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中华肥胖与代谢病电子杂志 ›› 2022, Vol. 08 ›› Issue (01) : 52 -55. doi: 10.3877/cma.j.issn.2095-9605.2022.01.009

综述

儿童代谢健康型肥胖的发病机制及预测指标
赵悦1, 马士凤1, 周娜1, 王茜1, 张聪1, 刘笑孝1, 蒋海燕1, 程思琪1, 郑荣秀1,()   
  1. 1. 300070,天津医科大学
  • 收稿日期:2021-11-20 出版日期:2022-02-28
  • 通信作者: 郑荣秀
  • 基金资助:
    天津市环境营养与人群健康重点实验室开放项目(2020ENKL05); 天津医科大学总医院青年孵育基金(303073000501); 天津市医学重点学科(专科)

Pathogenesis and predictors of metabolically healthy obesity in children

Yue Zhao1, Shifeng Ma1, Na Zhou1, Xi Wang1, Cong Zhang1, Xiaoxiao Liu1, Haiyan Jiang1, Siqi Cheng1, Rongxiu Zheng1,()   

  1. 1. Department of Pediatrics, Tianjin Medical University, Tianjin 300070, China
  • Received:2021-11-20 Published:2022-02-28
  • Corresponding author: Rongxiu Zheng
引用本文:

赵悦, 马士凤, 周娜, 王茜, 张聪, 刘笑孝, 蒋海燕, 程思琪, 郑荣秀. 儿童代谢健康型肥胖的发病机制及预测指标[J/OL]. 中华肥胖与代谢病电子杂志, 2022, 08(01): 52-55.

Yue Zhao, Shifeng Ma, Na Zhou, Xi Wang, Cong Zhang, Xiaoxiao Liu, Haiyan Jiang, Siqi Cheng, Rongxiu Zheng. Pathogenesis and predictors of metabolically healthy obesity in children[J/OL]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2022, 08(01): 52-55.

儿童代谢健康型肥胖(MHO)是指体质量指数(BMI)达到儿童肥胖症标准,但尚未发现有代谢指标的异常。与代谢异常型肥胖(MUO)相比,MHO儿童未来发生高血压、高血脂、2型糖尿病等并发症的风险降低。确定MHO儿童的定义,阐明MHO的发病机制与预测因素,对儿童肥胖的分层管理及针对性治疗十分重要,有利于肥胖儿童的长期预后。目前关于儿童MHO的研究较少,本文就其发病机制及预测因素等方面进行综述,为进一步研究儿童MHO的早期诊断和预后判断提供新思路。

Metabolically healthy obesity (MHO) in children is defined as the body mass index (BMI) meets the standard of childhood obesity, but no metabolic abnormalities have been found. Compared with metabolic abnormality obesity (MUO), children with MHO have a reduced risk of future complications such as hypertension, hyperlipidemia, and type 2 diabetes. It is important to define MHO children and clarify the pathogenesis and predictors of MHO for stratified management and targeted treatment of childhood obesity, which is beneficial to the long-term prognosis of obese children. At present, there are few studies on MHO in children. In this paper, the pathogenesis and predictive factors of MHO in children were reviewed, providing new ideas for further study on early diagnosis and prognosis of MHO in children.

