Inflammation and fatness in adolescents with and without Down syndrome: UP & DOWN study.
In teens with Down syndrome, waist fat drives inflammation harder than in typical peers, so measure waist-to-height early and often.
01Research in Context
What this study did
Mulder et al. (2020) compared body fat and blood inflammation markers in teens with Down syndrome to same-age peers without disabilities.
They used waist-to-height ratio and blood tests from the Spanish UP&DOWN cohort.
What they found
Teens with Down syndrome carried more body fat.
Their inflammatory markers rose faster per extra centimeter of waist than in typical teens.
How this fits with other research
Izquierdo-Gomez et al. (2015) showed vigorous exercise boosts fitness in the same teen group, yet does not shrink fat.
Bertapelli et al. (2016) review agrees: exercise alone rarely cuts weight in Down syndrome youth.
McQuaid et al. (2024) flips the story in adults: extra weight in middle-aged Down syndrome adults does not raise inflammation, except for leptin.
The teen years seem to be a special window when fat and inflammation are tightly linked.
Why it matters
Track waist-to-height ratio at every clinic visit for teens with Down syndrome. Pair movement programs with diet or family-level changes, since exercise by itself is unlikely to trim waistlines. Early, combined action may prevent the inflammatory spike seen in this study.
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02At a glance
03Original abstract
BACKGROUND: The main objective of this study was to describe the inflammatory status of adolescents with Down syndrome (DS) and their relationship with adiposity. METHODS: Ninety-five adolescents with DS (44.2% girls) and a control group of 113 adolescents (47.8% girls), aged between 11 and 18 years old, from the UP & DOWN study were included in this substudy. Serum C-reactive protein, C3 and C4 complement factors, total proteins, interleukin-6, tumour necrosis factor-α, insulin, cortisol, leptin, adiponectin, galactin-3 and visfatin were analysed; homeostatic model assessment index was calculated. In order to evaluate adiposity, we measured the following body fat variables: weight, height, waist circumference and skinfold thicknesses. Birth weight was obtained by questionnaire. In addition, body mass index, waist-to-height ratio (WHtR) and body fat percentage (BF%) were calculated. RESULTS: Down syndrome group showed higher levels of body mass index, WHtR, waist circumference, BF% and lower birth weight than controls (P < 0.001). In the general linear model in the total sample, WHtR was positively associated with C3 and C4 (P < 0.001) as well as with leptin levels (P = 0.015). BF% was positively associated with total proteins (P = 0.093) and leptin levels (P < 0.001). DS was positively associated with total proteins (P < 0.001), C3 (P = 0.047) and C4 (P = 0.019). Despite the higher levels of adiposity found in DS group, no direct association was found between BF% and leptin levels, comparing with the control group. CONCLUSIONS: These findings suggest that abdominal obesity should be controlled in adolescents because of its relationship with acute phase-inflammatory biomarkers but especially in DS adolescents who may show a peculiar metabolic status according to their relationship between adiposity and inflammatory biomarkers.
Journal of intellectual disability research : JIDR, 2020 · doi:10.1111/jir.12697