HealthDay News — Cardiometabolic risk and homeostatic model assessment (HOMA) of insulin resistance (IR) increase with increasing body mass index (BMI) categories among children, and cardiorespiratory fitness (CRF) may attenuate the risk, according to a study published in Diabetes Care.

Christine Delisle Nyström, from the Karolinska Institutet in Stockholm, and colleagues conducted a pooled study involving cross-sectional data from 3 projects, with 1247 children aged 8 to 11 years. The authors used the sum of the sex- and age-specific z scores for triglycerides, high-density lipoprotein (HDL) cholesterol, glucose, and the average of systolic and diastolic blood pressure, and HOMA-IR to assess cardiometabolic risk.

The researchers identified a significant linear association between the risk score and BMI categories (P trend ≤ .001), with a 0.5 standard deviation higher risk score for every incremental rise in BMI category (P < .001). As BMI categories rose, the risk score was attenuated by CRF, with the biggest difference seen in the most obese children; only in mild obesity was the attenuation significant (P = .048). Compared with obese fit children, normal-weight unfit children had a significantly lower risk score (P < .001); obese fit vs unfit children had a significant reduction in the risk score (P = .027). The results were similar for HOMA-IR.

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“As BMI categories rose so did cardiometabolic risk and HOMA-IR, which highlights the need for obesity prevention/treatment programs in childhood,” the authors write.

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Nystrom CD, Henriksson P, Martinez-Vizcaino V, et al. Does cardiorespiratory fitness attenuate the adverse effects of severe/morbid obesity on cardiometabolic risk and insulin resistance in children? a pooled analysis [published online September 22, 2017]. Diabetes Care. doi: 10.2337/dc17-1334.