Higher steroid sulfation is linked to successful weight loss in obese children

Objective Little information is available on the steroid sulfates profile in obese children. Therefore, we examined whether sulfated steroids are linked with weight status and associated comorbidities in obese children. Methods We analyzed 66 obese children (mean age 10.5 ± 2.5 years, 57.6% female, 53.9% prepubertal, mean BMI 27.0 ± 4.6 kg/m2, 50% with BMI-SDS reduction >0.5, 50% without BMI-SDS reduction) who participated in an outpatient 1-year intervention program based on exercise, behavior and nutrition therapy. We measured intact sulfated steroids (cholesterol sulfate (CS), pregnenolone sulfate (PregS), 17αOH pregnenolone sulfate (17OH-PregS), 16αOH dehydroepiandrosterone sulfate (16OH-DHEAS), DHEAS, androstenediol-3-sulfate, androsterone sulfate and epiandrosterone sulfate) by LC–MS/MS, and insulin resistance index HOMA, lipids, blood pressure at baseline and 1 year later. Results All sulfated steroids except 17OH-PregS, 16OH-DHEAS, androsterone sulfate and epiandrosterone sulfate were higher in boys compared to girls. Concentrations of CS before intervention were higher in children who lost weight. After 1 year of treatment, both groups showed increased levels of DHEAS, 16OH-DHEAS and androstenediol-3-sulfate, but PregS was only increased in children with weight loss. None of the steroid sulfates was significantly related to cardiovascular risk factors or HOMA except 17OH-PregS, which was associated with systolic blood pressure both in cross-sectional (β-coefficient: 0.09 ± 0.07, P = 0.020) and longitudinal analyses (β-coefficient: 0.06 ± 0.04, P = 0.013) in multiple linear regression analyses. Conclusions Since higher steroid sulfation capacity was associated with successful weight intervention in children disruption of sulfation may be associated with difficulties to lose weight. Future studies are necessary to prove this hypothesis.

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Fetuin-A and Its Relation to Metabolic Syndrome and Fatty Liver Disease in Obese Children Before and After Weight Loss

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2008-1505 ◽

2008 ◽

Vol 93 (11) ◽

pp. 4479-4485 ◽

Cited By ~ 125

Author(s):

Thomas Reinehr ◽

Christian L. Roth

Keyword(s):

Insulin Resistance ◽

Blood Pressure ◽

Metabolic Syndrome ◽

Weight Loss ◽

Fatty Liver Disease ◽

Weight Status ◽

Resistance Index ◽

Obese Children ◽

Fetuin A ◽

Insulin Resistance Index

Context: There are very limited data available concerning the relationships between fetuin-A, weight status, nonalcoholic fatty liver disease (NAFLD), and features of the metabolic syndrome (MetS) in obese humans, and especially in children. Objective: Our objective was to study the longitudinal relationships between fetuin-A, NAFLD, and MetS in obese children. Design: This was a 1-yr longitudinal follow-up study. Setting: This study was performed in primary care. Patients: A total of 36 obese and 14 lean children was included in the study. Intervention: An outpatient 1-yr intervention program based on exercise, behavior, and nutrition therapy was performed. Main Outcome Measures: Changes of weight status (sd score-body mass index), waist circumference, fetuin-A, blood pressure, lipids, transaminases, insulin resistance index homeostasis model assessment (HOMA), and prevalence of NAFLD (defined by liver ultrasound) were calculated. Results: The 12 obese children with NAFLD had significantly higher fetuin-A levels (0.35 ± 0.07 g/liter) than the 24 obese children without NAFLD (0.29 ± 0.06 g/liter) and the 14 normal weight children (0.29 ± 0.05 g/liter). Fetuin-A levels were independent of age, pubertal stage, and gender. Fetuin-A correlated significantly to systolic (r = 0.50) and diastolic blood pressure (r = 0.41), insulin resistance index HOMA (r = 0.28), and high-density lipoprotein-cholesterol (r = −0.31). Changes of fetuin-A correlated significantly to changes of insulin resistance index HOMA (r = 0.34), systolic (r = 0.31) and diastolic blood pressure (r = 0.37), and waist circumferences (r = 0.36). Substantial weight loss in 21 children led to a significant decrease of fetuin-A and the prevalence of NAFLD in contrast to the 15 children without substantial weight loss. Conclusions: Fetuin-A levels were higher in children with NAFLD, and were related to insulin resistance and to features of the MetS in both cross-sectional and longitudinal analyses. Therefore, fetuin-A might be a new promising link between obesity and its comorbidities.

