/fendo.2019.00865.Search in Google Scholar PubMed PubMed Central
14. MacLeod, L, Bouchard, DR, Hébert, JJ, Boudreau, JG, Sénéchal, M. Association between a comprehensive movement assessment and metabolically healthy overweight obese adults. Sci Rep 2020;10:117. https://doi.org/10.1038/s41598-020-58089-1.Search in Google Scholar PubMed PubMed Central
15. Sénéchal, M, Wicklow, B, Wittmeier, K, Hay, J, MacIntosh, AC, Eskicioglu, P, et al.. Cardiorespiratory fitness, and adiposity in metabolically healthy overweight and obese youth. Pediatrics 2013;132:e85–92. https://doi.org/10.1542/peds.2013-0296.Search in Google Scholar PubMed
16. Camhi, SM, Waring, ME, Sisson, SB, Hayman, LL, Must, A. Physical activity, and screen time in metabolically healthy obese phenotypes in adolescents and adults. J Obes 2013;2013:984613. https://doi.org/10.1155/2013/984613.Search in Google Scholar PubMed PubMed Central
17. Vinciguerra, F, Tumminia, A, Baratta, R, Ferro, A, Alaimo, S, Hagnäs, M, et al.. Prevalence and clinical characteristics of children and adolescents with metabolically healthy obesity: role of insulin sensitivity. Life 2020;10:127. https://doi.org/10.3390/life10080127.Search in Google Scholar PubMed PubMed Central
18. Primeau, V, Coderre, L, Karelis, AD, Brochu, M, Lavoie, ME, Messier, V, et al.. Characterizing the profile of obese patients who are metabolically healthy. Int J Obes 2011;35:971–81. https://doi.org/10.1038/ijo.2010.216.Search in Google Scholar PubMed
19. Matthias, B. Are there still healthy obese patients? Curr Opin Endocrinol Diabetes Obes 2012;19:341–6.10.1097/MED.0b013e328357f0a3Search in Google Scholar PubMed
20. Phillips, CM, Perry, IJ. Does inflammation determine metabolic health status in obese and nonobese adults? J Clin Endocrinol Metab 2013;98:1–10. https://doi.org/10.1210/jc.2013-2038.Search in Google Scholar PubMed
21. Marques-Vidal, P, Velho, S, Waterworth, D, Waeber, G, von Känel, R, Vollenweider, P. The association between inflammatory biomarkers and metabolically healthy obesity depends of the definition used. Eur J Clin Nutr 2012;66:426–35. https://doi.org/10.1038/ejcn.2011.170.Search in Google Scholar PubMed
22. O’Connell, J, Lynch, L, Hogan, A, Cawood, TJ, O’Shea, D. Preadipocyte factor-1 is associated with metabolic profile in severe obesity. J Clin Endocrinol Metab 2011;96:E680–4. https://doi.org/10.1210/jc.2010-2026.Search in Google Scholar PubMed
23. Yudkin, JS, Stehouwer, C, Emeis, J, Coppack, S. C-reactive protein in healthy subjects: associations with obesity, insulin resistance, and endothelial dysfunction: a potential role for cytokines originating from adipose tissue? Arterioscler Thromb Vasc Biol 1999;19:972–8. https://doi.org/10.1161/01.atv.19.4.972.Search in Google Scholar PubMed
24. Koster, A, Stenholm, S, Alley, DE, Kim, LJ, Simonsick, EM, Kanaya, AM, et al.. Body fat distribution and inflammation among obese older adults with and without metabolic syndrome. Obesity 2010;18:2354–61. https://doi.org/10.1038/oby.2010.86.Search in Google Scholar PubMed PubMed Central
© 2021 Walter de Gruyter GmbH, Berlin/Boston
