Insulin Resistance as a Diagnostic Criterion for Metabolically Healthy Obesity in Children

摘要

Supplemental Digital Content is available in the text ABSTRACT Objectives: In recent years, a subgroup of individuals with obesity has been described as having a lower risk of metabolic and cardiovascular complications. These individuals have what is referred to as metabolically healthy obesity (MHO), which has a favorable metabolic profile and a lower probability of long-term complications. The definition of this subtype in children is not clear. The aim of the present study was to determine whether Homeostasis Model Assessment (HOMA) above a set threshold could be the marker of metabolically unhealthy obesity (MUO) in children, or a parameter that can be used in the overall assessment. It is intended to compare the International Diabetes Federation (IDF) criteria against HOMA in the diagnosis of MUO. Methods: This observational, retrospective, cohort study included children with obesity and analyzed their metabolic state by means of blood testing and dual-energy X-ray absorptiometry. Results: A total of 96 patients were included, 44.8% boys and 55.2% girls, ages 6–17?years. The patients with MHO according to the HOMA criterion were younger ( P ?=?0.001), had a lower body mass index (BMI) z score ( P ?=?0.006), waist–height index ( P ?=?0.009), hip–height index ( P ?=?0.010), blood glucose ( P ?=?0.003), insulin ( P ?