Cardiometabolic risk factors in preschool children with abdominal obesity from Medellín, Colombia

Abstract

Background Abdominal obesity (AO) is linked to inflammation and insulin resistance (IR). However, there is limited information on whether preschoolers with AO present these risk factors. We evaluated the association between AO and cardiovascular risk factors in preschoolers. Methods We enrolled 232 children (2–5 years), of whom 50% had AO. Serum total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-c), high-density lipoprotein-cholesterol (HDL-c), triglycerides (TG), apolipoprotein B (Apo-B) and apolipoprotein A-1 (Apo-A1), glucose, insulin, high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-alpha (TNF-α), interleukin (IL)-6, IL-1β, monocyte chemoattractant protein (MCP-1/CCL2), leptin, adiponectin, vascular cell adhesion molecule (VCAM-1/CD106) and intercellular adhesion molecule (ICAM-1/CD54) were measured. The homeostatic model assessment of IR (HOMA-IR) was calculated. We analyzed these variables according to the presence of AO and other metabolic syndrome (MetS) components. Results A total of 75.8% of children with AO had one or more risk factors for MetS. Children with AO had significantly higher body mass indexes (BMIs), insulin, HOMA-IR, TG, very low-density lipoprotein-cholesterol (VLDL-c) and TC/HDL-c ratio and lower HDL-c, compared to children without AO; but there were no differences in inflammatory markers. After adjusting for BMI, sex and age, the differences between groups were not significant for any variable. Waist circumference (WC) was correlated with insulin (r=0.547; p<0.001), TG (r=0.207; p=0.001), ICAM-1 (r=0.213; p=0.039), hs-CRP (r=0.189; p=0.015) and glucose (r=0.187; p=0.004). After adjusting for BMI, age and sex, AO plus one MetS component contributed to individual variation in glucose, insulin, HOMA-IR and TG. Conclusions AO in preschool children is associated with greater IR and atherogenic lipid profiles, although these findings seem to be more related to general obesity than just central obesity. In addition, our data suggest that IR may precede the elevation of systemic cytokines in obese children, unlike findings in adults. More studies in pediatric populations are needed to elucidate these associations.

Association of Total and High Molecular Weight Adiponectin with Components of Metabolic Syndrome in Mexican Children

“…The analysis of anthropometric variables according to weight status has confirmed that each component of the MetS worsens with increasing weight, independent of sex (27). As has been reported previously (26,28,29) and was found in our study, several parameters did not show significant differences between overweight and obese children, except for a significantly higher WC in the obese group, which reinforces its importance as a risk indicator. The impaired levels of insulin, HOMA-IR, TG, HDL-C, and total-and HMW-adiponectin in the obese group compared to the normal group confirm the remarkable impact of obesity on metabolic disorders.…”

“…Regarding biochemical parameters, total-adiponectin had the strongest inverse correlation respect to HMW adiponectin, with glycaemia, followed by number of MetS components, HOMA-IR and insulin concentration. Similar findings have been described, where total adiponectin had a significant inverse relation with HOMA-IR and obesity, and its low concentration was an essential determinant of insulin sensitivity and HDL in children and may predict type 2 diabetes (7,29,32,34,35). No significant correlation was found for biochemical parameters related to fat metabolism (e.g., TG, HDL-C, LDL-C and TChol), probably due to the young age of the population and the pathophysiology of MetS (24,36).…”

“…No significant correlation was found for biochemical parameters related to fat metabolism (e.g., TG, HDL-C, LDL-C and TChol), probably due to the young age of the population and the pathophysiology of MetS (24,36). Longitudinal studies showed that blood pressure and TG decreased when HOMA decreases, independently of changes in BW, supporting the hypothesis that insulin resistance is the central abnormality contributing to these cardiovascular risk factors and development of atherosclerosis and MetS (24,29). The studies found that insulin resistance, or its accomplice, hyperinsulinemia could precede to dyslipidemia, enhancing the output of very-LDL and raising TG; this lipid overload in muscle is diverted to the liver, promoting fatty liver and atherogenic dyslipidemia (37).…”

Diet quality, general health and anthropometric outcomes in a Latin American population: evidence from the Colombian National Nutritional Survey (ENSIN) 2010

“…Considering that fatty acid consumption is a strong AHEI component and is assessed based on three criteria, this index might be associated with abdominal obesity. Such an approach could provide useful insights to determine whether further health interventions should be employed in Colombia, where waist circumference and other measures of obesity have been associated with cardio-metabolic markers in young children (28) .…”

Healthy lifestyles and physical fitness are associated with abdominal obesity amongLatin‐Americanand Spanish preschool children: A cross‐cultural study

“…[31][32][33] Other local studies showed a prevalence of 50.4% and 50% of AO in Spanish and Colombian preschoolers, respectively, but up-to-date information is not available for the entire country. 34,35 Therefore, the purpose of this study was to determine the association between the lifestyles of children (i.e., MD, PA, and ST) with AO of preschoolers from three Spanish-speaking countries (Chile, Colombia, and Spain) with different socioeconomic levels and HDI indicators.…”