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Vitamin D status and parathyroid hormone in obese children before and after weight loss

Acta Endocrinologica ◽

10.1530/eje-07-0188 ◽

2007 ◽

Vol 157 (2) ◽

pp. 225-232 ◽

Cited By ~ 123

Author(s):

Thomas Reinehr ◽

Gideon de Sousa ◽

Ute Alexy ◽

M Kersting ◽

Werner Andler

Keyword(s):

Vitamin D ◽

Weight Loss ◽

Parathyroid Hormone ◽

Insulin Sensitivity ◽

Weight Status ◽

Intervention Program ◽

Model Assessment ◽

Obese Children ◽

Percentage Body Fat ◽

Before And After

Objective: The roles of vitamin D and parathyroid hormone (PTH) are discussed controversially in obesity, and studies of these hormones in obese children are limited. Therefore, we studied the relationships between PTH, 1,25-dihydroxy-vitamin D (1,25-OH Vit D), 25-hydroxy-vitamin D (25-OH Vit D), weight status, and insulin sensitivity before and after weight loss in obese children. Methods: Fasting serum PTH, 1,25-OH Vit D, 25-OH Vit D, inorganic phosphate, calcium, alkaline phosphatase (AP), insulin, glucose, and weight status (SDS–BMI and percentage body fat) were determined in 133 obese children (median age 12.1 years) and compared with 23 non-obese children. Furthermore, these parameters were analyzed in 67 obese children before and after participating in a 1-year obesity intervention program. Results: Obese children had significantly (P < 0.001) higher PTH and lower 25-OH Vit D concentrations compared with non-obese children, while calcium, phosphate, AP, and 1,25-OH Vit D did not differ significantly. Changes of PTH (r = 0.23, P = 0.031) and 25-OH Vit D (r = −0.27, P = 0.013) correlated significantly with changes of SDS–BMI, but not with changes of insulin sensitivity (homeostasis model assessment; HOMA-B%). Reduction of overweight in 35 children led to a significant (P < 0.01) decrease of PTH concentrations and an increase in 25-OH Vit D levels. Conclusions: PTH levels were positively and 25-OH Vit D concentrations were negatively related to weight status. Since these alterations normalized after weight loss, these changes are consequences rather than causes of overweight. A relationship between PTH, vitamin D, and insulin sensitivity based on the HOMA index was not found in obese children. Further longitudinal clamp studies are neccessary to study the relationship between vitamin D and insulin sensitivity.

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Retinol-Binding Protein 4 and Its Relation to Insulin Resistance in Obese Children before and after Weight Loss

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2007-2745 ◽

2008 ◽

Vol 93 (6) ◽

pp. 2287-2293 ◽

Cited By ~ 56

Author(s):

Thomas Reinehr ◽

Birgit Stoffel-Wagner ◽

Christian L. Roth

Keyword(s):

