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The Effect of Gluten-free Diet on Cardiovascular Risk Factors in Newly Diagnosed Pediatric Celiac Disease Patients. J Pediatr Gastroenterol Nutr 2019; 68:684-688. [PMID: 30562306 DOI: 10.1097/mpg.0000000000002235] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVES Although gluten-free diet (GFD) is the only proven therapy for celiac disease (CD), its effect on cardiovascular disease (CVD) risk factors is still unclear. Our aim was to determine whether adherence to GFD affects CVD risk factors among newly diagnosed pediatric CD subjects. METHODS We prospectively enrolled pediatric subjects undergoing upper gastrointestinal endoscopy for suspected CD. We collected anthropometric and laboratory parameters related to CVD risk factors at the time of CD diagnosis and 1 year after initiation of a GFD and evaluated changes in CVD risk factors. Paired t tests or Wilcoxon nonparametric tests were used, each when appropriate. RESULTS One hundred ten newly diagnosed CD pediatric subjects were included in the analysis. There were 64 (58.2%) girls and the mean age at diagnosis was 6.8 ± 3.4 years. Median body mass index z scores (P = 0.84), rates of underweight or overweight (P = 0.32), and rates of elevated blood pressure (P = 0.78) remained unchanged. Although median fasting insulin levels increased (1.9 vs 5.4 μU/mL, P < 0.001), insulin resistance as measured by homeostatic model assessment did not increase after 1 year of GFD (P = 0.16). Although rates of dyslipidemia remained unchanged, median high-density lipoprotein levels increased on GFD (47 vs 51 mg/dL, P < 0.001). CONCLUSIONS In this pediatric CD cohort, GFD for 1 year was not associated with increased CVD risk factors. The long-term significance of these mild changes is yet to be determined.
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Di Taranto MD, de Falco R, Guardamagna O, Massini G, Giacobbe C, Auricchio R, Malamisura B, Proto M, Palma D, Greco L, Fortunato G. Lipid profile and genetic status in a familial hypercholesterolemia pediatric population: exploring the LDL/HDL ratio. ACTA ACUST UNITED AC 2019; 57:1102-1110. [DOI: 10.1515/cclm-2018-1037] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 12/12/2018] [Indexed: 12/11/2022]
Abstract
Abstract
Background
Familial hypercholesterolemia (FH) is a genetic disorder caused by mutations in genes involved in low-density lipoprotein (LDL) uptake (LDLR, APOB and PCSK9). Genetic diagnosis is particularly useful in asymptomatic children allowing for the detection of definite FH patients. Furthermore, defining their genetic status may be of considerable importance as the compound heterozygous status is much more severe than the heterozygous one. Our study aims at depicting the genetic background of an Italian pediatric population with FH focusing on the correlation between lipid profile and genetic status.
Methods
Out of 196 patients with clinically suspected FH (LDL-cholesterol [LDL-C] levels above 3.37 mmol/L, cholesterol level above 6.46 mmol/L in a first-degree relative or the presence of premature cardiovascular acute disease in a first/second-degree relative), we screened 164 index cases for mutations in the LDLR, APOB and PCSK9 genes.
Results
Patients with mutations (129/164) showed increased levels of LDL-C, 95th percentile-adjusted LDL-C and LDL/high-density lipoprotein (HDL) ratio and decreased levels of HDL-C, adjusted HDL-C. The association of the LDL/HDL ratio with the presence of mutations was assessed independently of age, (body mass index) BMI, parental hypercholesterolemia, premature coronary artery disease (CAD), triglycerides by multivariate logistic regression (odds ratio [OR]=1.701 [1.103–2.621], p=0.016). The LDL/HDL ratio gradually increased from patients without mutations to patients with missense mutations, null mutations and compound heterozygotes.
Conclusions
In conclusion, the LDL/HDL ratio proved to be a better parameter than LDL-C for discriminating patients with from patients without mutations across different genetic statuses.
