Metabolically Healthy Obesity in Pediatric Population

NCT04694937 | Unknown

• 1 other identifier: 0799-20
• Study Type: observational
• Target: 100
• Locations: 0 countries
• Sites: N/A

Brief Summary

The global epidemic of childhood obesity, with the accompanying rise in the prevalence of endocrine, metabolic, and cardiovascular comorbidities in youth, represents one of the most important public health issues of the modern world. Nevertheless, a distinct subgroup of youth with obesity less prone to the development of metabolic disturbances, called "metabolically healthy obese" (MHO), has come into focus. Defining the MHO subpopulation within the youth with obesity is of high importance in order to elucidate the mechanisms protecting against the clustering of cardiometabolic risk factors, and for its clinical, preventive, and therapeutic decision-making implications. Little is known about the mechanisms of development of metabolic disturbance in pediatric obesity. Cardiac autonomic function, which can be measured non-invasively with heart rate variability (HRV), has been suggested as a potential mechanism underlying the development of metabolic syndrome and cardiovascular disease. The aims of the present study were to investigate clinical, anthropometric, and socio-demographic and lifestyle predictors of MHO in this group and to asses correlation between HRV and the metabolic syndrome progression or improvement , in order to reveal if HRV can serve as a predictor to metabolic disturbance in pediatric obesity population Materials and Methods The study will be performed in the Nutrition and Obesity Clinic of the Pediatric Gastroenterology Unit at "Dana Dwek" Children's Hospital. All children and adolescents that that will be admitted to our clinic between January 2021 to December 2022 will include in the study. sociodemographic parameters will be collected from the medical files.Blood will be drawn for complete metabolic assesment. MUO children will be defined according to the recent international definition. Resting HRV will be measured by Pulse Oximeter (BM2000A/Shanghai Berry Electronic Tech Co., Ltd.). The measurement will be performed twice - at two consecutive visits at the clinic, as part as the routine follow up of the patient every 3 months.

Conditions

Obesity; Pediatric Obesity; Metabolic Syndrome

Outcome Measures

Primary Outcomes (1)

• prevalnce of metabolic disorder in obese pediatric population

  measurment of glucose , insulin and lipid profile in all th chorot

  2 years

Secondary Outcomes (1)

• heart rate variability

  2 years

Study Arms (2)

metabolic healthy obese

Demographic, clinical laboratory and heart rate variability assesment

Device: heart rate variabilty measured by pulse oximetry

metabolic unhealthy obese

Demographic, clinical laboratory and heart rate variability assesment

Device: heart rate variabilty measured by pulse oximetry

Interventions

heart rate variabilty measured by pulse oximetry DEVICE

Resting HRV will be measured by Pulse Oximeter BM2000A/Shanghai Berry Electronic Tech Co., Ltd. that is validated for this purpose and is approved by FDA. The measurement, at the patient's fingertip, takes 5 minutes. The measurement will be performed twice - at two consecutive visits at the clinic, as part as the routine follow up of the patient every 3 months. HRV will be correlated to demographic and metabolic parameters between patients. In order to reveal whether HRV can serve as a predictor to metabolic disease progression or improvement, HRV will be correlated to metabolic parametrers in the same patient at two time-points.

metabolic healthy obese; metabolic unhealthy obese

Eligibility Criteria

• Age: 10 Years - 18 Years
• Sex: all
• Age Groups: Child (0-17), Adult (18-64)
• Sampling Method: Probability Sample

Study Population

The study will be performed in the Nutrition and Obesity Clinic of the Pediatric Gastroenterology Unit at "Dana Dwek" Children's Hospital. All children and adolesecnt that that will be admitted to our clinic between December 2020 to December 2022 will include in the study.

You may qualify if:

• All children 10-18 with obesity, males and females, who attend the obesity clinic in the pediatric gastroenterology unit at "Dana-Dwek" children's hospital, Tel Aviv Sourasky Medical Center, will be included

You may not qualify if:

• Children with conditions that may affect HRV (e.g. congenital or acquired heart disease, other inflammatory conditions) will be excluded.
• withdrawal criteria: children and parents that will refuse to participate in the telephone interview will withdrawl from the study.

Sponsors & Collaborators

• Tel-Aviv Sourasky Medical Center: lead

Related Publications (1)

