# Progressive increase of cardiometabolic risk in Brazilian children according to obesity phenotypes

## TL;DR

The study finds that Brazilian children with different obesity types show increased cardiometabolic risks, even when BMI is normal.

## Contribution

The study introduces a novel classification of obesity phenotypes in children and links them to cardiometabolic risks beyond BMI.

## Key findings

- Children with normal-weight obesity (NWO) had 5 cardiometabolic risk factors compared to normal-weight lean (NWL) children.
- Excess weight children had 11 cardiometabolic risk factors compared to NWL children.
- NWO children showed intermediate risk levels between NWL and excess weight children.

## Abstract

We investigated the association of obesity phenotypes with MetS and components scores, subclinical inflammation, anti- and oxidative markers in children.

This is a cross-sectional study with 364 children (8 and 9-year-olds) in Viçosa, Minas Gerais, Brazil. Children were classified as: 1.“normal-weight lean” (NWL) when they had normal-weight by BMI and adequate fat percentage assessed by DXA; 2. “normal-weight obesity” (NWO) for those with normal-weight and excess fat; and 3. “excess weight” for those with overweight/obesity and excess fat. The score for the MetS and its components was estimated, and the inflammatory and oxidative stress markers were measured. Multiple linear regression was used.

Of thirteen cardiometabolic risk factors investigated, five were positively associated with the NWO, compared to NWL. Moreover, eleven cardiometabolic risk factors were associated with excess weight, compared to NWL. When the two phenotypes of excess body fat were contrasted, we found eight cardiometabolic risk factors associated with excess weight, compared to NWO.

An intermediate cardiometabolic risk was observed in children with the NWO phenotype when comparing the status of NWL to excess weight. This study reinforces the importance of investigating cardiometabolic risk in early ages, independent of BMI.