Metabolic Risk Factors Are Associated With Weight Status Change Over Four Years in Children Aged 4–6 Years With Obesity

AIM: It is unclear how early childhood obesity treatment affects metabolic risk. This study assessed long-term metabolic health in children with obesity aged 4-6 years and examined associations with weight status. METHODS: This prospective cohort study pooled data from the Sweden-based More and Less randomized controlled trial, which compared a parent support program with standard care in 2012-2016. Children met the International Obesity Task Force (IOTF) criteria for obesity. Anthropometrics and metabolic risk factors were collected at baseline, 12 and 48 months. Associations between metabolic markers and weight status were examined using linear mixed models. RESULTS: Data from 106/177 (60%) children, mean age at baseline 5.3 years, were analysed. At baseline, 33/90 (36.6%) had elevated metabolic risk markers. At 48 months, one unit of body mass index standard deviation score (BMI SDS) was associated with higher glycosylated haemoglobin (HbA1c IFCC) (0.99 mmol/mol), higher fasting insulin (2.72 mIU/L) and lower high-density lipoprotein (HDL) (-0.16 mmol/L or -6.2 mg/dL). A BMI SDS reduction ≥ 0.25 was associated with lower HbA1c and triglycerides at 12 months, and a reduction ≥ 0.5 with lower total cholesterol at 48 months. CONCLUSION: Improved weight status may reverse metabolic disturbances present in early childhood.