Prevalence and cluster of cardiometabolic biomarkers in overweight and obese schoolchildren: Results from a large survey in Southwest Germany

Abstract

BACKGROUND: Obesity is associated with substantial metabolic changes and subclinical inflammation. We explored associations between body mass index (BMI) and cardiometabolic biomarkers and their clustering in overweight and obese schoolchildren. METHODS: In this population-based, cross-sectional study among 450 children 10 years old, we measured adiponectin, leptin, inflammatory markers, apolipoprotein (apo) AI and B, and lipoprotein-associated phospholipase A2 (Lp-PLA2). Except for adiponectin and apoAI (10th percentile) the 90th percentile was used as cutoff point. Body weight was categorized in age- and sex-specific BMI percentiles and overweight and obesity according to International Obesity Task Force definitions. RESULTS: In linear regression models, all cardiometabolic markers except apoB were statistically significantly associated with overweight. In logistic regression models, compared with the reference category (25th-75th percentile of BMI), overweight was associated with increased concentrations of leptin [odds ratio (OR) 59.80; 95% CI 16.68 -214.39], C-reactive protein (6.30; 2.95-13.45), fibrinogen (2.82; 1.33- 6.01), and low apoAI (2.62; 1.19 -5.75). Overweight was positively associated with interleukin-6, Lp-PLA2, and apoB concentrations and inversely with adiponectin concentrations. Most importantly, in obese children 35% showed one, 20% two, 10% three, and 15% four or more abnormal cardiometabolic biomarkers. The number of abnormal cardiometabolic markers increased in overweight (ptrend<0.001) and obese (p trend<0.001) children. CONCLUSIONS: Overweight and obesity in children are associated with complex metabolic changes and a lowgrade inflammatory response, and thus might not only accelerate cardiovascular disease later on, but may also be associated with the initiation of atherosclerosis in early life. © 2007 American Association for Clinical Chemistry.