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Affiliation(s)
- Maria Donata Di Taranto
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche , Università degli Studi di Napoli Federico II , Naples , Italy
- CEINGE Biotecnologie Avanzate s.c. a r.l. , Naples , Italy
| | - Renato de Falco
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche , Università degli Studi di Napoli Federico II , Naples , Italy
- CEINGE Biotecnologie Avanzate s.c. a r.l. , Naples , Italy
| | - Ornella Guardamagna
- Dipartimento di Scienze della Sanità Pubblica e Pediatriche , Università degli Studi di Torino , Turin , Italy
| | - Giulia Massini
- Dipartimento di Scienze della Sanità Pubblica e Pediatriche , Università degli Studi di Torino , Turin , Italy
| | - Carola Giacobbe
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche , Università degli Studi di Napoli Federico II , Naples , Italy
- CEINGE Biotecnologie Avanzate s.c. a r.l. , Naples , Italy
| | - Renata Auricchio
- Dipartimento di Scienze Mediche Traslazionali , Università degli Studi di Napoli Federico II , Naples , Italy
| | - Basilio Malamisura
- Dipartimento di Scienze Mediche Traslazionali , Università degli Studi di Napoli Federico II , Naples , Italy
| | - Michela Proto
- Dipartimento di Scienze Mediche Traslazionali , Università degli Studi di Napoli Federico II , Naples , Italy
| | - Daniela Palma
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche , Università degli Studi di Napoli Federico II , Naples , Italy
- CEINGE Biotecnologie Avanzate s.c. a r.l. , Naples , Italy
| | - Luigi Greco
- Dipartimento di Scienze Mediche Traslazionali , Università degli Studi di Napoli Federico II , Naples , Italy
| | - Giuliana Fortunato
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche , Università degli Studi di Napoli Federico II , Naples , Italy
- CEINGE Biotecnologie Avanzate s.c. a r.l. , via Gaetano Salvatore 486 , 80145 Naples , Italy , Phone: +39-081.746.4200
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CCR5-Δ32 polymorphism is a genetic risk factor associated with dyslipidemia in patients with type 1 diabetes. Cytokine 2019; 114:81-85. [DOI: 10.1016/j.cyto.2018.11.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 10/18/2018] [Accepted: 11/05/2018] [Indexed: 02/06/2023]
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Barbour-Tuck E, Erlandson MC, Johnson W, Muhajarine N, Foulds H, Baxter-Jones ADG. At what age do normal weight Canadian children become overweight adults? Differences according to sex and metric. Ann Hum Biol 2019; 45:478-485. [PMID: 30497298 DOI: 10.1080/03014460.2018.1546900] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The prevalence of overweight and obesity doubles between adolescence and young adulthood; however, the exact age, and appropriate metric to use to identify when overweight develops is still debated. AIM To examine the age of onset of overweight by sex and four metrics: body mass index (BMI), fat mass (%FM), waist circumference (WC) and waist-to-height ratio (WHtR). SUBJECTS AND METHODS Between 1991 and 2017, serial measures of body composition were taken on 237 (108 males) individuals (aged 8-40 years of age). Hierarchical random effects models were used to develop growth curves. Curves were compared to BMI, %FM and WC overweight age- and sex-specific cut-points. RESULTS In males, the BMI growth curve crossed the cut-point at 22.0 years, compared to 23.5 and 26.5 years for WHtR and %FM, respectively; WC cut-off was not reached until 36 years. In females, the BMI growth curve crossed the overweight cut-point at 21.5 years, compared to 14.2 years for %FM and 21.9 and 27.5 years for WC and WHtR, respectively. CONCLUSION In summary, overweight onset occurs during young adulthood with the exception of WC in males. BMI in males and %FM in females were the metrics identifying overweight the earliest.
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Affiliation(s)
- E Barbour-Tuck
- a College of Kinesiology , University of Saskatchewan , Saskatoon , SK , Canada
| | - M C Erlandson
- a College of Kinesiology , University of Saskatchewan , Saskatoon , SK , Canada
| | - W Johnson
- b School of Sport, Exercise and Health Sciences , Loughborough University , Loughborough , UK
| | - N Muhajarine
- c Department of Community Health and Epidemiology , University of Saskatchewan , Saskatoon , SK , Canada
| | - H Foulds
- a College of Kinesiology , University of Saskatchewan , Saskatoon , SK , Canada
| | - A D G Baxter-Jones
- a College of Kinesiology , University of Saskatchewan , Saskatoon , SK , Canada
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Guzzetti C, Ibba A, Casula L, Pilia S, Casano S, Loche S. Cardiovascular Risk Factors in Children and Adolescents With Obesity: Sex-Related Differences and Effect of Puberty. Front Endocrinol (Lausanne) 2019; 10:591. [PMID: 31507538 PMCID: PMC6718449 DOI: 10.3389/fendo.2019.00591] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Accepted: 08/12/2019] [Indexed: 01/12/2023] Open
Abstract
Objectives: To evaluate the effect of gender and puberty on cardiovascular risk factors (CVRF) in obese children and adolescents. Methods: One thousand four hundred and nine obese patients [age 9.7 (2.2-17.9) y; 646 Male] were studied. Subjects were stratified according to Tanner pubertal staging and age into prepubertal ≤ and >6 ys (G1 and G2), pubertal stage 2-3 (G3), and pubertal stage 4-5 (G4). Waist circumference (WC), systolic and diastolic blood pressure (SP, DP), fasting plasma glucose, insulin, post Oral Glucose Tolerance Test glucose and insulin, and lipids were evaluated. Insulin resistance was evaluated by HOMA index. Patients with no CVRF were considered metabolically healthy (MHO). Results: The percentage of MHO patients was 59.8% in G1 while was consistently around 30% in the other groups. WC was more frequently abnormal in G2 males. Pubertal progression was associated with a decrease in WC abnormalities. SP was more frequently abnormal in G4 males and pubertal progression was associated with higher prevalence of abnormal SP in males. Pubertal progression was associated with an increase in hypertension rate in both sexes. HOMA was more frequently abnormal in G2 and G3 females. HDL, LDL, and TG were more frequently abnormal in G2 females. Dyslipidemia rate was higher in G2 females. Pubertal progression was associated with higher prevalence of abnormal HDL in males. Conclusions: Sex and pubertal status influence the frequency of abnormalities of CVRF in obese children and adolescents. CVRF are already present in prepubertal age. Identifying patients with higher risk of metabolic complications is important to design targeted and effective prevention strategies.
