Normal Weight Youth Research Articles

Association of Biomarkers for Dyslipidemia, Inflammation, and Oxidative Stress with Endothelial Dysfunction in Obese Youths: A Case-Control Study.

The United Arab Emirates (UAE), with its characteristic local population, geography, and history, presents several risk factors for cardiovascular diseases (CVDs) in obese individuals. Obesity and its associated complications, including diabetes, atherogenic dyslipidemia, and CVDs leading to significant health risks. In the present study, "Youths" defined as young people between 18 and 22 years. We assessed dyslipidemia, inflammation, and oxidative stress biomarker levels and their association with endothelial dysfunction (ED) in both overweight/obese and normal weight youths of UAE. There were 160 youths with overweight/obese (BMI ≥ 25 kg/m2) patients and healthy age- and sex-matched normal weight (BMI ≤ 24.9 kg/m2) as controls participated in this study. The anthropometric data and blood samples were collected to assess the biomarkers for dyslipidemia, inflammation, oxidative stress, ED from all the youths. The overall mean age and male-to-female ratio were 20±1.5years and 1.0:1.2, respectively. There was statistically significant difference in HDL-C (p<0.001), triglycerides (TG) (p<0.001), ApoA (p=0.002), ApoB/ApoA ratio (p=0.009) between the overweight/obese and normal weight youths. Among, inflammatory markers: hs-CRP, IL-6, TNF-α also showed significant p<0.001 and oxidative stress markers: DNA/RNA Damage, catalase and nitric oxide (NO) showed significant p<0.001 between groups. Spearman correlation of ED markers with lipid profile markers showed Vitamin C levels positively correlated with HDL-C (p<0.001) and negatively correlated with glucose (p<0.001). ICAM-1showed significant negative correlation with HDL-C (p<0.01) and ApoA (p<0.001) but positive correlation with TG (p<0.01) and HbA1c (p<0.001) among groups. Spearman correlation of ED markers with inflammatory/oxidative stress biomarkers showed Vitamin C levels negatively correlated with ferritin (p < 0.001), NO (p < 0.001), GGT (p < 0.001), and ALT (p < 0.001) levels. The ICAM-1showed significant positive correlation with hs-CRP (p < 0.01), IL-6 (p < 0.001), TNF-α (p < 0.01), GGT (p < 0.05), and ALT (p < 0.05) in both groups. This study revealed a strong link between the biomarkers of dyslipidemia, inflammation, and oxidative stress with ED in overweight/obese patients. This study might be used to predict future cardiovascular events in this population.

Revised Case Finding Protocol for Dysglycemia in Chile: A Call for Action in Other Populations

ObjectiveGuidelines recommend case finding for dysglycemia (prediabetes and type 2 diabetes [T2D]) in adults or youth older than 10 years with overweight/obesity, but increased adiposity has not been associated with dysglycemia in some Hispanic populations. This study aims to determine the prevalence of dysglycemia in this population using simplified criteria independent of body mass index and age to request an oral glucose tolerance test (OGTT). MethodsCross-sectional retrospective analysis of medical records from a clinical center in Chile (2000-2007). OGTT was obtained from any patient with 1 cardiometabolic risk factor (CMRF) independent of age and body mass index. ResultsIn total, 4969 adults (mean age ± SD) 45.7 ± 15.9 years and 509 youths 16.6 ± 3.0 years were included. The prevalence (%, 95% CI) of prediabetes doubled that of T2D in youths (14.1%, 1.4-17.4 vs 6.3%, 4.5-8.7) and tripled it in adults (36.0%, 34.7-37.4 vs 10.7%, 9.8-11.5). In underweight and normal-weight adults, 22% (12.0-36.7) and 29.2% (26.4-32.1) had prediabetes, whereas 4.9% (1.3-16.1) and 8.8% (7.2-10.7) had T2D, respectively. In normal weight youths, 10.5% (6.7-15.9) and 2.9% (1.2-6.6) had prediabetes and T2D, respectively. In adults, but not in youths, most dysglycemia categories were related to overweight/obesity. ConclusionThis study supports a public health policy to identify more people at risk for cardiovascular disease by implementing a revised case finding protocol for dysglycemia using OGTT in even normal weight patients over 6 years of age when there is at least 1 CMRF. Reanalysis of case finding protocols for cardiometabolic risk in other populations is warranted.

Effects of High-Intensity Interval Training on Selected Adipokines and Cardiometabolic Risk Markers in Normal-Weight and Overweight/Obese Young Males-A Pre-Post Test Trial.

