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Background  High sodium intake is associated with the development of chronic diseases such as obesity. Although its role in obesity remains controversial, there may be a correlation between salt sensitivity and the early onset of chronic diseases in obese children.    Methods  In all, 2,163 Korean children (1,106 boys and 1,057 girls) aged 8–9 years were recruited from seven elementary schools in Seoul. To evaluate whether obesity risk was modulated by the salt sensitivity, 11 SNPs related to salt sensitive genes (SSG) became the target of sodium intakes in obese children.    Results  BP, HOMA-IR, LDLc, TG, and the girls’ sodium intake significantly increased, but HDLc significantly decreased with increase in BMI. Regardless of sex, the obesity risk was 5.27-fold (CI; 1.320–27.560) higher in the Q2 to Q5 of sodium intake adjusted by energy (4044.9–5058.9 mg/day) than in the lowest Q1 level (2287.6 mg/day) in obese children. BP was sensitively dependent on insulin resistance and lipid accumulation in all subjects; however, sodium intake may be an independent risk factor of obesity without increasing BP in girls.  GRK4 A486V  mutant homozygote was highly distributed in the obese group, but other SNPs had no impact. The obesity risk increased 7.06, 16.8, and 46.09-fold more in boys with  GRK4 A486V ,  ACE , and  SLC12A3  mutants as sodium intake increased. Among girls, the obesity risk increased in  GRK4 A486V  heterozygote and  CYP11β-2  mutant homozygote although sodium intake was relatively lower, implying that  ACE ,  SLC12A ,  CYP11β-2 , and  GRK4 A486V  polymorphisms showed gender-based differences with regard to interaction between sodium intake and obesity.    Conclusion  A high sodium intake markedly increased the obesity risk in variants of  GRK4 A486V  regardless of sex. The obesity risk increased with  GRK4 A486V ,  ACE , and  SLC12A3  variants in boys, whereas it increased with  GRK4 A486V  and  CYP11B2  variants in girls as sodium intake increased. Obese children with the specific gene variants are recommended to reduce their sodium intake.

Gender-Based Differences on the Association between Salt-Sensitive Genes and Obesity in Korean Children Aged between 8 and 9 Years