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Di Costanzo A, Pacifico L, Chiesa C, Perla FM, Ceci F, Angeloni A, D’Erasmo L, Di Martino M, Arca M. Genetic and metabolic predictors of hepatic fat content in a cohort of Italian children with obesity. Pediatr Res 2019; 85:671-677. [PMID: 30710115 PMCID: PMC6760560 DOI: 10.1038/s41390-019-0303-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 12/11/2018] [Accepted: 01/01/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To comprehensively explore metabolic and genetic contributors to liver fat accumulation in overweight/obese children. METHODS Two hundred thirty Italian children with obesity were investigated for metabolic parameters and genotyped for PNPLA3, TM6SF2, GCKR, and MBOAT7 gene variants. Percentage hepatic fat content (HFF%) was measured by nuclear magnetic resonance. RESULTS HFF% was positively related with BMI, HOMAIR, metabolic syndrome, ALT, AST, γGT, and albumin. Carriers of [G] allele in PNPLA3, [T] allele in GCKR and [T] allele in TM6SF2 genes had significantly higher hepatic fat content than wild-type carriers. HFF% was explained for 8.7% by metabolic and for 16.1% by genetic factors and, a model including age, gender, BMI, HOMAIR, PNPLA3, GCKR, and TM6SF2 variants was the best predictor of HFF%, explaining 24.8% of its variation (P < 0.001). A weighted-genetic risk score combining PNPLA3, GCKR, and TM6SF2 risk alleles was associated with almost eightfold higher risk of NAFLD. CONCLUSIONS Our data highlighted the predominant role of genetic factors in determining the amount of liver fat content in children with obesity.
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Affiliation(s)
- Alessia Di Costanzo
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, 00161, Rome, Italy.
| | - Lucia Pacifico
- grid.7841.aDepartment of Pediatrics, Sapienza University of Rome, 00161 Rome, Italy
| | - Claudio Chiesa
- 0000 0001 1940 4177grid.5326.2Institute of Translational Pharmacology, National Research Council, 00133 Rome, Italy
| | | | - Fabrizio Ceci
- grid.7841.aDepartment of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Antonio Angeloni
- grid.7841.aDepartment of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Laura D’Erasmo
- grid.7841.aDepartment of Internal Medicine and Medical Specialties, Sapienza University of Rome, 00161 Rome, Italy
| | - Michele Di Martino
- grid.7841.aDepartment of Radiology, Sapienza University of Rome, 00161 Rome, Italy
| | - Marcello Arca
- grid.7841.aDepartment of Internal Medicine and Medical Specialties, Sapienza University of Rome, 00161 Rome, Italy
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Stavnsbo M, Resaland GK, Anderssen SA, Steene-Johannessen J, Domazet SL, Skrede T, Sardinha LB, Kriemler S, Ekelund U, Andersen LB, Aadland E. Reference values for cardiometabolic risk scores in children and adolescents: Suggesting a common standard. Atherosclerosis 2018; 278:299-306. [PMID: 30477756 DOI: 10.1016/j.atherosclerosis.2018.10.003] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 09/12/2018] [Accepted: 10/04/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS International reference values for cardiometabolic risk variables, to allow for standardization of continuous risk scores in children, are not currently available. The aim of this study was to provide international age- and gender-specific reference values for cardiometabolic risk factors in children and adolescents. METHODS Cohorts of children sampled from different parts of Europe (North, South, Mid and Eastern) and from the United States were pooled. In total, 22,479 observations (48.7% European vs. 51.3% American), 11,234 from girls and 11,245 from boys, aged 6-18 years were included in the study. Linear mixed-model regression analysis was used to analyze the associations between age and each cardiometabolic risk factor. RESULTS Reference values for 14 of the most commonly used cardiometabolic risk variables in clustered risk scores were calculated and presented by age and gender: systolic blood pressure (SBP), diastolic blood pressure (DBP), waist circumference (WC), body mass index (BMI), sum of 4 skinfolds (sum4skin), triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), TC:HDL-C ratio, glucose, insulin, homeostatic model assessment-score (HOMA-score), and cardiorespiratory fitness (CRF). CONCLUSIONS This study suggests a common standard to define cardiometabolic risk in children. Adapting this approach makes single risk factors and clustered cardiometabolic disease risk scores comparable to the reference material itself and comparable to cardiometabolic risk values in studies using the same strategy. This unified approach therefore increases the prospect to estimate and compare prevalence and trends of cardiometabolic risk in children when using continuous cardiometabolic risk scores.
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Affiliation(s)
- Mette Stavnsbo
- Western Norway University of Applied Sciences, Department of Sport, Food and Natural Sciences, PO BOX 133, N-6856, Sogndal, Norway; Norwegian School of Sport Sciences, Department of Sports Medicine, PO Box 4014, Sognsveien 220, Ullevaal Stadion, Oslo, Norway.
