Background/Objectives: To examine the association between metabolic dysfunction-associated fatty liver disease (MAFLD) and bone mineral density in school-aged children. To investigate the association between metabolic dysfunction-associated fatty liver disease (MAFLD) and bone mineral density among school-aged children using a propensity score-matched study design. Methods: A cross-sectional analysis was performed using baseline data from the Beijing Children and Adolescents Health Cohort, with samples collected between September 2022 and May 2023. The study included 5170 children aged 7-18 years. Standardized questionnaires collected behavioral, lifestyle, and dietary data. Anthropometric measurements (height, weight, waist circumference) were obtained to calculate body mass index (BMI). Fasting venous blood samples were analyzed for glucose and lipid profiles. Clinical assessments included pubertal development evaluation, abdominal ultrasound for hepatic steatosis, oscillometric blood pressure measurement, quantitative ultrasound for calcaneal bone mineral density (BMD), and bioelectrical impedance analysis for body fat percentage. MAFLD was diagnosed as hepatic steatosis combined with metabolic abnormalities (assessed via BMI, blood glucose, lipid levels, and blood pressure). Propensity score matching (PSM) was conducted at a 1:3 ratio between the MAFLD and non-MAFLD groups, matching on age, sex, and pubertal stage. Multiple linear regression, conditional logistic regression, and quantile regression (10th-90th percentiles) were used to analyze the association between MAFLD and BMD. Results: Of 5170 participants, 579 had MAFLD and were matched to 1737 non-MAFLD controls (standardized mean differences < 0.001). Children with MAFLD had higher BMI, body fat percentage, and waist circumference, and lower BMD versus controls. Multiple linear regression confirmed a significant negative association between MAFLD and BMD, which was stronger in boys and mid-pubertal children. Conditional logistic regression analyses further showed that boys with MAFLD had a higher risk of reduced BMD. The odds ratios were 1.77 (95% CI: 1.14-2.75) overall, 2.74 (95% CI: 1.56-4.81) among those aged 12-14 years, 1.81 (95% CI: 1.04-3.17) in mid-puberty, and 2.27 (95% CI: 1.17-4.40) in late puberty. Quantile regression revealed the strongest associations between MAFLD and BMD at the 40th-75th percentiles (regression coefficients: -9.5 to -6.7). Conclusions: MAFLD was associated with lower bone mineral density in children, with the strongest associations observed in the lower-to-middle range. Boys, children in mid-puberty, and those with obesity may represent particularly vulnerable groups with respect to bone health in the presence of MAFLD. This highlights the importance of early MAFLD identification and targeted interventions to mitigate long-term skeletal risks. Prospective studies are needed to clarify the causal pathways between MAFLD and pediatric bone health, and future research should integrate multiple factors to elucidate the underlying mechanisms.

AIMS:Obesity in children is heterogeneous, but BMI-based risk stratification does not capture important differences in body composition or cardiometabolic risk factors. We aimed to develop a body composition-based obesity phenotyping framework and examine its associations with cardiometabolic risk factor transitions. MATERIALS AND METHODS:Utilising nine body composition metrics (whole-body and regional fat/muscle mass index, visceral fat area) from 2262 children with obesity in a training cohort, we applied the Discriminative Dimensionality Reduction Tree algorithm to construct a continuous two-dimensional phenotypic manifold. Modified Poisson regression and spatial autocorrelation analyses were used to evaluate associations between the mapped spatial dimensions and 2-year cardiometabolic risk factors transitions (progression and recovery). The topological framework was externally validated in an independent cohort of 330 children with obesity. RESULTS:Obesity phenotypes were mapped onto two principal axes to define three clinical profiles (mixed fat-muscle elevation, adiposity-dominant, and muscle-dominant), with their underlying structure consistently reproduced across external replication cohort. Dimension 1 was positively associated with progression to hypertension (RR = 1.18, 95% CI 1.09-1.28), high LDL-C (1.29, 1.13-1.49), and hyperuricemia (1.22, 1.13-1.30) and inversely with hypertension recovery (0.84, 0.76-0.92). Dimension 2 showed positive association with hypertension progression (1.27, 1.03-1.58) and inverse association with high LDL-C recovery (0.48, 0.23-0.96). DDRTree-derived dimensions showed no clear predictive advantage over BMI or body composition metrics in most analyses, suggesting the DDRTree manifold should be used for exploratory visualisation rather than clinical prediction. CONCLUSIONS:Phenotypic manifold mapping of childhood obesity identifies body composition subtypes with divergent short-term cardiometabolic risk trajectories.

