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Pediatrics

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

International Journal of Obesity volume 47, pages 1247–1255 (2023)Cite this article

Subjects

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.

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Fig. 1: Flow-chart describing patients’ enrollment.

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Data availability

The data presented in this study are available on request from the corresponding author. The data are not publicly available due to the presence of information that could compromise research participant privacy.

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Funding

This paper was supported by funding with protocol number 204328/20 provided by Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania “Luigi Vanvitelli”.

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Authors and Affiliations

  1. Department of Woman, Child, and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy

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

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  1. Anna Di Sessa
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  2. Antonio Paride Passaro
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  3. Alberto Maria Colasante
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  4. Speranza Cioffi
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Contributions

Conceptualization, ADS and PM; methodology, ADS, EMDG; software, ADS, PM, AP; validation, EMDG, PM; formal analysis, ADS, PM; investigation, AP, SG, EMDG; data curation, APP, AMC, SC, GRU; writing—original draft preparation, ADS, PM; writing—review and editing, ADS, PM, EMDG; visualization, PM, AP; supervision, PM. All authors have read and agreed to the published version of the manuscript.

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Correspondence to Anna Di Sessa.

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Di Sessa, A., Passaro, A.P., Colasante, A.M. et al. Kidney damage predictors in children with metabolically healthy and metabolically unhealthy obesity phenotype. Int J Obes 47, 1247–1255 (2023). https://doi.org/10.1038/s41366-023-01379-1

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