• 1. Wang Y, Lobstein T. Worldwide trends in childhood overweight and obesity. Int J Pediatr Obes. (2006) 1:11-25. doi: 10.1080/1747 2. Zimmet P, Alberti KG, Kaufman F, Tajima N, Silink M, Arslanian S, et al. The metabolic syndrome in children and adolescents - an IDF consensus report. Pediatr Diabetes. (2007) 8:299-306. doi: 10.1111/j.1399-5448.2007. 00271.x 3. Bluher S, Schwarz P. Metabolically healthy obesity from childhood to adulthood - does weight status alone matter?Metabolism. (2014) 63:1084-92 4. Primeau V, Coderre L, Karelis AD, Brochu M, Lavoie ME, Messier V, et al. Characterizing the profile of obese patients who are metabolically healthy. Int J Obes. (2011) 35:971-81. doi: 10.1038/ijo.2010.216 5. Weiss R, Taksali SE, Dufour S, Yeckel CW, Papademetris X, Cline G, et al. The "obese insulin-sensitive" adolescent: importance of adiponectin and lipid partitioning. J Clin Endocrinol Metab. (2005) 90:3731-7. doi: 10.1210/jc.2004-2305 6. Karelis AD. Metabolically healthy but obese individuals. Lancet. 2008 372:1281-3. doi: 10.1016/S0140-6736(08)61531-7 7. Karelis AD, St-Pierre DH, Conus F, Rabasa-Lhoret R, Poehlman ET. Metabolic and body composition factors in subgroups of obesity: what do we know? J Clin Endocrinol Metab. (2004) 89:2569-75. 8. Sims EA. Are there persons who are obese, but metabolically healthy? Metabolism. (2001) 50:1499-504. 9. Bluher M. The distinction of metabolically 'healthy' from 'unhealthy' obese individuals. Curr Opin Lipidol. (2010) 21:38-43. 10. Damanhoury S, Newton AS, Rashid M, Hartling L, Byrne JLS, Ball GDC. Defining metabolically healthy obesity in children: a scoping review. Obes Rev. (2018) 19:1476-91 11. Vukovic R, Milenkovic T, Mitrovic K, Todorovic S, Plavsic L, Vukovic A, et al. Preserved insulin sensitivity predicts metabolically healthy obese phenotype in children and adolescents. Eur J Pediatr. (2015) 174:1649-55. 12. KiessW, PenkeM, Sergeyev E, NeefM, AdlerM, Gausche R, et al. Childhood obesity at the crossroads. J Pediatr Endocrinol Metab. (2015) 28:481-4. 13. Chen F, Liu J, Yan Y, Mi J, China Child and Adolescent Cardiovascular Health (CCACH) Study Group. Adolescent cardiovascular health study group. abnormal metabolic phenotypes among urban chinese children: epidemiology and the impact of DXA-measured body composition. Obesity. (2019) 27:837-44 14. Nasreddine L, Tamim H, Mailhac A, AlBuhairan FS. Prevalence and predictors of metabolically healthy obesity in adolescents: findings from the national "Jeeluna" study in Saudi-Arabia. BMC Pediatr. (2018) 18:281. 15. Roberge JB, Van Hulst A, Barnett TA, Drapeau V, Benedetti A, Tremblay A, et al. Lifestyle habits, dietary factors, and the metabolically unhealthy obese phenotype in youth. J Pediatr. (2019) 204:46-52. 16. Thayer JF, Yamamoto SS, Brosschot JF. The relationship of autonomic imbalance, heart rate variability and cardiovascular disease risk factors. Int J Cardiol 2010; 141(2): 122-131. 17.Liao D, Cai J, Rosamond WD, et al. Cardiac autonomic function and incident coronary heart disease: A populationbased case-cohort study. The ARIC study. Atherosclerosis risk in communities study. Am J Epidemiol 1997; 145(8): 696-706 18. Carnethon MR, Golden SH, Folsom AR, Haskell W, Liao D. Prospective investigation of autonomic nervous system function and the development of type 2 diabetes: The atherosclerosis risk in communities study, 1987-1998. Circulation 2003; 107(17): 2190-2195. 19. Carnethon MR, Prineas RJ, Temprosa M, et al. The association among autonomic nervous system function, incident diabetes, and intervention arm in the diabetes prevention program. Diabetes Care 2006; 29(4): 914-919 20.La Rovere MT, Bigger JT Jr, Marcus FI, Mortara A, Schwartz PJ. Baroreflex sensitivity and heart-rate variability in prediction of total cardiac mortality after myocardial infarction. ATRAMI (autonomic tone and reflexes after myocardial infarction) investigators. Lancet 1998; 351(9101): 478-484

  BACKGROUND

MeSH Terms

Conditions

Obesity; Pediatric Obesity; Metabolic Syndrome

Condition Hierarchy (Ancestors)

Overweight; Overnutrition; Nutrition Disorders; Nutritional and Metabolic Diseases; Body Weight; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Insulin Resistance; Hyperinsulinism; Glucose Metabolism Disorders; Metabolic Diseases

Study Officials

• shlomi cohen, md

  pediatric gastroenterology

  PRINCIPAL INVESTIGATOR

Central Study Contacts

hadar lev, md

CONTACT

00972527360713; hadarlev6@gmail.com

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Director

Study Record Dates

• First Submitted: December 31, 2020
• First Posted: January 5, 2021
• Study Start: January 15, 2021
• Primary Completion: January 15, 2022
• Study Completion: January 30, 2022
• Last Updated: January 5, 2021

Record last verified: 2021-01

Data Sharing

• IPD Sharing: Will not share