BACKGROUND AND AIMS:While triglyceride-glucose (TyG) index has been proposed as an indicator of various cardiovascular outcomes, the diagnostic and prognostic value of TyG in obesity phenotypes transition remain unclear. We aimed to investigate the longitudinal association between TyG and transitions between metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO). METHODS AND RESULTS:Data were derived from a 2-year follow-up prospective cohort study included 15,391 children aged 6-16 years in China. A nested case-control design was employed, identifying 331 pairs of incident MUO cases and matched MHO controls, as well as 420 pairs of incident MHO cases and matched MUO controls. Conditional logistic regression was used to analyze the associations between TyG and obesity phenotype transitions. An approximately linear association between TyG and the odds of obesity phenotype transition was observed in sex-stratified restrict cubic spine regression. Per 1-unit increase in TyG index was significantly associated with a 2.39-fold (OR 3.39; 95 %CI 2.20-5.21; P < 0.001) increase in the risk of progression from MHO to MUO, after controlling for sociodemographic factors and baseline cardiovascular parameters. Accordingly, higher TyG levels were linked to decreased odds of transitioning from MUO to MHO (OR 0.17; 95 % CI 0.11-0.26; P < 0.001). The TyG index demonstrated greater variable importance and standardized regression coefficient than other cardiovascular metabolic parameters in the prediction of obesity phenotypes transition. CONCLUSION:Our findings suggest that TyG index is a valuable predictor of pediatric obesity phenotype transitions, highlighting its potential as a valuable tool for obesity management.

Low skeletal muscle mass has been shown to be a predictor of mortality, but very few studies have focused on the association between appendicular skeletal muscle mass and mortality risk in a large sample. This study aimed to determine the associations of low appendicular skeletal muscle mass with all-cause and cause-specific mortality in an adult population in the United States. Data were retrieved from 21,938 participants aged 20–85 years from the National Health and Nutrition Examination Survey (NHANES) (1999–2006 and 2011–2018) and merged with the Public-use Linked Mortality File of 2018. The appendicular skeletal muscle mass index (kg/m2) was determined by the skeletal muscle mass in the arms and legs (in kg) and divided by the square of the height (in meters) 2 (kg/m2). Sex-specific quintiles were then used to categorize the appendicular skeletal muscle mass index. The major outcome in this study was mortality from all causes, and the secondary outcome was mortality from heart disease or cancer. Cox proportional hazards models were used to calculate hazard ratios, and 95% confidence intervals for all-cause and competing risk regression analyses were performed to analyze heart disease mortality and cancer mortality. During a 10.9-year median follow-up, 1632 males and 1253 females died. Compared with those of the 5th quintile of the skeletal muscle index, the fully adjusted HRs (95% CIs) of all-cause mortality were 0.81 (0.72–0.92), 0.63 (0.52–0.76), 0.52 (0.43–0.63), and 0.65 (0.52–0.81) for the 1st, 2nd, 3rd, and 4th quintiles of the skeletal muscle index, respectively. A 20-percentile increase in the appendicular skeletal muscle index was associated with a lower risk of all-cause mortality (HR, 0.86; 95% CI, 0.81–0.91) (P < 0.001 for trend) and a lower risk of cancer mortality (HR, 0.87; 95% CI, 0.78–0.96) (P = 0.009 for trend). High appendicular skeletal muscle mass was associated with decreased all-cause mortality and cancer mortality in adults, and interventions aimed at maintaining appropriate appendicular skeletal muscle mass may help prevent premature death.

