Assessment of biochemical liver markers, physical activity, fitness and body mass index for a cardiometabolic risk model in childhood

Abstract

224 words Abstract 2 ObjectiveTo investigate the effect of liver cell injury markers in clustered risk assessment model for identification of children at risk of cardiometabolic disease Design/SettingThis cross-sectional observational study was carried out in primary schools in Liverpool and Ulster, UK. Participants were 10-12 year old healthy schoolchildren who underwent anthropometric measurements, phlebotomy, cardiorespiratory fitness and physical exercise assessments. Main outcome measuresThe main outcome measures included assessment of high and low cardiometabolic risk participants through a clustered risk score model, which incorporated covariates implicated in the pathogenesis of the metabolic syndrome: body mass index, waist circumference, blood pressure, proinflammatory cytokines, markers of systemic inflammation, liver cell injury markers, lipid profile, cardiorespiratory fitness and time spent in activity. ResultsChildren classified as fit or active have lower cardiometabolic risk than their 'unfit' or 'inactive' peers. This fact remained unchanged whether markers of hepatocyte injury were included in the clustered risk assessment model or not. ConclusionsThe clustered risk score model is a non-invasive and scientifically robust method of cardiometabolic risk assessment in childhood, which reiterates the importance of weight reduction and promotion of cardiorespiratory fitness from childhood. Our study did not show any significant contribution of liver cell injury markers, however larger scale research is 3 needed so as to fully evaluate the effect of these widely used markers in early cardiometabolic risk stratification in children.4