Simple SummaryAdipose tissue secretes bioactive substances called adipokines that affect cardiometabolic health. High-intensity interval training has a beneficial effect on cardiometabolic health, but its impact on adipokines is unclear. This research aims to assess the effects of 8-week high-intensity interval training on plasma levels of four adipokines (leptin, adiponectin, chemerin, and omentin-1) and cardiometabolic risk markers in normal- and excess-weight young males. The findings suggest a beneficial role of adiponectin and omentin, and a harmful role of leptin and chemerin in cardiometabolic health. Following the training, plasma omentin-1 levels had increased in normal- and excess-weight youth, but adiponectin, leptin, and chemerin levels had not changed in both groups. Body mass, fat mass, plasma lipids, and insulin sensitivity improved in excess-weight group, only. Body composition seems not to influence the response of adipokines to high-intensity interval training.The study aimed to assess effects of high-intensity interval training (HIIT) on plasma adipokines and cardiometabolic markers in normal and excess weight youth. Eighteen healthy young males (18.2 ± 1.06 yrs.) were divided in normal-weight group (NWG; body mass index (BMI), 20.5 ± 1.51 kg/m2; n = 9) and excess-weight group (EWG; BMI, 30.8 ± 4.56 kg/m2; n = 9). Participants performed an eight-week HIIT program without caloric restriction. Body composition, plasma leptin, adiponectin, chemerin, omentin-1, lipids, C-reactive protein (CRP), and the homeostasis model assessment index for insulin resistance (HOMA-IR) were assessed before and after the HIIT program. The program resulted in significant increases in omentin levels (p < 0.01) in EWG (27%) and NWG (22%), but no changes in leptin, adiponectin, and chemerin in both groups. BMI (−1.62%; p = 0.015), body fat (−1.59%; p = 0.021), total cholesterol (−11.8%; p = 0.026), triglycerides (−21.3%; p = 0.023), and HOMA-IR (−31.5%; p = 0.043) decreased in EWG only. Repeated measures detected significant interaction “Time x Group” for body mass and BMI only. Eight-week HIIT program improved body composition, lipid profile, and insulin sensitivity in excess-weight individuals. It resulted in an increase in omentin levels in both normal- and excess-weight groups, but no changes in leptin, adiponectin, and chemerin. Body composition has not influenced the response of the four adipokines to HIIT.

Association between body composition and blood pressure in normal-weight Chinese children and adolescents

BackgroundThe aim of this study was to assess the associations of body fat distribution and lean body mass (LBM) with blood pressure (BP) in normal-weight Chinese children and adolescents.MethodsA total of 898 normal-weight Chinese children and adolescents, aged 10–18 years, were included this cross-sectional study via a cluster sampling method. The bioelectrical impedance analysis (BIA) was used to measure body composition. The participants were measured for blood pressure (BP) using a calibrated electronic sphygmomanometer according to the standard method by the "American Hypertension Education Project Working Group".ResultsBody composition was related to abnormal BP in normal-weight children and adolescents. After the model adjusted for age, smoking, and drinking, regression analysis showed that fat mass percentage (FMP) was negatively associated with abnormal BP, while LBM was positively associated with abnormal BP in boys(P < 0.05). Whereas FMP and visceral fat level (VFL) were positively associated with abnormal BP in girls (P < 0.05).ConclusionsThere are sex differences in the relationships between total body fat, visceral fat and lean body mass with abnormal BP in normal-weight youths. Therefore, it is of great significance to pay attention to the relative influence of the body composition of the boys and girls in the prevention and treatment of hypertension in youths.

How does exposure to overnutrition in utero lead to childhood adiposity? Testing the insulin hypersecretion hypothesis in the EPOCH cohort.

Our aim was to explore metabolic pathways linking overnutrition in utero to development of adiposity in normal-weight children. We included 312 normal-weight youth exposed or unexposed to overnutrition in utero (maternal BMI ≥25kg/m2 or gestational diabetes). Fasting insulin, glucose and body composition were measured at age ~10years (baseline) and ~16years (follow-up). We examined associations of overnutrition in utero with baseline fasting insulin, followed by associations of baseline fasting insulin with adiposity (BMI z score [BMIZ], subcutaneous adipose tissue [SAT], visceral adipose tissue [VAT]), insulin resistance (HOMA-IR) and fasting glucose during follow-up. >All participants were normal weight at baseline (BMIZ -0.32 ± 0.88), with no difference in BMIZ for exposed vs unexposed youth (p = 0.14). Of the study population, 47.8% were female sex and 47.4% were of white ethnicity. Overnutrition in utero corresponded with 14% higher baseline fasting insulin (geometric mean ratio 1.14 [95% CI 1.01, 1.29]), even after controlling for VAT/SAT ratio. Higher baseline fasting insulin corresponded with higher BMIZ (0.41 [95% CI 0.26, 0.55]), SAT (13.9 [95% CI 2.4, 25.4] mm2), VAT (2.0 [95% CI 0.1, 3.8] mm2), HOMA-IR (0.87 [95% CI 0.68, 1.07]) and fasting glucose (0.23 [95% CI 0.09, 0.38] SD). Overnutrition in utero may result in hyperinsulinaemia during childhood, preceding development of adiposity. However, our study started at age 10years, so earlier metabolic changes in response to overnutrition were not taken into account. Longitudinal studies in normal-weight youth starting earlier in life, and with repeated measurements of body weight, fat distribution, insulin sensitivity, beta cell function and blood glucose levels, are needed to clarify the sequence of metabolic changes linking early-life exposures to adiposity and dysglycaemia.

