Dyslipidemia, subclinical inflammation, hepatic cholestasis and endothelial dysfunction in schoolchildren with excess fat: A study from the United Arab Emirates

Abstract

BackgroundThe impact of obesity on cardiovascular health of young children is still to be fully illustrated. This study measured biomarkers for glycemic control, lipid metabolism, systemic inflammation, endothelial dysfunction, and hepatic cholestasis in schoolchildren. Its main purpose was to determine whether metabolic derangements could be detected in young children with excess fat.MethodThis cross-sectional study involved 967 children in the second, sixth, and tenth grades (median age, 7.3, 11.3, and 15.4 years, respectively). Using the International Obesity Task Force interpretation (IOTF) of body-mass-index (BMI), children were stratified as thin (<5th centiles), normal (5th to <85th centiles), overweight (85th to <95th centiles), obese (95th to <98th centiles), or extremely-obese (≥98th centiles). Waist circumference was also measured. Several metabolic determinations were then used as surrogate biomarkers for cardiovascular risks.ResultsPrevalence of BMI≥85th centile among the second graders was 13.1%, sixth graders 42.2%, and tenth graders 33.8%. BMI≥85th centile was associated with a tendency for higher hemoglobin A1c (p≥0.160) and higher blood glucose (p≥0.197). For the second graders, BMI≥85th centile was associated with higher high-sensitivity C-reactive protein (hs-CRP, p<0.001), higher tumor necrosis factor-α (TNF-alpha, p<0.001), higher interleukin-6 (IL-6, p<0.001), higher soluble intercellular cytoadhesive molecule-1 (sICAM-1), higher triglycerides (p≤0.024), and lower high-density lipoprotein (HDL, p<0.001). Additionally, for the sixth and tenth graders, BMI≥85th centile was associated with higher gamma-glutamyl transferase (GGT, p<0.001). In the sixth graders, BMI≥85th centile was insignificantly changed with sICAM-1 or the soluble vascular cytoadhesive molecule-1 (sVCAM-1).ConclusionsThe studied children with excess fat had increased risks for developing systemic inflammation, dyslipidemia, endothelial dysfunction, cholestasis, and diabetes. These results suggest that metabolic biomarkers should be included in the routine assessment of children with an overweight problem.

Pro-Inflammatory Diet Is Associated with Adiposity during Childhood and with Adipokines and Inflammatory Markers at 11 Years in Mexican Children

“…In this study, hsCRP was significantly higher in children with overweight or obesity whereas IL6 levels showed no differences between groups. Our results regarding hsCRP agree with several previous studies in which it has been associated in children with overweight and obesity in different populations [47][48][49]. In this study, leptin levels were significantly increased in children with overweight and obesity, as has consistently been observed in previous studies [50][51][52].…”

Distribution of Cardiometabolic Risk Factors in School-Aged Children with Excess Body Weight in the Al Ain City, United Arab Emirates: A Cross-Sectional Study

“…Furthermore, in our study, excess weight boys and girls had increased CVD risk factors such as higher TG, low HDL-C in boys, and elevated SBP in girls compared to normal-weight children. The relationship between excess body fat and CMRF has been reported in the literature, and researchers have explained that the chronic inflammatory process is caused by excess fat accumulated explicitly in the abdominal cavity [41][42][43]. In our previous report [43], we demonstrated that dyslipidemia was adversely associated with endothelial dysfunction in school-aged children and, through this research, we identified that excess weight children had concomitant lipid profile disorders and particularly increased TG levels at early ages.…”

“…The relationship between excess body fat and CMRF has been reported in the literature, and researchers have explained that the chronic inflammatory process is caused by excess fat accumulated explicitly in the abdominal cavity [41][42][43]. In our previous report [43], we demonstrated that dyslipidemia was adversely associated with endothelial dysfunction in school-aged children and, through this research, we identified that excess weight children had concomitant lipid profile disorders and particularly increased TG levels at early ages. Our study findings imply that abnormal weight gain must be identified early, the primary prevention of CVD in children be prioritized, and the risks for undesirable structural and metabolic changes must ultimately be reduced.…”

Nutrition Situation Analysis in the UAE: A Review Study

“…Nonetheless, as stated in the literature review, in addition to obesity, undernutrition also remains an issue. Studies in Saudi Arabia and Egypt reported several children to be undernourished and stunted [ 18 , 19 , 99 ]. Similarly, a study conducted in the UAE in 2013 reported that 7.6% of Emirati schoolchildren were underweight [ 21 ].…”