Elevated metabolites of acetaminophen in cord blood of children with obesity

Summary Background High‐throughput metabolomics has been used cross‐sectionally to evaluate differential metabolic profiles associated with human obesity. Objectives This study longitudinally assessed the cord blood metabolome to explore if metabolic signatures of obesity at age 3–5 are apparent at birth. Methods In a nested case–control design, metabolomics analysis was performed on umbilical cord blood of 25 children who developed obesity by age 3–5 years, compared with 25 sex‐matched non‐obese children enrolled as part of an ongoing birth cohort. Logistic regression models were used to identify significant metabolites, adjusting for maternal pre‐pregnancy obesity. Results Children who had obesity by age 3–5 years had elevated levels of medium and long chain fatty acids including stearate, oleate and palmitate at birth. Children with obesity were also more likely to have elevated levels of acetaminophen metabolites at birth, specifically: 3‐(N‐acetyl‐L‐cystein‐S‐yl) acetaminophen, 2‐hydroxyacetaminophen sulfate, 2‐methoxyacetaminophen glucuronide and p‐acetamidophenyl glucuronide. Conclusion Although the observed increases in lipids are consistent with previous metabolomic studies of obesity, this study is the first to report associations between acetaminophen metabolites and obesity in children; however, we lack mechanistic insights for this link. Larger human studies with longer follow‐up and laboratory‐controlled animal experiments are needed to clarify associations.