The metabolically healthy obesity (MHO), a sub-phenotype of obesity with a favorable metabolic profile, has been the focus of recent research interest. But the potential role of genetic predisposition or lifestyle factors in the MHO phenotype is yet to be clarified. We aimed to investigate the impact factors of MHO status in Chinese children.Design and Method:
1790 overweight and obese children aged 6–18 years old were included in this study. Participants were classified as MHO or metabolically unhealthy obesity (MUO) based on insulin resistance (IR) or cardio-metabolic risk (CR) factors (blood pressure, lipids and glucose). 28 genetic variants previously reported from GWAS on obesity, hypertension and dyslipidemia were genotyped. The environmental factors of lifestyle, socio-economic status and birth weight were assessed by questionnaire. Overweight and obesity were defined using the sex- and age-specific BMI cut-offs recommended by the International Obesity Task Force. Age, sex, tanner stage and residence were adjusted for covariates.Results:
The prevalence of MHO-IR and MHO-CR were 60.7% and 30.7%, respectively. Proportion of severe obesity and central obesity and levels of BMI and WC were lower in MHO children compared with MUO children regardless of definitions. In addition to BMI and WC, the frequency of meat and fruit consumption, GNPDA2- rs10938397 and KCTD15-rs29941 were independent predictors of MHO-IR, whereas the frequency of meat consumption, FTO -rs9939609, and CYP17A1- rs11191548 were independent predictors of MHO-CR.Conclusions:
At least one-third of Chinese obese children can be classified as MHO. Both genetic predisposition and environment factors contribute to the prediction of MHO status.