Disclosures: The authors report no relevant financial disclosures.
November 15, 2021
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Central adiposity gain during childhood associated with worse cardiometabolic profile

Disclosures: The authors report no relevant financial disclosures.
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Adolescents who have increasing central adiposity during childhood are likely to have worsening cardiometabolic health markers, according to study findings published in Obesity.

In data from 620 children enrolled in Project Viva, greater gains in central adiposity as measured by waist circumference and DXA from middle childhood to early adolescence were associated with an adverse cardiometabolic profile, according to Allison Wu, MD, attending physician in pediatric gastroenterology and nutrition at Boston Children’s Hospital.

Wu is an attending physician in pediatric gastroenterology and nutrition at Boston Children’s Hospital.

“Monitoring of central adiposity gain via waist circumference may provide additional information to complement existing BMI measures in identification of children at higher cardiometabolic risk,” Wu told Healio.

Wu and colleagues obtain data from Project Viva, an ongoing prospective cohort study in which women were enrolled during prenatal visits. Researchers obtained data from 620 children who participated in follow-up visits at middle childhood (mean age, 7.8 years) and early adolescence (mean age, 12.9 years) and had indirect and direct central adiposity measures recorded at both visits with at least one cardiometabolic outcome measured. Waist circumference was used to measure indirect adiposity, and DXA scans were performed to measure direct adiposity. Systolic blood pressure, triglycerides, HDL cholesterol, alanine aminotransferase, homeostatic model assessment of insulin resistance (HOMA-IR), high-sensitivity C-reactive protein, leptin and adiponectin were used as cardiometabolic markers.

From middle childhood to early adolescence, participants had a median increase of 2.6 cm per year in waist circumference, 2.7 cm2 per year in visceral adipose tissue, 11.5 cm2 per year in subcutaneous abdominal adipose tissue and 0.7 kg per year in trunk fat.

After adjusting for covariates and changes to total adiposity and height, each standard deviation increase in waist circumference was associated with higher log triglycerides (beta = 0.07 mg/dL; 95% CI, 0.02-0.13), log HOMA-IR (beta = 0.15 U; 95% CI, 0.08-0.23), log alanine aminotransferase (beta = 0.07 U/L; 95% CI, 0.03-0.12), log high-sensitivity C-reactive protein (beta = 0.43 mg/L; 95% CI, 0.28-0.58) and log leptin (beta = 0.35 ng/mL; 95% CI, 0.27-0.43). Waist circumference gain was also associated with lower log adiponectin (beta = –0.09 mg/dL; 95% CI, –0.15 to –0.03).

All three measures of direct central adiposity were associated with higher systolic BP z score in early adolescence. Additionally, each standard deviation increase in subcutaneous abdominal adipose tissue was associated with higher log HOMA-IR (beta = 0.12 U; 95% CI, 0.01-0.22) and log alanine aminotransferase (beta = 0.11 U/L; 95% CI, 0.05-0.18) and lower log HDL cholesterol (beta = –0.06 mg/dL; 95% CI, –0.11 to –0.02). Higher trunk fat was also associated with increased log HOMA-IR (beta = 0.18 U; 95% CI, 0.07-0.29) and log alanine aminotransferase (beta = 0.09 U/L; 95% CI, 0.02-0.16) and lower log HDL cholesterol (beta = –0.07 mg/dL; 95% CI, –0.12 to –0.02).

“When comparing the direct and indirect measures of central adiposity gain, there was no single measure that demonstrated the best predictive value for most of the cardiometabolic health outcomes,” Wu said.

For more information:

Allison Wu, MD, can be reached at allison.wu@childrens.harvard.edu.