Phenotyping Metabolically Healthy Obese Adolescents

The global epidemic of childhood obesity and the accompanying rise in the prevalence of endocrine, metabolic, and cardiovascular comorbidities among the youth represents one of the most important public health issues of the modern world. The earlier occurrence and increase in the prevalence of both pediatric obesity and metabolic syndrome (MS) lead to a potential decline in life expectancy such that the youth of today could be the first generation to live shorter lives than their parents.

In the context of the childhood obesity pandemic, a distinct subgroup of obese youth who are less prone to the development of metabolic disturbances, termed "metabolically healthy obese" (MHO), has recently been characterized. Despite their obese state, MHO individuals display a "favorable" metabolic profile, with preserved insulin sensitivity, normal BP and glucose regulation, normal lipid and liver enzyme levels, as well as a normal hormonal, inflammation and immune profile. Although the MHO status might not necessarily translate into lower mortality and can evolve into "metabolically unhealthy obese" (MUO) phenotype during puberty, defining the MHO subpopulation among obese youth is critically important in order to elucidate the mechanisms protecting against the clustering of cardiometabolic risk factors, and their implications on clinical, preventive, and therapeutic decision-making.

Only few studies have evaluated predictors and risk factors for MUO, and they were based on a variety of definitions of MHO and the criteria used for defining it. Moreover, little is known about the mechanisms of the development of metabolic disturbances in pediatric obesity. More data are needed in order to identify the parameters most capable of predicting clinically significant outcomes. In this research, the researchers aim to investigate socio-demographic, clinical, anthropometric, physiological, and lifestyle predictors of MHO.

Aim:

1. To investigate socio-demographic, clinical, anthropometric, and lifestyle predictors for MHO.
2. To investigate the interaction between fat mass and distribution, muscle mass and strength and physical activity level on metabolic morbidity in obese adolescents.
3. To investigate the association between MHO predictors and metabolic disturbances.