Kidney damage predictors in children with metabolically healthy and metabolically unhealthy obesity phenotype

Di Sessa, Anna; Passaro, Antonio Paride; Colasante, Alberto Maria; Cioffi, Speranza; Guarino, Stefano; Umano, Giuseppina Rosaria; Papparella, Alfonso; Miraglia del Giudice, Emanuele; Marzuillo, Pierluigi

doi:10.1038/s41366-023-01379-1

Cited by 7 publications

(3 citation statements)

References 50 publications

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“…In the wide perspective of cardiometabolic burden of pediatric obesity, the obesity-related glomerulopathy has recently gained remarkable attention [ 44 , 45 ]. Similarly to adults [ 46 ], emerging data demonstrated that children with OB are at higher risk of kidney damage (expressed as renal function decline with or without hypertension and/or proteinuria) [ 47 , 48 , 49 , 50 ]. Of note, cardiometabolic parameters have been closely associated to kidney injury, suggesting an intimate link between renal function and OB, but also with the obesity-related dysmetabolic state [ 45 , 51 , 52 ].…”

Section: Discussionmentioning

confidence: 99%

Sex-Related Differences in Cardiovascular Risk in Adolescents with Overweight or Obesity

Di Bonito,

Di Sessa,

Licenziati

et al. 2024

Rev. Cardiovasc. Med.

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Background: Pediatric obesity is closely associated with cardiometabolic comorbidities, but the role of sex in this relationship is less investigated. We aimed to evaluate sex-related differences on cardiometabolic risk factors and preclinical signs of target organ damage in adolescents with overweight/obesity (OW/OB). Methods: The main cross-sectional study included 988 adolescents (510 boys and 478 girls) with OW/OB aged 10–18 years. In all youths clinical and biochemical variables were evaluated and an abdominal echography was performed. Echocardiographic data for the assessment of left ventricular mass (LVM) and relative wall thickness (RWT) were available in an independent sample of 142 youths (67 boys and 75 girls), while echographic data of carotid intima media thickness (cIMT) were available in 107 youths (59 boys and 48 girls). Results: The three samples did not differ for age, body mass index, and sex distribution. In the main sample, boys showed higher waist-to-height ratio (WHtR) values ( p 0.0001) and fasting glucose levels ( p = 0.002) than girls. Lower levels of estimates glomerular filtration rate (eGFR) were found in girls vs boys ( p 0.0001). No sex-related differences for prediabetes and hyperlipidemia were observed. A higher prevalence of WHtR 0.60 (57.3% vs 49.6%, p = 0.016) and fatty liver disease (FLD) (54.5% vs 38.3%, p 0.0001) as well as a trend for high prevalence of hypertension (40.4 vs 34.7%, p = 0.06) were observed in boys vs girls. More, a higher prevalence of mild reduced eGFR (MReGFR) ( 90 mL/min/1.73 ) was observed in girls vs boys (14.6% vs 9.6 %, p 0.0001). In the sample with echocardiographic evaluation, boys showed higher levels of LVM ( p = 0.046), and RWT ( p = 0.003) than girls. Again, in the sample with carotid echography, boys showed higher levels of cIMT as compared to girls ( p = 0.011). Conclusions: Adolescent boys with OW/OB showed higher risk of abdominal adiposity, FLD, and increased cardiac and vascular impairment than girls, whereas the latter had a higher risk of MReGFR. Risk stratification by sex for cardiometabolic risk factors or preclinical signs of target organ damage should be considered in youths with OW/OB.

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Section: Discussionmentioning

confidence: 99%

Sex-Related Differences in Cardiovascular Risk in Adolescents with Overweight or Obesity

Di Bonito,

Di Sessa,

Licenziati

et al. 2024

Rev. Cardiovasc. Med.

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“…Records of 788 young people with OW/OB observed in the period 2016–2020 were analyzed. Inclusion criteria were: age 6–16 years, TH levels within normal range (according to the limit of laboratory in each center), as previously described [ 5 ]. Exclusion criteria were: thyroid diseases, genetic or endocrine obesity, chronic diseases, diabetes mellitus, and any pharmacological treatment.…”

Section: Methodsmentioning

confidence: 99%

“…The available results regarding the link between TH and renal function are still conflicting [1][2][3]. Two independent studies recently observed that mild reduced estimated glomerular filtration rate (MReGFR) was associated with an abnormal cardiometabolic phenotype in young people with overweight/obesity (OW/OB) [4,5]. However, the relationship between MReGFR and TH is unexplored in children and adolescents with OW/ OB.…”

Section: Introductionmentioning

confidence: 99%

Sensitivity to Thyroid Hormones and Reduced Glomerular Filtration in Children and Adolescents with Overweight or Obesity

Di Bonito,

Corica,

Marzuillo

et al. 2023

Horm Res Paediatr

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Background: Reduced central sensitivity to thyroid hormones (TH) has been observed in euthyroid adults with reduced renal function. This topic is unexplored in young people with overweight or obesity (OW/OB). Objective: To evaluate the association between sensitivity to TH and mild reduced estimated glomerular filtration rate (MReGFR) in euthyroid children and adolescents with OW/OB. Methods: Data of 788 euthyroid children and adolescents with OW/OB (aged 6-16 years), recruited from seven Italian centers for the care of OW/OB, were evaluated. Peripheral sensitivity to TH was estimated through the FT3/FT4 ratio, while central sensitivity was assessed by estimating TSH index (TSHI), Thyrotroph T4 Resistance Index (TT4RI), Thyroid Feedback Quantile-based Index (TFQI), Parametric Thyroid Feedback Quantile-based Index (PTFQI). MReGFR was defined by an eGFR value ≥60 and ≤90 mL/min/1.73 m2. Results: Subjects with MReGFR had significantly lower levels of FT3/FT4 ratio (0.43±0.09 vs 0.44±0.10; p=0.028) and higher levels of TSH (2.89±1.00 vs 2.68±0.99; p=0.019), TSH Index (2.95±0.45 vs 2.85±0.55; p=0.031), TFQI [1.00 (0.98-1.00) vs 1.00 (0.97-1.00); p=0.046] and PTFQI (0.66±0.17 vs 0.60±0.23; p=0.006) compared with individuals with normal eGFR. Odds ratio of MReGFR raised of 1.2-3.2-fold for each increase of 1 mIU/L in TSH, 1 unit in TSHI, and PTFQI, but not for FT3/FT4 ratio. Conclusion: MReGFR is associated with reduced indices of central sensitivity to TH in euthyroid children and adolescents with OW/OB. This preliminary observation should be confirmed in prospective studies.

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Kidney function evaluation in children and adolescents with obesity: a not-negligible need

Barlabà,

Grella,

Tammaro

et al. 2024

Eur J Pediatr

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Kidney damage predictors in children with metabolically healthy and metabolically unhealthy obesity phenotype

Cited by 7 publications

References 50 publications

Sex-Related Differences in Cardiovascular Risk in Adolescents with Overweight or Obesity

Sex-Related Differences in Cardiovascular Risk in Adolescents with Overweight or Obesity

Sensitivity to Thyroid Hormones and Reduced Glomerular Filtration in Children and Adolescents with Overweight or Obesity

Kidney function evaluation in children and adolescents with obesity: a not-negligible need

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