CONTEXT: The importance of fasting GLP-1 in altered metabolic outcomes has been questioned.

OBJECTIVE: To assess if fasting GLP-1 differs in children and adolescents with overweight/obesity compared to a population-based reference, and whether concentrations predict cardiometabolic risk (CMR) factors.

METHODS: Analyses were based on The Danish Childhood Obesity Data- and Biobank, a cross-sectional study including children and adolescents, 6-19 years old, from an obesity clinic group (n = 1978) and from a population-based group (n = 2334). Fasting concentrations of plasma total GLP-1 and quantitative CMR factors were assessed. The effects of GLP-1 as a predictor of CMR risk outcomes were examined by multiple linear and logistic regression modelling.

RESULTS: The obesity clinic group had higher fasting GLP-1 concentrations (median 3.3 pmol/L; interquartile range 2.3-4.3) than the population-based group (2.8 pmol/L; 2.1-3.8; P < 2.2E-16). BMI SDS, waist circumference and total body fat percentage were significant predictors of fasting GLP-1 concentrations in boys and girls. Fasting GLP-1 concentrations positively associated with HOMA-IR, fasting values of insulin, hs-CRP, C-peptide, triglycerides, ALT, HbA1c and SDS of diastolic and systolic blood pressure. A 1-SD increase in fasting GLP-1 associated with an increased risk of insulin resistance (Odds ratio [OR] 1.59), dyslipidemia (OR 1.16), increased ALT (OR 1.14), hyperglycemia (OR 1.12) and hypertension (OR 1.12).

CONCLUSIONS: Overweight/obesity in children and adolescents is associated with increased fasting plasma total GLP-1 concentrations, which was predictive of higher cardiometabolic risk factors.