Systemic Inflammation Characterizes Lack of Metabolic Health in Nonobese HIV-Infected Men

Background. Increasing body mass index (BMI) is generally associated with loss of metabolic health, although some obese individuals remain metabolically healthy. Among nonobese men, HIV infection has been associated with a lower prevalence of metabolic health. Methods. We conducted a cross-sectional analysis of 470 HIV-infected and 368 HIV-uninfected men enrolled in the Multicenter AIDS Cohort Study Cardiovascular substudy. Circulating biomarker levels were compared by BMI category and by HIV serostatus. Poisson regression with robust variance determined associations between metabolic health and circulating inflammatory biomarker levels after adjusting for factors previously associated with metabolic health. Results. HIV-infected men were younger and less likely to be obese. Among HIV-infected, normal weight metabolically healthy men (compared to unhealthy) had significantly lower circulating levels of interleukin- (IL-) 6, soluble tumor necrosis factor receptors (sTNFR) I and II, and homeostatic model assessment of insulin resistance (HOMA-IR), higher adiponectin, less visceral fat, and more subcutaneous fat. Among HIV-uninfected normal weight men and obese men (regardless of HIV serostatus), metabolic health was associated only with higher levels of adiponectin, less visceral fat, and lower HOMA-IR values. In multivariate analyses restricted to HIV-infected men, lower hs-CRP, sTNFRI, sTNFRII, and HOMA-IR and higher adiponectin levels were associated with metabolic health. Additional adjustment for visceral adiposity did not alter results. Conclusions. Among HIV-infected normal weight men, metabolic health was associated with less systemic inflammation, a relationship that, among normal weight men, was unique to HIV+ men and did not exist among obese men of either HIV serostatus.

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Abstract 075: Differences In Body Composition At Baseline And In Response To Exercise Training By Metabolic Health And Weight Status

Circulation ◽

10.1161/circ.143.suppl_1.075 ◽

2021 ◽

Vol 143 (Suppl_1) ◽

Author(s):

Alexis Jones ◽

Jacob L Barber ◽

James S Skinner ◽

Claude Bouchard ◽

Mark A Sarzynski

Keyword(s):

Body Composition ◽

Exercise Training ◽

Visceral Fat ◽

Weight Status ◽

Normal Weight ◽

Metabolic Health ◽

Fat Free Mass ◽

Obese Adults ◽

Change Models ◽

Metabolically Healthy

Background: Body composition is known to differ across metabolic health and weight phenotypes. Regular exercise improves body composition, yet little is known about differences in exercise response across metabolic health and weight phenotypes. Methods: Normal weight (n=376) and overweight/obese (OWOB) adults (n=456) from the HERITAGE Family Study (56% female, 38% Black) completed a 20-week endurance training program. Four groups based on baseline BMI and metabolic risk were created: metabolically healthy normal weight, MHNW; metabolically unhealthy normal weight, MUNW; metabolically healthy OWOB, MHO; and metabolically unhealthy OWOB, MUO. Unhealthy was defined as having ≥2 metabolic syndrome components. General linear models tested for differences in baseline and change in measures of body composition (fat mass [FM], fat-free mass [FFM], % body fat [%BF], visceral fat) after adjusting for age, sex, and ethnicity (and baseline value in change models). Results: Table 1 shows adjusted mean baseline and change in body composition values by group. Baseline body composition tended to track with weight status, with NW adults having lower FM, %BF, and visceral fat compared to obese adults (p<0.05), regardless of metabolic health. However, the MHO group had lower baseline values of these traits compared to MUO (p<0.05). Body composition measures significantly improved with exercise training in all groups, however, the magnitude of change differed between groups. For example, both NW groups had larger decreases in %BF compared to the obese groups, with MUNW showing the largest decrease. Conversely, MHNW showed the largest decrease in visceral fat, which was greater than both obese groups, but change in visceral fat was similar between MHO and MUNW. Conclusions: Normal weight adults tended to have better body composition profiles at baseline and larger improvements with exercise compared to obese adults, regardless of metabolic health. Within weight groups, body composition improved regardless of metabolic health status.

