Mean Body Mass Index Z-score Research Articles

Time-Course Evaluation of Body Mass Index in Japanese Children With Obstructive Sleep Apnea Syndrome After Adenotonsillectomy: A Three-Years Follow-Up Study.

Delayed physical growth is a common complication of pediatric obstructive sleep apnea syndrome (OSAS). Adenotonsillectomy (AT) is the first-line treatment for pediatric OSAS. Only a few studies have performed time-course BMI evaluation in pediatric OSAS patients post-operatively. Thus, we aimed to evaluate the time-course changes in pediatric OSAS patients after AT. Thirty-three children with OSAS who underwent AT were included and divided into two groups on the basis of their BMI z-scores (delayed physical growth group, n = 15; non-delayed physical growth group, n = 18). Clinical records of height and weight were collected before AT and at 6, 12, 24, and 36 months after AT. Changes in the mean BMI z-scores of the two groups were assessed up to 36 months. The mean BMI z-score was significantly increased in the delayed physical growth group at 6 months after AT. In contrast, the increase in mean BMI z-score was not observed in the non-delayed physical growth group. Growth improvement was noted in pediatric OSAS patients with delayed physical growth after AT. Our results suggest that AT is a promising therapy for improving the physical growth of pediatric OSAS patients with such problems.

Effectiveness of a gamification strategy to prevent childhood obesity in schools: a cluster-randomized controlled trial

AbstractIntroductionSchool-based interventions to prevent obesity have shown heterogeneous results. Recent school-based trials with “negative” have cast doubt on their effectiveness. In the Juntos Santiago trial, we used an innovative, theory-based gamification strategy to increase motivation and participation in healthy behavioural changes. This is the first trial, to our knowledge, to use gamification to prevent childhood obesity.ObjectiveTo examine the effectiveness of a multicomponent gamification strategy to prevent obesity in 5th and 6th-grade schoolchildren in Santiago de Chile.Materials and methodsSchool-based, parallel cluster-randomized controlled trial. 81 schools in two municipalities in Santiago, Chile, with more than 40 students in 5th and 6th grade altogether were eligible. Schools were randomized and sequentially invited to participate. The multicomponent intervention was a gamification strategy with four components: (i) healthy challenges (snacks, steps and healthy activities); (ii) gamification incentives, such as points, levels, leaderboards and badges; (iii) rewards (infrastructure and fun activity) and (iv) an online platform for parents and students to monitor the progress. Participants were followed up at 5 and 8 months. Pre-registered primary outcomes were body mass index (BMI) z-score and waist circumference (WC) at 8 months. Secondary outcomes were BMI and systolic (SBP) and diastolic blood pressure (DBP) at 8 months. Multilevel analysis adjusted for individual and school-level covariates were used.Results24 schools (9 controls) and 2333 students (709 controls) were assessed at baseline and 2264 students (689 controls) were assessed at 8 months. The mean BMI z-score was lower in the intervention group compared to the control group at 8 months (mean difference -0.132, 95% CI -0.249; -0.014), while no difference was observed for WC. Mean BMI and SBP were lower in the intervention arm compared to the control arm (mean difference for SBP -0.139; 95% CI -2.39; -0.40). No difference was observed for DBP.DiscussionThe gamification strategy appears to prevent childhood obesity and reduce systolic blood pressure in school children in Santiago. These effects are larger than the pooled effects from existing meta-analyses. Further research should identify which components of the gamification strategy were more effective.Trial registrationClinicalTrials.gov NCT03459742Funded byMayors Challenge 2016, Bloomberg Philanthropies

Characterizing the weight-glycemia phenotypes of type 1 diabetes in youth and young adulthood

IntroductionIndividuals with type 1 diabetes (T1D) present with diverse body weight status and degrees of glycemic control, which may warrant different treatment approaches. We sought to identify subgroups sharing phenotypes...

Prevalence and risk factors for nonalcoholic fatty liver disease in obese children in rural Punjab, India.