| | - Geir K Resaland
- Western Norway University of Applied Sciences, Department of Sport, Food and Natural Sciences, PO BOX 133, N-6856, Sogndal, Norway
| | - Sigmund A Anderssen
- Western Norway University of Applied Sciences, Department of Sport, Food and Natural Sciences, PO BOX 133, N-6856, Sogndal, Norway; Norwegian School of Sport Sciences, Department of Sports Medicine, PO Box 4014, Sognsveien 220, Ullevaal Stadion, Oslo, Norway
| | - Jostein Steene-Johannessen
- Norwegian School of Sport Sciences, Department of Sports Medicine, PO Box 4014, Sognsveien 220, Ullevaal Stadion, Oslo, Norway; Kristiania University College, Faculty of Health Sciences, PO Box 1155, Sentrum, 0107, Oslo, Norway
| | - Sidsel L Domazet
- University of Southern Denmark, Department of Sports Science and Clinical Biomechanics, Center of Research in Childhood Health, Campusvej 55, 5230, Odense M, Denmark
| | - Turid Skrede
- Western Norway University of Applied Sciences, Department of Sport, Food and Natural Sciences, PO BOX 133, N-6856, Sogndal, Norway; Norwegian School of Sport Sciences, Department of Sports Medicine, PO Box 4014, Sognsveien 220, Ullevaal Stadion, Oslo, Norway
| | - Luis B Sardinha
- Universidade de Lisboa, Fac Motricidade Humana, CIPER, Exercise and Health Laboratory, Estrada Dacosth, Cruz-Quebrada, 1499, Lisbon, Portugal
| | - Susi Kriemler
- University of Zürich, Epidemiology, Biostatistics and Prevention Institute, Hirschengraben 84, 8001, Zürich, Switzerland
| | - Ulf Ekelund
- Norwegian School of Sport Sciences, Department of Sports Medicine, PO Box 4014, Sognsveien 220, Ullevaal Stadion, Oslo, Norway
| | - Lars B Andersen
- Western Norway University of Applied Sciences, Department of Sport, Food and Natural Sciences, PO BOX 133, N-6856, Sogndal, Norway; Norwegian School of Sport Sciences, Department of Sports Medicine, PO Box 4014, Sognsveien 220, Ullevaal Stadion, Oslo, Norway
| | - Eivind Aadland
- Western Norway University of Applied Sciences, Department of Sport, Food and Natural Sciences, PO BOX 133, N-6856, Sogndal, Norway
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Novotny R, Davis J, Butel J, Boushey CJ, Fialkowski MK, Nigg CR, Braun KL, Leon Guerrero RT, Coleman P, Bersamin A, Areta AAR, Barber LR, Belyeu-Camacho T, Greenberg J, Fleming T, Dela Cruz-Talbert E, Yamanaka A, Wilkens LR. Effect of the Children's Healthy Living Program on Young Child Overweight, Obesity, and Acanthosis Nigricans in the US-Affiliated Pacific Region: A Randomized Clinical Trial. JAMA Netw Open 2018; 1:e183896. [PMID: 30646266 PMCID: PMC6324447 DOI: 10.1001/jamanetworkopen.2018.3896] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
IMPORTANCE Pacific Islanders have among the highest rates of obesity and type 2 diabetes in the world. Targeting children is critical for primary prevention. OBJECTIVES To prevent young child overweight and obesity and to improve health in the US-Affiliated Pacific region via the Children's Healthy Living Program. DESIGN, SETTING, AND PARTICIPANTS In this multijurisdictional, multilevel, multicomponent community randomized clinical trial, where all evaluable children were analyzed according to the random assignment of their community, hierarchical difference-in-difference models accounted for the community randomization, community clustering with jurisdictions, and these models were adjusted for the age and sex distribution of the community. The setting was 27 communities in 5 jurisdictions (Alaska, American Samoa, Commonwealth of the Northern Mariana Islands, Guam, and Hawaii). Participants were 4329 children (time 1) and 4042 children (time 2) aged 2 to 8 years in 27 selected communities from October 7, 2012, to October 25, 2015. Data analysis was completed in June 2018. INTERVENTIONS Nineteen activities addressed policy, environment, messaging, training, and 6 target behaviors (sleep time, screen time, physical activity, fruits and vegetables, water, and sugar-sweetened beverages). MAIN OUTCOMES AND MEASURES Primary outcomes were body size measurements. Secondary outcomes were acanthosis nigricans, sleep quality and duration, dietary intake, physical activity, and other questionnaire reponses. RESULTS The study included 27 communities and 8371 evaluable children (mean [SD] age, 5.4 [1.8] years; 50.9% male [n = 4264]). Data analysis included 952 children in the intervention group and 930 children in the control group aged 2 to 5 years at time 1; 825 children in the intervention group and 735 children in the control group aged 2 to 5 years at time 2; 565 children in the intervention group and 561 children in the control group aged 6 to 8 years at time 1; and 517 children in the intervention group and 560 children in the control group aged 6 to 8 years at time 2. The intervention communities showed significant improvement compared with control communities in overweight and obesity prevalence (effect size [d] = -3.95%; 95% CI, -7.47% to -0.43%), waist circumference (d = -0.71 cm; 95% CI, -1.37 to -0.05 cm), and acanthosis nigricans prevalence (d = -2.28%; 95% CI, -2.77% to -1.57%). Age and sex subgroup analysis revealed greater difference among the intervention communities in acanthosis nigricans prevalence in the group aged 2 to 5 years (-3.99%) vs the group aged 6 to 8 years (-3.40%), and the interaction was significant (d = 0.59%, P < .001), as well as the smaller difference in the group aged 2 to 5 years (-0.10%) vs the group aged 6 to 8 years (-1.07%) in screen time (d = -0.97 hour per day, P = .01). CONCLUSIONS AND RELEVANCE The intervention reduced the prevalence of young child overweight and obesity and acanthosis nigricans. Comprehensive, effective, and sustainable interventions are needed to improve child health in the US-Affiliated Pacific region. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01881373.