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Does metabolic health in overweight and obesity persist? – Individual variation and cardiovascular mortality over two decades

Acta Endocrinologica ◽

10.1530/eje-16-0095 ◽

2016 ◽

Vol 175 (2) ◽

pp. 133-143 ◽

Cited By ~ 13

Author(s):

Akaal Kaur ◽

Desmond G Johnston ◽

Ian F Godsland

Keyword(s):

Insulin Resistance ◽

Cardiovascular Risk ◽

Health Status ◽

Cardiovascular Mortality ◽

Normal Weight ◽

Metabolic Health ◽

Overweight And Obesity ◽

Cross Sectional ◽

Increased Risk ◽

Metabolically Healthy

Objective Overweight and obese individuals may be metabolically healthy, but attention needs to be given to long-term persistence of this trait and any associated variation in cardiovascular risk. Design Cross-sectional and longitudinal variation in metabolic health and associated cardiovascular mortality were analysed in 1099 white European-origin normal-weight and overweight or obese males followed for 20years. Methods Definitions of metabolic health were based on LDL and HDL cholesterol, triglycerides, blood pressure, fasting glucose and cardiovascular risk. Insulin resistance (e.g. HOMA-IR) and sub-clinical inflammation (ESR and white blood cell count) were explored. Cardiovascular mortality risks and persistence of metabolic health status were evaluated. Results There were 87 cardiovascular deaths. Insulin resistance was increased in metabolically healthy overweight or obese participants (median HOMA-IR 2.63, 95% CI: 1.79–3.65, P<0.001) relative to normal-weight participants (median HOMA-IR 1.67, 95% CI: 1.08–2.67, P<0.001) as was sub-clinical inflammation but metabolically healthy overweight or obese individuals were not at increased risk of cardiovascular mortality compared with the metabolically healthy normal-weight individuals (hazard ratio 1.13, 95% CI: 0.34–3.72, P=0.8). The proportions of initially metabolically healthy overweight or obese who remained metabolically healthy for visits 2, 3 and 4 were 54, 48 and 39% respectively, and for initially normal-weight individuals, 68, 51 and 41%. A lower proportion of metabolically healthy overweight or obese individuals remained metabolically healthy at visit 2 compared with normal-weight individuals (P=0.007), but proportions converged thereafter. Conclusions Despite being insulin resistant and having greater sub-clinical inflammation, and despite instability in metabolic health status, metabolically healthy overweight or obese individuals were at no greater risk of cardiovascular mortality than their normal-weight equivalents.

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Association between ultrasonographically measured visceral fat tissue thickness and proinflammatory adipokines in obesity

Vojnosanitetski pregled ◽

10.2298/vsp181003198c ◽

2020 ◽

Vol 77 (11) ◽

pp. 1146-1153

Author(s):

Veljko Crnobrnja ◽

Branislava Ilincic ◽

Edita Stokic ◽

Marijana Basta-Nikolic ◽

Sonja Slankamenac ◽

...

Keyword(s):

Visceral Fat ◽

Linear Regression Analysis ◽

Subcutaneous Fat ◽

Serum Levels ◽

Study Groups ◽

Normal Weight ◽

Fat Tissue ◽

Tissue Thickness ◽

Anthropometric Indices ◽

Cross Sectional

Background/Aim. Obesity status can be assessed with numerous anthropometric, morphological and functional indices and this study was designed to assess relationship among them. The aim of this study was to investigate associations between anthropometric indices, ultrasonography measurement of visceral and subcutaneous fat tissue thickness and certain proinflammatory adipokines level. Methods. This cross-sectional study comprised a consecutive sample of 60 obese respondents without obesity-related comorbidities, and 20 age-matched healthy normal-weight controls. Anthropometric [body mass index (BMI), waist circumference (WC), neck circumference (NC), body fat, a body shape index (ABSI)], and ultrasonographic indices [thickness of intraabdominal fatt tissue (IAFT), visceral fat (VF), maximum subcutaneous fat (Max SFT), minimal subcutaneous fat (Min SFT)], and serum levels of chemerin and resistin were assessed in all subjects. Results. All anthropometric indices showed statistically significant differences between study groups. The mean IAFT, Max SFT, Min SFT and VF were significantly higher in the obese group compared to controls (p < 0.01, for all). Serum levels of chemerin and resistin correlated positively with BMI, percentage of fat adipose tissue (FAT, %), total FAT (kg), and VF (p < 0.05, for all). Also, we observed significant correlation between resistin and NC (r = 0.23, p = 0.03) and ABSI (r = 0.22, p = 0.04). In multivariable linear regression analysis, chemerin (? = 0.23; p = 0.008) and resistin (? = 0.43; p =0.002) were independently and significantly associated only with VF. Conclusion. Obesity indices, both classical and newer ones, are in positive, statistically significant correlation with the level of proinflammatory cytokines. Ultrasonographically measured VF thickness, independently associated with adipokine levels, may improve assessment of proinflammatory fat tissue characteristics. Further studies are needed to precisely define the use of ultrasonographic fat tissue measurements into clinical practice.

