Associations Between Body Composition and Metabolic Health in Children With Obesity

Abstract

Childhood obesity is an increasing public health problem with heterogeneous metabolic health outcomes. In children, distinguishing differences in body composition between individuals with metabolically healthy obesity (MHO) and those with metabolic syndrome (MS) may be useful for understanding the impact of body composition on metabolic health. This cross-sectional study included 193 children aged 6–10 years with obesity (BMI > 95th percentile). Fat and lean mass distributions were measured by dual-energy X-ray absorptiometry to assess body composition. Among the study population, 45.1% were classified as MHO, while 25% presented MS. Compared with children with MHO, those with MS had significantly greater fat mass and lean mass. Body composition was strongly correlated with metabolic dysfunction, including insulin resistance, hypoalphalipoproteinaemia, and hypertriglyceridaemia. These findings reveal a definitive association between body composition indices and metabolic syndrome status in children with obesity. However, not all children with obesity develop metabolic abnormalities, highlighting the importance of detailed body composition analysis in assessing metabolic health risk.