| Summary: | Factors related to metabolically healthy obesity (MHO) are not well characterized in adolescents. The study’s aim was to investigate the impact of skeletal muscle mass (SMM) on MHO in adolescents. A secondary analysis was performed using the data of 221 Korean overweight and obese adolescents aged 12⁻18 years from the Korean National Health and Nutrition Examination Survey. Appendicular skeletal muscle (ASM) mass and total body fat mass were measured by dual-energy X-ray absorptiometry. Being metabolically unhealthy was defined using three definitions: Having ≥1, ≥2, or ≥3 cardiometabolic risk factors (CRFs; waist circumference, blood pressure, glucose, triglycerides, and HDL-cholesterol). Multiple logistic regression analyses adjusted for age and lifestyle factors were performed to assess the association between ASM and MHO. In boys, the risk for having either ≥2 CRFs or ≥3 CRFs was significantly lower with higher weight-adjusted ASM and ratio of ASM to fat mass after controlling for covariates, but this association was not significant with CRFs ≥ 1. In girls, all adjusted odds ratios were not significant. Findings indicate that SMM is a potentially protective factor against cardiometabolic abnormality in adolescents with MHO, showing gender difference. This heightens the importance of SMM in the management of obesity, especially in boys.
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