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Gender Stratified Analyses of the Association of Skinfold Thickness with Hypertension: A Cross-Sectional Study in General Northeastern Chinese Residents

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph15122748 ◽

2018 ◽

Vol 15 (12) ◽

pp. 2748

Author(s):

Yuyan Liu ◽

Yongfang Li ◽

Jing He ◽

Ping Ma ◽

Luyang Yu ◽

...

Keyword(s):

Chinese Women ◽

Subcutaneous Fat ◽

Skinfold Thickness ◽

Cross Sectional Study ◽

Normal Weight ◽

Regression Analyses ◽

Sectional Study ◽

Cross Sectional ◽

Subscapular Skinfold Thickness ◽

Overweight Or Obesity

The association of hypertension with skinfold thickness (ST) in adults is not clear. Our study was aimed at finding out the association of hypertension with ST in different gender and obesity categories. This is a cross-sectional study based on 2336 Chinese residents (767 men). Both subscapular skinfold thickness (SST) and tricep skinfold thickness (TST) were examined. We estimated the association of hypertension with per SD increase of SST and TST using multivariable logistic regression analyses in men and women. Six subgroups were stratified using cutoff points of body mass index (BMI) and ST: larger and smaller ST in normal weight (BMI < 24 kg/m2), overweight (24 kg/m2 ≤ BMI < 28 kg/m2) and obesity (BMI ≥ 28 kg/m2), respectively. The association of hypertension with ST was only shown in women after adjustment for other risk factors. Among women of the normal weight subgroup, higher prevalence of hypertension was shown in those with larger ST. No difference of the prevalence of hypertension was found between women with larger ST in the normal weight subgroup and those with smaller ST in overweight or obesity subgroups. Our study suggested that even for people with normal weight, it was necessary to monitor the subcutaneous fat using ST for preventing hypertension at least in general Chinese women.

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Pattern of Adiponectin, Osteocalcin, Irisin, FGF-21, and MCP-1 According to the Body Size Phenotype: Could They Be Markers of Metabolic Health in Mexican-Mestizo Middle-Aged Women?

Metabolites ◽

10.3390/metabo11110771 ◽

2021 ◽

Vol 11 (11) ◽

pp. 771

Author(s):

Lourdes Balcázar-Hernandez ◽

Lourdes Basurto ◽

Leticia Manuel-Apolinar ◽

Sara Vega-García ◽

Norma Basurto-Acevedo ◽

...

Keyword(s):

