Iron Status and Metabolically Unhealthy Obesity in Prepubertal Children

• Published in: Obesity (Silver Spring, Md.) Vol. 27; no. 4; pp. 636 - 644
• Main Authors: Suárez‐Ortegón, Milton Fabian, Echeverri, Isabella, Prats‐Puig, Anna, Bassols, Judit, Carreras‐Badosa, Gemma, López‐Bermejo, Abel, Fernández‐Real, Jose Manuel
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.04.2019
• Subjects: Adolescent; C-Reactive Protein - metabolism; Child; Child, Preschool; Cross-Sectional Studies; Exercise; Female; Health risk assessment; Humans; Insulin resistance; Iron - blood; Male; Metabolic Syndrome - blood; Metabolic Syndrome - complications; Obesity; Overweight - blood; Overweight - complications; Pediatric Obesity - blood; Pediatric Obesity - complications; Phenotype; Pilot Projects; Puberty - physiology; Sexual Maturation - physiology; Teenagers
• ISSN: 1930-7381; 1930-739X
• DOI: 10.1002/oby.22425

Objective This study aimed to evaluate the association of metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO) with iron status markers in prepubertal children. Methods Three hundred twelve prepubertal children with overweight and obesity from a pediatric general Spanish population were evaluated. MHO and MUO were defined as obesity with the absence or presence of metabolic syndrome components. Phenotypes of metabolically healthy overweight including obesity (MHOV) and metabolically unhealthy overweight including obesity (MUOV) were also studied and defined using the same criteria. Serum ferritin, transferrin, and blood hemoglobin levels were evaluated. Results Prevalence rates of MHOV and MHO were 35% (n = 111/312) and 27.1% (n = 42/155), respectively. Ferritin and hemoglobin levels were higher in children with MUOV versus MHOV (P < 0.05). MUO was positively associated with ferritin (beta [95% CI] = 0.43 [0.05 to 0.81]) and hemoglobin levels (0.43 [0.05 to 0.81]). These associations remained significant independently of age, sex, C‐reactive protein, physical activity, and BMI/waist z scores in bivariate linear regression models. In multivariable models, transaminase levels attenuated the association of MUO with ferritin and hemoglobin levels (P > 0.05). Conclusions MUOV and MUO are associated with higher ferritin and hemoglobin levels in prepubertal children affected by overweight and obesity. Increased circulating ferritin in MUO might be influenced by liver injury.