Fasting insulin resistance affects the prevalence of metabolically healthy obesity in Brazilian adolescents
Aim We aimed to assess the influence of fasting insulin resistance on metabolically healthy obesity (MHO) prevalence in adolescents and to identify associated factors. Methods This retrospective, registry‐based, cross‐sectional study included 418 (51.9% girls) 10‐ to 18‐year‐old adolescents with obe...
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| Veröffentlicht in: | Acta Paediatrica 2019-07, Vol.108 (7), p.1295-1302 |
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| container_title | Acta Paediatrica |
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| creator | Marra, Nivea Fazanaro Bechere Fernandes, Maria Teresa Melo, Maria Edna Cruz, Rodrigo Marques Tess, Beatriz Helena |
| description | Aim
We aimed to assess the influence of fasting insulin resistance on metabolically healthy obesity (MHO) prevalence in adolescents and to identify associated factors.
Methods
This retrospective, registry‐based, cross‐sectional study included 418 (51.9% girls) 10‐ to 18‐year‐old adolescents with obesity from a tertiary outpatient clinic in Sao Paulo, Brazil, between 2009 and 2013. The prevalence of MHO was estimated according to two definitions: (i) no cardiometabolic risk factors (CMRF) by the International Diabetes Federation parameters and (ii) no CMRF and homeostatic model assessment for insulin resistance |
| doi_str_mv | 10.1111/apa.14684 |
| format | Article |
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We aimed to assess the influence of fasting insulin resistance on metabolically healthy obesity (MHO) prevalence in adolescents and to identify associated factors.
Methods
This retrospective, registry‐based, cross‐sectional study included 418 (51.9% girls) 10‐ to 18‐year‐old adolescents with obesity from a tertiary outpatient clinic in Sao Paulo, Brazil, between 2009 and 2013. The prevalence of MHO was estimated according to two definitions: (i) no cardiometabolic risk factors (CMRF) by the International Diabetes Federation parameters and (ii) no CMRF and homeostatic model assessment for insulin resistance <3.16. Adjusted prevalence ratios and 95% confidence intervals (CI) evaluated the association of gender, age, pubertal stages, skin colour and degree of obesity with MHO.
Results
Metabolically healthy obesity prevalence was lower in definition II than definition I (12.7%; 95% CI 9.1–16.3% versus 43.1%; 95% CI 38.0–48.2%, respectively). Adjusted results showed negative association between severe obesity and MHO by both definitions (p ≤ 0.01). Male and later pubertal stages were also less likely to have MHO, but neither remained significant in definition II.
Conclusion
Metabolically healthy obesity prevalence decreased when insulin resistance was part of the definition. Detecting pre‐clinical insulin resistance may improve the management of treatment‐seeking adolescents, especially when they present no CMRF.</description><identifier>ISSN: 0803-5253</identifier><identifier>EISSN: 1651-2227</identifier><identifier>DOI: 10.1111/apa.14684</identifier><identifier>PMID: 30536824</identifier><language>eng</language><publisher>Norway: Wiley Subscription Services, Inc</publisher><subject>Adolescents ; Brazil ; Diabetes mellitus ; Fasting ; Health risks ; Insulin ; Insulin resistance ; Metabolically healthy obesity ; Obesity ; Prevalence ; Risk factors ; Skin ; Teenagers</subject><ispartof>Acta Paediatrica, 2019-07, Vol.108 (7), p.1295-1302</ispartof><rights>2018 Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd</rights><rights>2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.</rights><rights>Copyright ©2019 Foundation Acta Pædiatrica</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3534-70769b6aad5f4e4e59e5109a5ec273dade1e2b8259067223e4220c78a937a8353</citedby><cites>FETCH-LOGICAL-c3534-70769b6aad5f4e4e59e5109a5ec273dade1e2b8259067223e4220c78a937a8353</cites><orcidid>0000-0002-9921-9234 ; 0000-0002-9819-4573</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fapa.14684$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fapa.14684$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30536824$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Marra, Nivea Fazanaro</creatorcontrib><creatorcontrib>Bechere Fernandes, Maria Teresa</creatorcontrib><creatorcontrib>Melo, Maria Edna</creatorcontrib><creatorcontrib>Cruz, Rodrigo Marques</creatorcontrib><creatorcontrib>Tess, Beatriz Helena</creatorcontrib><title>Fasting insulin resistance affects the prevalence of metabolically healthy obesity in Brazilian adolescents</title><title>Acta Paediatrica</title><addtitle>Acta Paediatr</addtitle><description>Aim
We aimed to assess the influence of fasting insulin resistance on metabolically healthy obesity (MHO) prevalence in adolescents and to identify associated factors.
