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Updated: Feb 8, 2026
Author Spotlight: Assessing the Cardiovascular Profile of Patients with Metabolic Syndrome
Published on: September 27, 2024
Metabolically healthy and metabolically unhealthy obese children both have increased carotid intima-media thickness:
Giovanni Farello1,2, Annarita Antenucci3, Stefano Stagi4
1Department of Pediatrics, University of L'Aquila, Via Vetoio 1, 67100, L'Aquila, Italy. giovanni.farello@cc.univaq.it.
Insights
Obese children, regardless of metabolic health, show increased carotid intima-media thickness (CIMT), indicating a higher cardiovascular disease risk compared to normal-weight children. Obesity itself is a significant risk factor for heart disease.
Area of Science:
- Pediatric Endocrinology
- Cardiovascular Health
- Metabolic Syndrome
Background:
- Childhood obesity is a growing concern with potential long-term health implications.
- Metabolically healthy obese (MHO) children may still face elevated cardiovascular disease (CVD) risks.
- Obese children with metabolic disorders (MUO) are known to have increased CVD risk.
Purpose of the Study:
- To assess cardiovascular disease risk in MHO children, MUO children, and normal-weight controls.
- To compare carotid intima-media thickness (CIMT) as a marker of subclinical atherosclerosis among these groups.
- To determine if metabolic health status modifies CVD risk in obese children.
Main Methods:
- Carotid Doppler ultrasound was used to measure CIMT in 204 obese children (42 MHO, 162 MUO) and 99 normal-weight controls.
- Metabolic parameters (glucose, lipids) and anthropometric data were collected for all participants.
- Statistical analysis, including analysis of variance, was employed to compare CIMT across groups.
Main Results:
- Mean CIMT was significantly higher in both MHO and MUO children compared to normal-weight controls (p < 0.01).
- No significant difference in mean CIMT was observed between MHO and MUO children.
- Obesity was associated with increased CIMT, irrespective of the presence of metabolic abnormalities.
Conclusions:
- Childhood obesity is an independent risk factor for cardiovascular disease.
- Increased CIMT in obese children suggests subclinical atherosclerosis, even in the absence of metabolic disorders.
- Early identification and management of obesity are crucial for preventing future cardiovascular events.
Background:
The cardiovascular disease risk was assessed in metabolically healthy obese (MHO) children, obese children with metabolic disorders (MUO), and to a control group of normal-weight children using carotid intima-media thickness (CIMT).
Methods:
Participants were 204 obese children (114 M, 90 F), including 162 MUO (74 M, 88 F) and 42 MHO (24 M, 18 F), and 99 gender- and age-matched controls (45 M, 54 F). Glucose, triglycerides, total cholesterol, high-density and low-density lipoprotein cholesterol, and other serum values were determined in peripheral blood. Anthropometric parameters, blood pressure, and a carotid Doppler ultrasound scan were also acquired. The mean CIMT of obese subjects and controls was compared by analysis of variance. Abnormality of even one of the metabolic parameters assessed involved assignation to the MUO group. Mean CIMT was compared in MHO and MUO children.
Results:
Mean CIMT in control children was 402.97 ± 53.18 μm (left carotid artery) and 377.85 ± 52.47 μm (right carotid artery). In MHO and MUO patients CIMT was respectively 453.29 ± 62.04 and 460.17 ± 92.22 μm (left carotid artery) and 446.36 ± 49.21 and 456.30 ± 85.7 μm (right carotid artery). The mean CIMT was not significantly different in MUO and MHO children, whereas it showed a significant difference between both groups of obese children and controls (p < 0.01).
Conclusion:
CIMT was significantly greater in obese patients, also in those without metabolic alterations, than in normal-weight children. Obesity is therefore an important risk factor for cardiovascular disease in itself, also in the absence of metabolic abnormalities.
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