Association between metabolically healthy obesity and carotid intima-media thickness in Korean adolescents with overweight and obesity
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Purpose: Data regarding the association between metabolically healthy obesity (MHO) and preclinical atherosclerosis in childhood are lacking. Carotid intima-media thickness (cIMT) is a noninvasive method used to assess cardiovascular risk. This study examined the relationships among cIMT, metabolic phenotypes, and cardiometabolic risk factors (CMRFs) in overweight and obese adolescents.Methods: Anthropometric, biochemical, and cIMT data were collected. The study participants were categorized as MHO or metabolically unhealthy obesity (MUO) based on insulin resistance. CMRFs were assessed using blood pressure (BP); levels of triglycerides, high-density lipoprotein cholesterol (HDL-C), and fasting plasma glucose; or a diagnosis of diabetes mellitus. Differences in cIMT values were evaluated according to the metabolic phenotype and factors associated with cIMT.Results: Among the 111 participants (80 boys, 72.1%), 23 (20.7%) were classified as MHO and 88 (79.3%) as MUO. The MHO group exhibited lower glycated hemoglobin and triglyceride levels and higher HDL-C levels compared to those exhibited by the MUO group (all P<0.01). The cIMT values did not differ significantly between the MHO and MUO groups. The high cIMT tertile group revealed higher systolic BP compared to that exhibited by the low cIMT tertile group (123.7±2.1 mmHg vs. 116.9±1.6 mmHg, P=0.028). Mean cIMT was positively correlated with age (β=0.009) and body mass index (BMI) (β=0.033) after adjusting for covariates (both P<0.05).Conclusion: In overweight and obese Korean adolescents, cIMT was associated with age and BMI but not with metabolic phenotype or CMRFs. Further research is warranted to determine the relationship between cIMT during adolescence and cardiovascular outcomes during adulthood.
Abstract
Purpose: Data regarding the association between metabolically healthy obesity (MHO) and preclinical atherosclerosis in childhood are lacking. Carotid intima-media thickness (cIMT) is a noninvasive method used to assess cardiovascular risk. This study examined the relationships among cIMT, metabolic phenotypes, and cardiometabolic risk factors (CMRFs) in overweight and obese adolescents.Methods: Anthropometric, biochemical, and cIMT data were collected. The study participants were categorized as MHO or metabolically unhealthy obesity (MUO) based on insulin resistance. CMRFs were assessed using blood pressure (BP); levels of triglycerides, high-density lipoprotein cholesterol (HDL-C), and fasting plasma glucose; or a diagnosis of diabetes mellitus. Differences in cIMT values were evaluated according to the metabolic phenotype and factors associated with cIMT.Results: Among the 111 participants (80 boys, 72.1%), 23 (20.7%) were classified as MHO and 88 (79.3%) as MUO. The MHO group exhibited lower glycated hemoglobin and triglyceride levels and higher HDL-C levels compared to those exhibited by the MUO group (all P<0.01). The cIMT values did not differ significantly between the MHO and MUO groups. The high cIMT tertile group revealed higher systolic BP compared to that exhibited by the low cIMT tertile group (123.7±2.1 mmHg vs. 116.9±1.6 mmHg, P=0.028). Mean cIMT was positively correlated with age (β=0.009) and body mass index (BMI) (β=0.033) after adjusting for covariates (both P<0.05).Conclusion: In overweight and obese Korean adolescents, cIMT was associated with age and BMI but not with metabolic phenotype or CMRFs. Further research is warranted to determine the relationship between cIMT during adolescence and cardiovascular outcomes during adulthood.
참고문헌 (39)
- Di Cesare M, "The epidemiological burden of obesity in childhood : a worldwide epidemic requiring urgent action", BMC Med, 17, pp.212~ (2019)
- Kim JH, "Secular trends in pediatric overweight and obesity in Korea", J Obes Metab Syndr, 29, pp.12~17 (2020)
- Lee J, "Endocrine comorbidities of pediatric obesity", Clin Exp Pediatr, 64, pp.619~627 (2021)
- Yoo SE, "Increasing prevalence of fasting hyperglycemia in adolescents aged 10-18 years and its relationship with metabolic indicators : the Korea National Health and Nutrition Examination Study(KNHANES), 2007-2018", Ann Pediatr Endocrinol Metab, 27, pp.60~68 (2022)
- Kim M, "Cardiometabolic risk factors and metabolic syndrome based on severity of obesity in Korean children and adolescents : data from the Korea National Health and Nutrition Examination Survey 2007-2018", Ann Pediatr Endocrinol Metab, 27, pp.289~299 (2022)
- Simmonds M, "Predicting adult obesity from childhood obesity : a systematic review and meta-analysis", Obes Rev, 17, pp.95~107 (2016)
- Phillips CM, "Metabolically healthy obesity across the life course : epidemiology, determinants, and implications", Ann N Y Acad Sci, 1391, pp.85~100 (2017)
- Blüher M, "Metabolically healthy obesity", Endocr Rev, 41, pp.bnaa004~ (2020)
- Videira-Silva A, "Metabolically healthy overweight adolescents : definition and components", Ann Pediatr Endocrinol Metab, 25, pp.256~264 (2020)
- Kim HY, "Temporal trends in the prevalence of metabolically healthy overweight and obesity in Korean youth : data from the Korea National Health and Nutrition Examination Survey 2011-2019", Ann Pediatr Endocrinol Metab, 27, pp.134~141 (2022)
- Hinnouho GM, "Metabolically healthy obesity and risk of mortality : does the definition of metabolic health matter?", Diabetes Care, 36, pp.2294~2300 (2013)