BACKGROUND:Pediatric nonalcoholic fatty liver disease (NAFLD) is associated with insulin resistance, hypertension, metabolic syndrome, cardiovascular problems, and increased risk of chronic liver disease and Type II diabetes mellitus. The aim of the study was to assess the metabolic profiles and associated risk factors of NAFLD in obese children.MATERIALS AND METHODS:Children with a body mass index (BMI) of >27 kg/m2 an adult equivalent cutoff (Indian Academy of Paediatrics, 2015 guidelines) aged 5–18 years presenting to the pediatric outpatient unit of PGIMER Satellite Centre, Sangrur, India, were retrospectively recruited over a 1-year period. Anthropometry, lipid profile, thyroid levels, liver function test, fasting blood sugar, and blood pressure were measured. Ultrasonography was used to diagnose NAFLD. Logistic regression was used to assess the risk factors.RESULTS:A total of 100 children participated in the study. The mean age was 10.6 ± 2.6 years and the mean BMI-Z score was 2.6 ± 0.5. The prevalence of NAFLD was 62%. Alanine transaminase (ALT) was significantly elevated in all the children with NAFLD. Lipid levels and BMI Z-score were similar in both groups. Unadjusted odds ratio shows statistically significant association of ALT (2.058 [1.11–1.01]) and waist circumference (1.089 [1.19–0.99]) with NAFLD. With adjusted odds ratio only, ALT (1.12 [1.24–1.01]) was found to be significantly associated with NAFLD.CONCLUSION:There is quite a high prevalence of nonalcoholic fatty liver in obese Indian children. All children with raised liver enzymes should undergo sonography to rule out NAFLD.

Do physical activity and screen time mediate the association between European fathers\u2019 and their children\u2019s weight status? Cross-sectional data from the Feel4Diabetes-study

BackgroundMost research on parenting and childhood obesity and obesity-related behaviours has focused on mothers while fathers have been underrepresented. Yet, recent literature has suggested that fathers uniquely influence their children’s lifestyle behaviours, and hence could also affect their weight status, but this has not yet been scientifically proven. Therefore, the present study aimed to determine whether the association between fathers’ weight status and their children’s weight status is mediated by fathers’ and children’s movement behaviours (i.e. physical activity (PA) and screen time (ST)).MethodsCross-sectional data of 899 European fathers and their children were analyzed. Fathers/male caregivers (mean age = 43.79 ± 5.92 years, mean BMI = 27.08 ± 3.95) completed a questionnaire assessing their own and their children’s (mean age = 8.19 ± 0.99 years, 50.90% boys, mean BMIzscore = 0.44 ± 1.07) movement behaviours. Body Mass Index (BMI, in kg/m2) was calculated based on self-reported (fathers) and objectively measured (children) height and weight. For children, BMI z-scores (SD scores) were calculated to obtain an optimal measure for their weight status. Serial mediation analyses were performed using IBM SPSS 25.0 Statistics for Windows to test whether the association between fathers’ BMI and children’s BMI is mediated by fathers’ PA and children’s PA (model 1) and fathers’ ST and children’s ST (model 2), respectively.ResultsThe present study showed a (partial) mediation effect of fathers’ PA and children’s PA (but not father’s ST and children’s ST) on the association between fathers’ BMI and children’s BMI (model for PA; coefficient: 0.001, 95% CI: [0.0001, 0.002]; model for ST; coefficient: 0.001, 95% CI: [0.000, 0.002]). Furthermore, fathers’ movement behaviours (PA and ST) were positively associated with their children’s movement behaviours (PA and ST) (model for PA, coefficient: 0.281, SE: 0.023, p < 0.001; model for ST, coefficient: 0.345, SE: 0.025, p < 0.001).ConclusionsThese findings indicate that the influence of fathers on their children’s weight status partially occurs through the association between fathers’ PA and children’s PA (but not their ST). As such, intervening by focusing on PA of fathers but preferably of both members of the father-child dyad (e.g. engaging fathers and their children in co-PA) might be a novel and potentially effective strategy for interventions aiming to prevent childhood overweight and obesity. Longitudinal studies or intervention studies confirming these findings are however warranted to make meaningful recommendations for health intervention and policy.Trial registrationThe Feel4Diabetes-study is registered with the clinical trials registry http://clinicaltrials.gov, ID: 643708.

An educational intervention to prevent overweight in pre-school years: a cluster randomised trial with a focus on disadvantaged families

