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Pediatrics

Insulin sensitivity is reduced in children with high body-fat regardless of BMI

International Journal of Obesity volume 42, pages 985–994 (2018)Cite this article

Subjects

Abstract

Purpose

To examine the association between insulin sensitivity and adiposity in children stratified according to their body mass index (BMI: normal weight, NW; overweight or obese, OW/OB) and body-fat percentage (BF%: adipose or NonAdipose), and determine whether cardiorespiratory fitness (CRF) ameliorates any deleterious associations.

Methods

This prospective cohort study comprises a cross-sectional and longitudinal analyses of data collected at baseline and 2 years later on children (7.7–13.4 years) attending public school in Denmark. Levels of CRF were measured using the Andersen test, whereas BF% was measured by dual-energy X-ray absorptiometry (DXA). Fasting plasma glucose and insulin concentrations were measured and the homoeostatic model assessment of insulin resistance (HOMA-IR) used to assess insulin sensitivity.

Results

Approximately 8% of children classified as normal weight by BMI had high BF% (NW + Adipose). Children with high BF% had significantly higher insulin (NW + adipose: 32.3%; OW/OB + Adipose: 52.2%) and HOMA-IR scores (NW + Adipose: 32.3%; OW/OB + Adipose: 55.3%) than children classified as NW without high BF% (reference group; NW + NonAdipose). Adjusting for CRF reduced this difference, but did not completely ameliorate these associations. Longitudinally, children with high BF% (OW/OB + Adipose or NW + Adipose) had significantly worse insulin sensitivity 2 years later than NW + NonAdipose children (All p < 0.001). The few children (n = 14) who improved their BMI or BF% during the 2 years follow-up, no longer had significantly worse insulin sensitivity than children with NW + NonAdipose.

Conclusion

High BF% in children is associated with significantly lower insulin sensitivity even when BMI is considered NW. Longitudinally, insulin sensitivity is lower in children with high BF% with or without high BMI. The CRF was a significant covariate in these models, but CRF did not completely ameliorate the effects of high BF% on insulin sensitivity.

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Acknowledgements

We gratefully acknowledge the work of numerous research staff and PhD students who have participated in the data collection for the CHAMPS study-DK. We thank children, parents and teachers in the schools involved in the project, and we are grateful for the cooperation with the Svendborg Project, Sport Study Sydfyn and the municipality of Svendborg.

Funding

Funding for the study has been provided by The TRYG Foundation, University College Lillebaelt, University of Southern Denmark, The Nordea Foundation, The IMK Foundation, The Region of Southern Denmark, The Egmont Foundation, The A.J. Andersen Foundation, The Danish Rheumatism Association, Østifternes Foundation, Brd. Hartmann’s Foundation, TEAM Denmark, The Danish Chiropractor Foundation, and The Nordic Institute of Chiropractic and Clinical Biomechanics. Finally, the authors wish to acknowledge the members of the CHAMPS study-DK not listed as coauthors of this paper: C. T. Rexen, E. Jespersen, NC Moller and C. Franz.

Author information

Authors and Affiliations

  1. School of Psychology and Exercise Science, Murdoch University, Murdoch, Australia

    Timothy J. Fairchild & Niels Wedderkopp

  2. Department of Sports Science and Clinical Biomechanics, Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, University of Southern Denmark, Odense, Denmark

    Heidi Klakk, Anders Grøntved & Niels Wedderkopp

  3. University College Lillebaelt, Odense, Denmark

    Heidi Klakk

  4. Hans Christian Andersen Children’s Hospital, Odense University Hospital, Odense, Denmark

    Malene Heidemann

  5. Orthopedic Department, Hospital of South-Western Denmark, Esbjerg, Denmark

    Niels Wedderkopp

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  1. Timothy J. Fairchild
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Correspondence to Timothy J. Fairchild.

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Fairchild, T.J., Klakk, H., Heidemann, M. et al. Insulin sensitivity is reduced in children with high body-fat regardless of BMI. Int J Obes 42, 985–994 (2018). https://doi.org/10.1038/s41366-018-0043-z

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