Alterações antropométricas, metabólicas e inflamatórias em crianças pré-púberes com e sem excesso de peso e suas associações com a gordura abdominal

Abstract

Pediatric obesity has become an epidemic and a public health issue in developed and developing countries. In Brazil, recent studies show that one third of Brazilian children live with excess weight. Characterized by an excessive body fat that can lead to health damages and derives from the interaction of various factors, such as genetic, environmental and psychological factors. Previous studies have shown a connection between pediatric obesity and cardiovascular disease risk markers and that the atherosclerotic process begins in life’s very first decades. There are multiple ways to estimate body fat, whether through anthropometric measurement or image exams. The abdominal fat evaluation is especially important for being more associated with cardiovascular risk markers. In this case, ultrasonography gains prominence in pediatrics as an imaging method for evaluating abdominal fat since it does not involve risks of ionizing radiation for children, in addition to being fast, less expensive compared to other imaging tests and does not involve sedation. The present study aimed to search for correlations and associations of cardiovascular risk markers, especially inflammatory biomarkers, with abdominal fat assessed by ultrasonography. The study involved 241 children, 115 females and 126 males, aged five to ten years, 156 of whom were obese, 37 overweight and 48 normal weight, pre-pubertal, aiming to eliminate the influence of sexual steroids in this analysis. An evaluation of the distribution of anthropometric and metabolic variables and inflammation markers was carried out with calculation of medians and quartiles, in addition to simple and logistic regression analyses. The results found show an association between abdominal fat assessed by ultrasound and metabolic data, especially between abdominal wall thickness greater than or equal to the 75th percentile and the homeostasis model assessment for insulin resistance in simple logistic regression (OR: 1.83; CI: 1.24 : 2.70), but a greater association of abdominal fat with inflammatory markers and anthropometric measurements, especially with the relationship between waist circumference and height, which in the adjusted logistic regression model showed a positive association with abdominal wall thickness greater than or equal to the 75th percentile and intra-abdominal fat thickness greater than or equal to the 75th percentile (OR: 50x109; CI: 17x101: 15x1018 and OR: 34x1010; CI: 23x103: 50x1017 respectively). Abdominal wall fat had a greater association with inflammation than intra-abdominal fat in the sample, with a positive association between tumor necrosis factor alpha and abdominal wall thickness greater than or equal to the 75th percentile in adjusted logistic regression (OR: 18 .12; 95% CI: 1.57 : 209.55). This type of fat appears to have the greatest impact on chronic inflammation related to excess weight in young children.