Cardiovascular disorders of metabolically healthy obese adolescents

Abstract

The theory of “metabolically healthy obesity” has become very popular among researchers across the world. Meanwhile, the information about cardiovascular condition of metabolically healthy obese children is rather scant. The aim of the present study is to improve the knowledge of cardiovascular condition of metabolically healthy obese children compared with those who are lean and healthy and suffer from metabolic syndrome. Two hundred and eight obese adolescents, grouped as metabolically healthy and metabolically un- healthy, were examined with an analysis of body composition, metabolic parameters, evaluation of left ventricular geometry and function, 24-hours blood pressure monitoring, and carotid intima-media thick- ness. The results have shown 69% could be considered as metabolically healthy by the International Diabe- tes Federation criteria for metabolic syndrome evaluation. Deterioration of cardiovascular parameters was determined in both metabolically healthy and metabolically unhealthy subjects. Eccentric left ven- tricular hypertrophy with a diastolic dysfunction together with systolic hypertension and thickening of carotid vessels were identified. Systolic-diastolic dysfunction was identified in 22% of metabolically healthy obese and in 54.8% of metabolically unhealthy obese. There was no isolated systolic dysfunction in any child. It seems unlikely to identify a healthy cardiovascular profile in metabolically healthy obese children. Rather, it should be identified as gradual progression of disorders before detrimental changes. Cardiac imaging and arterial blood pressure monitoring are necessary for the routine examination of all obese kids. It appears the new approaches with a more sensitive cut-offs for metabolic parameters are necessary for identifying metabolic health and making a cardiovascular risk prognosis.