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Affiliation(s)
- Rachel Novotny
- Department of Human Nutrition, Food and Animal Science, College of Tropical Agriculture and Human Resources, University of Hawaii at Manoa, Honolulu
| | - James Davis
- Office of Biostatistics and Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu
| | - Jean Butel
- Department of Human Nutrition, Food and Animal Science, College of Tropical Agriculture and Human Resources, University of Hawaii at Manoa, Honolulu
| | - Carol J. Boushey
- Department of Human Nutrition, Food and Animal Science, College of Tropical Agriculture and Human Resources, University of Hawaii at Manoa, Honolulu
- Nutrition Support Shared Resource, University of Hawaii Cancer Center, Honolulu
| | - Marie Kainoa Fialkowski
- Department of Human Nutrition, Food and Animal Science, College of Tropical Agriculture and Human Resources, University of Hawaii at Manoa, Honolulu
| | - Claudio R. Nigg
- Office of Public Health Studies, Myron B. Thompson School of Social Work, University of Hawaii at Manoa, Honolulu
| | - Kathryn L. Braun
- Office of Public Health Studies, Myron B. Thompson School of Social Work, University of Hawaii at Manoa, Honolulu
| | | | - Patricia Coleman
- Cooperative Research and Extension Education Services, Northern Marianas College, Saipan, Northern Mariana Islands
| | - Andrea Bersamin
- Department of Biology and Wildlife, University of Alaska, Fairbanks
| | - Aufai Apulu Ropeti Areta
- Agriculture, Community and Natural Resources Division, American Samoa Community College, Pago Pago
| | - Leroy R. Barber
- Division of Agriculture and Life Sciences, College of Natural and Applied Sciences, University of Guam, Mangilao
| | - Tayna Belyeu-Camacho
- Cooperative Research and Extension Education Services, Northern Marianas College, Saipan, Northern Mariana Islands
| | - Joshua Greenberg
- School of Natural Resources and Extension, University of Alaska, Fairbanks
| | - Travis Fleming
- Agriculture, Community and Natural Resources Division, American Samoa Community College, Pago Pago
| | | | - Ashley Yamanaka
- Office of Public Health Studies, Myron B. Thompson School of Social Work, University of Hawaii at Manoa, Honolulu
| | - Lynne R. Wilkens
- Department of Human Nutrition, Food and Animal Science, College of Tropical Agriculture and Human Resources, University of Hawaii at Manoa, Honolulu
- Biostatistics and Informatics Shared Resource, University of Hawaii Cancer Center, Honolulu
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Percentile curves for cardiometabolic disease markers in Canadian children and youth: a cross-sectional study. BMC Pediatr 2018; 18:314. [PMID: 30266080 PMCID: PMC6162958 DOI: 10.1186/s12887-018-1289-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 09/20/2018] [Indexed: 11/10/2022] Open
Abstract
Background The objective of this study to develop percentile curves for cardiometabolic disease markers in a population-based sample of Canadian children and youth. Methods The analysis used data from 6116 children and adolescents between 6 and 19 years of age who participated in the Canadian Health Measures Survey cycles 1 (2007/2009), 2 (2009/2011), and 3 (2012/2013). Total cholesterol, HDL cholesterol, and hemoglobin A1c levels as well as fasting levels of triglycerides, insulin, and homeostasis model assessment insulin resistance were measured using standardized procedures. Age- and sex-specific centiles for all markers were calculated using Cole and Green’s LMS method. Results With the exception of hemoglobin A1c, all markers showed age- and sex-related differences during childhood and adolescence. Conclusions We have developed centile curves for cardiometabolic disease markers in Canadian children and adolescents and demonstrated age and sex differences that should be considered when evaluating these markers in this age group.
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Calculating a Continuous Metabolic Syndrome Score Using Nationally Representative Reference Values. Acad Pediatr 2018; 18:589-592. [PMID: 29496545 DOI: 10.1016/j.acap.2018.02.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 02/13/2018] [Accepted: 02/18/2018] [Indexed: 01/17/2023]
Abstract
OBJECTIVE The prevalence of metabolic syndrome in youth varies on the basis of the classification system used, prompting implementation of continuous scores; however, the use of these scores is limited to the sample from which they were derived. We sought to describe the derivation of the continuous metabolic syndrome score using nationally representative reference values in a sample of obese adolescents and a national sample obtained from National Health and Nutrition Examination Survey (NHANES) 2011-2012. METHODS Clinical data were collected from 50 adolescents seeking obesity treatment at a stage 3 weight management center. A second analysis relied on data from adolescents included in NHANES 2011-2012, performed for illustrative purposes. The continuous metabolic syndrome score was calculated by regressing individual values onto nationally representative age- and sex-specific standards (NHANES III). Resultant z scores were summed to create a total score. RESULTS The final sample included 42 obese adolescents (15 male and 35 female subjects; mean age, 14.8 ± 1.9 years) and an additional 445 participants from NHANES 2011-2012. Among the clinical sample, the mean continuous metabolic syndrome score was 4.16 ± 4.30, while the NHANES sample mean was quite a bit lower, at -0.24 ± 2.8. CONCLUSIONS We provide a method to calculate the continuous metabolic syndrome by comparing individual risk factor values to age- and sex-specific percentiles from a nationally representative sample.