1069-P: How Does Exposure to Overnutrition In Utero Lead to Childhood Adiposity? A Longitudinal Study in the Exploring Perinatal Outcomes among Children (EPOCH) Cohort

We explored the longitudinal sequence of metabolic changes linking overnutrition in utero to development of adiposity among initially normal weight children in the EPOCH cohort. This study includes 312 normal weight youth (body mass index [BMI] z &amp;lt;1 SD per the World Health Organization growth reference) that were exposed (n=144) or unexposed (n=168) to overnutrition in utero (maternal BMI ≥25 kg/m2 or gestational diabetes). Fasting insulin, glucose and adiposity were obtained at research visits during childhood (age 10 y) and adolescence (age 16 y). We examined associations of overnutrition in utero with natural log transformed fasting insulin at baseline, followed by associations of baseline fasting insulin with adiposity (BMI z, subcutaneous [SAT] and visceral fat depots [VAT]), insulin resistance (HOMA-IR), and fasting glucose during follow-up using linear mixed models that accounted for child age, sex, and race/ethnicity; maternal education and prenatal smoking. Baseline BMI z, fasting glucose, HOMA-IR, and adiposity markers (except for slightly higher SAT in exposed youth [+10 mm2]) were not different by exposure status. Overnutrition in utero corresponded with 14% (1%, 29%) higher baseline fasting insulin, even after controlling for child VAT, SAT, or VAT:SAT. Higher baseline fasting insulin was, in turn, associated with greater adiposity (0.41 [0.26, 0.55] SD BMI z; 13.9 [2.4, 25.4] mm2 SAT; 2.0 [0.1, 3.8] mm2 VAT) and HOMA-IR (0.88 [0.69, 1.07]) across follow-up, but not with fasting glucose. These results suggest that overnutrition in utero may result in hyperinsulinemia during childhood and precede accrual of adiposity. However, since our study started at age 10 y, studies in normal weight youth starting earlier, and with repeated assessments of insulin sensitivity, β cell function and glycemia, are needed to clarify the sequence of metabolic changes resulting from early exposures. Disclosure W. Perng: None. M. M. Kelsey: Other Relationship; Self; Boehringer Ingelheim (Canada) Ltd., Daiichi Sankyo, Janssen Pharmaceuticals, Inc., Merck Sharp &amp; Dohme Corp. K. A. Sauder: None. D. Dabelea: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases (R01DK068001); Colorado Clinical and Translational Sciences Institute (KL2-TR002534 to W.P.)

Asthma and Physical Activity in Urban Children.

Asthma and obesity disproportionately affect urban minority children. Avoidance of physical activity contributes to obesity, and urban children with asthma are at risk for lower levels of physical activity. We examined associations between lung function and moderate to vigorous physical activity (MVPA) and moderators of this association in a diverse sample of children with asthma. Urban children (N = 142) ages 7-9 with persistent asthma and their caregivers completed a study of asthma and physical activity. Longitudinal mixed effects models examining daily-level asthma and physical activity evaluated the association between asthma and MVPA, and the moderating effect of weight, and cultural/contextual factors on this association. Average daily MVPA was below recommended guidelines. Differences in MVPA were found by racial/ethnic group (p = .04) and weight (p = .001). Poorer asthma status was associated with lower MVPA in Latino and Black participants (p's < .05), and in normal weight youth (p = .01). Body mass index (BMI) moderated the association between asthma and MVPA. Those with lower BMI had more optimal asthma status and higher MVPA levels, whereas associations attenuated for participants with higher BMI (p = .04). Caregivers' perceptions of neighborhood safety and fear of asthma were marginally associated with children's symptoms and MVPA: as perceptions of safety decreased and fear increased, associations between asthma and MVPA weakened (p's = .09 and .07, respectively). Suboptimal asthma status is associated with less MVPA in urban children. Weight status and cultural/contextual factors play a role in the association and are worthy targets for future research and intervention.

