Fasting insulin resistance affects the prevalence of metabolically healthy obesity in Brazilian adolescents

Autor(es)

Marra, Nivea Fazanaro ^[1] ; Bechere Fernandes, Maria Teresa ^[2] ; de Melo, Maria Edna ^[3] ; da Cruz, Rodrigo Marques ^[4] ; Tess, Beatriz Helena ^[1]

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Fac Med FMUSP, Dept Med Prevent, Av Dr Arnaldo 455, 2 Andar, BR-01246903 Sao Paulo, SP - Brazil

^[2] Univ Sao Paulo, Fac Med FMUSP, Dept Pediat, Sao Paulo - Brazil

^[3] Univ Sao Paulo, Hosp Clin HCFMUSP, Fac Med FMUSP, Liga Obesidade Infantil, Sao Paulo - Brazil

^[4] Univ Sao Paulo, Inst Matemat & Estat, Dept Estat, Sao Paulo - Brazil

• Tipo de documento: Artigo Científico
• Fonte: ACTA PAEDIATRICA; v. 108, n. 7, p. 1295-1302, JUL 2019.
• Citações Web of Science: 2

Resumo

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. (AU)

• Processo FAPESP: 15/23559-9 - Prevalência e fatores associados ao fenótipo "obesidade metabolicamente benigna" em uma população de crianças e adolescentes obesos atendidos na Liga de Obesidade Infantil do HC-FMUSP
• Beneficiário: Nivea Fazanaro Marra
• Modalidade de apoio: Bolsas no Brasil - Mestrado