Context Bone age assessment (BAA) is critical for pediatric endocrinology. Traditional methods are complex and time-consuming, and current computer-aided systems have made progress but still lacking in robustness. Objective Develop simplified BAA methods to aid pediatricians in quick clinical assessments. Design Overall, 5551 left-hand X-ray images were collected from a cross-sectional survey in 2022 and 2023. Bone age (BA) was assessed using the Tanner-Whitehouse 3-China/radius-ulna-short bone method. The linear regression models were constructed with BA as the dependent variable and 13 radius-ulna-short bone bones' grades as independent variables. Setting A cross-sectional survey in Beijing, China. Participants A total of 5551 children aged 3 to 18 years. Main Outcome Measures Model accuracy was evaluated by R-2, residuals, and root mean square error, and BA with an error margin <= 0.5 years. Results When bone grades were consistent, a single or few bones may serve as proxies for BA, such as metacarpals and phalanges reaching grade 6, the BA for boys and girls were 13.0 to 13.5 years and 10.9 to 11.5 years, respectively. When bone grades were inconsistent, regression models were needed. Comparatively, the 3-bone models have advantages and are proposed for clinically simplified BAA. The simplified 3-bone model (radius, ulna, and metacarpal I) yielded an R-2 > 0.94 and a root mean square error < 0.5 years. When considering puberty stages, specific bone combination models can further improve assessment accuracy. Conclusion These 3-bone models could be useful for rapid BAA, with improved accuracy when puberty stages is included. Further validation is warranted to test their robustness across populations and scenarios.

Abnormal lipid profiles are a major risk factor for cardiovascular diseases, and childhood obesity has been linked to changes in lipid metabolism in adults. However, the relationship between childhood obesity and adult lipid profiles, as well as the potential sex differences, remain unclear. This study aimed to examine the association between childhood obesity and abnormal lipid metabolism in young adults, specifically focusing on sex differences. Data were obtained from the Beijing Blood Pressure Cohort Study, which included 1220 participants aged 28–45 years. Childhood obesity was defined based on body mass index (BMI) and subscapular skinfold thickness (SSFT) measurements. Adult lipid profiles, including triglycerides (TG), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), and total cholesterol (TC), were measured. Logistic regression models were used to assess the association between childhood obesity and adult lipid profiles, adjusting for potential confounders. During the follow-up period, 18 (2.9

Context:Accurate adult height prediction remains a challenge in pediatric endocrinology. Traditional bone age (BA) based methods are time-consuming, software-dependent, and unreliable, while ignoring the critical effect of pubertal progression on growth potential. Objective:In this work we aimed to develop a clinically optimized model for adult height prediction by replacing traditional BA with key bone grades to quantify growth potential, integrating pubertal stages to account for pubertal-stage growth variations, and establishing a direct mapping between "key bone grades + pubertal stage" and height growth potential. Methods:A cross-sectional study was conducted in Beijing (2022-2023). We performed Tanner-Whitehouse 3/radius-ulna-short bone grading and pubertal staging including prepuberty, on puberty, and completing puberty. Spearman analysis identified key bone combinations most associated with BA and height. An integrated model combining bone grades and pubertal stage was developed and validated in an independent cohort followed to adult height. Results:Key Spearman correlation revealed strong correlations of the radius, ulna and metacarpal I grading with BA (ρ = 0.94-0.96), with bone combinations (ρ = 0.98-0.99) outperforming any single bones. Three types of bone combinations (radius + ulna, radius + metacarpal I, and radius + ulna + metacarpal I) integrating with pubertal stages demonstrated approximately equivalent predictive performance for adult height prediction. Considering bone representativeness and feasibility, we prefer to propose the radius + metacarpal I combination with puberty stages as the clinically optimized model for adult height prediction. Independent validation cohort confirmed superior accuracy of the proposed model vs traditional BA-based methods: Mean prediction error was reduced from 0.71 cm to 0.02 cm, while the proportion of predictions error of 3 cm or less increased from 66.9% to 73.5%. Conclusion:The integrated bone-puberty model significantly improves prediction accuracy by incorporating skeletal maturity and pubertal dynamics. Its streamlined 2-bone protocol offers a practical tool for growth monitoring and clinical decision-making.

