Ann Pediatr Endocrinol Metab > Volume 25(4); 2020 > Article |
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Ethical statement
This study was approved by the Ethics Committee of the Faculty of Medicine of the University of Lisbon, Portugal (271/2016), and is in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed assent/consent was provided by all participants and their respective caretakers.
Characteristic |
Cross-sectional sample |
P-value | Total |
Longitudinal sample |
P-value | Total | ||
---|---|---|---|---|---|---|---|---|
Girls | Boys | Girls | Boys | |||||
Race, Caucasian | 222/256 (86.7) | 201/231 (87.0) | 0.998* | 237/487 (88.1) | 88/96 (91.7) | 72/80 (90.0) | 0.294* | 160/176 (90.9) |
Age (yr) | 14.5±2.2 | 14.1±2.1 | 0.032 | 14.4±2.2 | 14.4±2.0 | 14.1±2.1 | 0.410 | 14.3±2.0 |
Age (mo) | 175±26 | 170±25 | 0.033 | 172±26 | 173±24 | 170±25 | 0.429 | 171±24 |
Weight (kg) | 82.9±18.6 | 86.8±24.1 | 0.048 | 84.7±21.5 | 81.5±15.9 | 88.2±25.5 | 0.043 | 84.6±21.0 |
Height (cm) | 158.9±7.5 | 164.3±10.6 | <0.001 | 161.5±9.5 | 158.3±7.9 | 163.6±11.0 | <0.001 | 160.7±9.8 |
BMI (kg/m2) | 32.61±6.07 | 31.68±6.28 | 0.098 | 32.17±6.18 | 32.34±4.85 | 32.45±6.33 | 0.899 | 32.39±5.82 |
BMI z-score | 2.65±1.09 | 2.84±1.03 | 0.050 | 2.74±1.07 | 2.65±.82 | 3.03±1.06 | 0.012 | 2.83±.95 |
WC (cm) | 101.3±12.9 | 104.3±14.7 | 0.030 | 102.7±13.9 | 101.6±10.8 | 105.9±16.8 | 0.078 | 103.4±13.8 |
Pubertal status | <0.001* | <0.001* | ||||||
Tanner stage II | 28/248 (11.3) | 70/218 (32.1) | 55/466 (21.3) | 10 (10.4) | 24 (30.0) | 34 (19.3) | ||
Tanner stage III | 35/248 (14.1) | 40/218 (18.4) | 36/466 (14.0) | 11 (11.5) | 13 (16.3) | 24 (13.6) | ||
Tanner stage IV | 38/248 (15.3) | 46/218 (21.1) | 50/466 (19.4) | 17 (17.7) | 19 (23.7) | 36 (20.5) | ||
Tanner stage V | 147/248 (59.3) | 62/218 (28.4) | 117/466 (45.3) | 58 (60.4) | 24 (30.0) | 82 (46.6) | ||
BFM (%) | 44.2±5.7 (256) | 40.1±7.2 (231) | <0.001 | 42.2±6.8 (487) | 44.3±4.8 | 42.0±6.9 | 0.015 | 43.3±5.9 |
SMM (%) | 31.1±4.0 | 33.3±4.4 | <0.001 | 32.1±4.3 | 31.0±2.8 | 32.2±4.1 | 0.038 | 31.6±3.5 |
SBP (mmHg) | 119±12 | 118±13 | 0.539 | 118.1±12.6 | 119±11 | 117±13 | 0.463 | 118±12 |
DBP (mmHg) | 63±10 | 62±10 | 0.459 | 62.5±10.2 | 62±10 | 62±9 | 0.961 | 62±10 |
Glucose (mg/dL) | 83.7±11.8 | 85.5±8.5 | 0.072 | 84.6±10.4 | 83.8±7.4 | 86.1±8.5 | 0.053 | 84.9±8.0 |
Insulin (μlU/mL) | 21.7±11.4 (229) | 20.9±14.1 (211) | 0.892 | 21.3±12.8 (440) | 22.8±11.2 | 21.0±12.5 | 0.333 | 22.0±11.8 |
HOMA-IR | 4.61±2.74 (229) | 4.50±3.50 (211) | 0.729 | 4.56±3.12 (440) | 4.80±2.52 | 4.52±2.79 | 0.519 | 4.67±2.64 |
TC (mg/dL) | 153.1±31.1 (256) | 154.0±29.5 (231) | 0.757 | 153.5±30.3 (487) | 154.3±29.9 | 157.9±32.1 | 0.453 | 156.0±30.9 |
LDL-C (mg/dL) | 86.6±23.4 (224) | 90.0±25.5 (209) | 0.155 | 88.2±24.4 (433) | 88.1±25.9 | 91.8±26.6 | 0.370 | 89.7±26.2 |
