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Height, adiposity and hormonal cardiovascular risk markers in childhood: how to partition the associations?

Wells, JC; Cole, TJ; (2014) Height, adiposity and hormonal cardiovascular risk markers in childhood: how to partition the associations? Int J Obes (Lond) , 38 (7) pp. 930-935. 10.1038/ijo.2014.24. Green open access

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Abstract

Objective:Obesity is associated with rapid growth during childhood. There is uncertainty over how to adjust for body size, when using adiposity as a proxy for cardiovascular risk. We studied associations of height, body composition (by dual-energy X-ray absorptiometry) and cardiovascular risk markers (insulin resistance (IR), leptin) in children.Methods:Using partial correlations in 172 children aged 7-12 years, we investigated associations of (a) fat mass with IR or leptin, adjusting for height, or lean mass, and (b) height or lean mass with IR or leptin, adjusting for fat mass. Analyses were conducted both cross-sectionally at each age, and for changes between 7 and 12 years.Results:Height, fat mass, lean mass, IR and leptin were all inter-correlated at all ages. Whilst fat mass was strongly associated with IR and leptin, height was independently negatively associated with leptin (whole sample, adjusting for age: boys r=-0.12, girls r=-0.13; P<0.001). Independent of adiposity, height was also associated with insulin IR (whole sample, adjusting for age: boys r=0.11, girls r=0.20; P<0.001). When analyzed by year of age, these associations tended to remain significant at older ages. Change in height from 7-12 years was also associated with change in IR (boys: r=0.18, P<0.05; girls: r=0.34, P<0.01), independently of change in adiposity, with similar findings for lean mass.Conclusions:During childhood, markers of cardiovascular risk have a complex profile, responding to growth as well as fat accumulation. Taller and faster-growing children have elevated risk markers, independently of their adiposity. These findings have implications for the interpretation of pediatric indices of adiposity that aim to adjust for body size. Adiposity indices that perform best at summarizing metabolic risk may not be those that perform best at understanding the developmental aetiology of risk.International Journal of Obesity accepted article preview online, 10 February 2014; doi:10.1038/ijo.2014.24.

Type: Article
Title: Height, adiposity and hormonal cardiovascular risk markers in childhood: how to partition the associations?
Open access status: An open access version is available from UCL Discovery
DOI: 10.1038/ijo.2014.24
Publisher version: http://dx.doi.org/10.1038/ijo.2014.24
Additional information: © 2014 Macmillan Publishers Limited All rights reserved. This work is licensed under a Creative Commons Attribution 3.0 Unported License. To view a copy of this license, visit http:// creativecommons.org/licenses/by/3.0/
Keywords: BMI; cardiovascular risk; size adjustment; adiposity; leptin; insulin resistance
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept
URI: https://discovery.ucl.ac.uk/id/eprint/1421229
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