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.
Acknowledgments
The authors express sincere appreciation to the parents/guardians and children who participated in the study. To the “Buen Comienzo” Program of the Major Office, Medellín-Colombia, for the contribution of children’s data and blood samples. We also thank the Hospital Universitario San Vicente Fundación for allowing the use of the Luminex® equipment; and to the E.S.E. Hospital Venancio Díaz from Sabaneta, Antioquia, for permitting the use of an automatic analyzer.
Author contributions: CME did the experiments, analyzed data and wrote the manuscript. JCAR was involved in the conceptual design of the study, analyzed data and helped with the statistical analysis. NGL was involved in the initial concept of the study and in writing research projects for funding, validating the protocol and performing the apolipoprotein measurements. HASR was involved in the initial concept of the study and in writing research projects for funding. MHG and MR were involved in the initial design of the study with the “Buen Comienzo” Program and in collecting children data. AAA was involved in the initial design of the study. JBA conceived the study, wrote the research projects for funding, analyzed the data and wrote the manuscript. All the authors reviewed and approved the final manuscript.
Research funding: This study was supported in part by: (a) Program of “Buen Comienzo”, Unidad de Seguridad Alimentaria, Secretaría de Inclusión Social y Familia. Alcaldía de Medellín-Colombia; (b) a grant from the Banco Universitario de Programas y Proyectos de Extensión – BUPPE – Universidad de Antioquia, 2013; (c) a grant from the Institución Universitaria Colegio Mayor de Antioquia – IUCMA, to purchase the inflammatory kits; and (d) Roche diagnostics for the contribution of the apolipoprotein kits.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
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