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Abo El-Asrar M, Ismail EAR, Thabet RA, Kamel AS, NehmedAllah S. Osteopontin as a marker of vasculopathy in pediatric patients with type 1 diabetes mellitus: Relation to vascular structure. Pediatr Diabetes 2018; 19:1107-1115. [PMID: 29687557 DOI: 10.1111/pedi.12686] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 04/16/2018] [Accepted: 04/16/2018] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Type 1 diabetes mellitus (T1DM) is associated with serious micro-vascular and macro-vascular complications. Osteopontin (OPN) has emerged as a strong predictor of incipient diabetic nephropathy and a first-ever cardiovascular event in adults with T1DM. OPN is linked to coronary atherosclerosis in type 2 diabetes. The aim of the study was to test the hypothesis that OPN could be a potential marker for micro-vascular complications in children and adolescents with T1DM and we assessed its relation to carotid and aortic intima media thickness (CIMT and AIMT) as non-invasive index for subclinical atherosclerosis. METHODS Eighty patients with T1DM ≤18 years were divided into 2 groups according to the presence of micro-vascular complications and compared with 40 age- and sex-matched healthy controls. Fasting blood glucose, high sensitivity C-reactive protein (hs-CRP), HbA1c, urinary albumin creatinine ratio (UACR), OPN, CIMT, and AIMT were assessed. RESULTS Both CIMT and AIMT were significantly higher in patients with and without micro-vascular complications compared with healthy controls (P < .001). OPN concentrations were significantly elevated in all diabetic patients compared with controls (P = .002). OPN was also significantly higher in patients with micro-vascular complications than patients without (P < .001) but levels were comparable among those without complications and controls (P = .322). Receiver operating characteristic curve analysis revealed that OPN cut-off value 90 ng/mL could differentiate patients with and without micro-vascular complications with 81.7% sensitivity and 95.8% specificity. Significant positive correlations were found between OPN and HbA1c, UACR, CIMT, and AIMT. CONCLUSIONS OPN could be considered a marker of vasculopathy and subclinical atherosclerosis in pediatric T1DM.
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Affiliation(s)
| | | | | | - Ashraf Sayed Kamel
- Pediatric Department, Faculty of Medicine, Fayoum University, Faiyum, Egypt
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Role of neopterin as a biochemical marker for peripheral neuropathy in pediatric patients with type 1 diabetes: Relation to nerve conduction studies. Int Immunopharmacol 2018; 59:68-75. [PMID: 29627577 DOI: 10.1016/j.intimp.2018.03.026] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 03/17/2018] [Accepted: 03/27/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND Neopterin, a marker of inflammation and cellular immune response, is elevated in conditions of T-cell or macrophages activation. Diabetic peripheral neuropathy (DPN) is associated with inflammatory/immune processes and therefore, we hypothesized that neopterin could be used as a marker of neuropathy in type 1 diabetes mellitus (T1DM). AIM To measure neopterin levels in children and adolescents with T1DM and assess its possible relation to DPN and nerve conduction studies (NCS). METHODS Sixty patients aged ≤18 years and >5 years disease duration were subjected to neurological assessment by neuropathy disability score (NDS) and NCS for median, ulnar, posterior tibial and common peroneal nerves. Mean fasting blood glucose, lipid profile, HbA1c, high sensitivity C-reactive protein (hs-CRP) and serum neopterin levels were assessed. Patients were compared with 30 age- and sex-matched healthy controls. RESULTS The frequency of DPN according to NDS was 40 (66.7%) patients out of 60 while NCS confirmed that only 30 of those 40 patients had this complication (i.e. 50% out of the total studied patients). Neopterin levels were significantly higher in patients with DPN than those without (median [IQR], 53.5 [35-60] nmol/L versus 17 [13-32] nmol/L) and healthy controls (5.0 [3.2-7.0] nmol/L) (p < 0.001). Significant positive correlations were found between neopterin levels and HbA1c (r = 0.560, p = 0.005), serum creatinine (r = 0.376, p = 0.003), total cholesterol (r = 0.405, p = 0.026) and hs-CRP (r = 0.425, p = 0.012) among patients with DPN. Neopterin levels were positively correlated to motor latency of tibial and common peroneal nerves as well as motor and sensory latencies of median and ulnar nerves. Logistic regression analysis revealed that neopterin was a significant independent variable related to DPN (Odds ratio, 2.976). Neopterin cutoff value 32 nmol/L could differentiate patients with and without DPN with 100% sensitivity and 96.7% specificity. CONCLUSIONS Neopterin could be used as an early reliable serum biomarker for DPN in pediatric patients with T1DM.