Insulin Resistance ◽

Body Mass Index ◽

Weight Loss ◽

Body Mass ◽

Weight Status ◽

Retinol Binding Protein ◽

Homa Index ◽

Obese Children ◽

Retinol Binding Protein 4 ◽

Lean Children

Abstract Context: There are limited and controversial data concerning the relationships between retinol-binding protein 4 (RBP4), weight status, and insulin resistance in obese humans and especially in children. Objective: Our objective was to study the longitudinal relationships among RBP4, insulin resistance and weight status in obese children. Design, Setting, and Patients: We conducted a 1-yr longitudinal follow-up study in a primary-care setting with 43 obese children (median age 10.8 yr) and 19 lean children of same the age and gender. Intervention: Our outpatient 1-yr intervention program was based on exercise, behavior, and nutrition therapy. Main Outcomes Measures: Changes of weight status (body mass index sd score), RBP4, molar RBP4/serum retinol (SR) ratio, insulin resistance index homeostasis model assessment (HOMA), and quantitative insulin sensitivity check index (QUICKI). Results: Obese children had significantly (P < 0.01) higher RBP4 concentrations and a higher RBP4/SR ratio compared with lean children. In multiple linear regression analyses adjusted to age, gender, and pubertal stage, RBP4 was significantly correlated to insulin and body mass index. Pubertal children demonstrated significantly decreased QUICKI and significantly increased HOMA index, insulin, and RBP4 concentrations compared with prepubertal children. Changes of RBP4 correlated significantly to changes of insulin (r = 0.29), HOMA index (r = 0.29), QUICKI (r = 0.22), and weight status (r = 0.31). Substantial weight loss in 25 children led to a significant (P < 0.001) decrease of RBP4, RBP4/SR, blood pressure, triglycerides, insulin, and HOMA index and an increase in QUICKI in contrast to the 18 children without substantial weight loss. Conclusion: RBP4 levels were related to weight status and insulin resistance in both cross-sectional and longitudinal analyses, suggesting a relationship between RBP4, obesity, and insulin resistance in children.

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Cross-Sectional and Longitudinal Associations between Body Mass Index and Cardiometabolic Risk Factors in Adolescents in a Country of the African Region

International Journal of Endocrinology ◽

10.1155/2013/801832 ◽

2013 ◽

Vol 2013 ◽

pp. 1-10 ◽

Cited By ~ 5

Author(s):

Tanica Lyngdoh ◽

Bharathi Viswanathan ◽

Edwin van Wijngaarden ◽

Gary J. Myers ◽

Pascal Bovet

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Body Mass Index ◽

Young Adults ◽

Body Mass ◽

Weight Status ◽

Cardiometabolic Risk ◽

Linear Regression Analysis ◽

Cardiometabolic Risk Factors ◽

Cross Sectional

We assessed the association between several cardiometabolic risk factors (CRFs) (blood pressure, LDL-cholesterol, HDL-cholesterol, triglycerides, uric acid, and glucose) in 390 young adults aged 19-20 years in Seychelles (Indian Ocean, Africa) and body mass index (BMI) measured either at the same time (cross-sectional analysis) or at the age of 12–15 years (longitudinal analysis). BMI tracked markedly between age of 12–15 and age of 19-20. BMI was strongly associated with all considered CRFs in both cross-sectional and longitudinal analyses, with some exceptions. Comparing overweight participants with those having a BMI below the age-specific median, the odds ratios for high blood pressure were 5.4/4.7 (male/female) cross-sectionally and 2.5/3.9 longitudinally (P<0.05). Significant associations were also found for most other CRFs, with some exceptions. In linear regression analysis including both BMI at age of 12–15 and BMI at age of 19-20, only BMI at age of 19-20 remained significantly associated with most CRFs. We conclude that CRFs are predicted strongly by either current or past BMI levels in adolescents and young adults in this population. The observation that only current BMI remained associated with CRFs when including past and current levels together suggests that weight control at a later age may be effective in reducing CRFs in overweight children irrespective of past weight status.

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Weight Status Is Associated with Blood Pressure, Vital Capacity, Dental Decay, and Visual Acuity among School-Age Children in Chengdu, China

Annals of Nutrition and Metabolism ◽

10.1159/000454888 ◽

2016 ◽

Vol 69 (3-4) ◽

pp. 237-245 ◽

Cited By ~ 8

Author(s):

Rong Peng ◽

Shiyun Li ◽

Hongbin Zhang ◽

Honglian Zeng ◽

Biyu Jiang ◽

...

Keyword(s):

