(P20-046-25) Urinary Volatile Organic Compounds in Obese vs. Normal Weight Children: Insights Into Racial and Socioeconomic Disparities

Objectives: Childhood obesity affects multiple organ systems, contributing to significant morbidity and an increased risk of premature mortality. It is linked to early atherosclerosis and cardiovascular disease in adulthood. The analysis of volatile organic compounds (VOCs) offers an opportunity to identify novel biomarkers associated with disease. While prior studies have examined VOCs signatures in breath related to obesity, limited research has focused on urinary VOCs. Moreover, many studies have not accounted for confounding variables such as racial and socioeconomic status (SES) disparities, which are closely associated with childhood obesity prevalence. This study aimed to evaluate the urinary VOCs profile in overweight/obese versus normal-weight children and identify VOCs that predict obesity outcomes.

Methods: A total of 159 children, including 61 overweight/obese and 98 normal-weight participants, were enrolled in this cross-sectional study. Obesity and normal weight were classified based on body mass index z-scores. Urine samples were analyzed using solid-phase micro-extraction gas chromatography-mass spectrometry under glucuronidase and sulfatase conditions.

Results: Multiple linear regression was applied to assess the association between urinary VOCs and obesity, evaluate the effects of race and SES, and identify VOCs differentiating overweight/obese and normal weight children. A total of 67 VOCs were identified under enzyme-treated conditions, distinguishing overweight/obese from normal-weight children. Of these, 10 VOCs were significant predictors of obesity even after adjusting for racial and SES disparities (p < 0.01). The identified VOCs included hexanal, 4'-(2-methylpropyl) acetophenone, 2-pentylfuran, 3-(3-hydroxyphenyl) propionic acid, geraniol, gamma-dodecalactone, benzaldehyde, 4-heptanone, creosol, and furan. These VOCs demonstrated receiver operating characteristic (ROC) area under the curve values between 0.503 and 0.737,with sensitivity and specificity exceeding 0.6.

Conclusions: This study shows that VOCs signatures differ significantly between overweight/obese and normal-weight children. These differences have potential diagnostic and predictive value for obesity outcomes, with SES serving as an important confounding variable in childhood obesity predictions.

Funding Sources: NIH-R15