ObjectiveThis study aimed to analyze the growth patterns of height and foot length (FL) among Chinese children aged 3–18 and examine their associations with puberty development.MethodsA cross-sectional survey was conducted in September 2022 in Beijing. Data were collected through questionnaires and on-site physical examinations. The growth patterns and velocity of height and FL in different age groups were described, and their associations with puberty development were analyzed.ResultsFrom an age perspective, the peak FL growth occurred between 9 and 11 years (boys were 11 years and girls were 9 years), while the peak height growth occurred at 11 ~ 13 years for boys and 9 ~ 11 years for girls. Additionally, boys and girls reached 99.0% of their final FL at the ages of 14 and 13, respectively, while they reached 99.0% of their final height at the ages of 16 and 15, respectively. From the perspective of Tanner stage, the age of peak FL growth in boys coincided with the age of the G2 stage, while in girls it occurred slightly earlier than the mean age of the B2 stage. The peak height growth for both boys and girls occurred between Tanner stages 2 and 3.ConclusionBoys and girls reach their peak FL growth at 11 and 9 years old, respectively, which were both 2 years earlier than their peak height growth. The peak FL growth occurred around the onset of puberty, while the peak height growth occurred between Tanner stages 2 and 3.

The aim of the study was to investigate the association between serum ferritin and hypertension among American adults from National Health and Nutrition Examination Survey (NHANES) 1999 to 2018. A total of 16,125 participants were included. Weighted logistic regression and subgroup analyses were performed to explore the association. We found that serum ferritin was closely correlated to hypertension. Individuals with high serum ferritin were more likely to have higher systolic or diastolic blood pressure (SBP, DBP) than those with lower serum ferritin. Restricted cubic spline showed a significant non-linear association between serum ferritin and SBP/DBP. Higher level of serum ferritin (Q3 74.1-147 mu g/L and Q4 > 147 mu g/L) was found to have positive association with high SBP [Q3 (OR: 1.246, 95% CI:1.020-1.523), Q4 (OR: 1.354, 95% CI:1.096-1.674)], and hypertension [Q3 (OR: 1.283, 95% CI:1.099-1.499), Q4 (OR: 1.424, 95% CI:1.197-1.63)] in the whole population. In people aged between 20 and 60, subjects with high serum ferritin were significantly associated with a higher risk of hypertension, but in those over 60, the relationship between serum ferritin level and hypertension is negative. A non-linear association between serum ferritin and SBP, as well as DBP, was discovered. There was age difference in association between serum ferritin and hypertension in American adults, and further researches were needed to understand the mechanisms behind the difference.