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Saure C, Caminiti C, Weglinski J, de Castro Perez F, Monges S. Energy expenditure, body composition, and prevalence of metabolic disorders in patients with Duchenne muscular dystrophy. Diabetes Metab Syndr 2018; 12:81-85. [PMID: 28869151 DOI: 10.1016/j.dsx.2017.08.006] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 08/20/2017] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Duchenne muscular dystrophy (DMD) is a severe muscular disease characterized by progressive loss of functional muscle mass followed by changes in body composition. AIM To describe body composition, resting energy expenditure (REE), and metabolic disorders in DMD patients followed-up at a tertiary care center. To analyze the association with type of steroid and ambulatory status, and to compare obese DMD patients with patients with multifactorial obesity. POPULATION AND METHODS A prospective, observational, cross-sectional study was conducted. Anthropometric measurements were taken, evaluating body composition with bioelectrical impedance analysis (BIA), REE with indirect calorimetry, and biochemical parameters in all DMD patients seen between June 2013 and April 2014. RESULTS 63 boys between 5.4 and 18.7years of age were evaluated. Diagnosis of obesity ranged from 28% measuring body mass indexZ-score (BMIZ-score) to 70% using percentage of fat mass (%FM). Patients who had lost gait had a significantly higher %FM than those in whom gait was preserved (72% vs 46%, p<0.05). Insulin resistance was present in 29% associated with BMI Z-score and waist circumference and 40% had dyslipidemia associated with %FM, both of which were steroid independent. In obese DMD patients REE was lower than predicted and also lower than controls, and persist when dividing the patients into ambulators and non-ambulators. CONCLUSIONS A high prevalence of obesity was observed. BMI-Z-score underestimates the degree of FM. No correlation was found between steroid type and body composition or metabolic disorders. No differences were found in REE between ambulators and non-ambulators. Obese DMD patients have a lower REE than controls.
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Affiliation(s)
- Carola Saure
- Department of Nutrition and Diabetes, Hospital JP Garrahan, Argentina.
| | - Carolina Caminiti
- Department of Nutrition and Diabetes, Hospital JP Garrahan, Argentina.
| | - Julieta Weglinski
- Department of Nutrition and Diabetes, Hospital JP Garrahan, Argentina.
| | | | - Soledad Monges
- Department of Neurology, Hospital J P Garrahan, Argentina.
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Ahmadpour F, Nourbakhsh M, Razzaghy-Azar M, Khaghani S, Alipoor B, Abdolvahabi Z, Zangoei M. THE ASSOCIATION OF PLASMA LEVELS OF miR-34a AND miR-149 WITH OBESITY AND INSULIN RESISTANCE IN OBESE CHILDREN AND ADOLESCENTS. ACTA ENDOCRINOLOGICA (BUCHAREST, ROMANIA : 2005) 2018; 14:149-154. [PMID: 31149251 PMCID: PMC6516521 DOI: 10.4183/aeb.2018.149] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
CONTEXT MicroRNAs (miRNAs) are short noncoding RNAs involved in posttranscriptional regulation of gene expression that influence various cellular functions including glucose and lipid metabolism and adipocyte differentiation. OBJECTIVE The aim of this study was to evaluate the levels of miR-34a and miR-149 and their relationship with metabolic parameters in obese children and adolescents. DESIGN Seventy children and adolescents were enrolled in the study. Plasma levels of microRNAs were evaluated by real-time PCR using SYBR green and analyzed by ΔCt method. Plasma concentrations of visfatin and insulin were measured by ELISA method. Glucose and lipid profile were determined colorimetrically. HOMA-IR was calculated and used as an index of insulin resistance (IR). RESULTS miR-34a was significantly lower in subjects with insulin resistance compared to obese children with normal insulin sensitivity. There was an inverse relationship between miR-34a levels and both insulin and HOMA-IR. On the other hand, miR-149 was significantly correlated with visfatin. There was no significant difference in miR-34a and miR-149 between obese and normal weight subjects. CONCLUSIONS miR-34a is associated with insulin and HOMA-IR and thus seems to be involved in IR. miR-149 is inversely associated with visfatin levels which could be indicative of anti-inflammatory effect of this miRNA.
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Affiliation(s)
- F. Ahmadpour
- Iran University of Medical Sciences, School of Medicine, Department of Biochemistry, Tehran, Islamic Republic of Iran
| | - M. Nourbakhsh
- Iran University of Medical Sciences, School of Medicine, Department of Biochemistry, Tehran, Islamic Republic of Iran
| | - M. Razzaghy-Azar
- Tehran University of Medical Sciences, Endocrinology and Metabolism Molecular - Cellular Sciences Institute, Metabolic Disorders Research Center, Tehran, Islamic Republic of Iran
- Iran University of Medical Sciences, “H. Aliasghar” Children’s Hospital, Tehran, Islamic Republic of Iran
| | - Sh. Khaghani
- Tehran University of Medical Sciences, School of Medicine, Department of Biochemistry, Tehran, Islamic Republic of Iran
| | - B. Alipoor
- Tehran University of Medical Sciences, School of Medicine, Department of Biochemistry, Tehran, Islamic Republic of Iran
| | - Z. Abdolvahabi
- Iran University of Medical Sciences, School of Medicine, Department of Biochemistry, Tehran, Islamic Republic of Iran
| | - M. Zangoei
- Tehran University of Medical Sciences, School of Medicine, Department of Biochemistry, Tehran, Islamic Republic of Iran
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Sadeghabadi ZA, Nourbakhsh M, Alaee M, Larijani B, Razzaghy-Azar M. Peroxisome proliferator-activated receptor gamma expression in peripheral blood mononuclear cells and angiopoietin-like protein 4 levels in obese children and adolescents. J Endocrinol Invest 2018; 41:241-247. [PMID: 28733963 DOI: 10.1007/s40618-017-0730-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 07/10/2017] [Indexed: 01/20/2023]
Abstract
PURPOSE The peroxisome proliferator-activated receptor γ (PPARγ) is highly expressed in adipose tissue and functions as transcriptional regulator of metabolism and adipocyte differentiation. Angiopoietin-like protein 4 (ANGPTL4), a central player in various aspects of energy homoeostasis, is induced by PPARγ. The aim of this study was to evaluate ANGPTL4 plasma levels and PPARγ gene expression in peripheral blood mononuclear cells (PBMCs) of children and adolescents with obesity and their association with metabolic parameters. METHODS Seventy children and adolescents (35 obese and 35 age- and gender-matched control subjects), were selected. PBMCs were separated and their total RNA was extracted. After cDNA synthesis, PPARG gene expression was analyzed by real-time PCR. Relative differences in gene expression were calculated by ΔCt method using β-actin as a normalizer. Serum ANGPTL4 and insulin were measured using ELISA, and insulin resistance (IR) was calculated by the homeostatic model assessment of insulin resistance (HOMA-IR). Fasting plasma glucose (FPG), triglyceride, total cholesterol, LDL-C and HDL-C were also measured. RESULTS The expression of the PPARG gene as well as the plasma ANGPTL4 levels were significantly diminished in obese subjects as compared to control ones. However, they were not significantly different in obese children with IR compared to obese children without IR or in those with or without metabolic syndrome. A significant positive correlation was found between PPARγ and ANGPTL4 (r = 0.364, p = 0.002). PPARγ expression levels were also significantly correlated with FPG (r = -0.35, p = 0.003). CONCLUSION PPARγ is decreased in childhood obesity and may be responsible for diminished ANGPTL4 levels.
