ESPE Abstracts

Background: Metabolic and hemodynamic obesity-related disorders are a major risk factor for cardiovascular disease in children with excess body fat mass. Studies in adults suggest that serum homocysteine is a marker of atherosclerosis and is associated with vascular dysfunction. Studies in children are inconclusive. The aim of the study was to evaluate the association between homocysteine concentrations and lipid and carbohydrate metabolism parameters in obese and overweight adolescents.

Material and Methods: The study involved 42 obese, 14 overweight and 25 normal weight participants aged 10.0 to 17.6 years. Anthropometric measurements were performed in each patient. Overweight and obesity were defined according to the value of z-score BMI for age and sex: z-score BMI ≥ 1 was considered overweight, z-score BMI ≥ 2 was classified as obesity. Serum homocysteine, fasting glucose, fasting insulin, uric acid and lipid profile parameters were assessed. Additionally, oral glucose tolerance test (OGTT) was performed in obese and overweight children. Following atherogenic and insulin resistance indices were calculated: Matsuda Index, Quantitative Insulin Sensitivity Check Index (QUICKI), Homeostasis Model Assessment-Insulin Resistance (HOMA-IR), triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) ratio. The concentration of non-HDL was also evaluated.

Results: Serum homocysteine concentrations were comparable in the groups of children with obesity, overweight and normal body weight [median: 11.08 (9.04-12.81) vs. 10.71 (9.79-1350) vs 12.45 (10.88-14.44), respectively] and did not differ after taking gender into account. Homocysteine concentrations correlated with age (r= 0.47, P= 0.017) in normal weight children and with waist circumference (r= 0.85, P= 0.001) in overweight children. We did not find any associations in obese children. Homocysteine was not associated with anthropometric parameters, lipid profile, or atherogenic and insulin resistance indices in any of the study groups.

Conclusion: We did not find any statistical differences in homocysteine concentrations in children with excess body fat mass compared to normal weight peers. Cardiovascular obesity-related risk factors did not correlate with homocysteine levels. We may assume, that changes in homocysteine concentrations may appear later in adulthood.