Background: There is limited research providing an overall understanding of bone mineral density (BMD) changes throughout different stages of life. This study aimed to investigate the pattern of BMD changes across childhood, adolescence, adulthood, and old age, as well as exploring the critical time of peak BMD (PBMD). Methods: Participants of three major ethnicities from National Health and Nutrition Examination Survey 1999 to 2018 were involved: 46,381 and 20,944 participants aged 8–85 years old were included in the Lumbar spine BMD (LSBMD) and femoral neck BMD (FNBMD) studies, respectively. BMD was measured using dual-energy X-ray absorptiometry. The generalized additive model was used to construct smoothed percentile curves. Results: Both males and females experienced a sharp increase in LSBMD during puberty, with females reaching their PBMD earlier than males. Females’ LSBMD remained higher than males’ before the age of approximately 50, except for Non-Hispanic Blacks. For males, LSBMD reached a plateau at around 30 years old after reaching the peak value. Females exhibited two peak points on the fitted curves, with the second PBMD occurring around 36–37 years old. Ethnic variations were observed, with Non-Hispanic Blacks displaying the highest BMD levels at all ages. Non-Hispanic Whites and Mexican Americans had lower BMD levels, with Mexican Americans generally exhibiting the lowest BMD. FNBMD reached its peak earlier than LSBMD, and males consistently had higher FNBMD than females. Conclusions: This nationally representative study contributes to the understanding of BMD changes across the lifespan, and might provide guidance for bone health interventions in different population groups.

Background and aim: Obesity and hyperuricemia (HUA) often coexist and have been widely accepted as risk factors for hypertension, but the role of uric acid (UA) in the relationship between obesity and hypertension remains unknown in children and adolescents.Methods and results: A total of 7525 subjects aged 6-16 years were from the School-based Cardiovascular and Bone Health Promotion Program (SCVBH) at baseline (2017) and followed up in 2019. Multivariable logistic regression with interaction terms, cross-lagged panel analysis, and causal mediation model were applied to delineate the joint impact of obesity and HUA on hyper-tension, including the interaction effect, the temporal association, and the mediating effect of UA in the relationship between obesity and hypertension. There were 10.8 % of the participants with normotension at baseline developed hypertension after two years of follow-up. Cross-lagged panel analysis showed that the two-time point association was significant only from baseline BMI to follow-up UA (b 1 = 0.302, P < 0.001), but not from baseline UA to follow-up BMI (beta 2 = 0.002, P = 0.745). Multivariable logistic regression showed that both obesity and HUA increased the risk of hypertension, but no interaction effect between HUA and obesity. The causal mediation analysis found that UA partially mediated the association between BMI and SBP (mediate proportion: 20.3 %, 95 % CI: 17.4-22.9 %) or DBP (mediate proportion: 11.9 %, 95 % CI: 3.9-18.2 %). The results were consistent in the analysis of systolic hypertension rather than diastolic hypertension.Conclusions: It is mediating effect that UA played in the progress from obesity to hypertension, particularly systolic hypertension in children and adolescents.(c) 2023 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

Background and aims: Although the associations of vitamin D with obesity and metabolic abnormalities have been reported, the role of vitamin D in the transition of obesity phenotype remains unclear but is highly desired since it is crucial to identify potential methods for obesity management. Therefore, we aimed to investigate the relationship between vitamin D and the risk for metabolically unhealthy obesity (MUO) or metabolically healthy obesity (MHO) in metabolically healthy children with 2 years of follow-up.Methods: Data were collected from a population-based cohort consisting of 6424 metabolically healthy children aged 6-16 years at baseline. Metabolic abnormalities including hypertension, high triglycerides (TG), low high-density lipoprotein cholesterol (HDL-C), hyperglycemia, and hyperuricemia were assessed both at baseline and follow-up. Baseline serum 25-hydroxyvitamin D (25[OH]D) concentrations were measured as exposure. The obesity phenotype transition was evaluated by weight status with the combination of metabolic health status from baseline to follow-up.Results: During a 2-year follow-up, 889 (13.8 %) incident MUO cases occurred. For participants with obesity, each 10 nmol/L increment in 25(OH)D concentrations was associated with a 21 % (95%CI: 13 %similar to 43 %) and a 7 % (95%CI: 1 %similar to 14 %) decreased risk in high TG and hyperuricemia, respectively. A 51 % (95%CI: 22 %similar to 69 %) lower risk of MUO was observed in participants with sufficient vitamin D levels (>= 50 nmol/L) compared to those with vitamin D deficiency (<30 nmol/L). Besides, among children who were MHO at baseline, those with sufficient vitamin D levels (>= 50 nmol/L) were more likely to transition to metabolically healthy normal weight (MHNW) than vitamin D deficient individuals (<30 nmol/L).Conclusions: Vitamin D may prevent the development of MUO and help increase the transition from MHO to MHNW. The findings highlight that vitamin D might be an effective nutrient for obesity management.