HDL-C (mg/dL) | 48.9±11.2 (256) | 47.8±11.1 (231) | 0.330 | 48.4±11.1 (487) | 47.5±9.7 | 49.9±11.1 | 0.132 | 48.4±11.1 |
TG (mg/dL) | 84.7±45.6 (256) | 88.2±45.7 (231) | 0.417 | 86.4±45.6 (487) | 93.2±53.6 | 91.5±40.0 | 0.823 | 92.4±47.7 |
ALT | 19.6±10.6 (230) | 25.6±16.6 (213) | <0.001 | 22.5±14.1 (443) | 21.6±10.1 | 28.2±18.6 | 0.006 | 24.7±15.0 |
CRP (mg/dL) | 0.47±0.64 (221) | 0.43±0.62 (227) | 0.650 | 0.45±0.62 (451) | 0.37±0.52 | 0.43±0.48 | 0.580 | 0.40±0.50 |
cIMT† | 103.0±25.1 (109) | 94.2±21.0 (103) | 0.052 | 99.3±23.8 (211) | - | - | - | - |
VO2max (mL/kg/min) | 20.4±2.6 (109) | 21.9±3.7 (103) | 0.030 | 21.0±3.2 (211) | - | - | - | - |
Values are presented as mean±standard deviation (number) or number (%).
BMI, body mass index; WC, waist circumference; BFM, body fat mass; SMM, skeletal muscle mass; SBP, systolic blood pressure; DBP, diastolic blood pressure; HOMA-IR, insulin resistance assessment; TC, total cholesterol; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; TG, triglycerides; ALT, alanine aminotransferase; CRP, C-reactive protein; cIMT, carotid intima-media thickness; VO2max, maximum rate of oxygen consumption.
Variable |
Cross-sectional sample |
P-value |
Longitudinal sample |
P-value | ||
---|---|---|---|---|---|---|
MHO* | Non-MHO | MHO* | Non-MHO | |||
Race, Caucasian | 177/200 (88.5) | 246/287 (85.7) | 0.363† | 62/68 (91.2) | 98/108 (90.7) | 0.505† |
Overweight, BMI 85th–97th percentile | 34 (17) | 10 (3.5) | <0.001† | 11 (16.2) | 5 (4.6) | 0.009† |
Sex, girls | 106 (53.0) | 150 (52.3) | 0.873† | 34 (50.0) | 62 (57.4) | 0.337† |
Age (mo) | 170±26 | 175±26 | 0.050 | 169±24 | 173±25 | 0.380 |
BMI | 30.37±5.22 | 33.42±6.49 | <0.001 | 31.01±5.02 | 33.27±6.13 | 0.008 |
BMI z-score | 2.44±.95 | 2.96±1.09 | <0.001 | 2.60±.87 | 2.97±.97 | 0.012 |
WC (cm) | 98.4±11.7 | 105.6±14.5 | <0.001 | 100.4±10.5 | 105.6±15.4 | 0.020 |
Tanner stage | 0.804† | 0.804† | ||||
II | 49/188 (26.1) | 49/278 (17.6) | 16 (23.5) | 18 (16.7) | ||
III | 26/188 (13.8) | 49/278 (17.6) | 11 (16.3) | 13 (12.0) | ||
IV | 33/188 (17.5) | 51/278 (18.4) | 13 (19.1) | 23 (21.3) | ||
V | 80/188 (42.6) | 129/278 (46.4) | 28 (41.1) | 54 (50.0) | ||
BFM (%) | 40.9±6.4 (200) | 43.1±6.9 (287) | 0.001 | 42.7±6.2 | 43.6 (5.8) | 0.373 |
SMM (%) | 32.6±4.1 | 31.8±4.4 | 0.056 | 31.9±3.8 | 31.3 (3.3) | 0.311 |
VO2max (mL/kg/min) | 21.4±2.4 | 20.8±3.7 | 0.321 | - | - | |
OW duration (mo) | 96±49 | 109±53 | 0.026 | 95±37 | 113±52 | 0.022 |
Values are presented as mean±standard deviation (number) or number (%).
MHO, metabolically healthy overweight/obese; BMI, body mass index; WC, waist circumference; BFM, body fat mass; SMM, skeletal muscle mass; VO2max, maximum rate of oxygen consumption; OW, overweight.