Prevalence of Mildly Reduced Estimated GFR by Height- or Age-Related Equations in Young People With Obesity and Its Association with Cardiometabolic Risk Factors

To compare the prevalence of mildly reduced estimated glomerular filtration rate (MRGFR) (eGFR >60 and<90mL/min/1.73m2), calculated by two creatinine-based equations, and its association with cardiometabolic risk factors (CMRF) in youth with overweight (OW)/obesity (OB). This is a multicenter cross-sectional study involving university and non-university hospital pediatrics departments. We enrolled 3,118 youth with OW/OB (5-14years) and 286 healthy normal weight (NW) youth. eGFR was calculated using bedside Schwartz equation (eGFRBSE) and Full Age Spectrum equation (eGFRFAS). In OW/OB group we analyzed the association between eGFR calculated by both equations and CMRF. Uric acid (UA) and birth weight were available in 2,135 and in 1,460 youth. The prevalence of MRGFR was 3.8% in NW versus 7.8% in OW/OB (P=.016) by eGFRBSE, and 8.7% in NW versus 19.4% in OW/OB (P<.0001) by eGFRFAS. eGFRBSE and eGFRFAS identified 242 and 605 young people with OW/OB with MRGFR, respectively. Individuals with MRGFR according with both equations showed lower birth weight, younger age, higher BMI-SDS, non-high-density lipoprotein-cholesterol and UA as compared to those with normal eGFR. To examine whether the eGFRFAS was associated with a worse CMR profile also in the range of normal eGFRBSE, we reclassified young people with normal eGFRBSE (n=2,876) according with eGFRFAS. Out of youth with normal eGFRBSE, 366 (12.7%) presented MRGFR by eGFRFAS and had lower age, higher BMI-SDS, BP and UA than the remaining youth reclassified as normal eGFRFAS. MRGFR is associated with an altered CMR profile in a large sample of young people with overweight (OW)/obesity (OB). The eGFRFAS equation identifies a higher prevalence of youth with MRGFR, compared to eGFRBSE equation.

Relationship of Circulating Endothelial Cells With Obesity and Cardiometabolic Risk Factors in Children and Adolescents.

BackgroundCirculating endothelial cells (CECs) reflect early changes in endothelial health; however, the degree to which CEC number and activation is related to adiposity and cardiovascular risk factors in youth is not well described.Methods and ResultsYouth in this study (N=271; aged 8–20 years) were classified into normal weight (body mass index [BMI] percentage <85th; n=114), obesity (BMI percentage ≥95th to <120% of the 95th; n=63), and severe obesity (BMI percentage ≥120% of the 95th; n=94) catagories. CEC enumeration was determined using immunohistochemical examination of buffy coat smears and activated CEC (percentage of vascular cell adhesion molecule‐1 expression) was assessed using immunofluorescent staining. Cardiovascular risk factors included measures of body composition, blood pressure, glucose, insulin, lipid profile, C‐reactive protein, leptin, adiponectin, oxidized low‐density lipoprotein cholesterol, carotid artery intima–media thickness, and pulse wave velocity. Linear regression models examined associations between CEC number and activation with BMI and cardiovascular risk factors. CEC number did not differ among BMI classes (P>0.05). Youth with severe obesity had a higher degree of CEC activation compared with normal weight youth (8.3%; 95% CI, 1.1–15.6 [P=0.024]). Higher CEC number was associated with greater body fat percentage (0.02 per percentage; 95% CI, 0.00–0.03 [P=0.020]) and systolic blood pressure percentile (0.01 per percentage; 95% CI, 0.00–0.01 [P=0.035]). Higher degree of CEC activation was associated with greater visceral adipose tissue (5.7% per kg; 95% CI, 0.4–10.9 [P=0.034]) and non–high‐density lipoprotein cholesterol (0.11% per mg/dL; 95% CI, 0.01–0.21 [P=0.039]).ConclusionsMethods of CEC quantification are associated with adiposity and cardiometabolic risk factors and may potentially reflect accelerated atherosclerosis as early as childhood.

High blood pressure in Chinese youth across categories of BMI and waist circumference.

BMI and waist circumference (WC) have commonly been used to identify obesity in practice. The aim of the present study was to assess the blood pressure (BP) status among Chinese college students categorized by BMI and WC. A total of 4226 college students (2107 males and 2119 females) aged 19-22 years included in the study. The WHO BMI cutoffs were used to define underweight, normal weight and overweight. The WC cutoffs (90 cm for man and 80 cm for woman) were used to define central obesity. High BP was defined as SBP/DBP ≥140/90 mmHg. The BP status of subjects within each category across BMI and WC were assessed. When subjects were categorized by BMI, overweight males and females had a higher prevalence of high BP than their nonoverweight counterparts. When WC was used to diagnose central obesity, subjects with central obesity had a higher prevalence of high BP than those with normal WC. A positive association between BMI, WC and BP was also observed even in normal-weight subjects, with 'high normal BMI' subgroup (BMI = 23.7-24.9) had a higher BP level and prevalence of high BP than 'low normal BMI' subgroups (BMI = 18.5-19.7 and BMI = 19.8-21.0, P < 0.05). Prevention of overweight/obesity in youth may be an effective approach for preventing the development of hypertension in the future; for normal-weight youth, it is essential to keep their BMI at a lower level within normal range.

