Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Dec;47(12):1247-1255.
doi: 10.1038/s41366-023-01379-1. Epub 2023 Sep 9.

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

Anna Di Sessa  1 , Antonio Paride Passaro  2 , Alberto Maria Colasante  2 , Speranza Cioffi, Stefano Guarino  2 , Giuseppina Rosaria Umano  2 , Alfonso Papparella  2 , Emanuele Miraglia Del Giudice  2 , Pierluigi Marzuillo  2
Affiliations

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

Anna Di Sessa et al. Int J Obes (Lond). 2023 Dec.

Abstract

Background: Obesity and kidney damage have been closely linked in adults, but little is still known in childhood.

Objective: To identify predictors of kidney damage in children with metabolically healthy (MHO) and metabolically unhealthy (MUO) obesity phenotypes.

Methods: We retrospectively examined 396 children with obesity (mean age 10.72 ± 2.71 years, body mass index-standard deviation score, BMI-SDS, 2.23 ± 0.57) stratified according to metabolic phenotypes. Kidney damage was defined as the presence of reduced estimated glomerular filtration rate (eGFR < 90 mL/min/1.73m2) and/or albuminuria (≥ 30 mg/g urinary creatinine).

Results: Kidney damage was found in 20.9% of the study population. Children with kidney damage had higher BMI-SDS, homeostasis model assessment of insulin resistance (HOMA-IR), and inflammation markers levels and increased prevalence of non-alcoholic fatty liver disease (NAFLD) than those without kidney damage (all p < 0.005). MUO and MHO subjects had respectively an odds ratio (OR) to show kidney damage of of 1.92 (95%CI:1.22-3.01; p = 0.005) and 1.05 (95%CI:1.00-1.09; p = 0.028) after adjustments. Moreover, we found that only HOMA-IR was closely associated to kidney damage in MUO group (OR = 2.07;95%CI:1.20-3.57; p = 0.007), while HOMA-IR (OR = 1.15;95%CI:1.02-1.29; p = 0.011) and uric acid (OR = 1.15;95% CI:1.02-1.30; p = 0.010) were the only significant risk factors for kidney damage in MHO group.

Conclusion: An increased risk of kidney damage has been observed in children with obesity and in particular in those with MUO phenotype. As their role on kidney function, HOMA-IR should be monitored in MUO children and both HOMA-IR and uric acid in MHO children.

PubMed Disclaimer

References

    1. Jebeile H, Kelly AS, O’Malley G, Baur LA. Obesity in children and adolescents: epidemiology, causes, assessment, and management. Lancet Diabetes Endocrinol. 2022;10:351–65. - PubMed - PMC
    1. Di Bonito P, Pacifico L, Licenziati MR, Maffeis C, Morandi A, Manco M, et al. Elevated blood pressure, cardiometabolic risk and target organ damage in youth with overweight and obesity. Nutr Metab Cardiovasc Dis. 2020;30:1840–7. - PubMed
    1. Marzuillo P, Grandone A, Di Sessa A, Guarino S, Diplomatico M, Umano GR, et al. Anthropometric and Biochemical Determinants of Estimated Glomerular Filtration Rate in a Large Cohort of Obese Children. J Ren Nutr. 2018;28:359–62. - PubMed
    1. Eslam M, Alkhouri N, Vajro P, Baumann U, Weiss R, Socha P, et al. Defining paediatric metabolic (dysfunction)-associated fatty liver disease: an international expert consensus statement. Lancet Gastroenterol Hepatol. 2021;6:864–73. - PubMed
    1. Di Sessa A, Guarino S, Umano GR, Arenella M, Alfiero S, Quaranta G, et al. MAFLD in Obese Children: A Challenging Definition. Children (Basel). 2021;8:247. - PubMed

Publication types