Methods
This retrospective, registry‐based, cross‐sectional study included 418 (51.9% girls) 10‐ to 18‐year‐old adolescents with obesity from a tertiary outpatient clinic in Sao Paulo, Brazil, between 2009 and 2013. The prevalence of MHO was estimated according to two definitions: (i) no cardiometabolic risk factors (CMRF) by the International Diabetes Federation parameters and (ii) no CMRF and homeostatic model assessment for insulin resistance <3.16. Adjusted prevalence ratios and 95% confidence intervals (CI) evaluated the association of gender, age, pubertal stages, skin colour and degree of obesity with MHO.
Results
Metabolically healthy obesity prevalence was lower in definition II than definition I (12.7%; 95% CI 9.1–16.3% versus 43.1%; 95% CI 38.0–48.2%, respectively). Adjusted results showed negative association between severe obesity and MHO by both definitions (p ≤ 0.01). Male and later pubertal stages were also less likely to have MHO, but neither remained significant in definition II.
Conclusion
Metabolically healthy obesity prevalence decreased when insulin resistance was part of the definition. Detecting pre‐clinical insulin resistance may improve the management of treatment‐seeking adolescents, especially when they present no CMRF.</description><subject>Adolescents</subject><subject>Brazil</subject><subject>Diabetes mellitus</subject><subject>Fasting</subject><subject>Health risks</subject><subject>Insulin</subject><subject>Insulin resistance</subject><subject>Metabolically healthy obesity</subject><subject>Obesity</subject><subject>Prevalence</subject><subject>Risk factors</subject><subject>Skin</subject><subject>Teenagers</subject><issn>0803-5253</issn><issn>1651-2227</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp1kcFu1DAQhi0EokvhwAsgS1zoIa09thPnuK0oIFWCA5ytSTJhXbzJYjug8PR12cIBiblYGn3-NPp_xl5KcS7LXOABz6WurX7ENrI2sgKA5jHbCCtUZcCoE_YspVshQLW6fspOlDCqtqA37Ns1puynr9xPaQl-4pGSTxmnnjiOI_U58bwjfoj0AwPdr-eR7yljNwffYwgr3xGGvFv53JW_eS0qfhnxlw8eJ47DHCj1NOX0nD0ZMSR68fCesi_Xbz9fva9uPr77cLW9qXpllK4a0dRtVyMOZtSkybRkpGjRUA-NGnAgSdBZMK2oGwBFGkD0jcVWNWiL4pS9OXoPcf6-UMpu78sFIeBE85IcSGNKTKaBgr7-B72dlziV6xyALslZa2Whzo5UH-eUIo3uEP0e4-qkcPcNuNKA-91AYV89GJduT8Nf8k_kBbg4Aj99oPX_Jrf9tD0q7wCbxo_i</recordid><startdate>201907</startdate><enddate>201907</enddate><creator>Marra, Nivea Fazanaro</creator><creator>Bechere Fernandes, Maria Teresa</creator><creator>Melo, Maria Edna</creator><creator>Cruz, Rodrigo Marques</creator><creator>Tess, Beatriz Helena</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7TM</scope><scope>7TS</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-9921-9234</orcidid><orcidid>https://orcid.org/0000-0002-9819-4573</orcidid></search><sort><creationdate>201907</creationdate><title>Fasting insulin resistance affects the prevalence of metabolically healthy obesity in Brazilian adolescents</title><author>Marra, Nivea Fazanaro ; Bechere Fernandes, Maria Teresa ; Melo, Maria Edna ; Cruz, Rodrigo Marques ; Tess, Beatriz Helena</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3534-70769b6aad5f4e4e59e5109a5ec273dade1e2b8259067223e4220c78a937a8353</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adolescents</topic><topic>Brazil</topic><topic>Diabetes mellitus</topic><topic>Fasting</topic><topic>Health risks</topic><topic>Insulin</topic><topic>Insulin resistance</topic><topic>Metabolically