ObjectiveTo investigate how serum 25-hydroxyvitamin D (25[OH]D) affects height growth velocity and the risk of low bone mineral density (BMD) in children.DesignA population-based prospective cohort study.Patients and methodsA total of 10 450 participants with complete follow-up records from a cohort were included in the current study. Serum 25(OH)D concentrations were measured at baseline and 2-year follow-up, and the average of 2-time measurements was used for analysis. Low BMD was defined as calcaneus speed of sound Z-score ≤ −1. The associations of vitamin D with height growth velocity and the risks of incident low BMD were evaluated using adjusted β and risk ratio (RR).ResultsAfter multivariable adjustment, an inverse L-shaped association between serum 25(OH)D concentrations and height growth velocity was observed, leveling off up to 40–60 nmol/L. Overall, each 10 nmol/L higher serum 25(OH)D concentration was associated with a 0.15 cm/year higher height growth velocity (P < 0.001) and a 7% decreased risk of low BMD [RR (95%CI): 0.93 (0.87~0.98)]. Compared to those with vitamin D deficiency, participants who had sufficient vitamin D had a 22% lower risk for low BMD [RR(95%CI): 0.78 (0.62~0.98)]. However, no significant associations between vitamin D and the risk of low BMD were found in overweight and obese children.ConclusionThese findings highlight the importance of maintenance of sufficient 25(OH)D concentrations and healthy body weight during childhood in height growth and bone health promotion.

Background: Understanding the age-related change of bone mineral density (BMD) is crucial for improving bone health and early prevention of osteoporosis. To explore the overall picture of the change of BMD across life course, and to identify the time of peak BMD (PBMD).Methods: Participants of three major ethnicities with valid BMD data from National Health and Nutrition Examination Survey 1999 to 2018, a series nationally representative cross-sectional surveys, were involved. 46381 and 20944 participants aged 8-85 years old were included for LSBMD and FNBMD study respectively. Lumbar spine BMD (LSBMD) and femoral neck BMD (FNBMD) were measured with DXA (dual-energy X-ray absorptiometry). The max value of weighted mean BMD of particular age was calculated to represent the PBMD. The generalized additive model was used to construct smoothed percentile curves.Findings: 46381 and 20944 participants were included for LSBMD and FNBMD study respectively. Females’ LSBMD were higher than males’ before age of around 50 for Mexican Americans and Non-Hispanic Whites, but for Non-Hispanic Black this trend stopped when reaching females’ PBMD. For males, the LSBMD started to decrease slightly after reaching the peak value, and then reached to a plateau at about 30 years old. Males’ LSBMD peaked later than that of females, and FNBMD reached peak value earlier than LSBMD. Males’ FNBMD was higher at all ages and peaked later than females. For males, the FNBMD started to decrease after the PBMD, and almost no plateau was found. But for females, the FNBMD started to decrease after the PBMD, and then reached a plateau, since when all of their femoral neck had a continuous bone mineral loss. Females reached their femoral neck PBMD 1-2 years earlier than males, and the age gaps were less than that for lumbar spine PBMD (2-4 years).Interpretation: An overall picture of changes on human lumbar spine and femoral neck BMD was plotted. Bone mineral mainly accumulates during puberty. Lumbar spine BMD peaked at the first half of the third decade, later than femoral neck. Females have earlier peak of BMD than males, and the peak differs by ethnicity and regions.Funding: This research was funded by the National Natural Science Foundation of China (Grant number: 82103862), and the Public Service Development and Reform Pilot Project of Beijing Medical Research Institute (Grant number: BMR2021-3).Declaration of Interests: The authors declare no conflict of interest.Ethics Approval Statement: The NCHS Research Ethics Review Board approved NHANES, and informed consent was obtained from all subjects involved in the study. Both parental consent and child assent were required for children aged 7–17 years in the examination part, while parental consent alone was sufficient for children aged 0-6 years.

