Parent reported nutritional risk and laboratory indices of cardiometabolic risk and in preschool-aged children

Navindra Persaud 1 , 2 , Hedyeh Ziai 1 , Gerald Lebovic 1 , Jonathon L. Maguire 1 , 3 , 4 , 5 , 6 , Marina Khovratovich 4 , Janis A. Randall Simpson 7 , Khosrow Adeli 8 , 9 , Jill Hamilton 3 , 10 , Brian W. McCrindle 3 , 11 , Patricia C. Parkin 1 , 3 , 5 , 6 , Catherine S. Birken 1 , 3 , 5 , 6 , 12  and on behalf of the TARGet Kids! collaboration
  • 1 Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
  • 2 Department of Family and Community Medicine, University of Toronto and St. Michael’s Hospital, Toronto, Ontario, Canada
  • 3 Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
  • 4 Department of Pediatrics, St. Michael’s Hospital, Toronto, Ontario, Canada
  • 5 Division of Pediatric Medicine and the Pediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, Ontario, Canada
  • 6 Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
  • 7 Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
  • 8 Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
  • 9 Clinical Biochemistry, Department of Pediatric Laboratory Medicine, Hospital for Sick Children, Toronto, Ontario, Canada
  • 10 Divison of Endocrinology, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
  • 11 Division of Cardiology, The Hospital for Sick Children, Toronto, Ontario, Canada
  • 12 Division of Pediatric Medicine, The Hospital for Sick Children, University of Toronto, 686 Bay St, ON M5G 0X4, Ontario, Canada
Navindra Persaud
  • Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
  • Department of Family and Community Medicine, University of Toronto and St. Michael’s Hospital, Toronto, Ontario, Canada
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, Hedyeh Ziai
  • Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
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, Gerald Lebovic
  • Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
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, Jonathon L. Maguire
  • Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
  • Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
  • Department of Pediatrics, St. Michael’s Hospital, Toronto, Ontario, Canada
  • Division of Pediatric Medicine and the Pediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, Ontario, Canada
  • Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
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, Marina Khovratovich, Janis A. Randall Simpson
  • Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
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, Khosrow Adeli
  • Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
  • Clinical Biochemistry, Department of Pediatric Laboratory Medicine, Hospital for Sick Children, Toronto, Ontario, Canada
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, Jill Hamilton
  • Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
  • Divison of Endocrinology, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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, Brian W. McCrindle
  • Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
  • Division of Cardiology, The Hospital for Sick Children, Toronto, Ontario, Canada
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, Patricia C. Parkin
  • Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
  • Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
  • Division of Pediatric Medicine and the Pediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, Ontario, Canada
  • Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
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, Catherine S. Birken
  • Corresponding author
  • Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
  • Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
  • Division of Pediatric Medicine and the Pediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, Ontario, Canada
  • Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
  • Division of Pediatric Medicine, The Hospital for Sick Children, University of Toronto, 686 Bay St, ON M5G 0X4, Ontario, Canada
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Abstract

Background:

Eating habits formed during childhood may contribute to the increasing prevalence of cardiometabolic disorders. Assessing nutritional risk in young children may help to prevent later cardiometabolic disease. The objective of this study was to determine whether parent-reported nutritional risk in preschool-aged children was associated with laboratory indices of cardiometabolic risk, namely leptin and insulin.

Methods:

In this cross-sectional study, the relationship between nutritional risk as determined by the parent-completed NutriSTEP® questionnaire was assessed and compared to the serum leptin and insulin concentrations, hormones involved in regulation of food intake and biomarkers of adiposity and cardiometabolic risk. The community-based primary care research network for children in Toronto, Canada (TARGet Kids!) was used. The participants were children aged 3–5 years recruited from TARGet Kids! A total of 1856 children were recruited from seven primary care practices. Of these, 1086 children completed laboratory testing. Laboratory data for leptin and insulin were available for 714 and 1054 of those individuals, respectively.

Results:

The total NutriSTEP® score was significantly associated with serum leptin concentrations (p=0.003); for each unit increase in the total NutriSTEP® score, there was an increase of 0.01 ng/mL (95% confidence interval [CI] 0.004–0.018) in serum leptin concentrations after adjusting for potential confounders. The total NutriSTEP® score was not significantly associated with serum insulin concentration.

Conclusions:

Parent reported nutritional risk is associated with serum leptin, but not insulin, concentrations in preschool-aged children. The NutriSTEP® questionnaire may be an effective tool for predicting future cardiometabolic risk in preschool-aged children.

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The Journal of Pediatric Endocrinology and Metabolism (JPEM) is the only international journal dedicated exclusively to endocrinology in the neonatal, pediatric and adolescent age groups, and publishes the results of clinical investigations in pediatric endocrinology and basic research. JPEM publishes Review Articles, Original Research, Case Reports, Short Communications and Letters to the Editor.

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