Physical fitness and activity, metabolic profile, adipokines and endothelial function in children

Penha, Jociene Terra da; Gazolla, Fernanda Mussi; Carvalho, Cecília Noronha de Miranda; Madeira, Isabel Rey; Rodrigues-Júnior, Flávio; Machado, Elisabeth de Amorim; Sicuro, Fernando Lencastre; Farinatti, Paulo; Bouskela, Eliete; Collett-Solberg, Paulo Ferrez

doi:10.1016/j.jped.2018.04.010

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Original articles • J. Pediatr. (Rio J.) 95 (5) • Sep-Oct 2019 • https://doi.org/10.1016/j.jped.2018.04.010 copy

Physical fitness and activity, metabolic profile, adipokines and endothelial function in children^☆ ☆ Please cite this article as: Penha JT, Gazolla FM, Carvalho CN, Madeira IR, Rodrigues-Junior F, Machado EA, et al. Physical fitness and activity, metabolic profile, adipokines and endothelial function in children. J Pediatr (Rio J). 2019;95:531-7.

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Abstract

Objectives:

The prevalence of obesity is increasing. The aim of this study was to investigate if there is endothelial dysfunction in children with normal or excess weight, and whether the metabolic profile, adipokines, and endothelial dysfunction would be more strongly associated with physical fitness or with physical activity levels.

Method:

Cross-sectional study involving children aged 5-12 years. The evaluation included venous occlusion plethysmography, serum levels of adiponectin, leptin and insulin, lipid profile, physical activity score (PAQ-C questionnaire), and physical fitness evaluation (Yo-Yo test).

Results:

A total of 62 children participated in this study. Based on the body mass index, 27 were eutrophic, 10 overweight and 25 obese. Triglycerides, LDL cholesterol, HOMA-IR, and leptin were higher in the obese and excess-weight groups compared to the eutrophic group (p < 0.01). HDL cholesterol and adiponectin levels were higher in the eutrophic group compared to the obese and excess-weight groups (p < 0.01). Flow-mediated vasodilation after hyperemia was higher in the eutrophic group in comparison to obese and excess-weight subjects (p < 0.05). There was no difference in the physical activity levels among groups measured by PAQ-C. The Yo-Yo test was significantly associated with HDL cholesterol (rho = −0.41; p = 0.01), and this association remained after adjusting for body mass index z-score (rho = 0.28; p = 0.03).

Conclusion:

This study showed that endothelial dysfunction is already present in obese children, suggesting a predisposition to atherosclerotic disease. Moreover, HDL cholesterol levels were correlated with physical fitness, regardless of body mass index.

KEYWORDS
Obesity; Endothelial dysfunction; Cardiovascular disease; Obesity; Overweight; Pediatrics

	Eutrophic	Overweight	Obese	p-Value	Excess weight	p-Value
Age (years)	8.0 (6.0-10.0)	9.0 (7.0-11.0)	9.0 (8.0-9.0)	0.4656	9.0 (8.0-10.0)	0.26
z-score BMI	-0.33 (-1.0-0.7)	1.35 (1.11-1.52)^b b Eutrophic × overweight.	2.85 (2.46-3.78)^a a Eutrophic × obese.	0.0001	2.58 (1.85-3.37)	<0.0001
Waist circumference (cm)	57 (53.5-62.4)	69.05 (63.9-74.2)^b b Eutrophic × overweight.	84.0 (80.0-91.0)^a a Eutrophic × obese.	0.0001	82 (72-89.5)	<0.0001
WHR	0.82 (0.80-0.83)	0.8 (0.78-0.82)^b b Eutrophic × overweight.	0.85 (0.82-0.88)^a a Eutrophic × obese.	0.01	0.84(0.8-0.88)	0.11
% fat	25.2 (20.5-31.5)	35.05 (29.8-39.8)^b b Eutrophic × overweight.	45.2 (41.8-48.6)^a a Eutrophic × obese. ,^c c Overweight × obese. Significance level (p < 0.05).	0.0001	43.3 (37.2-47.8)	<0.0001
PAQ-C z-score	4.39 (3.59-4.75)	3.5 (3.0-4.7)	3.8 (3.1-4.1)	0.1684	3.75 (3.01-4.67)	0.06
Yo-Yo test (m)	250 (240-320)	240 (160-300)	160 (100-220)^a a Eutrophic × obese. ,^c c Overweight × obese. Significance level (p < 0.05).	0.02	195 (115-240)	0.01
TG (mg/dL)	59.5 (44-73)	85 (60-109)	100 (80-121)^a a Eutrophic × obese.	0.001	93.5 (74.5-114)	0.0001
LDL (mg/dL)	88 (76-107.5)	94 (84-140)	102 (92-113)	0.09	102 (87-114)	0.04
HDL (mg/dL)	55.5 (47-61.5)	45 (45-47)	44 (37-51)^a a Eutrophic × obese.	0.01	45 (38.5-50.5)	0.001
HOMA-IR	1.1 (1.0-1.9)	2.4 (1.7-4.1)	3.64 (2.7-6.8)^a a Eutrophic × obese.	0.001	3.3 (2.2-5.7)	0.0001
Adiponectin (µg/mL)	13.3 (11.1-15.7)	8.57 (7.5-12.7)	6.91 (5.5-11.0)^a a Eutrophic × obese.	0.001	8 (5.6-11.8)	0.0001
Leptin (ng/mL)	3.6 (2.9-5.4)	12.87 (4.9-30.7)	29.8 (25.7-43.4)^a a Eutrophic × obese. ,^c c Overweight × obese. Significance level (p < 0.05).	<0.0001	29.6 (13.0-37.3)	<0.0001
FMD (mL/min/100 mL tissue)	2.6 (1.9-3.1)	2.2 (2.0-3.3)	2.15 (1.8-3.0)	0.6645	2.15 (1.9-3.0)	0.37
FMD hyperemia (mL/min/100 mL tissue)	5.8 (4.9-6.6)	4.92 (4.5-5.5)	4.7 (3.4-5.7)^a a Eutrophic × obese.	0.04	4.71 (3.7-5.5)	0.01

	r	p-Value	r	p-Value	r	p-Value	r	p-Value
TG (mg/dL)	-0.18	0.18	-0.01	0.97	-0.19	0.17	0.1	0.46
HDL (mg/dL)	0.18	0.17	-0.06	0.67	0.41	0.01	0.28	0.03
HOMA-IR	-0.42	0.01	-0.22	0.15	-0.38	0.01	0.02	0.92
Adiponectin (µg/mL)	0.32	0.02	0.12	0.42	0.13	0.37	-0.15	0.30
Leptin (ng/mL)	-0.50	0.001	-0.13	0.42	-0.40	0.01	-0.04	0.82
FMD hyperemia (mL/min/100 mL tissue)	0.02	0.90	-0.13	0.34	0.15	0.25	-0.06	0.68

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[1] * Corresponding author. E-mail:paulosolberg@yahoo.com (P.F. Collett-Solberg).