[1]
Vukovic R, Dos Santos TJ, Ybarra M, et al. Children With Metabolically Healthy Obesity: A Review [J]. Front Endocrinol (Lausanne), 2019, 10: 865
[2]
妇幼健康研究会. 中国儿童代谢健康型肥胖定义与筛查专家共识[J]. 中国妇幼健康研究, 2019, 30(12): 1487-1490.
[3]
Gregg EW, Shaw JE. Global Health Effects of Overweight and Obesity [J]. N Engl J Med, 2017, 377(1): 80-81.
[4]
Prince RL, Kuk JL, Ambler KA, et al. Predictors of metabolically healthy obesity in children [J]. Diabetes care, 2014, 37(5): 1462-1468.
[5]
Nasreddine L, Tamim H, Mailhac A, et al. Prevalence and predictors of metabolically healthy obesity in adolescents: findings from the national "Jeeluna" study in Saudi-Arabia [J]. BMC pediatrics, 2018, 18(1): 281.
[6]
Zhao M, López-Bermejo A, Caserta CA, et al. Metabolically healthy obesity and high carotid intima-media thickness in children and adolescents: international childhood vascular structure evaluation consortium [J]. Diabetes care, 2019, 42(1): 119-125.
[7]
Chen FF, Liu JT, Yan YK, et al. Abnormal Metabolic Phenotypes Among Urban Chinese Children: Epidemiology and the Impact of DXA-Measured Body Composition [J]. Obesity (Silver Spring, Md.), 2019, 27(5): 837-844.
[8]
Saioa G, Maite Q, Maria AV, et al. Metabolically healthy obesity and metabolically obese normal weight: a review [J]. J Physiol Biochem, 2021, 77(1): 175-189.
[9]
Badoud F, Perreault M, Zulyniak MA, et al. Molecular insights into the role of white adipose tissue in metabolically unhealthy normal weight and metabolically healthy obese individuals [J]. FASEB J, 2015, 29(3): 748-758.
[10]
Tynan GA, Hearnden CH, Oleszycka Ewa, et al. Endogenous oils derived from human adipocytes are potent adjuvants that promote IL-1α-dependent inflammation [J]. Diabetes, 2014, 63(6): 2037-2050.
[11]
Blüher M. The distinction of metabolically "healthy" from "unhealthy" obese individuals [J]. Curr Opin Lipidol, 2010, 21(1): 38-43.
[12]
Norbert S, Fritz S, Hans-Ulrich H. causes, characteristics, and consequences of metabolically unhealthy normal weight in humans [J]. Cell Metabolism, 2017, 26(2): 292-300.
[13]
Karpe F, Pinnick KE. Biology of upper-body and lower-body adipose tissue--link to whole-body phenotypes [J]. Nat Rev Endocrinol, 2015, 11(2): 90-100.
[14]
Kahn HS. Letter by Kahn Regarding Article, "Cardiovascular and Metabolic Heterogeneity of Obesity: Clinical Challenges and Implications for Management" [J]. Circulation, 2018, 138(14): 1494-1495.
[15]
Ross R, Aru J, Freeman J, et al. Abdominal adiposity and insulin resistance in obese men [J]. Am J Physiol Endocrinol Metab, 2002, 282(3): E657-663.
[16]
Ogorodnikova AD, Khan UI, McGinn AP, et al. ectopic fat and adipokines in metabolically benign overweight/obese women: the kronos early estrogen prevention study [J]. Obesity (Silver Spring), 2013, 21(8): 1726-1733.
[17]
Gonçalves CG, Glade MJ, Meguid MM. Metabolically healthy obese individuals: Key protective factors [J]. Nutrition, 2016, 32(1): 14-20.
[18]
Felix MW, Sonja V, Marko S, et al. The "Big Bang" in obese fat: Events initiating obesity-induced adipose tissue inflammation [J]. Eur J Immunol, 2015, 45(9): 2446-2456.
[19]
Walczak-Gałęzewska M, Ratajczak A, Pastusiak K, et al. Does metabolically healthy obesity exist? A 32-year-old man with BMI 78 kg/m2—to treat or not to treat? [J].Endokrynol Pol, 2020, 71(3): 281-282.
[20]
Catherine MP, Ivan JP. Does inflammation determine metabolic health status in obese and nonobese adults? [J]. J Clin Endocrinol Metab, 2013, 98(10): e1610-1619.
[21]
Claire L, Silva A, Wayne C, et al. Insulin resistance in children: consensus, perspective, and future directions [J]. The Journal of Clinical Endocrinology & Metabolism, 2010, 95(12): 5189-5198.
[22]
Iacobini C, Pugliese G, Blasetti FC, et al. Metabolically healthy versus metabolically unhealthy obesity [J]. Metabolism, 2019, 92: 51-60.
[23]
Catherine MP, Ivan JP. Does inflammation determine metabolic health status in obese and nonobese adults? [J]. J Clin Endocrinol Metab, 2013, 98(10): E1610-1619.
[24]
Prince RL, Kuk JL, Ambler KA, et al. Predictors of metabolically healthy obesity in children [J]. Diabetes Care, 2014, 37(5): 1462-1468.
[25]
Vukovic R, Milenkovic T, Mitrovic K, et al. Preserved insulin sensitivity predicts metabolically healthy obese phenotype in children and adolescents [J]. Eur J Pediatr. 2015, 174(12): 1649-1655.
