This past Monday 03/07/2023 at 16:00 h, Mr. Ferran Díaz read her doctoral thesis entitled: "Relació de la proteïna c-reactiva, el quocient neutròfils/limfòcits i l'adiponectina d'alt pes molecular amb paràmetres d'obesitat i de risc cardiometabòlic en nens prepuberals sans. Efecto modulador dels estils de vida" directed by Dr. Abel López-Bermejo, Dr. Judit Bassols and Dr. Anna Prats-Puig.

Summary

Obesity in the pediatric age group is one of the major public health problems and is associated with cardiometabolic risk factors (CMR). Low-grade inflammation plays a prominent role in the development of cardiometabolic alterations associated with obesity, intervening in the atherogenic process. Adipose tissue in obese patients acts as a source of inflammation and plays a prominent role in the pathogenesis of cardiometabolic disorders. Several markers of CMR, such as ultrasensitive C-reactive protein (hs-CRP), neutrophil/lymphocyte ratio (NL) and high molecular weight adiponectin (HMA), are part of the inflammatory process related to adipocyte activity. On the other hand, obesity and associated metabolic alterations depend to a large extent on environmental circumstances, such as lifestyles. An improvement in diet and physical activity can improve community health and prevent cardiometabolic disorders in the pediatric population in the future.

For this reason, the aim of this study was to determine the association between hs-CRP, NL ratio and MPA adiponectin with obesity and CMR factors in school-age children at a first baseline visit and after 4 years of follow-up, and to determine whether lifestyles modulate these associations.

This is an observational, descriptive, longitudinal clinical study. The sample consisted of a healthy prepubertal cohort of 8-year-old boys and girls from the primary health care reference areas of Girona. Demographic, clinical, analytical and ultrasonographic variables were assessed at the study visits (baseline and follow-up 4 years later).

The results show that hsCRP concentration is significantly associated with obesity and CMR parameters at baseline and follow-up visits. In children with less favorable physical activity, hsCRP is a predictor of several parameters of obesity and CMR, higher body mass index (BMI), abdominal circumference (AP), diastolic blood pressure (DBT), triglycerides (TG) and renal fat (RF) at 4 years of follow-up. A significant interaction was observed between physical activity, serum hsCRP concentration and RCM parameters (DBT, TG and RBC). All these associations remained significant in multiple linear regression analysis correcting for confounding variables. On the other hand, the NL ratio was significantly associated with obesity and CMR parameters at the baseline visit. In children with a less favorable diet, the NL ratio is a predictor of several parameters of obesity and CMR, higher BP and diastolic blood pressure (DBT) at follow-up. These associations remained significant in multiple linear regression analyses correcting for confounding variables. Finally, serum adiponectin concentration of APM is significantly associated with obesity and CMR parameters at baseline and follow-up visits. In children with a less favorable diet APM adiponectin is a predictor of CMR, higher HDL cholesterol at follow-up. In those with less favorable physical activity, APM adiponectin is also a predictor of CMR (higher TG, insulin and HOMA-IR) at follow-up. All these associations remain significant in multiple linear regression analysis correcting for confounding variables.

We can conclude that serum hs-CRP concentration, NL ratio value and serum APM adiponectin concentration are associated with obesity and CMR parameters in school-aged children and are predictors of these parameters at 4 years of follow-up. In addition, diet and physical activity modulate these associations.