Blood Pressure ◽

Visual Acuity ◽

Weight Status ◽

Vital Capacity ◽

Low Vision ◽

Normal Weight ◽

School Age Children ◽

School Age ◽

Obese Children ◽

Dental Decay

Aims: To examine the association of weight status with the prevalence of blood pressure (BP), vital capacity, dental decay, and visual acuity among school-age children in Chengdu, China and to find the potential role of weight status to predict the common and frequently occurring diseases among school-age children. Methods: A cross-sectional study was conducted among 12,297 children aged 6-18 years from 10 schools in the Jinniu District of Chengdu, China. Body height, weight, waist circumference (WC), and BP were measured. Vital capacity, dental decay, and visual acuity were detected. Results: The overall prevalence of underweight, overweight, obesity, abdominal obesity, high BP, bad vital capacity weight index, dental decay, and low vision were 7.18, 13.47, 7.57, 18.90, 2.78, 21.93, 38.81, and 45.79%, respectively. After controlling for age, gender, and WC, it was found that overweight and obese children had a higher risk of developing high BP than normal weight children ([OR 4.20, p < 0.001] and [OR 8.76, p < 0.001], respectively), And adjusting for age, gender, and chest circumference, the risk of having bad vital capacity weight index among children with overweight and obesity was higher ([OR 2.15, p < 0.001] and [OR 5.40, p < 0.001], respectively), and the risk with underweight was lower (OR 0.35, p < 0.001). After eliminating the influential factors of gender and age, children who were underweight were 1.16 times (OR 1.16, p = 0.048) more likely to have caries than children with normal weight, but obese children were found to have a lower prevalence for dental cavities than children with normal weight (OR 0.79, p = 0.002). Underweight and obese children had a higher prevalence of low vision; the OR of the appearance of low vision was 1.21 (p = 0.016) for underweight children and 1.23 (p = 0.009) for obese children after adjusting the age and gender. Conclusions: Abnormal weight status among Chengdu urban school-age children was found to be a severe health problem, and it was strongly associated with BP, vital capacity, dental decay, and visual acuity.

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Abstract P199: Keep Moving, Your Health Depends On It: Impact Of Improved Physical Activity And Weight Loss In A Wellness Program

Circulation ◽

10.1161/circ.129.suppl_1.p199 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Ebenezer T Oni ◽

Ehimen Aneni ◽

Maribeth Rouseff ◽

Thinh Tran ◽

Henry Guzman ◽

...

Keyword(s):

Physical Activity ◽

Blood Pressure ◽

Weight Loss ◽

Intervention Program ◽

South Florida ◽

Metabolic Equivalents ◽

Baseline Weight ◽

The Mean ◽

The Difference

Negative impact of CVD as the leading cause of death in the US is worsened by the significant burden of obesity and associated morbidity and concerns about the growing population inactivity. The American Heart Association has emphasized worksite-based interventions to improve CV health. We evaluated the benefits of improved physical activity(PA) and weight loss(WL) among employees of the Baptist Health South Florida enrolled in a wellness intervention program. Methods: Employees with two or more Cardio-metabolic risk factors , such as total cholesterol ≥ 200 mg/dl, systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg, hemoglobin A1C ≥ 6.5%, and body mass index (BMI) ≥ 30 were enrolled in an intervention program themed “My unlimited potential”. Interventions were focused on diet and PA modifications. We defined improved physical activity as the difference in the metabolic equivalents (METs) at 12 weeks follow-up and at baseline. WL (lbs) was the difference in weight at follow-up. The relationship between WL and changes in METs was explored in an ordered logistic regression. Results: Overall 203 (48±10 years, 78% females) employees were enrolled with a retention rate of 89% (n=181) at 12 weeks follow-up. At baseline the median weights was 211 lbs., and mean METs- 8.6, while at follow-up the median weight was 200 lbs, and the mean METs 11. At 12 weeks follow up 38% had significant WL (lost >5% of baseline weight). The median WL was 8.4 (IQR 4.8-13.0) lbs and the mean change in METs was 2.4±1.8. Median WL increased with increasing tertiles of METs change; tertile1- 6.5(4-11) lbs., tertile2- 9(6-13)lbs. tertile3- 11(7-15)lbs. Increased PA was related to increased WL across BMI categories adjusting for age, gender and baseline weight. Conclusion: This study points strongly toward the benefit of increasing PA among other lifestyle modification interventions in controlling weight. Although further follow-up of this population to evaluate sustainability of change is needed, our results clearly relate improved PA and health.