Objectives To investigate the relationship between antibiotic exposure and asthma in adults in the United States. Methods Data was obtained from the National Health and Nutrition Examination Survey (NHANES) conducted between 1999 and 2018. A total of 51,124 participants were included, excluding those who were aged < 20 years, female participants who were pregnant, and individuals who did not complete the prescription medications questionnaire and the medical conditions questionnaire regarding asthma status. Antibiotic exposure was defined as the utilization of antibiotics within the past 30 days, categorized based on the Multum Lexicon Plus therapeutic classification system. Asthma was defined as having a history of asthma or having an asthma attack or wheezing symptoms in the past year. Results The risk of asthma was found to be 2.557 (95% CI: 1.811, 3.612), 1.547 (95% CI: 1.190, 2.011) and 2.053 (95% CI: 1.344, 3.137) times greater in participants who had used macrolide derivatives, penicillin and quinolones in the past 30 days, respectively, compared with those not using antibiotics. After adjusting for demographic covariates and asthma-related factors, only macrolides derivatives were significantly associated with asthma in the 20–40 and 40–60 age groups. For individuals over 60 years old, quinolones were significantly associated with asthma. The effect of different types of antibiotic with asthma varied in male and female populations. Moreover, higher socioeconomic status, greater BMI, younger age, smoking habits, history of infection, chronic bronchitis, emphysema, and family history of asthma were all identified as risk factors for asthma. Conclusion Our study indicated that three types of antibiotics were significantly associated with asthma in different subgroups of the population. Therefore, the use of antibiotics should be more strictly regulated.

Background Accurate assessment of body composition (BC) is important to investigate the development of childhood obesity. A bioelectrical impedance analysis (BIA) device is portable and inexpensive compared with air displacement plethysmography (ADP) for the assessment of BC and is widely used in children. However, studies of the effectiveness of BIA are few and present different results, especially in pediatric populations. The aim of this study was to evaluate the agreement between BIA and ADP for estimating BC. Methods The BC of 981 Chinese children (3–5 years) was measured using the BIA device (SeeHigher BAS-H, China) and ADP (BOD POD). Results Our results showed that BIA underestimated fat mass (FM) and overestimated fat-free mass (FFM) in normal weight children ( P < 0.05), but the opposite trend was shown in children with obesity ( P < 0.05). The agreement between FM and FFM measured by the two methods was strong (CCC > 0.80). The linear regression equation of 5-year-old children was constructed. Conclusion The SeeHigher BAS-H multi-frequency BIA device is a valid device to evaluate BC in Chinese preschool children compared with ADP (BOD POD), especially in 5-year-old children or children with obesity. Further research is needed to standardize the assessment of BC in children.

