Important clues from blood lipid profiling in children with obesity may help predict future health problems like diabetes, heart disease, and steatotic liver disease. This opens the opportunity for a simple blood test to assess the risk of cardiometabolic diseases in children with obesity.
The number of children and teens with obesity is increasing worldwide, with over 250 million expected to be affected by 2030. It is a major public health crisis, as children with obesity risk developing insulin resistance, fatty liver, and high blood pressure, which may lead to diseases such as heart disease, type 2 diabetes and liver disease later in life. These health issues are connected to changes in the fats and oils in the body, so-called lipids.
Now, scientists at the University of Copenhagen have discovered that abnormal levels of lipid species, already known to be linked to heart and metabolic diseases in adults, are also associated with cardiometabolic risk factors in children with obesity. These results could lead to blood tests that would act as early warnings for future health problems.
"Our study shows that the impact of cardiometabolic associated lipid species emerges early in life in children with obesity, particularly affecting liver function and glucose metabolism," says Yun Huang, postdoc at the Novo Nordisk Foundation Center for Metabolic Research and first author of the study. The researcher adds:
"These risk lipid species could potentially be explored further as biomarkers for diagnosing or predicting cardiometabolic risk in children at high risk, offering new insights for early detection and intervention."
Lipids have traditionally been measured as good or bad cholesterol and triglycerides, and for many years, scientists have relied on these to assess disease risks. However, advancements in a chemistry technique called mass spectrometry have revealed that the body contains hundreds of different types of lipid species, allowing for a deeper understanding of how various lipids contribute to health risks.
A blood test to assess risk
The study involved analyzing the blood of nearly 1,000 children with obesity and comparing it to children with normal weight. The scientists also followed 186 children through a year of healthy lifestyle changes, including diet and exercise. The results were promising: 83% of these children lost weight.
In addition to the weight loss, the researchers discovered that the changes in lipids play a role in explaining the link between weight loss and improvements in the children's cardiometabolic traits.
Based on the results of their study, the researchers hope that it in the future will be possible for practitioners to draw a simple blood test to assess whether the child with obesity will be at risk of developing health issues such as prediabetes, hypertension and steatotic liver disease, which can develop into more severe complications later in life.
"This study reinforces the need to treat childhood obesity far more seriously, as it increases the risk of developing a range of diseases that lower quality of life," says Professor Torben Hansen from the Novo Nordisk Foundation Center for Basic Metabolic Research at the University of Copenhagen, and senior author of the study and adds:
"Thankfully, we have shown that early intervention can reverse the risk and allow children and teenagers the possibility of living long disease-free lives as adults."
How the researchers did
The scientists made their discoveries by drawing on the HOLBAEK Study biobank of more than 4,000 children with and without obesity at the Children's Obesity Clinic at Holbæk Hospital. Together with scientists at Steno Diabetes Center Copenhagen, they harnessed powerful mass spectrometry technology to map hundreds of individual lipid species, each with distinct structures and functions, providing a detailed picture of lipid metabolism. By analyzing the differences in the lipid profiles of 958 children with overweight or obesity and 373 who had normal weight, they gained deep insight into obesity altered lipid profiles and their link to cardiometabolic risk, and the ability to detect excessive fat in the liver.
To see how the lipid profiles of the children and teenagers would respond to a lifestyle intervention, 186 participants who underwent a one-year obesity management program at the Children's Obesity Clinic were examined before and after the treatment. The clinic is an accredited European Centre for Obesity Management that practices the Holbæk Obesity Treatment method, which comprises a range of lifestyle recommendations. 83 percent of participants reduced their weight, and the scientists discovered that levels of harmful lipids had clearly reduced alongside the weight loss. These changes in lipid species play a role in explaining the link between weight loss and improvements in cardiometabolic traits.