Lipid temporal trends in normal-weight youth

Analysis was done from National Health and Nutrition Examination Surveys 1988-2016. Data were extracted for 10- to 20-year-olds measured with anthropometrics and laboratory testing to determine proportions of NW versus EW with total cholesterol >190 mg/dL, high-density lipoprotein cholesterol (HDL-C) <40 mg/dL, and calculated non-HDL-C >145 mg/dL (N = 14,785). In survey-weighted regression analysis, a weight-status interaction term was used to examine effect modification in the lipid temporal trend. Over time, EW prevalence increased, whereas dyslipidemia decreased (trend P value < .001 for both). For the pooled sample, EW more than doubled the risk of each lipid disorder (P < .0001 for each). However, for each abnormal lipid, 26%-63% were NW. As the temporal trend in abnormal lipids declined, the proportion with abnormal lipids who were NW also declined. On regression analysis, temporal declines in NW and EW differed for HDL-C. NW constituted more than a quarter to half of youth with abnormal lipids. Over time, youth with abnormal lipids were less often NW. The novel observation that a high proportion of youth with abnormal lipids are NW is relevant to debates on universal lipid screening, the focus on weight reduction in youth lipid management, and conventional wisdom in cardiometabolic health.

1266-P: Puberty Is Associated with a Rising HbA1c, Even in Healthy Normal Weight Youth

Objective: ADA definitions of prediabetes are applied to children, yet little is known about the impact of the transient insulin resistance of puberty on glycemia. We aimed to evaluate the longitudinal trajectory of hemoglobin A1c (HbA1c) in youth with normal weight and with obesity as they progressed through puberty. Methods: Youth with normal weight (n=47, 49% female) or obesity (n=37, 62% female) of mixed race/ethnicity (Non-Hispanic White 34%, Hispanic 45%, Non-Hispanic Black 13%) entered the study in Tanner stage 2-3 (T2-3) and were followed until T5. Study visits were done at T2-3, T4, and T5 and included an IV glucose tolerance test, DXA, and fasting laboratory studies. HbA1c was measured by high-performance liquid chromatography and insulin sensitivity (Si), acute insulin response to glucose (AIRg), and disposition index (DI) were calculated. Group differences in HbA1c over time and time-dependent predictors of HbA1c were evaluated by mixed models, with and without adjusting for sex, race/ethnicity, and DXA %Fat. Results: Mean HbA1c was higher in youth with obesity (5.30±0.08%) vs. normal weight (5.10±0.06%, p=0.04) at baseline and each subsequent time point; differences were attenuated by adjusting for %Fat. HbA1c increased from T2/3 to T5 in the whole cohort (0.16±0.05%, p=0.004), and in youth with obesity (+0.18±0.08%, p=0.08), or normal weight (+0.14±0.05%, p=0.02); findings were similar after adjusting for sex, race/ethnicity, and %Fat. In a multivariate model adjusted for sex and race/ethnicity, HbA1c was associated with leptin (β=0.005, p=0.01) and adiponectin (β=-0.01p=0.02); these associations are similar after adjusting for %Fat. HbA1c was not associated with Si, AIRg or DI. Conclusions: Obesity is associated with higher HbA1c than normal weight during puberty. However, HbA1c increased during puberty, independent of body weight and composition. This increase in HbA1c is associated with changes in adipokines, but not with typical predictors of progression to diabetes (Si, DI). Disclosure M.M. Kelsey: Other Relationship; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo, Janssen Pharmaceuticals, Inc., Merck Sharp &amp; Dohme Corp. A.M. Hilkin: None. C. Severn: None. L. Pyle: None. K.J. Nadeau: None. P. Zeitler: Consultant; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo, Eli Lilly and Company, Merck &amp; Co., Inc. Funding American Diabetes Association (1-11-JF-23 to M.M.K.); Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD057022-04); University of Colorado Center for Women’s Health Research; Children’s Hospital Colorado Research Institute; National Institute for Diabetes and Digestive and Kidney Diseases (DK048520-13); National Center for Advancing Translational Sciences (UL1TR001082)

SUN-LB104 Metabolic Inflexibility: Is It a Feature of Obesity or a Characteristic of Metabolically Unhealthy Youth?