Background and ObjectivesVitamin D has been indicated to play an important role in the optimal function of the cardiovascular system. However, with limited evidence, it remains unclear whether vitamin D status transition during childhood would affect cardiometabolic risk factors. Thus, we aimed to identify the associations of the longitudinal trajectory of vitamin D status with cardiometabolic risk factors in children.MethodsA total of 10,482 participants with complete follow-up records from a large population-based prospective cohort study were included in this analysis. The 25-hydroxyvitamin D [25(OH)D] concentrations, blood pressure, blood lipids, and fasting blood glucose were determined. Vitamin D deficiency was defined as serum 25(OH)D concentrations below 30 nmol/L according to the Institute of Medicine recommendations. Based on the vitamin D status at baseline and follow-up, we identified four possible trajectories: (1) persistent non-deficiency (reference); (2) baseline non-deficiency to follow-up deficiency; (3) baseline deficiency to follow-up non-deficiency; (4) persistent deficiency. The relationships between cardiometabolic risk factors and vitamin D trajectories were evaluated using adjusted risk ratios (RRs).ResultsOverall, 35.1 and 24.2% of participants had vitamin D deficiency at the baseline and follow-up, respectively, and 15.1% were under the condition of persistent vitamin D deficiency. Compared to children with persistent non-deficiency, those who shifted from non-deficiency at baseline to deficiency at follow-up had a 2.09-fold (95% CI: 1.36, 3.23) increased risk of high triglyceride (TG). Besides, children with altered vitamin D status from deficiency to non-deficiency during follow-up were still at a significantly higher risk of high total cholesterol (TC) than the reference group [RR (95% CI): 1.39 (1.04, 1.86)]. Finally, children with persistent vitamin D deficiency were at the highest risks of high TC [RR (95% CI): 1.61 (1.18, 2.19), Ptrend < 0.001], high low-density lipoprotein cholesterol (LDL-C) [RR (95% CI): 1.53 (1.04, 2.27), Ptrend = 0.046], and high TG [RR (95% CI): 1.96 (1.34, 2.87), Ptrend = 0.003].ConclusionOur results suggest that persistent vitamin D deficiency might increase the risk of dyslipidemia in children, and vitamin D deficiency could have has short- and long-term effects on TG and TC, respectively.

ObjectiveTo describe the characteristics of body composition by air-displacement plethysmography (ADP) among Chinese preschool children.MethodsPreschool children were recruited from three kindergartens. Adiposity indices were evaluated using the ADP method. BMI, fat mass index (FMI), fat-free mass index (FFMI) and waist-to-height ratio (WHtR) were calculated. Overweight and obesity were diagnosed using the WHO reference. Analyses were executed by SPSS and MedCalc software. Smoothed curves were constructed using the lambda-mu-sigma (LMS) method.ResultsThis study evaluated the growth trend for body composition of ADP-based body fat indices based on a relatively large sample of preschool children, the first ever reported in China. A total of 1,011 children aged 3–5 years comprised our study population. BMI and FFMI increased with age, but the slope (P = 0.710) and y intercept (P = 0.132) in the BMI trend analysis demonstrated no differences between boys and girls. For the FFMI trend lines, the slope was significantly higher for boys than for girls (P = 0.013). The percentage of fat mass (FM%), FMI, and WHtR were negatively correlated with age for both sexes, except for FMI in girls (P = 0.094). The 95% CI regression lines for FM% according to different weight statuses intersected.ConclusionsADP is applicable to estimating body composition among Chinese preschool children. Misclassifications might occur when overweight/obese status is defined based on surrogate indices.

To assess the relationship between fat mass percentage (FMP) and glucose metabolism in children aged 0–18 years we performed a systematic review of the literature on Medline/PubMed, SinoMed, Embase and Cochrane Library using the PRISMA 2020 guidelines up to 12 October 2021 for observational studies that assessed the relationship of FMP and glucose metabolism. Twenty studies with 18,576 individuals were included in the meta-analysis. The results showed that FMP was significantly associated with fasting plasma glucose (FPG) (r = 0.08, 95% confidence interval (CI): 0.04–0.13, p < 0.001), fasting plasma insulin (INS) (r = 0.48, 95% CI: 0.37–0.57, p < 0.001), and homeostasis model assessment (HOMA)- insulin resistance (IR) (r = 0.44, 95% CI: 0.33–0.53, p < 0.001). The subgroup analysis according to country or overweight and obesity indicated that these associations remained significant between FMP and INS or HOMA-IR. Our results demonstrated that there is a positive relationship between FMP and FPG. Moreover, subgroup analysis according to country or overweight and obesity indicated that FMP is significantly associated with INS and HOMA-IR. This is the first known systematic review and meta-analysis to determine the associations of FMP with glucose metabolism in children and adolescents.