Association of inflammation with adiposity related metabolic derangements and waist-to-height ratio in predicting insulin resistance and low-grade inflammation among 8-9-year-old children in an urban area of Sri Lanka

Background: The inflammatory link between high adiposity and metabolic derangements and the usefulness of waist-to-height ratio (WHtR) in screening low grade inflammation and insulin resistance (IR) have not been documented among Sri Lankan children. Objectives: To describe association of inflammation with adiposity related metabolic derangements and develop cut-off values for WHtR in predicting IR and low-grade inflammation among 8-9-year-old children from an urban area of Sri Lanka Method: This paper analysed data collected for a case-control study where children with high body fat (BF) (n=147; male-76) and normal BF (n=152; male-75) were recruited from primary schools in the Colombo Municipal Council area. Anthropometry, % BF, fasting blood sugar, insulin, total cholesterol, high density lipoprotein-cholesterol, triglyceride, low density lipoprotein-cholesterol, high sensitivity C-reactive protein (hs-CRP), leptin, adiponectin and homeostasis model of IR were analysed. In addition, cut-offs of WHtR were developed to predict IR (>1.7) and low-grade inflammation (hs- CRP>1mg/L). Results: High BF group had significantly higher metabolic and inflammatory parameters than normal BF group in both sexes except adiponectin which was low in high BF group. Metabolic parameters were significantly higher among those with IR in males and females. Children with inflammation had higher %BF, WHtR and metabolic parameters than those with no inflammation. WHtR of 0.47 and 0.45 to detect inflammation, and 0.48 and 0.46 to detect IR, among males and females respectively showed good sensitivity and specificity. Conclusions: Inflammation and metabolic derangements increase with BF. WHtR is useful in screening for development of inflammation and IR.