Waist-to-height ratio, inflammation and CVD risk in obese children

Abstract

Objective: To evaluate the association between waist-to-height ratio (WHtR) and specific biomarkers of inflammation, CVD risk and endothelial dysfunction in prepubertal obese children. Design: Prospective, multicentre case-control study matched by age and sex. Setting: Children were recruited between May 2007 and May 2010 from primarycare centres and schools in three cities in Spain (Cordoba, Santiago de Compostela and Zaragoza). Subjects: Four hundred and forty-six (223 normal weight and 223 obese) Caucasian prepubertal children aged 6-12 years. Results: WHtR was higher in the obese than in the normal-weight children. Blood pressure, waist circumference, weight, height, insulin, plasma lipids, leptin, resistin, abnormal neutrophil and monocyte counts, C-reactive protein, IL-6, IL-8, TNF-a, myeloperoxidase, soluble intercellular adhesion molecule-1, selectin and plasminogen activator inhibitor-1 levels were higher in the obese than in the normal-weight group. Adiponectin and HDL-cholesterol were lower and glucose and metalloproteinase-9 showed no differences. Resistin, TNF-a and active plasminogen activator inhibitor-1 were associated with WHtR, a sensitive indicator of central obesity. Conclusions: Our results lead to the hypothesis that changes in biomarker levels of insulin resistance, inflammation and CVD risk before puberty might induce metabolic consequences of obesity in obese children before reaching adulthood.

Some Inflammatory and Endothelial Dysfunction Biomarker levels in Obese Pre-pubertal Children

“…The presence of low-grade inflammation in obese childrenthat appeared in this studywas evaluated by measuring serumconcentrationsof CRP and IL6,as both showed a highly significant difference compared to the non-obese children and a very strong positive correlation with each other and with HOMA-IR and BMI.In agreement with thisJiménez et al [31],Sonya et al [32],Olzaet al [33], andValle et al [34]; all affirmed that the levels of these inflammatory markers are elevated in prepubertal obese children and that are associated with insulin resistance with the subsequent possibility of development of diabetes and cardiovascular disease. Additionally, Oliveira et al [35] agreed this finding and added that CRP is strongly related with metabolic syndrome and its components including insulin resistance in obese youth.Semiz et al also approved this finding and stated that CRP correlated with BMI and BP which are risk factors for coronary heart disease, supporting the relationship between obesity, inflammation and atherosclerosis [36].IL-6 is an inflammatory cytokine that stimulates the hepatic productionof CRPthis can explain the state ofinflammationassociated with obesity, and could mediate, at least partially,obesity-related insulin resistance [37].…”

Resistin and visfatin concentrations are related to central obesity and inflammation in Brazilian children

“…Scientific evidence shows that WHtR was strongly associated with abdominal fat measured by advanced imaging techniques such as computed tomography and magnetic resonance imaging [18]. Several studies of sensitivity and specificity demonstrated the WHtR as a method to use for identifying childhood overweight, obesity, and tracking of inflammatory and cardiometabolic risk in 6-to 16-year-old children [4,6,7,[10][11][12].…”

“…Several anthropometric and body composition indexes have been used to measure obesity and to assess the risk of metabolic and cardiovascular diseases [3,4].…”

“…Excess body fat is a risk factor for cardiovascular disease (CVD) and type 2 diabetes (DM2) [1,[4][5][6], especially the visceral fat. Thus, it is essential to investigate measures that not only reflect body proportions but also body fat distribution.…”

“…Other studies have shown the important role of resistin in controlling the cascade of inflammatory cytokines, which makes it a pro-inflammatory marker next to visfatin [2,13,17]. In addition to pro-inflammatory action, visfatin is essential for β-pancreatic cells in insulin secretion [18,19] and also stands as a marker of visceral adipose tissue [4,20].…”