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Background: It is imperative to develop markers for risk stratification and detection of cardiometabolic comorbidities in children with obesity. The adipokines leptin and adiponectin are both involved in fat mass regulation and the development of obesity‐related disorders; furthermore, their ratio (leptin/adiponectin ratio) is suggested to be associated with insulin resistance and cardiometabolic risk. Objective: To evaluate associations between fasting serum concentrations of the adipokines (total leptin and adiponectin as well as the L/A ratio) and cardiometabolic comorbidities in children with overweight/obesity. Methods: A total of 2258 children with overweight/obesity or normal weight aged 6 to 18 years were studied. Differences in anthropometrics and adipokine concentrations were tested using Wilcoxon rank‐sum test. Associations between the adipokines and cardiometabolic risk were tested using Spearman's correlation and logistic regression, adjusted for age and body mass index SD score (BMI‐SDS). Results: Compared to normal weight children; children with overweight/obesity exhibited higher leptin concentrations, lower adiponectin concentrations, and higher L/A ratios. After adjusting for age and degree of obesity, girls with overweight/obesity in the upper quartile range for the L/A ratio, when compared with girls in the lower quartile range, were more likely to have insulin resistance (odds ratio [OR]: 7.78 [95% confidence interval [CI], 3.78‐16.65]), dysglycemia (OR: 3.08 [95% CI, 1.35‐7.31]), and dyslipidemia (OR: 2.53 [95% CI, 1.18‐5.59]); while boys were more likely to have insulin resistance (OR: 4.45 [95% CI, 2.03‐10.10]). Conclusions: Independent of the degree of obesity, leptin, adiponectin, and the L/A ratio were associated with insulin resistance and other cardiometabolic comorbidities in children with overweight/obesity, but the L/A ratio exhibited stronger associations than the respective adipokines. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether children and adolescents exhibiting an impaired glucose metabolism are more obese at treatment entry and less likely to reduce their degree of obesity during treatment. Methods: The present study is a longitudinal observational study, including children and adolescents from the Children's Obesity Clinic, Holbæk, Denmark. Anthropometrics, pubertal development, socioeconomic status (SES), and fasting concentrations of plasma glucose, serum insulin, serum C‐peptide, and whole blood glycosylated hemoglobin (HbA1c) were collected at treatment entry and at follow‐up. Proxies of Homeostasis Model Assessment 2‐insulin sensitivity (HOMA2‐IS) and Homeostasis Model Assessment 2‐β‐cell function (HOMA2‐B) were calculated with the Homeostasis Model Assessment 2 program. Results: In total, 569 (333 boys) patients, median 11.5 years of age (range 6‐22 years), and median body mass index (BMI) z‐score 2.94 (range 1.34‐5.54) were included. The mean BMI z‐score reduction was 0.31 (±0.46) after 13 months (range 6‐18) of treatment. At treatment entry, patients with impaired estimates of glucose metabolism were more obese than normoglycemic patients. Baseline concentration of C‐peptide was associated with a lower weight loss during treatment in girls (P = .02). Reduction in the insulin concentrations was associated with reduction in BMI z‐score in both sexes (P < .0001, P = .0005). During treatment, values of glucose, HbA1c, HOMA2‐IS, and HOMA2‐B did not change or impact the treatment outcome, regardless of age, sex, SES, or degree of obesity at treatment entry. Conclusion: The capability to reduce weight during multidisciplinary treatment in children and adolescents with overweight/obesity is not influenced by an impaired glucose metabolism at study entry or during the course of treatment. [ABSTRACT FROM AUTHOR]

Objective: Whether the definitions of impaired fasting glucose (IFG) from the American Diabetes Association (ADA) and the World Health Organization (WHO) differentially impact estimates of the metabolic profile and IFG‐related comorbidities in Danish children and adolescents is unknown. Methods: Two thousand one hundred and fifty four (979 boys) children and adolescents with overweight or obesity (median age 12 years) and 1824 (728 boys) children with normal weight (median age 12 years) from The Danish Childhood Obesity Biobank were studied. Anthropometrics, blood pressure, puberty, and fasting concentrations of glucose, insulin, glycosylated hemoglobin (HbA1c), and lipids were measured. Results: About 14.1% of participants with overweight or obesity exhibited IFG according to the ADA and 3.5% according to the WHO definition. Among individuals with normal weight, the corresponding prevalences were 4.3% and 0.3%. IFG was associated with a higher systolic blood pressure, higher concentrations of HbA1c, insulin, C‐peptide (P < .0001) and triglycerides (P = .03), and lower HOMA2‐IS and HOMA2‐B (P < .0001) independent of sex, age, puberty, waist‐to‐height ratio, and degree of obesity. Furthermore, IFG was associated with a higher risk for hypertension (OR = 1.66 [95%CI: 1.21; 2.28], P = .002) and dyslipidemia (OR = 1.90 [95%CI: 1.38; 2.56], P < .0001) compared with the group without IFG independent of age, sex, and puberty. Conclusions: The prevalence of IFG, when applying the ADA criterion compared with the WHO criterion, was 4 times higher in individuals with overweight and obesity and 14 times higher in individuals with normal weight in this study sample of children and adolescents. IFG was associated with a higher risk of hypertension and dyslipidemia compared with their normoglycemic peers regardless of the definition applied. [ABSTRACT FROM AUTHOR]