Abstract
Obesity is defined as abnormal or excessive fat accumulation that presents a risk to health. The ability to exercise is affected by adiposity, and this mechanism involves low-grade chronic inflammation and homeostatic stress produced mainly in adipocytes, which can result in abnormal adipokine secretion. To date, the gold standard for cardiorespiratory fitness assessment is considered to be the maximum oxygen uptake (VO2max). The aim of the present study was to assess the prognostic value of hematological parameters of childhood obesity, as potential predictors of cardiorespiratory fitness (VO2max), using a sample of children and adolescents with obesity and risk for diabetes. A total of 84 clinically healthy children and adolescents were recruited, of which 21 were considered lean, 22 overweight and 41 obese, with a mean age of 12.0 ± 1.9, 11.4 ± 2.0, and 11.2 ± 2.1 years old, in each weight status category, respectively. Age and sex did not differ between groups. Hematologic testing was performed after 12 h of fasting including glucose, serum lipids, insulin, hc-CRP, adiponectin, leptin and fibrinogen levels. Cardiorespiratory capacity for exercise was assessed to determine VO2max, using a cycle ergometer. The VO2max was negatively correlated with progressive strength to the BMIz (−0.656, p ≤ 0.001), hs-CRP (r = −0.341, p ≤ 0.002), glucose (r = −0.404, p ≤ 0.001) and insulin levels (r = −0.348, p ≤ 0.001), the homeostasis model assessment of insulin resistance (HOMA-IR) (r = −0.345, p ≤ 0.002), as well as to the leptin (r = −0.639, p ≤ 0.001) and fibrinogen concentrations (r = −0.520, p ≤ 0.001). The multivariate analysis revealed that only leptin and fibrinogen concentrations could predict the VO2max adjusted for the BMIz of participants. The receiver operating characteristic (ROC) curve for the diagnostic accuracy of leptin, hs-CRP and fibrinogen concentrations for the prediction of VO2max revealed a good diagnostic ability for all parameters, with leptin being the most promising one (area under the curve (AUC): 99%). The results verify that in children with obesity, VO2max may be predicted from hematological parameters (leptin and fibrinogen), possibly bypassing more invasive methods.
Highlights
Obesity is the result of a positive energy balance and/or physical inactivity, demonstrated by excessive body weight deposition for one’s height
Anthropometric indices were different between groups, with obese participants demonstrating greater Body mass index (BMI), BMI z-scores (BMIz), waist and hips circumferences, as well as waist/hips ratio
homeostasis model assessment of insulin resistance (HOMA-IR) and leptin levels were significantly lower among lean controls, compared to the obese, but in contrast, VO2max was significantly higher
Summary
Obesity is the result of a positive energy balance and/or physical inactivity, demonstrated by excessive body weight deposition for one’s height. The pathophysiology of obesity is complex and multifactorial, with the initial trigger stemming from homeostatic stress produced mainly in adipocytes, resulting in adipokine secretion attempting to balance energy homeostasis [1,2]. Leptin levels are increased during obesity, with a parallel reduction in circulating adiponectin [3,4,5]. Fibrinogen, a hemostatic protein produced by the hepatocytes, acts early on during the beginning of the atherothrombotic procedure [10,11]. Elevated fibrinogen concentrations have been reported in obese children and can serve as a prodromal atherosclerosis proxy index, for early intervention [8,12,13]
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