Variable |
Cross-sectional sample |
Longitudinal sample |
|||||||
---|---|---|---|---|---|---|---|---|---|
MHO* | Non-MHO | P-value |
Baseline |
P-value |
Overtime changes |
P-value | |||
MHO† | Non-MHO | MHO† | Non-MHO | ||||||
Abdominal obesity | 187/200 (93.5) | 279/287 (97.2) | 0.047‡ | 65/68 (95.6) | 104/108 (96.3) | 0.800‡ | 61 (89.7) | 101 (93.5) | 0.363‡ |
Hypertension | 0 (0) | 134 (46.7) | <0.001‡ | 0 (0) | 54 (50.0) | <0.001‡ | 14 (20.6) | 39 (36.1) | 0.029‡ |
Hyperglicemia | 0 (0) | 12 (4.2) | 0.003‡ | 0 (0) | 5 (4.6) | 0.072‡ | 2 (2.9) | 2 (2.8) | 0.949‡ |
Low HDL-C | 0 (0) | 186 (64.8) | <0.001‡ | 0 (0) | 63 (58.3) | <0.001‡ | 16 (23.5) | 53 (49.1) | 0.001‡ |
Hypertriglycerides | 0 (0) | 56 (19.5) | <0.001‡ | 0 (0) | 56 (23.1) | <0.001‡ | 7 (10.3) | 19 (17.6) | 0.184‡ |
HOMA-IR ≥90th percentile | 63/173 (36.4) | 146/267 (54.7) | <0.001‡ | 24/68 (35.3) | 59/108 (54.6) | 0.024‡ | 17 (25.0) | 40 (37.0) | 0.093‡ |
TC ≥95th percentile | 11/200 (5.5) | 21/287 (7.3) | 0.426‡ | 5 (7.4) | 12 (11.1) | 0.430‡ | 6 (8.8) | 8 (7.4) | 0.679‡ |
LDL-C ≥95th percentile | 8/170 (4.7) | 16/263 (6.1) | 0.541‡ | 3 (4.4) | 9 (8.3) | 0.309‡ | 7 (10.3) | 7 (10.3) | 0.754‡ |
ALT ≥95th percentile | 42/175 (24.0) | 88/268 (32.8) | 0.046‡ | 18 (26.5) | 48 (44.4) | 0.022‡ | 11 (16.2) | 38 (35.2) | 0.004‡ |
CRP >0.30 mg/dL | 49/186 (26.3) | 75/265 (28.3) | 0.647‡ | 18 (26.5) | 21 (19.4) | 0.147‡ | 8 (11.8) | 28 (25.9) | 0.047‡ |
Absence of altered levels in all the metabolic indicators investigated | 93/200 (46.5) | 0/287 (0) | <0.001‡ | 23/68 (33.8) | 0/108 (0) | <0.001‡ | 22 (32.4) | 14 (13.0) | <0.001‡ |
Values are presented as number (%).
MHO, metabolically healthy overweight/obese; HDL-C, high-density lipoprotein cholesterol; HOMA-IR, insulin resistance assessment; TC, total cholesterol; LDL-C, low-density lipoprotein cholesterol; ALT, alanine aminotransferase; CRP, C-reactive protein.
* MHO defined as the absence of any altered Metabolic Syndrome-based cardiometabolic indicator (i.e., blood pressure, glycemia, high-density lipoprotein cholesterol and triglycerides).
Variable |
Cross-sectional analysis |
Longitudinal analysis |
||||||
---|---|---|---|---|---|---|---|---|
B | OR | 95% CI | P-value | B | OR | 95% CI | P-value | |
MHO* | ||||||||
BMI z-score | -0.54 | 0.6 | 0.4–0.9 | 0.008 | ||||
Hypertension* | ||||||||
BMI z-score | ΔBMI z-score | 0.76 | 2.1 | 1.4–3.3 | 0.001 | 0.51 | 1.7 | 1.0–2.7 | 0.045 |
HOMA-IR ≥90th percentile* | ||||||||
BMI z-score | ΔBMI z-score | 0.88 | 2.4 | 1.4–4.1 | 0.001 | 0.99 | 2.7 | 1.4–4.1 | 0.004 |
TC ≥95th percentile * | ||||||||
WC | 0.08 | 1.1 | 1.0–1.2 | 0.006 | ||||
ALT ≥95th percentile * | ||||||||
ΔBMI z-score | 0.66 | 1.9 | 1.1–1.3 | 0.026 | ||||
CRP >0.30 mg/dL* | ||||||||
BMI z-score | 0.17 | 1.2 | 1.1–1.3 | 0.002 | ||||
No. of comorbidities† | ||||||||
WC | ΔBMI z-score | 0.23 | 1.0 | 1.0–1.0 | <0.001 | 0.35 | 1.4 | 1.27–1.58 | <0.001 |