BackgroundEarly prevention is a promising strategy for reducing obesity in childhood, and Early Years settings are ideal venues for interventions. This work evaluated an educational intervention with the primary aim of preventing overweight and obesity in pre-school children.MethodsA pragmatic, cluster randomised trial with a parallel, matched-pair design was undertaken. Interventions were targeted at both the cluster (Early Years’ Centres, matched by geographical area) and individual participant level (families: mother and 2-year old child). At the cluster level, a staff training intervention used the educational resource Be Active, Eat Healthy. Policies and provision for healthy eating and physical activity were evaluated at baseline and 12-months. The intervention at participant level was the Healthy Heroes Activity Pack: delivered over 6 months by Centre staff to promote healthy eating and physical activity in a fun, interactive way. Child and parent height and weight were measured at four time-points over 2 years. The trial primary outcome was the change in BMI z-score of the child between ages 2 and 4 years. Secondary outcomes consisted of parent-reported measures administered at baseline and two-year follow-up.ResultsFive pairs of Early Years’ Centres were recruited. Four pairs were analysed as one Centre withdrew (47 intervention families; 34 control families). At the cluster level, improvement in Centre policies and practices was similar for both groups (p = 0.830). At the participant level, the intervention group reduced their mean BMI z-score between age 2 and 4 years (p = 0.002; change difference 0.49; 95% CI 0.17 to 0.80) whereas the control group showed increasing BMI z-score throughout. Changes in parent-reported outcomes and parent BMI (p = 0.582) were similar in both groups.ConclusionsThe Healthy Heroes educational resource deterred excess weight gain in pre-school children from poor socioeconomic areas. With training, Early Years’ staff can implement the Healthy Heroes programme.Trial registrationISRCTN22620137 Registered 21st December 2016.

Anthropometric status and lipid profile among children and adolescents: Changes after 18-month follow-up

Overweight children and adolescents are more likely to evolve with high cholesterol, be obese adults and develop cardiovascular disease. The objective of this study was to identify the influence of anthropometric status on the changes in the lipid profile of children and adolescents during an 18-month follow-up period. A cohort study involving 540 boys and girls from 7 to 15 years of age was conducted over 18 months' follow-up. The outcome variables were the lipid indicators and the principal exposure variable was anthropometric status, measured by different indicators. A generalized estimating equation (GEE) approach was used to identify the associations of interest. Irrespective of age, sex, socio-economic status, physical activity and diet, for each gain of 1cm in the waist circumference (WC) mean in the adjusted model, triglyceride levels increased by a mean of 0.5mg/dl (p<0.000) and there was an increase of 0.21mg/dL in the total cholesterol after the 18-month period. The increase of 0.1 in the mean body mass index (BMI) Z-score promoted a gain of 2.7mg/dL in the triglycerides mean levels (p<0.000) and an increase of 1.5mg/dL in the total cholesterol mean levels (p=0.014) after the follow-up period. Regarding the waist-to-height ratio (WHtR) and conicity index (CI), an increment of 40.6mg/dL (p=0.02) and of 30.1mg/dL (p=0.01) was observed in the triglycerides' mean when the participants increased 0.1 in the WHtR mean and CI mean, and the same was observed in the total cholesterol mean, with an increase of 45.4,g/dL (p=0.02) and 19.3mg/dL (p=0.03), for each indicator, respectively. Changes of the traditional anthropometric indicators (WC and BMI) did not promote variations in the mean levels of LDL-cholesterol. HDL-cholesterol was not influenced by the changes in the anthropometric indicators. At the baseline, a higher triglyceride mean and lower levels of HDL-c were observed in children and adolescents with altered anthropometric status for all measures. Mean triglyceride and total cholesterol levels are influenced by changes in the anthropometric status, regardless of the measure, after 18 months of follow-up. However, for LDL-cholesterol, it was observed that changes in the traditional anthropometric indicators (WC and BMI) did not promote variations in the mean levels of this biochemical variable, while HDL-c was not influenced by changes in any of the anthropometric indicators.

Body mass index and movement behaviors among schoolchildren from 13 countries across a continuum of human development indices: A multinational cross-sectional study.

This study describes the distributions of body mass index (BMI) and movement behaviors among schoolchildren from 13 countries across a continuum of human development. Data were from a cross-sectional study of 9-11-year-old children (n = 8055) recruited from 269 urban schools in 13 countries, and an additional 7 rural schools in one of these countries (Mozambique). BMI was derived from objectively measured heights and weights. Moderate- to vigorous-intensity physical activity (MVPA), sedentary time (SED), and sleep duration were assessed by waist-worn Actigraph GT3X+ accelerometers. Linear models were used to describe the distributions of BMI z-scores, MVPA, SED, and sleep among sites across varying Human Development Indices (HDIs). Mean MVPA, SED, and sleep duration were 63.1 ± 27.3 minutes/day, 508.7 ± 72.4 minutes/day, and 8.8 ± 0.9 hours/night, respectively. Overall, 2.1% of the sample were thin, 19.5% overweight, and 11.7% were obese. Density curves (BMI z-scores and SED) for urban children in Mozambique showed significantly higher mean values compared with rural children. Boys had significantly higher mean MVPA compared with girls. Mean BMI z-scores were positively associated (β = .02; P = .004) with HDI, mean daily MVPA minutes were negatively associated (β = -.38; P = .025) with HDI, and mean SED time was positively associated with HDI (β = 1.18; P = .049). No significant association (β = .01; P = .29) was observed between sleep duration and HDI. Our findings show distinct differences in BMI and movement behavior profiles between urban and rural children in Mozambique. Mean BMI z-scores, MVPA, and SED differed by country HDI. These findings support the need to include both rural and urban participants in study samples.