- Kramer CK, "Are metabolically healthy overweight and obesity benign conditions? : a systematic review and meta-analysis", Ann Intern Med, 159, pp.758~769 (2013)
- Opio J, "Metabolically healthy overweight", obesity are associated with increased risk of cardiovascular disease in adults, even in the absence of metabolic risk factors : a systematic review and meta-analysis of prospective cohort studies, 2020, pp.21, e13127~
- George JM, "The carotid intima media thickness : a predictor of the clincal coronary events", J Clin Diagn Res, 7, pp.1082~1085 (2013)
- Willeit P, "Carotid intima-media thickness progression as surrogate marker for cardiovascular risk : meta-analysis of 119 clinical trials involving 100 667 patients", Circulation, 142, pp.621~642 (2020)
- Park MH, "Adiposity and carotid-intima media thickness in children and adolescents : a systematic review", BMC Pediatr, 15, pp.161~ (2015)
- Lim SM, "Association between blood pressure and carotid intima-media thickness", J Pediatr, 154, pp.667~671 (2009)
- Zhao M, "Metabolically healthy obesity and high carotid intima-media thickness in children and adolescents : international childhood vascular structure evaluation consortium", Diabetes Care, 42, pp.119~125 (2019)
- Farello G, "Metabolically healthy and metabolically unhealthy obese children both have increased carotid intima-media thickness : a case control study", BMC Cardiovasc Disord, 18, pp.140~ (2018)
- Kim JH, "The 2017 Korean National Growth Charts for children and adolescents : development, improvement, and prospects", Korean J Pediatr, 61, pp.135~149 (2018)
- Lee J, "Reference Values for Waist Circumference and Waist-Height Ratio in Korean Children and Adolescents", J Obes Metab Syndr, 31, pp.263~271 (2022)
- Matthews DR, "Homeostasis model assessment : insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man", Diabetologia, 28, pp.412~419 (1985)
- Yi KH, "Prevalence of insulin resistance and cardiometabolic risk in Korean children and adolescents : a population-based study", Diabetes Res Clin Pract, 103, pp.106~113 (2014)
- Kim SH, "Blood pressure reference values for normal weight Korean children and adolescents : data from the Korea National Health and Nutrition Examination Survey 1998-2016 : The Korean Working Group of Pediatric Hypertension", Korean Circ J, 49, pp.1167~1180 (2019)
- Damanhoury S, "Defining metabolically healthy obesity in children : a scoping review", Obes Rev, 19, pp.1476~1491 (2018)
- American Diabetes Association, "Diagnosis and classification of diabetes mellitus", Diabetes Care, 37(Suppl 1), pp.S81~S90 (2014)
- Kavey RE, "Cardiovascular risk reduction in high-risk pediatric patients : a scientific statement from the American Heart Association Expert Panel on Population and Prevention Science; the Councils on Cardiovascular Disease in the Young, Epidemiology and Prevention, Nutrition, Physical Activity and Metabolism, High Blood Pressure Research, Cardiovascular Nursing, and the Kidney in Heart Disease; and the Interdisciplinary Working Group on Quality of Care and Outcomes Research : endorsed by the American Academy of Pediatrics", Circulation, 114, pp.2710~2738 (2006)
- de Groot E, "Measurement of arterial wall thickness as a surrogate marker for atherosclerosis", Circulation, 109(23 Suppl 1), pp.III33~III38 (2004)
- Meyer AA, "Improvement of early vascular changes and cardiovascular risk factors in obese children after a sixmonth exercise program", J Am Coll Cardiol, 48, pp.1865~1870 (2006)
- Abellaneda Millán M, "Sonographic markers are useful for detection of early vascular deterioration in children with overweight", obesity : effect of a 1-year combined nutritional education and physical exercise program, 2023, pp.15, 894~
- Dalla Pozza R, "Intima media thickness measurement in children : a statement from the Association for European Paediatric Cardiology(AEPC)Working Group on Cardiovascular Prevention endorsed by the Association for European Paediatric Cardiology", Atherosclerosis, 238, pp.380~387 (2015)
- Jourdan C, "Normative values for intima-media thickness and distensibility of large arteries in healthy adolescents", J Hypertens, 23, pp.1707~1715 (2005)
- Doyon A, "Carotid artery intima-media thickness and distensibility in children and adolescents : reference values and role of body dimensions", Hypertension, 62, pp.550~556 (2013)
- Engelen L, "Reference intervals for common carotid intima-media thickness measured with echotracking : relation with risk factors", Eur Heart J, 34, pp.2368~2380 (2013)
- Dalla Pozza R, "Carotid intima media thickness and cardiac allograft vasculopathy after heart transplantation in childhood", Transplantation, 91, pp.e46~e47 (2011)
- Gooty VD, "Association between carotid intima media thickness, age, and cardiovascular risk factors in children and adolescents", Metab Syndr Relat Disord, 16, pp.122~126 (2018)
- Neuhauser HK, "Carotid intima-media thickness percentiles in adolescence and young adulthood and their association with obesity and hypertensive blood pressure in a population cohort", Hypertension, 79, pp.1167~1176 (2022)
- Ferreira JP, "Intima-Media Thickness Is Linearly and Continuously Associated With Systolic Blood Pressure in a Population-Based Cohort(STANISLAS Cohort Study)", J Am Heart Assoc, 5, pp.e003529~ (2016)
- Day TG, "The association between blood pressure and carotid intima-media thickness in children : a systematic review", Cardiol Young, 27, pp.1295~1305 (2017)