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  • Population Study Article
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Diagnostic accuracy of anthropometric indices for metabolically healthy obesity in child and adolescent population

Pediatric Research volume 94, pages 1824–1831 (2023)Cite this article

Abstract

Background

A variable percentage of children and adolescents with obesity do not have cardiometabolic comorbidities. A phenotype called metabolically healthy obese (MHO) has emerged to describe this population subgroup. Early identification of this condition may prevent the progression to metabolically unhealthy obesity (MUO).

Material and methods

A cross-sectional descriptive study of 265 children and adolescents from Cordoba (Spain) conducted in 2018. The outcome variables were MHO, established based on three criteria: International Criterion, HOMA-IR, and a combination of the previous two.

Results

The prevalence of MHO ranged from 9.4% to 12.8% of the study population, between 41% and 55.7% of the sample with obesity. The highest agreement was reached between the HOMA-IR definitions and the combined criteria. The waist-to-height ratio (WHtR) was the indicator with the highest discriminant capacity for MHO in 2 of the three criteria, with its best cut-off point at 0.47 for both.

Conclusion

The prevalence of MHO in children and adolescents differed according to the criteria used for diagnosis. The anthropometric variable with the most remarkable discriminating capacity for MHO was WHtR, with the same cut-off point in the three criteria analysed.

Impact statement

  • This research work defines the existence of metabolically healthy obesity through anthropometric indicators in children and adolescents.

  • Definitions that combine cardiometabolic criteria and insulin resistance are used to identify metabolically healthy obesity, as well as the prediction of this phenomenon through anthropometric variables.

  • The present investigation helps to identify metabolically healthy obesity before metabolic abnormalities begin.

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Fig. 1: Discriminant capacity of anthropometric indicators for Metabolic Healthy Obesity according to different criteria.

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Data availability

The raw data supporting the conclusions of this article will be made available by the authors without undue reservation.

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Authors and Affiliations

  1. Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Cordoba, 14004, Cordoba, Spain

    José-Miguel Guzmán-García, Manuel Romero-Saldaña, Guillermo Molina-Recio, Elena Raya-Cano & Rafael Molina-Luque

  2. Lifestyles, Innovation and Health Research Associate Group, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004, Cordoba, Spain

    Manuel Romero-Saldaña, Guillermo Molina-Recio & Rafael Molina-Luque

  3. Córdoba and Guadalquivir Health District, Reina Sofia University Hospital, Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), 14004, Cordoba, Spain

    Francisco-Javier Fonseca-del Pozo

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Contributions

J-.M.G-.G., M.R-.S., F-.J.F-.P., and R.M-.L. made substantial contributions to conception and design, acquisition of data, analysis, and interpretation of data. J-.M.G-.G., G.M-.R., and E.R-.C. involved in drafting the manuscript or revising it critically for important intellectual content. J-.M.G-.G., M.R-.S., G.M-.R., F-.J.F-.P., E.R-.C., and R.M-.L. given final approval of the version to be published, each author should have participated sufficiently in the work to take public responsibility for appropriate portions of the content, and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. All authors contributed to the article and approved the submitted version.

Corresponding author

Correspondence to Manuel Romero-Saldaña.

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The authors declare no competing interests.

Informed consent

All study subjects and their legal guardians were informed, verbally and in writing, of the objectives of the health study to which they were subjected. Informed consent was obtained under Law 41/2002, 14 November, the fundamental law regulating patient autonomy and the rights and obligations regarding clinical information and documentation. The study protocol complied with the Declaration of Helsinki for medical research involving human subjects and was approved by the Cordoba Bioethics Committee (Reference: 2353).

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Guzmán-García, JM., Romero-Saldaña, M., Molina-Recio, G. et al. Diagnostic accuracy of anthropometric indices for metabolically healthy obesity in child and adolescent population. Pediatr Res 94, 1824–1831 (2023). https://doi.org/10.1038/s41390-023-02693-0

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