A cross-sectional study on the deprivation and sex differences in health-related fitness measures in school children

ABSTRACTThis study aimed to investigate deprivation and sex differences in selected health-relatedfitness measures in 9-12-year-old children. Data were captured on 3,407 children (49.3% boys; aged 10.5 ± 0.6 years). Cardiorespiratory fitness(20 m multistage shuttle run test; 20 m MSRT), muscular strength (handgrip strength) and body mass index (BMI) were measured. Welsh Index of Multiple Deprivation (WIMD) scores were used to make quintile groups. A two-way Analysis of Variance examined differences in BMI z-score by sex and WIMD quintiles. Two-wayAnalysis of Covariances investigated the effect of sex and WIMD quintiles on grip strength and shuttles achieved in 20 m MSRT, adjusting for BMI z-score and maturation, repectively. Independent of sex, children in the middle quintile had a significantly higher mean BMI z-score (p = 0.029) than their least deprived counterparts. There was a significant increase in grip strength (p = 0.005) and20 m MSRT (boys p < 0.001; girls p = 0.028) between most and least deprived quintiles. Significant differences in 20 m MSRT score were more apparent with decreases in deprivation in boys.Overall, inequalities exist in health-related fitness by sex and deprivation. These results can be used to inform focused services to improve current and future health.

Stable prevalence of obesity among Ngāti Whātua 4-year-old children in 2010–2016

ABSTRACTRecent evidence indicates a slight decline in the overall prevalence of obesity in New Zealand children (including Māori), but it is unknown whether this pattern is reflected across all iwi. We examined obesity prevalence (body mass index (BMI) ≥95th percentile) among 4-year-old children of Ngāti Whātua descent (n = 2031) enrolled in the B4 School Check from 2010 to 2016. Possible differences according to sociodemographic factors were examined. There was no evidence that obesity prevalence among Ngāti Whātua children changed throughout the study period. Mean prevalence was 21.2%, but there was marked yearly variation, ranging from 17.5% to 23.2%. Overall, mean prevalence differed according to sociodemographic factors, being higher in boys than girls (24.5% vs 17.9%) and among children from most deprived compared to least deprived households (25.5% vs 16.2%). Their overall mean BMI z-score was 0.88 (95%CI 0.84, 0.93), with sociodemographic differences mirroring those for prevalence: boys 0.99 vs girls 0.78; and most deprived 0.90 vs least deprived households 0.76. In conclusion, In contrast to national figures, obesity prevalence among Ngāti Whātua children appeared to be unchanged throughout the study period, indicating national data from the larger Māori population in New Zealand cannot be assumed to reflect the trends within individual iwi.

4225Effectiveness of a behavioural incentive scheme linked to goal achievement in overweight children: a multicenter cluster randomized controlled trial

