AUTHOR=Gilardini Luisa , Croci Marina , Cavaggioni Luca , Pasqualinotto Lucia , Bertoli Simona 

TITLE=Sex differences in cardiometabolic risk factors and in response to lifestyle intervention in prepubertal and pubertal subjects with obesity

JOURNAL=Frontiers in Pediatrics

VOLUME=12

YEAR=2024

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2024.1304451

DOI=10.3389/fped.2024.1304451

ISSN=2296-2360

ABSTRACT=<sec><title>Objectives</title><p>Childhood obesity is a growing health problem and requires a tailored treatment. This study explored the sex differences in cardiovascular risk factors in children/adolescents with obesity and in response to a weight loss intervention.</p></sec><sec><title>Methods</title><p>Five hundred and thirty-three children/adolescents with obesity and their parents underwent to a 3-months lifestyle intervention program. Tanner criteria were used to assess the pubertal stage. Before and after 3 months, anthropometric measurements, blood pressure (BP), and biochemical measurements were assessed.</p></sec><sec><title>Results</title><p>Four hundred and forty five participants completed the treatment (age 12.4 ± 2.7 years, males 45.8%, prepubertal 29.2%, BMI <italic>z</italic> score 2.3 ± 0.2). In comparison to boys, prepubertal girls had higher values of BMI <italic>z</italic> score (2.4 ± 02 vs. 2.3 ± 0.2, <italic>p</italic> &lt; 0.05), waist circumference <italic>z</italic> score (2.2 ± 0.3 vs. 2.0 ± 0.3, <italic>p</italic> &lt; 0.05), HOMA-IR [2.9 (2.1–4.9) vs. 2.3(1.5–3.6), <italic>p</italic> &lt; 0.01], prevalence of hypertransaminasemia (41.3% vs. 17.7%, <italic>p</italic> &lt; 0.05) and lower levels of HDL cholesterol (46.2 ± 9.8 vs. 51.2 ± 10.5 mg/dl, <italic>p</italic> &lt; 0.05). In the pubertal stage, boys had worse cardiometabolic risk profile than girls, including unfavourable measure of systolic BP (<italic>z</italic> score: 0.6 ± 1.0 vs. 0.3 ± 1.0, <italic>p</italic> &lt; 0.01), fasting glucose (87.2 ± 6.1 vs. 84.8 ± 7.7 mg/dl, <italic>p</italic> &lt; 0.01), ALT (26.9 ± 21.5 vs. 20.2 ± 10.6 U/L, <italic>p</italic> &lt; 0.001) and uric acid (6.1 ± 1.9 vs. 5.0 ± 1.0 mg/dl, <italic>p</italic> &lt; 0.001). After the lifestyle intervention, changes in BMI <italic>z</italic> score (<italic>p</italic> &lt; 0.05) were higher in pubertal boys than pubertal girls. The systolic blood pressure decrease was greater in pubertal boys than in their female counterpart (Δ systolic BP: −7.2 mmHg in boys vs. −3.6 mmHg in girls, <italic>p</italic> &lt; 0.05; Δ systolic BP <italic>z</italic> score: −0.6 in boys vs. −0.3 in girls, <italic>p</italic> &lt; 0.05). LDL cholesterol showed an improvement only in boys, and ALT in the whole group.</p></sec><sec><title>Conclusion</title><p>Our study showed that a short-term lifestyle intervention is more effective in reducing BMI <italic>z</italic> score and cardiovascular risk factors in pubertal boys than in their female counterparts. Further investigation is needed to deepen this gender difference, especially to develop a tailor-made intervention.</p></sec>