044 - Sex Differences in Associations among Cardiometabolic Risk Factors and Serum Steroids in Adolescents with Obesity

Publication Number: 44.6924

Robin Shoemaker, University of Kentucky College of Medicine, Lexington, KY, United States; Margaret Murphy, University of Kentucky College of Medicine, Lexington, KY, United States; Hong Huang, University of Kentucky, Lexington, KY, United States; Yasir Alsiraj, University of Kentucky College of Medicine, Lexington, KY, United States; Aric Schadler, University of Kentucky Healthcare, Lexington, KY, United States; Aurelia Radulescu, University of Kentucky, Lexington, KY, United States; John A. Bauer, University of Kentucky College of Medicine, Lexington, KY, United States

Background: Rates of obesity and elevated blood pressure are increasing in children and adolescents, both in the United States and globally. Mechanisms linking these conditions are not well-understood.

Objective: We examined associations among concentrations of steroid hormones in serum with cardiometabolic risk factors (elevated blood pressure, blood glucose, total cholesterol to high density lipoprotein ratio, blood urea nitrogen, and ALT and/or AST) in girls and boys with obesity.

Design/Methods: As part of a pilot study, we recruited 82 children and adolescents (ages 12-17) with body mass index greater than the 95th percentile from a High BMI Clinic. Clinical data and blood samples were collected at the initial clinic visit. Serum concentrations of glucocorticoids, mineralocorticoids, and sex hormones were quantified using liquid chromatography with mass spectrometry. Data were grouped by sex (42 boys and 40 girls), and data were analyzed using 2-way ANOVA and uni/multivariate analysis.

Results: Both boys and girls with high BMI exhibited multiple cardiometabolic risk factors, and 82% from each group had three or more cardiometabolic risk factors. Sex differences were observed, where girls had higher diastolic blood pressure compared to boys (69.4 + 8.6 versus 66.4 + 5.1 mmHG; P< 0.05), and boys had higher ALT and AST levels and higher blood urea nitrogen. Age-adjusted analysis revealed greater serum concentrations in girls compared to boys of cortisol (100.3 + 69.8 versus 63.0 + 28.9 ng/mL; P< 0.05), and other sex differences among aldosterone (272.5 + 369.9 in girls versus 148.3 + 107.9 pg/mL in boys; P< 0.05) and sex hormones (androstenedione, testosterone, and estrogen). There was a significant interaction between sex and cortisol (p=0.023) for diastolic blood pressure in girls, but not boys.

Conclusion(s): Sex differences exist in cardiometabolic risk factors and co-existing conditions in adolescents with obesity. This may be partly attributed to differences in the interactions among sex hormones and gluco- and mineralocorticoids on blood pressure and other pathways associated with increased adiposity. Improved knowledge of mechanisms underlying the development of obesity with comorbid conditions in youth (and differences among girls and boys) may lead to improved strategies for risk classification and treatment.