Metals are redox-active substances that participate in central biological processes and may be
involved in a multitude of pathogenic events. However, considering the inconsistencies reported in the
literature, further research is crucial to disentangle the role of metal homeostasis in childhood obesity
and comorbidities using well-characterized cohorts and state-of-the-art analytical methods. To this end,
we studied an observational population comprising childrenwith obesity and insulin resistance, children
with obesity without insulin resistance, and healthy control children. A multi-elemental approach based
on the size-fractionation of metal species was applied to quantify the total content of various essential
and toxic elements in plasma and erythrocyte samples, and to simultaneously investigate the metal
fractions conforming the metalloproteome and the labile metal pool. The most important disturbances
in childhood obesity were found to be related to elevated circulating copper levels, decreased content of
plasmatic proteins containing chromium, cobalt, iron, manganese, molybdenum, selenium, and zinc, as
well as the sequestration of copper, iron, and selenium within erythrocytes. Interestingly, these metal
disturbances were normally exacerbated among children with concomitant insulin resistance, and in
turn were associated to other characteristic pathogenic events, such as inflammation, oxidative stress,
abnormal glucose metabolism, and dyslipidemia. Therefore, this study represents one-step further
towards a better understanding of the involvement of metals in the crosstalk between childhood obesity
and insulin resistance.