Body Size ◽

Cross Sectional Study ◽

Normal Weight ◽

The Body ◽

Metabolic Phenotype ◽

Obese Women ◽

Middle Aged ◽

Cross Sectional ◽

Metabolically Healthy Obese ◽

Metabolically Healthy

Variations in levels of some adipokines, myokines, osteokines, hepatokines and inflammatory cytokines contribute to abnormal glucose and lipid metabolism. The aim of this study was to determine the pattern of adiponectin, osteocalcin (OCN), irisin, FGF-21, and MCP-1 according to the body size phenotype of middle-aged women, and their associations with BMI, visceral adipose tissue (VAT), and HOMA-IR. A cross-sectional study in 265 women aged from 40 to 65 years was performed. The biochemical characteristics were evaluated in metabolically healthy normal weight, metabolically unhealthy normal weight, metabolically healthy obese, and metabolically unhealthy obese women. There was an association of OCN with BMI (r = −0.107; p = 0.047); adiponectin with BMI (r = −0.217; p = 0.001), insulin (r = −0.415; p = 0.0001), HOMA-IR (r = −0.429; p = 0.0001), and VAT (r = −0.134; p = 0.025); irisin with BMI (r = 0.604; p = 0.001), insulin (r = 0.446; p = 0.0001), HOMA-IR (r = 0.452; p = 0.0001), and VAT (r = 0.645; p = 0.0001); FGF−21 with insulin (r = −0.337; p= 0.030) and HOMA-IR (r = −0.341; p = 0.03); and MCP-1 with BMI (r = 0.481; p = 0.0001), VAT (r = 0.497; p = 0.001), insulin (r = 0.298; p= 0.001), and HOMA-IR (r = 0.255; p = 0.004). A multivariate analysis showed that an elevation of OCN (OR 1.4 (95%CI 1.06–1.81)) and a reduction of adiponectin (OR 0.9 (0.84–0.96)) were associated factors for a metabolic unhealthy phenotype in normal weight participants. Likewise, higher irisin (OR 1.007 (1.003–1.011)) and MCP-1 (1.044 (1.008–1.083)) were risk factors for a metabolic unhealthy phenotype in woman with obesity. OCN, adiponectin, irisin, FGF-21, and MCP-1 are associated with some metabolic parameters such as BMI, HOMA-IR, and VAT, and could be possible biomarkers of an unhealthy metabolic phenotype in middle-aged women.

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Circulating Serum Myonectin Levels in Obesity and Type 2 Diabetes Mellitus

Experimental and Clinical Endocrinology & Diabetes ◽

10.1055/a-0896-8548 ◽

2019 ◽

Cited By ~ 2

Author(s):

Zhu Li ◽

Yan-Ling Yang ◽

Yan-Juan Zhu ◽

Chen-Guang Li ◽

Yun-Zhao Tang ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Visceral Fat ◽

Subcutaneous Fat ◽

Chinese Patients ◽

Enzyme Linked Immunosorbent Assay ◽

Diabetic Patients ◽

Model Assessment

Abstract Objective Myonectin is one of the myokines and has gained interest as a potential new strategy to combat obesity and its associated disorders, such as type 2 diabetes mellitus (T2DM).The objective of this study was to investigate circulating serum myonectin levels in nondiabetes and T2DM and elucidate possible relationships between serum myonectin levels and metabolic parameters in patients with T2DM. Design A total of 362 Chinese patients with T2DM and 100 age- and sex-matched healthy controls were recruited in this study. Clinical characteristics, blood biochemistry, and circulating myonectin levels were measured by enzyme-linked immunosorbent assay. Results Circulating myonectin levels were significantly decreased in T2DM compared with controls. Obese nondiabetic controls had significantly lower serum myonectin levels compared with lean nondiabetic controls. In diabetic patients, serum myonectin concentrations were significantly negatively correlated with body mass index (BMI), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), C-reactive protein (CRP), hemoglobin A1c (HbA1c), fasting insulin (Fins), the homeostatic model assessment of insulin resistance (HOMA-IR), visceral fat area, and subcutaneous fat area. After adjusting for covariates, multivariate stepwise regression analysis demonstrated that BMI, LDL-C, TG, HOMA-IR, and visceral fat were the main independent predictors of low serum myonectin concentrations. Conclusions Circulating myonectin levels were decreased in T2DM patients and in obese subjects. Moreover, serum myonectin levels were correlated with metabolic markers of T2DM. These data suggest that myonectin may be a useful marker in predicting the development of obesity and T2DM.

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Evaluating Relationships between Visceral Fat Measures and Adipokines Concentrations among Women with a History of Preeclampsia

American Journal of Perinatology ◽

10.1055/s-0039-1692454 ◽

2019 ◽

Vol 37 (11) ◽

pp. 1140-1145

Author(s):

Suchitra Chandrasekaran ◽

Darcy Barry ◽

Susan Melhorn ◽

Thomas Easterling ◽

Hilary Gammill ◽

...

