Gender-related differences in cardiometabolic risk factors and lifestyle behaviors in treatment-seeking adolescents with severe obesity

Abstract

BackgroundObesity during adolescence is associated with cardiovascular mortality in adulthood. The adverse obesity-related cardiometabolic risk profile is already observed in adolescence. We aimed to examine possible gender differences in cardiometabolic risk factors and lifestyle behaviors among adolescents with severe obesity, hypothesizing that boys would have both a higher prevalence of the metabolic syndrome as well as less healthy lifestyle behaviors than girls.MethodsCross-sectional study of treatment-seeking adolescents with severe obesity who attended the Morbid Obesity Centre at Vestfold Hospital Trust and who were consecutively enrolled in the Vestfold Register of Obese Children between September 2009 and September 2015. A total of 313 adolescents aged 12 to 18 years were recruited, whereof 268 subjects (49% boys) completed a food and activity frequency questionnaire and were included in the analysis.ResultsMean (SD) age, BMI and BMI SDS were 15 (1.6) years, 38.6 (5.9) kg/m2 and 3.5 (0.6). Levels of LDL cholesterol, fasting insulin and glucose and diastolic blood pressure (DBP) did not differ between genders. Compared to girls, boys had significantly higher triglycerides (p = 0.037) and systolic blood pressure (SBP) (p = 0.003), as well as lower HDL cholesterol (p = 0.002). The metabolic syndrome was present in 27% of the boys and 19% of the girls (p = 0.140), and the prevalence of high DBP, dyslipidemia and dysglycemia also did not differ significantly between genders. The prevalence of high SBP was higher in boys than in girls (19% vs. 9%, p = 0.021). Gender was associated with a number of lifestyle habits, as a larger proportions of boys had higher screen time (p = 0.032), more regular breakfast eating (p = 0.023), higher intake of sugar sweetened soda (p = 0.036), and lower intake of vegetables than girls (p = 0.011). By contrast, physical activity level and intake of fruit and berries did not differ between genders.ConclusionsMale treatment-seeking adolescents with severe obesity had a more unfavorable set of metabolic and behavioral risk factors for cardiovascular disease than girls. Our results indicate that lifestyle behavioral markers should be thoroughly assessed in both genders, and possible gender-related differences in risk profile should be taken into account in future treatment programs.Electronic supplementary materialThe online version of this article (10.1186/s12887-018-1057-3) contains supplementary material, which is available to authorized users.

Gender-based differences in the clustering of metabolic syndrome factors in children and adolescents

“…In children and adolescents, only a limited number of studies reports gender differences on metabolic risk factors for MS [10][11][12][13]. Our results confirm data previously published, showing no significant gender differences in MS prevalence [11,12], however, the prevalence of some MS components, such as high SBP, was higher in males than in females. In our population, children with obesity did not exhibit a higher impaired fasting glucose in males nor a higher predominance of IR in females [36].…”

“…The major contributors of gender dimorphisms in glucose, lipid and energy homeostasis are "activation" effects of estrogens and androgens acting on their receptors after the onset of puberty. There are several studies demonstrating differences in the incidence of cardio-metabolic risk factors in obese children according to their gender, as well as pubertal status [10][11][12][13][14][15][16][17], however, the combinations and interactions of the clustered MS risk factors, are not fully detailed in the pediatric age.…”

Blueberry intake included in hypocaloric diet decreases weight, glucose, cholesterol, triglycerides and adenosine levels in obese subjects

“…On the other hand, female obese subjects that consumed blueberries in hypocaloric diet showed no statistical differences in weight, BMI, glucose and triglycerides while cholesterol and AD levels were decreased. We speculate that differences in effects observed in experimental variables such as weight, BMI, glucose and triglycerides between sexes might be related with metabolic aspects proper of male or female subjects (Dearden, Bouret, & Ozanne, 2018;Barstad et al, 2018).…”

Sugar-sweetened beverages increases the risk of hypertension among children and adolescence: a systematic review and dose–response meta-analysis

“…Different kinds of sugar-sweetened beverages were included in the self-reported SSB intake questionnaires form including: sugar sweetened sodas, carbonated beverages, caloric and sport drinks, lemonades, yogurt drinks, sweetened teas, non-100% fruit juices, cordials and other types. The age range was from 5 to 22 years old while most of the studies were performed in apparently healthy children and adolescents [8-11, 13, 15, 19, 23, 24, 27, 38, 39] and one study was performed in children with T 1 DM [26] and one in severe obesity [37]. The setting of the studies was community [8,11,15,23,39], school [9,10,13,24,27,38], home [19] and clinic [26,37].…”