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Journal of Pediatric Endocrinology and Metabolism

Editor-in-Chief: Kiess, Wieland

Ed. by Bereket, Abdullah / Darendeliler, Feyza / Dattani, Mehul / Gustafsson, Jan / Luo, Fei Hong / Mericq, Veronica / Toppari, Jorma

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Volume 29, Issue 5


Classification and clinical characterization of metabolically “healthy” obese children and adolescents

Liene Bervoets / Guy Massa
  • Corresponding author
  • Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
  • Department of Pediatrics, Jessa Hospital, Stadsomvaart 11, 3500 Hasselt, Belgium
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2016-02-24 | DOI: https://doi.org/10.1515/jpem-2015-0395


Background: Some obese children do not show cardiometabolic complications such as prediabetes, dyslipidemia or insulin resistance. The objective of the study was to classify obese children and adolescents as metabolically “healthy” obese (MHO) on the basis of three different definitions, and to compare cardiometabolic features with metabolically unhealthy obese (MUO) children and adolescents.

Methods: The study included 156 obese children and adolescents aged between 10 and 18. Subjects were classified as MHO or MUO using three definitions based on the: (1) pediatric International Diabetes Federation (IDF) criteria; (2) homeostatic model assessment of insulin resistance (HOMA-IR); (3) combination of the previous two definitions. Cardiometabolic features were compared between MHO and MUO subjects.

Results: Six to 19% obese children and adolescents were classified as MHO, and showed a better insulin sensitivity, lower prevalence of prediabetes, lower triglycerides and lower triglyceride-to-HDL-C ratio compared to MUO.

Conclusions: Less than 20% obese children and adolescents are identified as MHO and show a healthier cardiometabolic profile as compared to MUO. Implementation of the proposed classifications in future clinical research could contribute towards the standardization of the MHO definition and offer new insights into the manifestation of the pediatric MHO phenotype.

Keywords: adolescents; children; insulin resistance; metabolic syndrome; obesity


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About the article

Corresponding author: Prof. Dr. Guy Massa, Department of Pediatrics, Jessa Hospital, Stadsomvaart 11, 3500 Hasselt, Belgium, Phone: +32 11 30 89 80, Fax: +32 11 30 98 98, E-mail: ; and Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium

Received: 2015-10-04

Accepted: 2015-12-14

Published Online: 2016-02-24

Published in Print: 2016-05-01

Citation Information: Journal of Pediatric Endocrinology and Metabolism, Volume 29, Issue 5, Pages 553–560, ISSN (Online) 2191-0251, ISSN (Print) 0334-018X, DOI: https://doi.org/10.1515/jpem-2015-0395.

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