Keyword(s):

Visceral Fat ◽

Subcutaneous Fat ◽

Secondary Analysis ◽

Cross Sectional Study ◽

Sectional Study ◽

Anthropometric Data ◽

Cross Sectional ◽

Blood Samples ◽

Plasma Adiponectin ◽

History Of

Abstract Objective We sought to evaluate associations between postpartum plasma adipokine concentrations among women with a history of preeclampsia (PE) without severe features (MPE), PE with severe features (SPE), and no PE (NPE). We also investigated relationships between adipokines and computed tomography (CT)-quantified measures of visceral fat (VF) area (VFA) and subcutaneous fat area (SCFA). Study Design We performed a secondary analysis of data collected as part of a previously performed cross-sectional study at our institution. Women with and without a history of PE were recruited in 10 years after delivery. VFA and SCFA measures were performed by CT scan. Anthropometric data and peripheral blood samples from subjects were collected concurrently. Results Plasma adiponectin concentrations (µg/mL) were significantly lower among MPE (18.5 ± 7.1) compared with NPE (27.3 ± 13.8) and SPE (25.7 ± 9.6). Leptin (p = 0.32) and resistin (p = 0.93) concentrations were similar among the groups. Adiponectin concentrations more closely aligned with VFA (β = −0.001, p = 0.03), while resistin concentrations trended toward correlating with SCFA (β = 0.02, p = 0.05). Leptin was not preferential to VFA or SCFA. Conclusion VF distribution may contribute to the variation in PE phenotype. Adiponectin specifically may be a promising marker representing VFA.

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Comparison between metabolically healthy obesity and metabolically unhealthy obesity by different definitions among Mexican children

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2019-0077 ◽

2020 ◽

Vol 33 (2) ◽

pp. 215-222 ◽

Cited By ~ 2

Author(s):

María Lola Evia-Viscarra ◽

Rodolfo Guardado-Mendoza

Keyword(s):

Blood Pressure ◽

Family Background ◽

Density Lipoprotein ◽

Model Assessment ◽

Metabolically Healthy Obesity ◽

Cvd Risk ◽

Cross Sectional ◽

Mexican Children ◽

Metabolically Healthy ◽

Metabolically Unhealthy Obesity

AbstractBackgroundThere is no consensus on the definition of metabolically healthy obesity (MHO) and the diagnostic criteria in children.ObjectivesTo estimate the prevalence of MHO and compare clinical and biochemical characteristics between MHO and metabolically unhealthy obesity (MUO), and to evaluate the association between MUO and cardiovascular disease (CVD) risk, anthropometrics and family background using different definitions in children.MethodsThis was a cross-sectional study. Participants included 224 obese children between the years 2007 and 2017. MHO was defined by three different criteria: (i) absence of metabolic syndrome (MHO-MS), (ii) no insulin resistance (IR) by homeostatic model assessment (HOMA) <3.16 cut-off (MHO-IR3.16) and (iii) absence of IR at <95th percentile for Mexican children (MHO-95th).ResultsThe prevalence of MHO-MS, MHO-IR3.16 and MHO-IR95th was 12.9%, 56.3% and 41.5%, respectively. The prevalence of simultaneous MHO-MS plus MHO-IR95th was 5.36%. Children with MHO-MS vs. MUO-MS showed lower height, weight and body mass index (BMI) percentiles; MHO-IR3.16 vs. MUO-IR3.16 showed lower age, acanthosis, Tanner, waist circumference (WC), waist-to-height ratio (WHtR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and glucose; and MHO-IR95th vs. MUO-IR95th showed lower acanthosis, WC, DBP, glucose and high high-density lipoprotein cholesterol (HDL-C). MUO-MS was associated with WC > 90th, type 2 diabetes mellitus (T2DM) in first-degree relatives and obesity in siblings. MUO-IR3.16 was associated with pubertal stages, WC > 90th, WHtR > 0.55 and fasting hyperglycemia. MUO-IR95th was associated with WHtR > 0.55 and HDL < 10th. MHO-MS and MHO-IR3.16 or MHO-IR95th did not have agreement.ConclusionsThe prevalence of MHO varied depending on the definition, although the real MHO with no MS or IR is very low. Low DBP and high HDL-C in MHO were present in any definition. Association of MUO with anthropometric, biochemical and family background differs across definitions.

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Does a “Cushion Effect” Really Exist? A Morphomic Analysis of Vulnerable Road Users with Serious Blunt Abdominal Injury

Healthcare ◽

10.3390/healthcare9081006 ◽

2021 ◽

Vol 9 (8) ◽

pp. 1006

Author(s):

Yu-San Tee ◽

Chi-Tung Cheng ◽

Chi-Hsun Hsieh ◽

Shih-Ching Kang ◽

Chih-Yuan Fu ◽

...