healthy obesity</topic><topic>Obesity</topic><topic>Prevalence</topic><topic>Risk factors</topic><topic>Skin</topic><topic>Teenagers</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Marra, Nivea Fazanaro</creatorcontrib><creatorcontrib>Bechere Fernandes, Maria Teresa</creatorcontrib><creatorcontrib>Melo, Maria Edna</creatorcontrib><creatorcontrib>Cruz, Rodrigo Marques</creatorcontrib><creatorcontrib>Tess, Beatriz Helena</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Physical Education Index</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>MEDLINE - Academic</collection><jtitle>Acta Paediatrica</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Marra, Nivea Fazanaro</au><au>Bechere Fernandes, Maria Teresa</au><au>Melo, Maria Edna</au><au>Cruz, Rodrigo Marques</au><au>Tess, Beatriz Helena</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Fasting insulin resistance affects the prevalence of metabolically healthy obesity in Brazilian adolescents</atitle><jtitle>Acta Paediatrica</jtitle><addtitle>Acta Paediatr</addtitle><date>2019-07</date><risdate>2019</risdate><volume>108</volume><issue>7</issue><spage>1295</spage><epage>1302</epage><pages>1295-1302</pages><issn>0803-5253</issn><eissn>1651-2227</eissn><abstract>Aim
We aimed to assess the influence of fasting insulin resistance on metabolically healthy obesity (MHO) prevalence in adolescents and to identify associated factors.
Methods
This retrospective, registry‐based, cross‐sectional study included 418 (51.9% girls) 10‐ to 18‐year‐old adolescents with obesity from a tertiary outpatient clinic in Sao Paulo, Brazil, between 2009 and 2013. The prevalence of MHO was estimated according to two definitions: (i) no cardiometabolic risk factors (CMRF) by the International Diabetes Federation parameters and (ii) no CMRF and homeostatic model assessment for insulin resistance <3.16. Adjusted prevalence ratios and 95% confidence intervals (CI) evaluated the association of gender, age, pubertal stages, skin colour and degree of obesity with MHO.
Results
Metabolically healthy obesity prevalence was lower in definition II than definition I (12.7%; 95% CI 9.1–16.3% versus 43.1%; 95% CI 38.0–48.2%, respectively). Adjusted results showed negative association between severe obesity and MHO by both definitions (p ≤ 0.01). Male and later pubertal stages were also less likely to have MHO, but neither remained significant in definition II.
Conclusion
Metabolically healthy obesity prevalence decreased when insulin resistance was part of the definition. Detecting pre‐clinical insulin resistance may improve the management of treatment‐seeking adolescents, especially when they present no CMRF.</abstract><cop>Norway</cop><pub>Wiley Subscription Services, Inc</pub><pmid>30536824</pmid><doi>10.1111/apa.14684</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-9921-9234</orcidid><orcidid>https://orcid.org/0000-0002-9819-4573</orcidid></addata></record> |
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| subjects | Adolescents Brazil Diabetes mellitus Fasting Health risks Insulin Insulin resistance Metabolically healthy obesity Obesity Prevalence Risk factors Skin Teenagers |
| title | Fasting insulin resistance affects the prevalence of metabolically healthy obesity in Brazilian adolescents |
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