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Pediatrics

Body fat, cardiovascular risk factors and brain structure in school-age children

Abstract

Background

In adults, cardiovascular risk factors are known to be associated with brain health. We hypothesized that these associations are already present at school-age. We examined the associations of adverse body fat measures and cardiovascular risk factors with brain structure, including volumetric measures and white matter microstructure, in 10-year-old children.

Methods

We performed a cross-sectional analysis in a population-based prospective cohort study in Rotterdam, the Netherlands. Analyses were based on 3098 children aged 10 years with neuroimaging data and at least one measurement of body fat and cardiovascular risk factors. Body fat measures included body mass index (BMI), fat mass index and android fat mass percentage obtained by Dual-energy X-ray absorptiometry. Cardiovascular risk factors included blood pressure, and serum glucose, insulin and lipids blood concentrations. Structural neuroimaging, including global and regional brain volumes, was quantified by magnetic resonance imaging. DTI was used to assess white matter microstructure, including global fractional anisotropy (FA) and mean diffusivity (MD).

Results

As compared to children with a normal weight, those with underweight had a smaller total brain and white matter volumes (differences −18.10 (95% Confidence Interval (CI) −30.97,−5.22) cm3, −10.64 (95% CI −16.82,−4.47) cm3, respectively). In contrast, one SDS (Standard Deviation Score) increase in fat mass index was associated with a smaller gray matter volume (differences −3.48 (95% CI −16.82, −4.47) cm3). Also, one SDS increase in android fat mass percentage was associated with lower white matter diffusivity (difference −0.06 (95% CI −0.10, −0.02) SDS). None of the other cardiovascular risk factors were associated with any of the brain outcomes.

Conclusions

Body fat measures, but not other cardiovascular risk factors, were associated with structural neuroimaging outcomes in school-aged children. Prospective studies are needed to assess causality, direction and long-term consequences of the associations.

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Code availability

The code/datasets generated during and/or analyzed during the current study are not publicly available but are available from the corresponding author on reasonable request.

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Acknowledgements

We gratefully acknowledge the contribution of the participating children, their mothers, general practitioners, hospitals, midwives and pharmacies in Rotterdam. The Generation R Study is conducted by the Erasmus Medical Center in close collaboration with the School of Law and Faculty of Social Sciences of the Erasmus University Rotterdam, the Municipal Health Service Rotterdam area, Rotterdam, the Rotterdam Homecare Foundation, Rotterdam and the Stichting Trombosedienst and Artsenlaboratorium Rijnmond (STAR), Rotterdam.

Funding

The general design of the Generation R Study is made possible by financial support from the Erasmus Medical Center, Rotterdam, the Erasmus University Rotterdam, the Netherlands Organization for Health Research and Development (ZonMw), the Netherlands Organization for Scientific Research (NWO), and the Ministry of Health, Welfare, and Sport. Dr VWVJ received grants from the European Research Council (ERC-2014-CoG-648916). This project was supported by funding support from the European Union’s Horizon 2020 research and innovation programme under grant agreements No 733206 (LifeCycle). Dr HEM was supported by Stichting Volksbond Rotterdam, the Dutch Brain Foundation (De Hersenstichting, project number GH2016.2.01) and the NARSAD Young Investigator Grant from the Brain & Behavior Research Foundation (grant number 27853). Supercomputing computations were supported by the NWO Physical Sciences Division: Exacte Wetenschappen, and SURFsara: Cartesius computer cluster [www.surfsara.nl].

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CCVS and HM had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. HM and VWVJ contributed to study concept and design. All authors contributed to analysis and interpretation of data. CCVS, VWVJ and HM contributed to drafting of the paper. All authors contributed to critical revision of the paper for important intellectual content.

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Correspondence to Hanan El Marroun.

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Silva, C.C.V., Jaddoe, V.W.V., Muetzel, R.L. et al. Body fat, cardiovascular risk factors and brain structure in school-age children. Int J Obes 45, 2425–2431 (2021). https://doi.org/10.1038/s41366-021-00913-3

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