Obese individuals have metabolic inflexibility evidenced by diminished fasting fat oxidation and blunted increase in respiratory quotient (RQ) from fasting to insulin-stimulated state. Metabolically unhealthy obese (MUHO) adolescents, unlike their metabolically healthy obese (MHO) peers, have unfavorable metabolic characteristics despite having comparable adiposity. We investigated if metabolic inflexibility is a characteristic of obesity per se or is unique to MUHO compared with MHO youth.Obese youth (n=188; age 14.1 ± 0.1 yrs [SE]; BMI 33.6 ± 0.4 kg/m2) were divided into 137 MUHO (age 14.1 ± 0.2 yrs; BMI 35.4 ± 0.5 kg/m2) and 51 MHO (age 13.9 ± 0.3 yrs; BMI 29.0 ± 0.7 kg/m2) based on cut points for in vivo insulin sensitivity (IS) [MHO within 1.5 SD and MUHO <1.5 SDs of 72 normal-weight (NW) adolescents’ IS values]. RQ (by indirect calorimetry) at fasting and during a hyperinsulinemic (80mu/m2/min)-euglycemic clamp was measured, and ∆RQ calculated. Body composition (by DEXA), visceral adipose tissue (VAT) (by CT and MRI), hepatic IS (HIS) (calculated from fasting hepatic glucose production by [6,6-2H2]glucose and fasting insulin), adipose IS (ATIS) (calculated from whole body lipolysis by [2H5]glycerol and fasting insulin), and peripheral IS were assessed.MUHO vs. MHO youth had blunted ∆RQ (0.088 ± 0.004 vs. 0.107 ± 0.007, p=0.035), but MHO was not different from NW (0.098 ± 0.004, p=0.893). Further, MUHO vs. MHO youth had lower HIS (15.3 ± 0.7 vs. 24.3 ± 1.6 (mg/kg/min·uU/mL)-1, p<0.0001) and lower ATIS (9.8 ± 0.5 vs. 22.3 ± 3.1 (umol/kg/min·uU/mL)-1, p<0.0001), but HIS and ATIS were not different between MHO and NW youth (24.3 ± 1.6 vs. 20.8 ± 1.2 (mg/kg/min·uU/mL)-1, and 22.3 ± 3.1 vs. 22.0 ± 1.4 (umol/kg/min·uU/mL)-1, p=ns for both). ∆RQ correlated with HIS (r=0.535), ATIS (r=0.288) and VAT (r=-0.309) (p<0.0001 for all), but not with BMI, BMI Z-scores or % body fat. The differences between MUHO and MHO youth in ∆RQ, HIS and ATIS remained significant after adjusting for % body fat, race, pubertal status and VAT.The present study reveals that metabolic inflexibility is not a feature of obesity, rather it is a characteristic of MUHO youth who have significantly lower ∆RQ compared with MHO youth, with no difference between MHO and NW youth. Moreover, MUHO compared with MHO youth have worse metabolic profile, represented in lower HIS and ATIS.

Association of visceral adiposity and systemic inflammation with sleep disordered breathing in normal weight, never obese adolescents

Objective/backgroundWhile obesity is a known risk factor for sleep disordered breathing (SDB), a large proportion of children with SDB are not overweight as per body mass index percentile (BMI%) criteria. This study aimed to examine whether premorbid or concurrent adiposity phenotypes and inflammation are associated with SDB in normal weight youth. Patients/methodsA total of 242 persistently non-overweight (BMI%<85) subjects from the Penn State Child Cohort (PSCC, N = 421, 5-12 y at baseline and 12-23 y at follow-up), were studied. The apnea/hypopnea index (AHI) was ascertained via polysomnography (PSG) at both time points. At follow-up, a dual-energy X-ray absorptiometry (DXA) scan assessed android and gynoid distribution and subcutaneous (SAT) and visceral (VAT) adiposity composition, while a fasting blood draw was assayed for C-reactive protein (CRP) and interleukin-6 (IL-6) levels. Multivariable linear regression models with AHI at follow-up as primary outcome were adjusted for sex, race, adenotonsillectomy, age and AHI at baseline. Results and conclusionsIncreased waist circumference (β = 0.227, p = 0.001) at baseline, but not BMI%, neck or hip circumference, was significantly associated with a higher AHI at follow-up. VAT (β = 0.309, p < 0.001), IL-6 (β = 0.243, p < 0.001), SAT (β = 0.235, p = 0.013), CRP (β = 0.221, p = 0.001), and an android distribution (β = 0.196, p = 0.003) at follow-up were significantly associated with a higher AHI at follow-up. Childhood central adiposity predicts SDB in adolescence, even in individuals who have never been overweight since childhood as per BMI criteria. Visceral adiposity and inflammation are concurrent to adolescent SDB, which supports the clinical utility of these biomarkers in predicting its associated cardiometabolic risk.

Association among Executive Function, Physical Activity, and Weight Status in Youth.