Abstract Background The prevalence of childhood overweight and obesity is becoming an increasing concern worldwide and management is vital for primary prevention of cardiovascular disease. Studies in adults have shown that provision of incentives may facilitate behaviour change but there are no similar studies targeting weight management in children. Purpose To determine effectiveness of a structured goal setting incentive scheme, delivered within a community program, on health outcomes (with a focus on cardiovascular risk factors) in overweight children at 6 and 18 months. Methods Single-blind, multicenter, cluster randomized controlled trial with 10 weeks, 6 and 18 month follow-up. Eligible sites had to be delivering the standard children's weight management program and enrol at least 10 children per term. Eligible children had to be 7–13 years and have a body mass index (BMI) &gt;85th percentile. Recruited sites were randomized to (i) standard weight management program plus incentive scheme (intervention) or (ii) standard program alone (control). The intervention group participated in the standard program plus received milestone based incentives for achievement of goals. Incentives were practical, and healthy in nature such as fun vegetable slicers, sports store vouchers, sport equipment and family zoo passes. Primary outcome was mean BMIz score at 18 months. Secondary outcomes included anthropometric (body weight, waist circumference), behavioural (physical activity, nutrition) and self-esteem (Physical Activity Enjoyment Scale, Rosenberg Self Esteem Scale) measures. Results A total of 37 sites (33 urban and 4 regional) and 512 children were recruited. There were no significant differences between the control and intervention groups at any follow-up time-points. There were significantly more participants in the intervention than control group who completed 10 sessions of the weight management program (23% v 13%, p=0.015). Compared to baseline, at 18 month follow-up, the total cohort achieved significant reductions in the mean BMIz score (1.7 v 1.0, p&lt;0.001), median screen time (16.5 v 15.8 hours/week p=0.0414), median number of fast food meals per week (1.0 v 0.7, p&lt;0.001) and significant increases in physical activity (6.0 v 10.0 hours/week, p&lt;0.001) and self-esteem score (20.7 v 22.0, p&lt;0.002). Conclusions The incentive scheme, delivered in addition to a standard community weight management program, did not have a significant impact on health outcomes in overweight children. However, the intervention increased program attendance and overall cohort achieved sustained improvements in clinical and lifestyle outcomes. The results of this study suggest that extrinsic rewards may not provide added value to current community weight management programs however, participation in such programs is likely to support primary prevention of cardiovascular disease. Acknowledgement/Funding This work was supported by National Heart Foundation (Australia) pilot funding as part of JR's Future Leader Fellowship, in-kind contributions from th

Can the Healthy Primary School of the Future offer perspective in the ongoing obesity epidemic in young children? A Dutch quasi-experimental study

ObjectivesSchools play an important role in promoting healthy behaviours in children and can offer perspective in the ongoing obesity epidemic. The ‘Healthy Primary School of the Future’ (HPSF) aims to...

Prenatal exposure to airborne polycyclic aromatic hydrocarbons and childhood growth trajectories from age 5–14 years

There is evidence that exposures to polycyclic aromatic hydrocarbons (PAH) and fine particles in air pollution are associated with higher childhood body mass index (BMI). Birth cohort analyses of prenatal exposures to PAH and child BMI Z-scores from age 5–14 years were conducted. African-American and Hispanic children born in the Bronx or Northern Manhattan, New York (1998–2006), whose mothers underwent personal air monitoring for airborne PAH exposure during pregnancy, were followed up with measurements of height and weight at approximate ages 5, 7, 9, 10, 11, 12.5 and 13.5 years. Multivariable generalized estimating equation analyses were used to relate prenatal airborne PAH exposures to child BMI Z-scores through time. The analyses adjusted for many known risk factors for childhood obesity and included interactions terms between age and exposure tertiles and age squared and exposure tertiles. In total, 535 children had at least one height and weight measure during follow-up. The prevalence of obesity was 20.6% at age 5 and increased across follow-ups until age 11 when it was 33.0%. At age 5, BMI Z-scores were significantly greater for children in the third tertile of exposure relative to the first tertile (0.35 Z-score units, 95% CI 0.09, 0.61, p = 0.007) and were non-significantly higher for the second tertile of exposure compared to the first tertile (0.25 Z-score units, 95% CI -0.02, 0.52, P = 0.075). The trajectories of BMI Z-scores by tertiles of exposure converged as the children aged, such that by age 11 years the estimated mean BMI Z-scores associated with each tertile of exposure were not different. Prenatal exposures to airborne PAH were associated with higher childhood BMI Z-scores at a young age, but growth trajectories converged by age 11 years. Accordingly, highly exposed children spend a greater proportion of their childhood with higher BMI Z-scores.

Decomposing ethnic differences in body mass index and obesity rates among New Zealand pre-schoolers.

To determine the extent to which ethnic differences in BMI Z-scores and obesity rates could be explained by the differential distribution of demographic (e.g. age), familial (e.g. family income), area (e.g. area deprivation), parental (e.g. immigration status), and birth (e.g. gestational age) characteristics across ethnic groups. We used data on 4-year-old children born in New Zealand who attended the B4 School Check between the fiscal years of 2010/2011 to 2015/2016, who were resident in the country when the 2013 census was completed (n = 253,260). We implemented an Oaxaca-Blinder decomposition to explain differences in BMI Z-score and obesity between Māori (n = 63,061) and European (n = 139,546) children, and Pacific (n = 21,527) and European children. Overall, 15.2% of the children were obese and mean BMI Z-score was 0.66 (SD = 1.04). The Oaxaca-Blinder decomposition demonstrated that the difference in obesity rates between Māori and European children would halve if Māori children experienced the same familial and area level conditions as Europeans. If Pacific children had the same characteristics as European children, differences in obesity rates would reduce by approximately one third, but differences in mean BMI Z-scores would only reduce by 16.1%. The differential distribution of familial, parental, area, and birth characteristics across ethnic groups explain a substantial percentage of the ethnic differences in obesity, especially for Māori compared to European children. However, marked disparities remain.