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Thyroid Volume and Thyroid Function Parameters Are Independently Associated with Weight Status in Overweight Children

Hormone Research in Paediatrics ◽

10.1159/000509786 ◽

2020 ◽

Vol 93 (5) ◽

pp. 279-286

Author(s):

Nina Lass ◽

Andre Barth ◽

Thomas Reinehr

Keyword(s):

Insulin Resistance ◽

Thyroid Function ◽

Weight Status ◽

Resistance Index ◽

Thyroid Volume ◽

Thyroid Stimulating Hormone ◽

Normal Weight ◽

Function Parameter ◽

Overweight Children ◽

Cross Sectional

Background: A relation between thyroid-stimulating hormone (TSH), insulin resistance – both of which are related to obesity – and thyroid volume has been suggested. Therefore, we analyzed thyroid volume and structure in relation to thyroid function parameters, weight status, and insulin resistance. Methods:This is a cross-sectional study in which weight status (BMI-SDS), thyroid function parameters (TSH, free tri-iodothyronine [fT3], and free thyroxine [fT4]), insulin resistance index (HOMA-IR), and thyroid volume (ultrasound) were determined in 617 overweight children (aged 10.4 ± 2.2 years, 50% male, BMI-SDS 2.5 ± 0.6) and in 27 normal-weight children of a similar age and gender. Furthermore, changes in thyroid volume and structure, and thyroid function parameters were analyzed in 83 obese children (51% male, mean age 10.3 ± 2.2) at baseline and at the end of a 1-year lifestyle intervention. Results: Overweight children had a significant greater thyroid volume (4.2 ± 1.8 vs. 4.1 ± 0.5 mL) and higher TSH (3.1 ± 1.5 vs. 2.4 ± 1.1 mU/L) and fT3 (4.4 ± 0.7 vs. 4.1 ± 0.5 pg/mL) concentrations compared to normal-weight children. In multiple linear regression analyses adjusted to multiple confounders, thyroid volume was significantly related to BMI-SDS (b coefficient 0.44 ± 0.10, r2 = 0.41) but not to any thyroid function parameter or HOMA-IR. Changes in BMI-SDS were significantly associated with changes in thyroid volume (r = 0.22). The changes in thyroid volume were not correlated to changes of any thyroid function parameter or HOMA-IR. Conclusions: Thyroid volume is positively correlated to weight status in childhood obesity and the change is reversible after weight loss independently of thyroid function parameters and insulin resistance. Further studies are needed to understand why thyroid volume is increased reversibly in overweight children.

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Weight cycling is associated with adverse cardiometabolic markers in a cross-sectional representative US sample

Journal of Epidemiology & Community Health ◽

10.1136/jech-2019-213419 ◽

2020 ◽

pp. jech-2019-213419

Author(s):

Lisa Kakinami ◽

Bärbel Knäuper ◽

Jennifer Brunet

Keyword(s):

Blood Pressure ◽

Insulin Sensitivity ◽

Weight Status ◽

Density Lipoprotein ◽

Normal Weight ◽

Lipoprotein Cholesterol ◽

Weight Cycling ◽

Cross Sectional ◽

Weight History ◽

Cardiometabolic Markers

BackgroundWhether weight cycling (repeated weight loss and regain) is associated with cardiometabolic health is unclear. Study objective was to examine whether weight cycling since young adulthood (ie, 25 years of age) was associated with cardiometabolic markers.MethodsData from a nationally representative cross-sectional US sample (National Health and Nutrition Examination Survey, 1999–2014) were used. Weight history was based on self-reported weight at age 25, 10 years prior and 1 year prior to the survey (n=4190, 51% male). Using current self-reported weight as the anchor, participants were classified as (1) stable weight, (2) weight losers, (3) weight gainers and (4) weight cyclers. Cardiometabolic markers included fasting lipids, insulin sensitivity and blood pressure. Multiple linear regressions were used to analyse weight history (reference: stable weight) and adjusted for covariates. Analyses incorporated the sampling design and survey weights and were stratified by sex or weight status.ResultsCompared with females with stable weight, female weight cyclers had worse lipids and homeostasis model assessment for insulin resistance (HOMA-IR) (all ps<0.05). Compared with males with stable weight, male weight cyclers had worse high-density lipoprotein cholesterol (HDL) and HOMA-IR (ps<0.05). Weight cyclers with normal weight had worse HDL and low-density lipoprotein cholesterol (ps<0.05), and weight cyclers with overweight or obesity had worse HOMA-IR (p=0.05). Blood pressure was not associated.ConclusionWeight cycling is adversely associated with cardiometabolic markers but associations differ by sex and weight status. While weight cycling is consistently associated with worse cardiometabolic markers among females, results are mixed among males. Weight cycling is associated with worse lipid measures for normal weight persons, and marginally worse insulin sensitivity for those with overweight/obesity.