Background and objectives: Executive function (EF) is an umbrella term that encompasses the set of higher-order processes. Core EFs are inhibition, interference control, working memory, and cognitive flexibility. The aim of the study was to compare the EF between normal weight (NW) and inactive overweight (OW), NW and sport trained (ST), ST and OW 16–19-year-old youths. In addition, the relationship between EF and peak oxygen uptake (VO2peak) was evaluated. Materials and Methods: 10 NW, 14 ST, and 10 OW youths participated in this study. EF was evaluated using the ANAM4 battery. VO2peak was measured during an increasing walking exercise (modified Balke test). Results: The NW youths demonstrated better visual tracking and attention (94.28% ± 3.11%/90.23% ± 2.01%), response inhibition (95.65% ± 1.83%/92.48% ± 1.05%), speed of processing, and alternating attention with a motor speed component (95.5% ± 3.51%/89.01% ± 4.09%) than the OW youths (p < 0.05). The ST youths demonstrated better visual tracking and attention (96.76% ± 1.85%/90.23% ± 2.01%), response inhibition (97.58% ± 0.94%/92.48% ± 1.05%), speed of processing, and alternating attention with a motor speed component (98.35% ± 1.35%/89.01% ± 4.09%) than the OW youths (p < 0.05). The ST youths demonstrated better EF results than NW youths (p < 0.05). Conclusions: The ST 16–19-year-old youths demonstrated better EF than their OW and NW peers. The NW youths demonstrated better EF than their OW peers. There was a significant correlation between VO2peak and EF indicators in all groups of participants.

Abstract MP26: Visceral Obesity and Systemic Inflammation Predict Sleep Disordered Breathing in Normal Weight, Never Obese Adolescents: A Longitudinal, Population-Based Study

Introduction: Although obesity is a known risk factor for sleep disordered breathing (SDB), a significant proportion of children with SDB are not obese or overweight as per body mass index percentile (BMI%) for age-and-sex. It is unknown whether premorbid or concurrent adiposity phenotypes are associated with SDB in normal weight youth. Hypothesis: We hypothesize that central obesity is a predictor of apnea/hypopnea index (AHI) in adolescents who have been otherwise normal weight since childhood. Methods: We analyzed data from the Penn State Child Cohort (N=421), a random population-based sample of 8.7 (1.7) year old children followed-up as 17.0 (2.3) year old adolescents. Of these, 242 subjects (49.2% female, 18.2% minority) were classified as persistently normal weight based on BMI%&lt;85 at both baseline and follow-up. Neck, hip and waist circumference (WC) were measured and “central obesity” was defined as a WC%≥85 for age-and-sex at baseline. During the follow-up exam, android and gynoid distribution and subcutaneous (SAT) and visceral (VAT) adipose tissue composition were assessed via DEXA scan, while inflammatory biomarkers were assayed from a fasting blood sample. The AHI was obtained from 9-hour, in-lab polysomnography at baseline and follow-up. Multivariable linear regression models examined the association between adiposity and inflammation with AHI at follow-up while adjusting for sex, race, adenotonsillectomy, age and AHI at baseline. Results: The average AHI at baseline was 0.7 (0.9) events/hour and 2.3 (6.3) events/hour at follow-up. Unadjusted analyses showed that WC (β=0.159) and central obesity (β=0.227) at baseline, but not BMI%, neck or hip circumference, and VAT (β=0.307), IL-6 (β=0.245), SAT (β=0.235), CRP (β=0.222), and android distribution (β=0.195) at follow-up were significantly (P&lt;0.05) associated with a higher follow-up AHI. Multivariable-adjusted analyses showed that VAT (β=0.299), IL-6 (β=0.191), central obesity (β=0.185) and CRP (β=0.163) were independently associated with a higher follow-up AHI. Conclusions: This is the first study to demonstrate that central obesity in childhood is a strong predictor of SDB in adolescence, even in individuals who have been persistently normal weight since childhood as per BMI% standards. These data support the clinical utility of simple measures of central obesity in childhood (i.e., WC) as early surrogate markers of increased risk of future development of SDB in the transition to adolescence. Furthermore, our study demonstrates that increased visceral adiposity and systemic inflammation are strong correlates of adolescent SDB, which supports the clinical utility of these biomarkers in predicting the cardiometabolic risk associated with adolescent SDB.

A17118 Is alcohol habits induced sympathetic stimulation blunted in overweight children and adolescents?

Objectives: We assessed in Congolese youths the interaction between alcohol habits and overweight on blood pressure and heart rate. Methods: We obtained lifestyle habits (by questionnaire), blood pressure and heart rate (Omron M6, HEM 7001E) and body mass index in 532 Congolese youths 10 to 19 years (girls: 50.4%). Overweight according to age and gender was derived from international tables. We analyzed the effect of drinking alcohol and overweight on BP and HR using generalized linear model procedure with age as covariate. Results: BP averaged 110 ± 13/69 ± 11mmHg and HR 83 ± 13beats/min. BP increased with age. Overweight (12.7%) predominated among girls (17.9% vs 7.5%;P < 0.001). Alcohol drinkers (23.1%; girls 21.5%, boys 24.7%) were older (P < 0.0001) than abstainers (16 ± 3vs14 ± 3years) with similar proportions among overweight (21.6%) and normal weight youths (23.3%). Age-adjusted SBP (115.3 ± 15.4 vs110.0 ± 12.7mmHg), DBP (72.6 ± 10.2vs68.9 ± 11.1mmHg) and HR (87 ± 9vs 79 ± 14beats/min) were significantly higher in overweight compared to normal weight youths; SBP (113. 5[95% CI:111.0–115.9]vs109.3[108.0 –110.7]mmHg) and HR (85[95% CI:77–94]vs 80[73–90]mmHg) were also higher among alcohol drinkers than abstainers. However, compared to abstainers, age-adjusted SBP in alcohol drinkers was 4.4[1.6–7.2]mmHg higher (P = 0.0024) among normal weight not among overweight youths (1.3[−11,7–14.3]mmHg;P = 0.839). Moreover, HR in alcohol drinkers was 7[0.6–12.2]beats/min faster (P = 0,008) in youths with normal weight, but only 2.1[−1.3–8.2]beats/min in the overweight ones. Conclusion: These effects on BP and HR suggest that sympathetic stimulation by alcohol habits could be partly blunted in the presence of overweight in these young subjects