Nutritional Status Trends in Brazilian Preschoolers: A Cohort Study.

Background: Determining trends in the nutritional status of children may guide care prevention beyond this age in an effort to reduce the prevalence and incidence of overweight and/or obese children. The objective of this study is to evaluate the evolution of the nutritional status of preschool children in two moments, with an interval of 2 years. Methods: This is a cohort study of a random probabilistic sample of preschool children attending public schools within an urban area of high human development index city, in the hinterland of São Paulo state. In 2016, we reassessed the nutritional status of 351 preschoolers evaluated in 2014, comparing the prevalence of overweight according to BMI >1 z-score. Results: The prevalence of overweight was 31.05% (2014) and 31.06% (2016) and mean BMI z-scores were 0.58 and 0.57, respectively. The nutritional status classification of the preschool children showed almost no agreement between the two time points (κ = 0.053). Nevertheless, children with overweight in 2014 had a relative risk of 1.96 of being overweight or obese in 2016 (p = 0.0473). Conclusions: Prevalence of overweight among preschoolers was the same at 2 and 5 years of age, with no tendency to grow. Despite this, 2-year-old preschoolers with overweight present a twofold higher relative risk for excessive weight at 5 years of age. These changes of nutritional status at preschool age evince the great flexibility of their nutritional condition during this period of life.

1356-P: Comparison of Serum Adipokines and Anthropometric Measures in Children with Type 1 Diabetes (T1D) and Obesity

Obesity or overweight occur in 40% of U.S. youth with T1D. While BMI is used to define obesity, it may not accurately reflect excess adiposity, which correlates better with metabolic dysfunction. However, it is difficult to measure adiposity without a research setting. In contrast, adipokines, which are produced by the adipose tissue, can be measured in serum. We aimed to analyze, in youth with T1D and obesity, the relationships of serum adipokines with measures of adiposity and cardiovascular risk factors. We studied participants in the T1D Exchange Metformin Study with a serum sample obtained before randomization (n=61, mean age=8.0 years [SD=3.0], 27.9% male, 82.0% non-Hispanic white, mean BMI percentile=99.0 ([SD=1.0], mean BMI Z-score=2.7 [SD=0.78], mean % of the 95th BMI percentile (%95th BMI pctle)=134.6 [SD=20.0]). We measured serum levels of adipokines and inflammatory markers. We studied the correlations between DEXA scan-derived measures of adiposity (e.g., % body fat) with adipokines (e.g., leptin, adiponectin) or anthropometric measures (e.g., % 95th BMI pctle [recommended measure for extreme obesity], BMI-Z score). DEXA % body fat was significantly correlated with % 95th BMI pctle (r=0.494, p&amp;lt;0.0001) or leptin (r=0.467, p=0.0002), without statistical difference between these two correlations (p = 0.857). The correlation between % body fat and BMI Z-score was weaker (r=0.29, p=0.0270). Higher adiponectin was correlated with cardiovascular protective factors, such as lower systolic blood pressure (p=0.039) and higher HDL cholesterol (p=0.001), while neither % 95th BMI pctle nor BMI Z-score were. Children with high adiponectin (&amp;gt;26.5 mg/L, distribution mean) were less likely to have high CRP &amp;gt;6 mg/L (1.6%) vs. children with low adiponectin (23.0%, p&amp;lt;0.05). Serum adipokines levels could be used as more convenient markers of adiposity than BMI measures, and potentially become therapeutic targets to improve clinical outcomes in children with T1D and obesity. Disclosure M.J. Redondo: None. X. Gu: None. S. Sisley: Advisory Panel; Self; Rhythm Pharmaceuticals, Inc. M. Tosur: None. A.F. Siller: None. M. Bondy: None. S. Devaraj: None.

1675-P: Does Intensification of Insulin Therapy Lead to Increased Body Fat among Youth and Young Adults with Type 1 Diabetes (T1D)?