[26]
Aldhoon-Hainerová I, Hainer V, Zamrazilová H. Impact of dietary intake, lifestyle and biochemical factors on metabolic health in obese adolescents [J]. Nutr Metab Cardiovasc Dis, 2017, 27(8): 703-710.
[27]
Aditi K, Vivian C, Sheila PC, et al. Differences between metabolically healthy vs unhealthy obese children and adolescents [J]. J Natl Med Assoc, 2017, 109(3): 203-210.
[28]
Rocha EPAA, Vogel M, Stanik J, et al. Serum uric acid levels as an indicator for metabolically unhealthy obesity in children and adolescents [J]. Horm Res Paediatr, 2018, 90(1): 1-9.
[29]
Selin E, Fatma D, Nihal H. Risk factors that affect metabolic health status in obese children [J]. J Pediatr Endocrinol Metab, 2017, 30(1): 49-55.
[30]
Reinehr T, Wolters B, Knop C, et al. Strong effect of pubertal status on metabolic health in obese children: a longitudinal study [J]. J Clin Endocrinol Metab, 2015, 100(1): 301-308.
[31]
Sénéchal M, Wicklow B, Wittmeier K, et al. Cardiorespiratory fitness and adiposity in metabolically healthy overweight and obese youth [J]. Pediatrics, 2013, 132(1): e85-92.
[32]
Heinzle S, Ball GD, Kuk JL. Variations in the prevalence and predictors of prevalent metabolically healthy obesity in adolescents [J]. Pediatr Obes, 2016, 11(5): 425-433.
[33]
Yoon DY, Lee YA, Lee J, et al. Prevalence and clinical characteristics of metabolically healthy obesity in Korean children and adolescents: data from the Korea National Health and Nutrition Examination Survey [J]. J Korean Med Sci, 2017, 32(11): 1840-1847.
[34]
Li LJ, Yin JH, Cheng H, et al. Identification of genetic and environmental factors predicting metabolically healthy obesity in children: data from the BCAMS Study [J]. J Clin Endocrinol Metab, 2016, 101(4): 1816-1825.
[35]
Joon YK, Hala T, Sara F. Michaliszyn, et al. Distinguishing characteristics of metabolically healthy versus metabolically unhealthy obese adolescent girls with polycystic ovary syndrome [J]. Fertil Steril, 2016, 105(6): 1603-1611.
[36]
Lee S, Arslanian S. Body composition and cardiorespiratory fitness between metabolically healthy versus metabolically unhealthy obese black and white adolescents [J]. J Adolesc Health, 2019, 64(3): 327-332.
[37]
Merav MG, Michal YG, Moshe P, et al. Which predictors differentiate between obese children and adolescents with cardiometabolic complications and those with metabolically healthy obesity? [J]. Pediatr Diabetes, 2018, 19(7): 1147-1155.
[38]
Chun S, Lee S, Son HJ, et al. Clinical characteristics and metabolic health status of obese Korean children and adolescents [J]. Korean J Fam Med, 2015, 36(5): 233-238.
[39]
Harald M, Sieglinde Z, Peter P, et al. Uric acid best predicts metabolically unhealthy obesity with increased cardiovascular risk in youth and adults [J]. Obesity (Silver Spring), 2013, 21(1): E71-77.
[40]
Jean-Baptiste R, Andraea VH, Tracie AB, et al. lifestyle habits, dietary factors, and the metabolically unhealthy obese phenotype in youth [J]. J Pediatr, 2018, 204: 46-52.
[41]
Cristina CS, Jonatan RR, Idoia L, et al. Prevalence of metabolically healthy but overweight/obese phenotype and its association with sedentary time, physical activity, and fitness [J]. J Adolesc Health, 2017, 61(1): 107-114.
[42]
Christoph AT, Maayan L, Tal K, et al. microbiota diurnal rhythmicity programs host transcriptome oscillations [J]. Cell, 2016, 167(6): 1495-1510.
[43]
Nedelec R, Jokelainen J, Miettunen J, et al. Early determinants of metabolically healthy obesity in young adults: study of the Northern Finland Birth Cohort 1966 [J]. Int J Obes (Lond), 2018, 42(10): 1704-1714.
[44]
Hosseinpanah F, Tasdighi E, Barzin M, et al. The association between transition from metabolically healthy obesity to metabolic syndrome, and incidence of cardiovascular disease: Tehran lipid and glucose study [J]. PloS one, 2020, 15(9): e0239164-e0239164.
[45]
Shengxu Li, Wei Chen, Srinivasan SR, et al. Relation of childhood obesity/cardiometabolic phenotypes to adult cardiometabolic profile: the Bogalusa Heart Study [J]. Am J Epidemiol, 2012, 176 (suppl 7): S142-149.
[46]
Paul Z, George A, Francine K, et al. The metabolic syndrome in children and adolescents [J]. Lancet, 2007, 369(9579): 2059-2061.
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