Myocardial Performance Index and Carotid Intima-Media Thickness in Children with Metabolically Healthy and Metabolically Unhealthy Obesity

Objective: To compare the myocardial performance index (MPI) and carotid intima-media thickness (cIMT) of children who are metabolically healthy obese (MHO) and metabolically unhealthy obese (MUO) with children without obesity. Methods: This study included obese patients between 6 and 17 years of age and age- and gender-matched healthy children. Two groups of obese patients were investigated: MUO and MHO. Results: There were 62 obese (MUO=30; MHO=32) and 30 healthy controls included. Compared to controls, the MPI score and cIMT of both obese groups were significantly larger (p=0.004 and p=0.003, respectively). However, there was no significant difference in MPI and cIMT between the MUO and MHO groups. Moreover, there were independent associations between higher MPI and body mass index-standard deviation score (BMI-SDS) (β=0.312, p=0.002) and between higher cIMT and waist circumference-SDS (WC-SDS) (β=0.371, p=0.003). Conclusion: The primary outcome of the study indicated that while both MPI and cIMT values were elevated in obese children compared to non-obese controls, there was no significant difference between MUO and MHO groups. This suggests that obesity itself, irrespective of metabolic health, is associated with increased cardiovascular risks. BMI-SDS and WC-SDS were useful markers for identifying children at cardiovascular risk in this cohort.