Intensive insulin therapy may have the unintended consequence of increased adiposity, contributing to the high prevalence of overweight and obesity in people with T1D. We examined the longitudinal association of insulin intensification with estimated body fat percentage (eBFP) among 746 individuals with T1D (age 10-21 years at initial visit) in the SEARCH for Diabetes in Youth study. eBFP was calculated using validated, published sex and race/ethnic specific formulae incorporating age and anthropometrics. Insulin intensification was defined as more intense, less intense or no change, in which “more intense” was an increased number of injections or addition of long-acting insulin, or a change from injections to an insulin pump. Sex-specific, linear mixed effects models used continuous eBFP at each available visit (baseline, and 1-4 follow-up visits; median T1D duration at the last visit, 8 years). Interaction terms between time and insulin intensification relative to change in eBFP tested the study hypothesis. Mean diagnosis age was 12.7 years ± 2.5, 47% were female, 80% non-Hispanic white. At baseline, mean BMIz score was 0.51 ± 0.93, with 32% overweight or with obesity. Although BMIz and weight status did not differ by sex, eBFP was significantly higher in females compared to males (32.4% ± 5.3 and 25.3% ± 5.9 respectively; p&amp;lt;0.0001). After adjustment for age at diagnosis, study site, and sociodemographic factors, there was a statistically significant increase in eBFP over time for females (4.8% over the median duration of 8 years) and a statistically significant decrease for males (1.6% over the median duration of 8 years). For females, this increase was 2.2% greater over the median duration of 8 years for more intense compared to less intense therapy (p=0.0009). Rates of change in eBFP did not depend on insulin intensification for males (p=0.09). Further work may determine metabolic and behavioral drivers of this unintended increase in eBFP, particularly among females with T1D. Disclosure E. Mayer-Davis: None. B.A. Reboussin: None. C. Pihoker: None. A.R. Kahkoska: None. D. Dabelea: None. L.M. Dolan: None. E.T. Jensen: None. D. Igudesman: None. J.M. Lawrence: None. S. Saydah: None. R. Wadwa: Advisory Panel; Self; Eli Lilly and Company. Research Support; Self; Beta Bionics, MannKind Corporation, Novo Nordisk Inc., Tandem Diabetes Care, Xeris Pharmaceuticals, Inc. Other Relationship; Self; Dexcom, Inc. Funding Centers for Disease Control and Prevention; National Institutes of Health

1328-P: Racial Differences in Comorbidities in Youth with T2D in the Pediatric Diabetes Consortium (PDC)

Background: Racial differences in diabetes control and cardiovascular disease risk factors have been reported in youth with diabetes, with minority youth having worse glycemic control and comorbidities compared with non-Hispanic white (NHW) peers. Methods: We examined racial differences in comorbidities in youth (&amp;lt;21 years at enrollment) with T2D (N=1217, 63% females) enrolled in the PDC Registry from February 2012 to June 2018. Demographic and clinical data collected from medical records and participant self-report were compared using logistic and linear regression models adjusted for relevant confounders. Results: The mean age at presentation was 13.4 ± 2.4 years, and mean BMI Z-score was 2.30 ± 0.45. African-American (AA) and Hispanic (H) youth had higher HbA1c and lower C-peptide at diagnosis compared to NHW, with AA 3 times as likely to present in DKA compared with NHW. Microalbuminuria was present in 11%, hypertension in 34% and dyslipidemia in 42% with no significant differences in these comorbidities among racial groups. Nonalcoholic fatty liver disease (NAFLD) was diagnosed in 9% and 11% of H and NHW, respectively vs. 2% in AA (Table). Conclusion: Minority youth with T2D presented with worse metabolic control compared with NHW, with higher rates of DKA in AA youth. Comorbidities exist in a large percentage of youth with T2D independent of ethnicity, except for NAFLD being less prevalent in AA. Disclosure F. Bacha: Research Support; Self; National Institute of Diabetes and Digestive and Kidney Diseases, Pediatric Diabetes Consortium. Other Relationship; Self; AstraZeneca, Jaeb Center for Health Research. P. Cheng: None. R.L. Gal: None. L.C. Beaulieu: None. C. Kollman: None. A. Adolph: None. I. Jindal: None. A.H. Shoemaker: Advisory Panel; Self; Rhythm Pharmaceuticals, Inc. Research Support; Self; AstraZeneca, GLWL Research Inc., Novo Nordisk Inc., Rhythm Pharmaceuticals, Inc., Soleno Therapeutics. R.M. Wolf: None. G.J. Klingensmith: Consultant; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Takeda Pharmaceutical Company Limited. Research Support; Self; Novo Nordisk Foundation. Stock/Shareholder; Spouse/Partner; Dexcom, Inc. W.V. Tamborlane: Consultant; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Medtronic MiniMed, Inc., Novo Nordisk Inc., Sanofi, Takeda Pharmaceutical Company Limited. Funding Boehringer Ingelheim; Novo Nordisk; Takeda Pharmaceutical Company Limited

