Endocrine Abstracts

Background: Associations between obesity and adipomyokines, inflammatory marker, and level of physical fitness have not been well evaluated in severe obesity in children and adolescents.

Method: Data on leptin, irisin, FGF21, hsCRP, glucose, insulin, physical fitness measured by arm curl test for upper extremity)and wall sit test for lower extremity were obtained in 266 participants who were recruited for ICAAN study, community- based multidisciplinary weight control program in severely obese Korean children and adolescents. Participants were classified into 3 groups according to their BMI status based on sex and age-specific BMI percentiles: severely obese (SO,≥120% of the 95th percentile), overweight or obse (OB, 85th-<120% of the 95th percentile), and non-obese (NW,<85th). Levels of circulating adipomyokines, inflammatory marker, insulin resistance (HOMA-IR), and physical fitness were compared across the groups adjusted for sex and age. Cross-sectional associations between obesity status and biomarker levels and physical fitness were assessed.

Results: Participants in SO group tended to have higher levels of leptin(NW, 12.19±1.05: OB, 25.64±1.05: SO, 40.77±1.09), hsCRP (NW, 0.37±1.09: OB,1.18±1.09: SO,1.82±1.16), and HOMA-IR (NW, 1.78±1.06: OB, 3.55±1.06: SO, 6.28±1.10) compared to participants in NW or OB(all P for trend <0.001). Levels of physical fitness tended to be significantly decreased across the BMI groups (P for trend, arm curl test 0.03: wall sit test <0.001). Circulating levels of irisin showed overall significance (P for trend 0.04), but did not show significant difference between groups. FGF-21 did not show significant difference across the BMI groups.

Conclusions: Severe obesity in children and adolescents compared with NW or OB is associated with higher levels of leptin, inflammatory marker and insulin resistance and lower levels of physical fitness, which implies problems with further weight gain and cardio-metabolic health risks.