Keyword(s):

Multivariate Analysis ◽

Visceral Fat ◽

Motor Vehicle ◽

Subcutaneous Fat ◽

Abdominal Injury ◽

Visceral Fat Area ◽

Cross Sectional ◽

Road Users ◽

Severity Of Injury ◽

Vulnerable Road Users

Introduction: The severity of injury from motor vehicle crashes (MVCs) depends on complex biomechanical factors, and the bodily features of the injured person account for some of these factors. By assuming that vulnerable road users (VRUs) have limited protection resulting from vehicles and safety equipment, the current study analyzed the characteristics of fat distribution measured by computed tomography (CT) imaging and investigated the existence of a “cushion effect” in VRUs. Materials and Methods: This retrospective study enrolled 592 VRUs involved in MVCs who underwent CT scans. Visceral fat area and subcutaneous fat cross-sectional area were measured and adjusted according to total body area (TBA) and are presented as the visceral fat ratio and the subQ fat ratio (subcutaneous fat ratio). Risk factors for serious abdominal injury (maximum abbreviated injury scale (MAISabd ≥ 3)) resulting from MVCs were determined by univariate and multivariate analysis. Results: MAISabd ≥ 3 was observed in 104 (17.6%) of the patients. The subQ fat ratio at the L4 vertebral level was significantly lower in the MAISabd ≥ 3 group than in the MAISabd < 3 group (24.9 ± 12.0 vs. 28.1 ± 11.9%; p = 0.015). A decreased L4 subQ fat ratio was associated with a higher risk for MAISabd ≥ 3 in multivariate analysis (odds ratio 0.063; 95% CI 0.008–0.509; p = 0.009). Conclusion: The current study supported the “cushion effect” theory, and protection was apparently provided by subcutaneous fat tissue. This concept may further improve vehicle and safety designation in the future.

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Oxidative stress and nitric oxide are increased in obese children and correlate with cardiometabolic risk and renal function

British Journal Of Nutrition ◽

10.1017/s0007114516002804 ◽

2016 ◽

Vol 116 (5) ◽

pp. 805-815 ◽

Cited By ~ 20

Author(s):

Liane Correia-Costa ◽

Teresa Sousa ◽

Manuela Morato ◽

Dina Cosme ◽

Joana Afonso ◽

...

Keyword(s):

Oxidative Stress ◽

Nitric Oxide ◽

Renal Function ◽

Cardiometabolic Risk ◽

Linear Trend ◽

Normal Weight ◽

No Production ◽

Model Assessment ◽

Obese Children ◽

Cross Sectional

AbstractOxidative stress and nitric oxide (NO) appear to represent important links between obesity and cardiovascular, metabolic and/or renal disease. We investigated whether oxidative stress and NO production/metabolism are increased in overweight and obese prepubertal children and correlate with cardiometabolic risk and renal function. We performed a cross-sectional evaluation of 313 children aged 8–9 years. Anthropometrics, 24-h ambulatory blood pressure, pulse wave velocity (PWV), insulin resistance (homoeostasis model assessment index (HOMA-IR)), inflammatory/metabolic biomarkers, estimated glomerular filtration rate (eGFR), plasma total antioxidant status (TAS), plasma and urinary isoprostanes (P-Isop, U-Isop), urinary hydrogen peroxide (U-H2O2), and plasma and urinary nitrates and nitrites (P-NOx, U-NOx) were compared among normal weight, overweight and obese groups, according to WHO BMI z-score reference. U-Isop were increased in the obese group, whereas U-NOx were increased in both overweight and obese children. U-Isop were positively correlated with U-H2O2, myeloperoxidase (MPO), high-sensitivity C-reactive protein, HOMA-IR and TAG. TAS correlated negatively with U-Isop and MPO and positively with PWV. HOMA-IR and U-H2O2 were associated with higher U-Isop, independently of BMI and eGFR, and total cholesterol and U-H2O2 were associated with U-NOx, independently of BMI, eGFR values and P-NOx concentration. In overweight and obese children, eGFR decreased across P-NOx tertiles (median: 139·3 (25th, 75th percentile 128·0, 146·5), 128·0 (25th, 75th percentile 121·5, 140·4), 129·5 (25th, 75th percentile 119·4, 138·3), Pfor linear trend=0·003). We conclude that oxidant status and NO are increased in relation to fat accumulation and, even in young children, they translate into higher values of cardiometabolic risk markers and affect renal function.

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