Beyond Cardiometabolic: Health Disorders Risk in Metabolically Healthy Obese Children – A Systematic Review and Meta-Analysis of 19,119 Children
Bibliographic record
Abstract
Richard Christophorus Kurniawan,1,* Frederick Suhamdy,1,* Muhammad Makarimal Akhlaq,1 Eko Fuji Ariyanto2,3 1Faculty of Medicine, Universitas Padjadjaran, Sumedang, West Java, 45363, Indonesia; 2Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Sumedang, West Java, 45363, Indonesia; 3Study Center for Medical Genetics, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, 40161, Indonesia*These authors contributed equally to this workCorrespondence: Richard Christophorus Kurniawan, Faculty of Medicine, Universitas Padjadjaran, Sumedang, West Java, 45363, Indonesia, Email richard24002@mail.unpad.ac.idBackground and Objectives: Childhood obesity is associated with both short-term and long-term health complications, yet a new obesity phenotype called metabolically healthy obesity (MHO) has emerged. While MHO is often perceived as a “benign” form of obesity, research specifically examining health disorders risks in children with MHO remains limited. This systematic review and meta-analysis aimed to evaluate health disorders in children with MHO.Methods: Following PRISMA 2020 guidelines, we systematically searched five databases (PubMed, Scopus, Google Scholar, EBSCO, and ScienceDirect) for observational studies examining MHO children aged 0– 18 years. The studies were analyzed using R and R Studio software, with study quality assessed using the Newcastle Ottawa Scale.Results: Ten studies with a total of 19,119 children were included in this review. Children with MHO demonstrated significantly higher overall health disorders risk compared to MHNW children (pooled OR 2.88, 95% CI [1.64; 5.06]). This trend aligns with the subgroups analysis of left ventricle hypertrophy, hypertension, and kidney damage. However, some of the subgroup analyses showed insignificant results. Additionally, MHO children showed lower risks of experiencing health disorders compared to MUO children (pooled OR 0.56, 95% CI [0.23; 1.34]). The underlying mechanism of the increased health risk is excess adipokines causing systemic inflammation and leading to increased various health risks.Conclusion: Despite metabolically “healthy” status, children with MHO remain at increased risk for health disorders compared to normal-weight peers. This systematic review and meta-analysis is the first one discussing the health disorders in children with MHO. More studies are required in the future to reinforce these findings in order to produce much more comprehensive insights.Keywords: children, disorders, metabolically healthy obesity, obesity
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.018 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.020 |
| Bibliometrics | 0.005 | 0.006 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".