Abstract P376: Cardiometabolic Abnormalities, Systemic Inflammation, and Oxidative Stress in Children

The increasing prevalence of childhood obesity has been well documented & is predictive of increased severity in obesity-related CVD risk factors & metabolic disorders, such as systemic inflammation & oxidative stress. While the poor long-term vascular consequences of these conditions are better understood in adults, the consequences of these obesity-associated metabolic disturbances are less studied in children. This study utilized the 12,476 children (<18 years) enrolled in the C8 Health Project, which resulted from the pretrial settlement of a class action lawsuit pursuant to contamination of the drinking water supply; we have recently published a complete description of this study (Frisbee et al, 2009). The current analysis used the large sample size available from this study to determine the severity of chronic inflammation & oxidative stress associated with cardiometabolic abnormalities, including obesity, dyslipidemia, & hyperglycemia, present either singly or in combination, in children. In this population, median age was 11.6 years, 48% were female, 40% were overweight or obese (OWT-OB; BMI≥85th percentile), 2% had glucose ≥126 mg/dL (HypGly), & 34% had total cholesterol ≥170 mg/dL or LDL cholesterol ≥110 mg/dL (DysLip), Additionally, median CRP, a biomarker of systemic inflammation, was 0.4 mg/L with 16% having CRP≥2 mg/L, & median GGT, a biomarker of oxidative stress, was 12.0 IU/L with 1.7% having GGT≥35 IU/L. In univariate analysis: CRP & GGT were statistically significantly higher in participants with OWT-OB; GGT but not CRP was higher in children with HypGly or DysLip; & both CRP & GGT were higher in children with any cardiometabolic abnormality. In linear regression analysis controlling for age, gender, SES (household income), a regular exercise program, & while simultaneously considering OWT-OB, HypGly, & DysLip: OWT-OB statistically significantly predicted CRP (b-coefficient±SE/adj R-square; 1.0±0.1/1.4%) though HypGly & DysLip were not, ceteris paribus, associated with CRP; OWT-OB (3.5±0.2/16.6%), HypGly (1.2±0.6/16.6%), & DysLip (2.1±0.2/16.6%) were all simultaneously predictive of GGT. In logistic regression analysis controlling for the same covariates & also simultaneously considering the same cardiometabolic abnormalities: OWT-OB (OR (95%CI); 3.8 (3.4-4.4)) & DysLip (1.2 (1.0=1.3)) but not HypGly increased the risk for CRP≥2 mg/L; similarly, OWT-OB (5.6 (3.5-8.7)) & DysLip (3.4 (2.3-5.0)) but not HypGly were associated with increased for oxidative stress (GGT≥35 IU/L). This study suggests that different cardiometabolic abnormalities have different associations with systemic inflammation & oxidative stress; obesity & dyslipidemia rather than hyperglycemia are more strongly associated with systemic inflammation & oxidative stress in children. Futher study is needed to elucidate gender & age-related differences in these associations.