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Factors associated with accelerometer measured movement behaviours among White British and South Asian children aged 6–8 years during school terms and school holidays

BMJ Open ◽

10.1136/bmjopen-2018-025071 ◽

2019 ◽

Vol 9 (8) ◽

pp. e025071 ◽

Cited By ~ 2

Author(s):

Liana Carmen Nagy ◽

Muhammad Faisal ◽

Maria Horne ◽

Paul Collings ◽

Sally Barber ◽

...

Keyword(s):

Physical Activity ◽

South Asian ◽

Primary Schools ◽

Weight Status ◽

Vigorous Physical Activity ◽

Multilevel Modelling ◽

Normal Weight ◽

Obese Children ◽

Cross Sectional ◽

Factors Associated

ObjectivesTo investigate factors associated with movement behaviours among White British (WB) and South Asian (SA) children aged 6–8 years during school terms and holidays.DesignCross-sectional.SettingThree primary schools from the Bradford area, UK.ParticipantsOne hundred and sixty WB and SA children aged 6–8 years.Primary and secondary outcomesSedentary behaviour (SB), light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) measured by accelerometry during summer, winter and spring and during school terms and school holidays. Data were analysed using multivariate mixed-effects multilevel modelling with robust SEs. Factors of interest were ethnicity, holiday/term, sex, socioeconomic status (SES), weight status, weekend/weekday and season.ResultsOne hundred and eight children (67.5%) provided 1157 valid days of data. Fifty-nine per cent of children were WB (n=64) and 41% (n=44) were SA. Boys spent more time in MVPA (11 min/day, p=0.013) compared with girls and SA children spent more time in SB (39 min, p=0.017) compared with WB children in adjusted models. Children living in higher SES areas were more sedentary (43 min, p=0.006) than children living in low SES areas. Children were more active during summer (15 min MVPA, p<0.001; 27 LPA, p<0.001) and spring (15 min MVPA, p=0.005; 38 min LPA, p<0.001) and less sedentary (−42 min and −53 min, p<0.001) compared with winter. Less time (8 min, p=0.012) was spent in LPA during school terms compared with school holidays. Children spent more time in MVPA (5 min, p=0.036) during weekend compared with weekdays. Overweight and obese children spent more time in LPA (21 min, p=0.021) than normal-weight children.ConclusionThe results of our study suggest that significant child level factors associated with movement behaviours are ethnicity, sex, weight-status and area SES. Significant temporal factors are weekends, school holidays and seasonality. Interventions to support health enhancing movement behaviours may need to be tailored around these factors.

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Circulating PGRN Levels Are Increased but Not Associated with Insulin Sensitivity or β-Cell Function in Chinese Obese Children

Disease Markers ◽

10.1155/2018/3729402 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7

Author(s):

Fengyun Wang ◽

Ting Chen ◽

Ling Sun ◽

Haitao Lv ◽

Xuan Li ◽

...

Keyword(s):

Blood Pressure ◽

Energy Homeostasis ◽

Cell Function ◽

Cross Sectional Study ◽

Obese Children ◽

Cross Sectional ◽

Pathological Mechanism ◽

Adult Humans ◽

Β Cell Function

Progranulin (PGRN), a novel peptide that has recently emerged as an important regulatory adipokine, is relevant to energy homeostasis and obesity in animals and adult humans. Little is known about its roles in children. The aim of the current study was to determine the potential role of PGRN and explore its relationship to various obesity-related markers in obese children. This was a cross-sectional study composed of 77 children (43 obese and 34 healthy, age 8.68 ± 0.28 and 8.46 ± 0.45 years, resp.). The PGRN levels were significantly higher in obese children (102.44 ± 4.18 ng/mL) comparing to controls (69.32 ± 5.49 ng/mL) (P<0.05). Moreover, the PGRN levels were positively correlated with triglyceride (TG), total cholesterol (TC), IL-6, systolic blood pressure (SBP), and diastolic blood pressure (DBP) in obese children after adjusted for BMI and age. However, there was no correlation of serum PGRN levels with OGTT-derived dynamic parameters, HOMA-IR, or HOMA-β in obese children. The results suggest that serum PGRN levels are significantly higher in obese children in China and correlate significantly with obesity-related markers. Increased PGRN levels may be involved in the pathological mechanism of childhood obesity.

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