Gender Differences in the Effect of Adiposity on Markers of Cardiovascular Risk in Prepubertal Children

Date of submission: 17-07-2019 | Date of acceptance: 29-07-2019 | Published: 27-01-2020

  • Diogo Alves Leal Faculty of Medicine, University of Porto, Porto, Portugal
  • Liane Correia Costa EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal | Department of Pediatric Nephrology, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário do Porto, Porto, Portugal | Instituto de Ciências Biomédicas de Abel Salazar, University of Porto, Porto, Portugal
  • Cláudia Moura Faculty of Medicine, University of Porto, Porto, Portugal | Division of Pediatric Cardiology, Integrated Pediatric Hospital, Centro Hospitalar Universitário São João, Porto, Portugal
  • Cláudia Mota Division of Pediatric Cardiology, Integrated Pediatric Hospital, Centro Hospitalar Universitário São João, Porto, Portugal
  • Ana Luísa Correia-Costa Faculty of Medicine, University of Porto, Porto, Portugal | Division of Pediatric Cardiology, Integrated Pediatric Hospital, Centro Hospitalar Universitário São João, Porto, Portugal
  • José Carlos Areias Faculty of Medicine, University of Porto, Porto, Portugal | Division of Pediatric Cardiology, Integrated Pediatric Hospital, Centro Hospitalar Universitário São João, Porto, Portugal
  • António Guerra Faculty of Medicine, University of Porto, Porto, Portugal | Division of Pediatric Nutrition, Integrated Pediatric Hospital, Centro Hospitalar Universitário São João, Porto, Portugal
  • Alberto Caldas Afonso EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal | Department of Pediatric Nephrology, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário do Porto, Porto, Portugal | Instituto de Ciências Biomédicas de Abel Salazar, University of Porto, Porto, Portugal
  • Ana Azevedo EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal | Public Health and Forensic Sciences and Medical Education Department, Faculty of Medicine, University of Porto, Porto, Portugal

Abstract

INTRODUCTION: In the last years, evidence has started to emerge on the presence of cardiometabolic differences between genders before puberty. This study aims to evaluate if the association between obesity and markers of cardiovascular risk is different between genders in 8 to 9-year-olds.

METHODS: Cross sectional study of 315 children (167 boys) aged 8-9 years old, followed in the birth cohort Generation XXI (Portugal). Measures included anthropometrics, insulin resistance levels (HOMA-IR), 24-hour ambulatory blood pressure and pulse wave velocity (PWV) were measured. We classified obesity according to WHO body mass index(BMI)-for-age reference values.

RESULTS: When adjusting for age and height, non-HDL cholesterol was higher among overweight and obese girls (16.22 and 19.75 mg/dL, respectively) and there was no effect among boys, although the interaction term with gender was not significant. The level of triglycerides was higher among the obese in both genders. Obese and overweight girls and obese boys showed increased log-HOMA-IR compared to their normal weight counterparts (0.09 increase for overweight girls, 0.29 for obese girls and 0.12 for obese boys) and gender had a significant interaction in this effect (p for interaction=0.003). Overweight girls had an increase of 0.25 m/s in PWV and obese girls an increase of 0.50 m/s. No effect was found among boys (p for interaction=0.031).

DISCUSSION: Gender plays a significant role in the effect of adiposity on insulin resistance and pulse wave velocity. A stronger association between obesity and insulin resistance was observed in girls and PWV was only associated with overweight-obesity in females.

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Published
2020-01-27
Section
Original articles