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Cardiometabolic risk factors in preschool children with abdominal obesity from Medellín, Colombia
Catalina Marín-Echeverri1, Juan C Aristizábal2, Natalia Gallego-Lopera3
1Escuela de Microbiología, Universidad de Antioquia UdeA, Medellín, Colombia.
Insights
Abdominal obesity in preschoolers is linked to insulin resistance and unhealthy lipid profiles. These risks appear more connected to overall body fat than central obesity alone.
Area of Science:
- Pediatric Endocrinology
- Cardiovascular Health
- Metabolic Syndrome
Background:
- Abdominal obesity (AO) is associated with inflammation and insulin resistance (IR) in adults.
- Limited data exists on these risk factors in preschoolers with AO.
Purpose of the Study:
- To evaluate the association between abdominal obesity and cardiovascular risk factors in preschool children.
- To investigate the relationship between AO, metabolic syndrome components, and biomarkers in young children.
Main Methods:
- 232 children (2-5 years) were enrolled, with 50% having AO.
- Measurements included lipids, glucose, insulin, inflammatory markers, and adipokines.
- Homeostatic model assessment of IR (HOMA-IR) was calculated.
Main Results:
- Children with AO showed higher BMIs, insulin, HOMA-IR, triglycerides, and TC/HDL-c ratio, with lower HDL-c.
- No significant differences in inflammatory markers were observed between groups.
- Waist circumference correlated with insulin, TG, ICAM-1, hs-CRP, and glucose.
Conclusions:
- Abdominal obesity in preschoolers is linked to increased IR and atherogenic lipid profiles, primarily due to general obesity.
- IR may precede elevated systemic cytokines in obese children, differing from adult findings.
- Further pediatric research is needed to clarify these associations.
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.
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