Vascular Function and Distribution of Adiponectin Isomers during Puberty in Children and Adolescents with Obesity

Relationships Between Gonadotropins, Sex Hormones, and Vascular Health in Adolescents with Normal Weight or Obesity

Objective: Relationships between gonadotropins, sex hormones, and vascular structure and function in adolescents of varying weight statuses have not been fully investigated. In the present study, we examined associations among these in female and male adolescents with normal weight or obesity. Methods: We performed a cross-sectional analysis of adolescents (n = 58; 12-<18 years) grouped according to BMI percentile (BMI%) into normal weight (5th-<85th BMI%; n = 25) and obesity (≥95th BMI%; n = 33) categories. Fasting blood samples were collected to measure follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone, and estradiol. Vascular function was measured via ultrasonography for measures of carotid artery diameter compliance (cDC), incremental elastic modulus (cIEM), and brachial artery flow mediated dilation (FMD). Results: Females with obesity had a significantly (p = 0.009) greater mean FMD compared with those with normal weight. FSH, LH, testosterone, and estradiol did not differ between normal weight and obesity groups in either sex. After adjusting for age and multiple comparisons, higher testosterone was associated with decreased cDC (R2 = 0.189; p = 0.018) and increased cIEM (R2 = 0.346; p = 0.002) across all females. In all males, higher estradiol was associated with decreased cDC (R2 = 0.404; p = 0.006) and increased cIEM (R2 = 0.411; p = 0.003). Conclusion: We found that testosterone and estradiol were associated with vascular measures in female and male adolescents, respectively. Future studies are needed to confirm these relationships in larger cohorts and among those with BMIs in the overweight (85th-<95th BMI%) and severe obesity (BMI ≥120% of the 95th percentile and/or ≥35 kg/m2) categories.

Overweight/Obesity-related microstructural alterations of the fimbria-fornix in the ABCD study: The role of aerobic physical activity

Childhood overweight/obesity has been associated with negative consequences related to brain function and may involve alterations in white matter pathways important for cognitive and emotional processing. Aerobic physical activity is a promising lifestyle factor that could restore white matter alterations. However, little is known about either regional white matter alterations in children with overweight/obesity or the effects of aerobic physical activity targeting the obesity-related brain alterations in children. Using a large-scale cross-sectional population-based dataset of US children aged 9 to 10 years (n = 8019), this study explored the associations between overweight/obesity and microstructure of limbic white matter tracts, and examined whether aerobic physical activity may reduce the overweight/obesity-related white matter alterations in children. The primary outcome measure was restriction spectrum imaging (RSI)-derived white matter microstructural integrity measures. The number of days in a week that children engaged in aerobic physical activity for at least 60 minutes per day was assessed. We found that females with overweight/obesity had lower measures of integrity of the fimbria-fornix, a major limbic-hippocampal white matter tract, than their lean peers, while this difference was not significant in males. We also found a positive relationship between the number of days of aerobic physical activity completed in a week and integrity measures of the fimbria-fornix in females with overweight/obesity. Our results provide cross-sectional evidence of sex-specific microstructural alteration in the fimbria-fornix in children with overweight/obesity and suggest that aerobic physical activity may play a role in reducing this alteration. Future work should examine the causal direction of the relationship between childhood overweight/obesity and brain alterations and evaluate potential interventions to validate the effects of aerobic physical activity on this relationship.

Clinical Significance of the Fetuin-A-to-Adiponectin Ratio in Obese Children and Adolescents with Diabetes Mellitus

Fetuin-A and adiponectin are inflammatory cytokines associated with obesity and insulin resistance. This study aimed to examine the fetuin-A-to-adiponectin ratio (FAR) in diabetic children and to determine the role of FAR. A total of 54 children and adolescents with diabetes mellitus (DM) and 44 controls aged 9–16 years were included in this study. Clinical characteristics, including plasma fetuin-A and adiponectin levels, were compared with respect to body mass index (BMI) and diabetes type. Of 98 children, 54.1% were obese, whereas 18.4% were obese and diabetic. FAR was higher in obese children with DM than in non-obese children and also in type 2 DM children than in type 1. FAR showed a stronger association with BMI than with fetuin-A and adiponectin individually, and its association was more prominent in diabetic children than in controls. BMI was a risk factor for increased FAR. Plasma fetuin-A was elevated in obese children, and its association with insulin resistance and β cell function seemed more prominent in diabetic children after adjustment for adiponectin. Thus, FAR could be a useful surrogate for the early detection of childhood metabolic complications in diabetic children, particularly those who are obese.