Neck circumference and cardiometabolic risk in children and adolescents: the moderator role of cardiorespiratory fitness

Ana Paula Sehn,Anelise Reis Gaya,Elza Daniel De Mello,Letícia Welser,Cesar Agostinis-Sobrinho,Carlos Cristi-Montero,Cézane Priscila Reuter,Caroline Brand

doi:10.1186/s12887-021-02696-y

Abstract

BackgroundThe increased incidence of cardiometabolic risk factors has become a public health issue, especially in childhood and adolescence. Thus, early identification is essential to avoid or reduce future complications in adulthood. In this sense, the present study aimed to verify the influence of cardiorespiratory fitness (CRF) as a moderator in the association between neck circumference (NC) and cardiometabolic risk in children and adolescents.MethodsCross-sectional study that included 2418 randomly selected children and adolescents (52.5% girls), aged 6 to 17 years old. Anthropometric measurements, such as NC and body mass index (BMI), and CRF was measured by the six-minute running/walking test, as well as cardiometabolic risk (systolic blood pressure, glucose, HDL-C, and triglycerides), were assessed.ResultsFor all age groups, NC showed a negative relationship with CRF. A significant interaction term was found for CRF x NC with cardiometabolic risk for children (6 to 9 years old), early adolescents (10 to 12 years old), and middle adolescents (13 to 17 years old). It was found that children who accomplished more than 1092.49 m in CRF test were protected against cardiometabolic risk when considering NC. In adolescents, protection against cardiometabolic risk was found when the CRF test was completed above 1424.14 m and 1471.87 m (early and middle stage, respectively).ConclusionsCRF is inversely associated with NC and acts as a moderator in the relationship between NC and cardiometabolic risk in children and adolescents. Therefore, this detrimental health impact linked to fatness might be attenuated by improving CRF levels.

Highlights

The increased incidence of cardiometabolic risk factors has become a public health issue, especially in childhood and adolescence
neck circumference (NC) showed a negative association with cardiorespiratory fitness (CRF), indicating that higher CRF is associated with lower NC (Table 2)
Findings of the present study indicate that CRF is inversely associated with NC in children and adolescents of different age groups

Summary

Introduction

The increased incidence of cardiometabolic risk factors has become a public health issue, especially in childhood and adolescence. Early identification is essential for generating strategies and monitoring public health progress to avoid or reduce adulthood complications [3, 4] In this sense, overweight and obesity are strongly associated with the development of cardiometabolic diseases [5,6,7]. Adiposity influence the development of dyslipidemia, increasing liver adipocytes [9], as well as in blood pressure levels [10], due to an increase of inflammatory markers, such as interleukin-6 that can cause an increase in C-reactive protein This increase of Creactive protein is associated with less nitric oxide that causes lower vasodilation dependent on the endothelium, and enhances the risk of developing cardiometabolic diseases [11]. Adipose tissue is a complex and highly active metabolic endocrine organ [12]

Methods

Results

Discussion

Conclusion