{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T06:04:09Z","timestamp":1789365849066,"version":"build-2803163510"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The relationship between hydration-related markers and abdominal adiposity severity in children with established abdominal obesity remains poorly understood. This study examined the associations of estimated plasma osmolality (ePosm) and urine specific gravity (USG) with waist-to-height ratio (WHtR) and BMI z-score in children and adolescents with abdominal obesity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-center cross-sectional study included 207 children and adolescents aged 6\u201317 years with abdominal obesity. WHtR and BMI z-score were used to characterize central and general adiposity, respectively. ePosm was estimated from serum sodium, potassium, glucose, and urea, while USG was obtained from routine urinalysis. Linear regression models were used to evaluate associations of ePosm and USG with WHtR and BMI z-score after adjusting for potential confounders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean BMI was 29.43\u2009\u00b1\u20095.20\u2005kg\/m\u00b2, mean BMI z-score was 2.44\u2009\u00b1\u20090.81, and mean WHtR was 0.62\u2009\u00b1\u20090.06. ePosm was inversely associated with WHtR in the overall cohort (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009\u22120.025 per 10 mOsm\/kg, 95% CI: \u22120.041 to \u22120.009;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.002), and reached statistical significance among boys aged 6\u201312 years in subgroup analysis. The association between ePosm and BMI z-score was weaker and less consistent. USG was not significantly associated with either WHtR or BMI z-score.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In children and adolescents with abdominal obesity, ePosm was inversely associated with WHtR, whereas USG showed no consistent association with adiposity phenotypes. The subgroup findings should be considered exploratory. Larger prospective studies are needed to confirm these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1925985","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T05:39:13Z","timestamp":1789364353000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Hydration-related indicators and adiposity measures in children and adolescents with abdominal obesity: a clinical cross-sectional study"],"prefix":"10.3389","volume":"14","author":[{"given":"Jiaying","family":"Cao","sequence":"first","affiliation":[{"name":"Pediatric Department, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Xu","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Anhui Province Children\u2019s Hospital","place":["Hefei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Wu","sequence":"additional","affiliation":[{"name":"Pediatric Department, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Wang","sequence":"additional","affiliation":[{"name":"Pediatric Department, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"785","DOI":"10.1016\/S0140-6736(25)00397-6","article-title":"Global, regional, and national prevalence of child and adolescent overweight and obesity, 1990\u20132021, with forecasts to 2050: a forecasting study for the global burden of disease study 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