The Association Between Breastfeeding and Body Composition During Adolescence (P11-123-19)

ObjectivesTo investigate whether breastfeeding duration during infancy was related to body composition in adolescence. MethodsThe analytic sample comprised 536 Mexico City adolescents enrolled in an ongoing cohort study. Breastfeeding duration was estimated based on mother’s report of when she started and stopped breastfeeding, assessed during follow up visits at 1, 3, 6, and 12 months postpartum. Trained health professionals conducted the anthropometric assessment of weight, height, waist circumference, and triceps, suprailiac, and subscapular skinfold thicknesses. Bioelectrical impedance was used to derive the fat, muscle, lean and trunk fat masses and percentages. Sex-specific linear regression was performed with body composition measures as outcomes and breastfeeding duration in months as a continuous exposure, accounting for age, maternal education, maternal smoking during pregnancy, maternal parity, birth weight, and length, length of gestation, and adolescent maturation status. ResultsThe median (IQR) age was 14.62 (3.90) years, and 51.49% were females. Mean (SD) Body Mass Index Z-score was 0.58 (1.19) for females and 0.42 (1.29) for males. Breastfeeding duration ranged from 0 to 34 months with a median duration of 6.50 (9.00) and 7.00 (8.00) months in females and males, respectively. In males, there was a statistically significant positive association between duration of breastfeeding and skeletal muscle and lean mass in crude models (β = 0.19 [95% CI 0.07, 0.30] and β = 0.29 [95% CI 0.11, 0.46], respectively. Nonetheless, these associations were attenuated and no longer statistically significant when age and other covariates were included in the linear model (for muscle mass β = 0.02 [95% CI - 0.06, 0.10]) and lean mass β = 0.03 [95% CI - 0.09, 0.15]). There were no associations between breastfeeding duration and other body composition outcomes either in crude or adjusted sex-specific models. ConclusionsAfter accounting for potential confounders, there was no evidence of a relationship between breastfeeding duration and adolescent body composition. Age was a crucial confounder, as younger adolescents in the cohort had shorter breastfeeding duration and lower skeletal and lean mass. Funding SourcesNIH/NIEHS and EPA.

Weight trends in a multiethnic cohort of pediatric acute lymphoblastic leukemia survivors: A longitudinal analysis.

BackgroundAs survival rates for childhood acute lymphoblastic leukemia (ALL) continue to improve, there is growing concern over the chronic health conditions that survivors face. Given that survivors of childhood ALL are at increased risk of cardiovascular complications and obesity, we sought to characterize BMI trends from diagnosis through early survivorship in a multi-ethnic, contemporary cohort of childhood ALL patients and determine if early weight change was predictive of long-term weight status.MethodsThe study population consisted of ALL patients aged 2–15 years at diagnosis who were treated with chemotherapy alone at Texas Children’s Hospital. Each patient had BMI z-scores collected at diagnosis, 30-days post-diagnosis, and annually for five years. Linear regression models were estimated to evaluate the association between: 1) BMI z-score change in the first 30 days and BMI z-scores at five-years post-diagnosis; and 2) BMI z-score change in the first year post-diagnosis and BMI z-scores at five-years post-diagnosis.ResultsThis retrospective cohort study included longitudinal data from 121 eligible patients. The mean BMI z-scores for the population increased significantly (p-value<0.001) from baseline (mean = 0.25) to 30 days post-diagnosis (mean = 1.17) before plateauing after one year post-diagnosis (mean = 0.99). Baseline BMI z-scores were statistically significant predictors to five year BMI z-scores (p <0.001). Independent of baseline BMI z-score and other clinical factors, the BMI z-score at one year post-diagnosis was significantly associated with BMI z-score at five-years post-diagnosis (β = 0.63, p <0.001), while BMI z-score at 30 days post-diagnosis was not (β = 0.10, p = 0.23).ConclusionOur results suggest that weight gain within the first year after diagnosis is more strongly associated with long-term BMI than early weight gain (within 30 days). If confirmed, this information may help identify a window of time during therapy when ALL patients would benefit most from weight management directed interventions.