Physical Activity, BMI, and Blood Pressure in US Youth: NHANES 2003-2006.

The objective of this study was to examine the independent and combined association of physical activity and body mass index (BMI) with blood pressure in youth. Youth aged 8-18 years from the 2003-2006 National Health and Nutrition Examination Survey (NHANES) with BMI, blood pressure, and physical activity (accelerometer) were included in the analyses. A total of 2585 subjects (1303 males; 47% of all 8- to 18-year-olds) met these criteria. Obese youth had a systolic blood pressure that was 8 mm Hg higher than normal weight youth. A significant interaction between BMI and physical activity on blood pressure was found (P < .001), and group differences among the BMI/activity groups showed that the 3 obese groups and the overweight/least active group had significantly higher systolic blood pressure than the normal weight/active group across all analyses. The overweight/least active and normal weight/least active groups had significantly higher diastolic blood pressure than the normal weight/active group as well. This study showed a significant independent and combined association of BMI and physical activity with blood pressure in youth. Interventions need to focus on the reduction of fatness/BMI as a way to reduce the cardiovascular risk in youth.

Obese and overweight youth: Risk for experiencing bullying victimization and internalizing symptoms.

Obese and overweight youth are at an increased risk for poor peer relations and psychosocial adjustment. Of particular concern is the high rate of bullying victimization experienced by obese and overweight youth. While it is known that victimized youth are at an increased risk for internalizing symptoms, few studies have examined if weight status exacerbates the association between victimization and internalizing symptoms. The current study drew upon data from over 43,000 youth attending 107 middle and high schools. Multilevel results suggested that compared with normal weight youth, both overweight and obese youth were at an increased risk for experiencing relational, verbal, and cyber victimization, with only obese youth being at an increased risk for experiencing physical victimization. Notably, the odds for experiencing cyber victimization were higher than the odds for experiencing other forms of victimization. Frequently victimized obese youth, but not frequently victimized overweight youth, had significantly higher levels of internalizing symptoms compared to their frequently victimized, normal-weight peers. Together, these findings highlight the increased risk for psychosocial adjustment problems among frequently victimized overweight and obese youth, suggesting these youth may require preventive interventions tailored to meet their unique needs. (PsycINFO Database Record

Effect of High-Intensity Interval Training on Plasma Omentin-1 Concentration in Overweight/Obese and Normal-Weight Youth

Objectives: Omentin-1 is a recently discovered adipokine, mainly produced by visceral adipose tissue, which is thought to improve insulin sensitivity. The study aimed to assess the association of plasma omentin-1 with cardiometabolic traits and physical performance and to test its response to high-intensity interval training (HIIT) in obese and normal-weight subjects. Methods: Nine overweight/obese (OG) and 9 normal-weight (NWG) young men performed an 8-week HIIT program. Body composition, physical performance, homeostasis model assessment index for insulin resistance (HOMA-IR) as well as plasma omentin-1and lipid levels were assessed before and after the HIIT program. Results: Baseline plasma omentin-1 was lower in OG than NWG men (359 ± 138 vs. 470 ± 114 ng/ml; p = 0.052). Plasma omentin-1 was related to body fat (r = -0.57; p = 0.03) and LDL-cholesterol (r = -0.49; p = 0.04). There was a trend towards significant association of omentin-1 with BMI (r = -0.47; p = 0.06) and VO2max (r = 0.41; p = 0.09). However, no association was observed with HOMA-IR. Following the HIIT program, omentin-1 concentrations have significantly (p < 0.01) increased in OG (359 ± 138 to 455 ± 126 ng/ml) and NWG men (470 ± 114 to 572 ± 115 ng/ml). In parallel, the cardiometabolic profile has improved with a significant decrease of HOMA-IR in OG. Conclusions: HIIT resulted in a plasma omentin-1 increase and an improvement with regard to cardiometabolic traits in the OG men, which may contribute to modulate insulin sensitivity.