Abstract
Oxidative stress could help explain the relationship between childhood obesity and a metabolically unhealthy (MU) status. Moreover, puberty could also influence this relationship, since it entails physiological cardiometabolic changes. We aimed to evaluate plasma antioxidants and oxidative stress biomarkers in MU and metabolically healthy (MH) prepubertal and pubertal children and their associations with pro-inflammatory and endothelial damage biomarkers, taking puberty into account. A total of 1444 Spanish children aged 3–17 years (48.9% males, 66% prepubertal, 47.1% with obesity) were recruited. Blood pressure, anthropometric and biochemical parameters were measured, and children were categorized as having a MU or MH status according to risk factors. Retinol, carotenes, tocopherols, total antioxidant capacity (TAC), oxidized low-density lipoprotein and selected pro-inflammatory and endothelial damage biomarkers were analyzed. General linear models adjusted for age, sex, recruitment center and body mass index, partial correlations and stepwise linear regressions were performed. Lower carotenes and tocopherols levels were found in MU than in MH children. Plasma TAC was lower in prepubertal and higher in pubertal children with obesity compared to normal-weight children. Antioxidants and oxidative stress biomarkers showed novel associations with several pro-inflammatory and endothelial damage biomarkers, with pubertal differences, supporting the importance of considering both the antioxidant and oxidative stress status and puberty in the prevention of metabolic diseases in childhood.
Highlights
Overweight and obesity are increasing worldwide, having become important health issues in childhood [1]
Our analyses showed significantly higher total antioxidant capacity (TAC) in pubertal compared to prepubertal children independently of BMI (Table 1)
Due to these observed differences between prepubertal and pubertal children, as well as to the different cutoffs of the applied criteria to classify the children as metabolically healthy (MH) or metabolically unhealthy (MU), all subsequent analyses were stratified by pubertal status
Summary
Overweight and obesity are increasing worldwide, having become important health issues in childhood [1]. Obesity is frequently associated with the presence of hypertension, dyslipidemia, and insulin resistance, which have been clustered under the term of metabolically unhealthy (MU) status. The relationship between oxidative stress, obesity, and cardiometabolic disease seems to be a consequence of low-grade inflammation [10]. In the presence of excess weight, a decreased antioxidant defense could further contribute to a higher cardiometabolic risk [11]. These changes are often complex to detect, due to the homeostatic responses of the organism, as well as to changes associated with childhood development, such as the onset of puberty [12]. Puberty entails a physiological insulin resistance that influences oxidative stress and inflammation [13,14]
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