title: Classification and clinical characterization of metabolically "healthy" obese children and adolescents.
abstract: BACKGROUND
  Some obese children do not show cardiometabolic complications such as prediabetes, dyslipidemia or insulin resistance. The objective of the study was to classify obese children and adolescents as metabolically "healthy" obese (MHO) on the basis of three different definitions, and to compare cardiometabolic features with metabolically unhealthy obese (MUO) children and adolescents.
  
  
  METHODS
  The study included 156 obese children and adolescents aged between 10 and 18. Subjects were classified as MHO or MUO using three definitions based on the: (1) pediatric International Diabetes Federation (IDF) criteria; (2) homeostatic model assessment of insulin resistance (HOMA-IR); (3) combination of the previous two definitions. Cardiometabolic features were compared between MHO and MUO subjects.
  
  
  RESULTS
  Six to 19% obese children and adolescents were classified as MHO, and showed a better insulin sensitivity, lower prevalence of prediabetes, lower triglycerides and lower triglyceride-to-HDL-C ratio compared to MUO.
  
  
  CONCLUSIONS
  Less than 20% obese children and adolescents are identified as MHO and show a healthier cardiometabolic profile as compared to MUO. Implementation of the proposed classifications in future clinical research could contribute towards the standardization of the MHO definition and offer new insights into the manifestation of the pediatric MHO phenotype.
authors.forename: Liene
authors.initials: L
authors.lastname: Bervoets
authors.forename: Guy
authors.initials: G
authors.lastname: Massa
mesh_terms: D000293:Adolescent; D001530:Belgium / Q000453:epidemiology; D016022:Case-Control Studies; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007333:Insulin Resistance; D008019:Life Style; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D009765:Obesity / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D015995:Prevalence