title: Adiposity, fitness and metabolic risk in children: a cross-sectional and longitudinal study.
abstract: OBJECTIVE
  To better understand the early development of cardiovascular disease, we examined the association of adiposity measures and cardiorespiratory fitness (CRF) with baseline values and changes in low-grade chronic inflammation and insulin resistance (IR) in school children.
  
  
  METHODS
  Eighty-three 1(st) and 5(th) grade children from a randomly selected control group of a physical activity intervention study (KISS) were prospectively studied during one academic year. Outcome variables included highly sensitive C-reactive protein (hs-CRP) and homeostasis assessment of IR (HOMA-IR). Adiposity measures included body mass index (BMI), waist circumference and the sum of skinfold thickness at four sites. CRF was assessed by the 20 m shuttle run test. All models were adjusted for age group, sex and pubertal group and included children who had a complete valid dataset for all variables.
  
  
  RESULTS
  Baseline metabolic markers correlated positively with measures of adiposity and inversely with CRF (all p ≤ 0.02). On average, longitudinal changes in hs-CRP concentration increased with high baseline BMI in boys and skinfold thickness in both genders (both p < 0.01). Increases in adiposity had an additional effect on these changes (adjusted R(2) of the models including baseline and change in adiposity 0.49-0.53, p < 0.001). On the other hand, longitudinal changes in HOMA-IR were positively related to changes in BMI and waist circumference (p ≤ 0.03). Increases in HOMA-IR, but not in hs-CRP concentrations, were associated with low baseline CRF (p = 0.01).
  
  
  CONCLUSIONS
  The relationship of baseline adiposity and CRF with increases in metabolic risk markers may have relevant implications for long-term cardiovascular risk. International Standard Randomised Controlled Trial Number (ISRCTN):
  
  
  BACKGROUND
  isrctn.org 15360785.
authors.affiliation: Service of Endocrinology, Diabetes and Metabolism, University of Lausanne, Lausanne, Switzerland. jardena.puder@chuv.ch
authors.forename: Jardena J
authors.initials: JJ
authors.lastname: Puder
authors.forename: Christian
authors.initials: C
authors.lastname: Schindler
authors.forename: Lukas
authors.initials: L
authors.lastname: Zahner
authors.forename: Susi
authors.initials: S
authors.lastname: Kriemler
mesh_terms: D050154:Adiposity; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D016009:Chi-Square Distribution; D002648:Child; D003430:Cross-Sectional Studies; D005080:Exercise Test; D005260:Female; D006293:Health Promotion; D006801:Humans; D007249:Inflammation / Q000276:immunology / Q000503:physiopathology*; D018836:Inflammation Mediators / Q000097:blood; D007333:Insulin Resistance; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000276:immunology / Q000503:physiopathology*; D009765:Obesity / Q000276:immunology / Q000503:physiopathology*; D016017:Odds Ratio; D010809:Physical Fitness; D011446:Prospective Studies; D012885:Skinfold Thickness; D013557:Switzerland; D013997:Time Factors; D055105:Waist Circumference
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators; D002097:C-Reactive Protein