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Affiliation(s)
- Z A Sadeghabadi
- Metabolic Disorders Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - M Nourbakhsh
- Department of Biochemistry, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.
| | - M Alaee
- Metabolic Disorders Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - B Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - M Razzaghy-Azar
- Metabolic Disorders Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- H. Aliasghar Hospital, Iran University of Medical Sciences, Tehran, Iran
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Perito ER, Phelps A, Vase T, Feldstein VA, Lustig RH, Rosenthal P. Subclinical Atherosclerosis in Pediatric Liver Transplant Recipients: Carotid and Aorta Intima-Media Thickness and Their Predictors. J Pediatr 2018; 193:119-127.e1. [PMID: 29224938 PMCID: PMC5794603 DOI: 10.1016/j.jpeds.2017.10.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 08/21/2017] [Accepted: 10/10/2017] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To investigate prevalence and predictors of cardiovascular risk in pediatric liver transplant recipients using noninvasive markers of subclinical atherosclerosis: carotid intima-media thickness (cIMT) and aorta intima-media thickness (aIMT). STUDY DESIGN Cross-sectional study of 88 pediatric liver transplant recipients. The cIMT and aIMT were measured by ultrasound imaging using standardized protocol. RESULTS Participants were 15.4 ± 4.8 years of age, and 11.2 ± 5.6 years post-transplantation. The cIMT and aIMT were both higher in males than females. In analyses adjusted for sex, age, and height, the cIMT was higher in subjects transplanted for chronic/cirrhotic liver disease and lower in subjects on cyclosporine (n = 9) than tacrolimus (n = 71). The cIMT was not associated with rejection history or current corticosteroid use. The cIMT increased with increasing diastolic blood pressure and triglycerides. The aIMT (n = 83) also increased with age, and its rate of increase post-transplant varied by age at transplantation. In adjusted analyses, aIMT was higher in subjects with glucose intolerance. In analysis of patients ≤20 years of age for whom blood pressure percentiles could be calculated (n = 66), aIMT increased with increasing diastolic blood pressure percentile (0.010 mm per 5-percentile; 95% CI, 0.000-0.021; P = 0.05). Neither the cIMT nor the aIMT was associated with obesity, systolic hypertension, or other dyslipidemia at study visit. CONCLUSION Measures of long-term cardiovascular risk were associated with conditions that are more common in pediatric liver transplant recipients than nontransplanted peers, namely, diastolic hypertension and glucose intolerance. Larger, longitudinal studies are warranted to investigate whether cIMT could be useful for stratifying these patients' cardiovascular risk-and potential need for proactive intervention-during long-term follow-up.
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Affiliation(s)
- Emily R. Perito
- Department of Pediatrics, UCSF Benioff Children’s Hospital, University of California, San Francisco, San Francisco, CA,Department of Epidemiology and Biostatistics, UCSF Benioff Children’s Hospital, University of California, San Francisco, San Francisco, CA
| | - Andrew Phelps
- Department of Radiology and Biomedical Imaging, UCSF Benioff Children’s Hospital, University of California, San Francisco, San Francisco, CA
| | - Tabitha Vase
- School of Medicine, UCSF Benioff Children’s Hospital, University of California, San Francisco, San Francisco, CA
| | - Vickie A. Feldstein
- Department of Radiology and Biomedical Imaging, UCSF Benioff Children’s Hospital, University of California, San Francisco, San Francisco, CA
| | - Robert H. Lustig
- Department of Pediatrics, UCSF Benioff Children’s Hospital, University of California, San Francisco, San Francisco, CA
| | - Philip Rosenthal
- Department of Pediatrics, UCSF Benioff Children’s Hospital, University of California, San Francisco, San Francisco, CA,Department of Surgery, UCSF Benioff Children’s Hospital, University of California, San Francisco, San Francisco, CA
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El-Samahy MH, Adly AA, Elhenawy YI, Ismail EA, Pessar SA, Mowafy MES, Saad MS, Mohammed HH. Urinary miRNA-377 and miRNA-216a as biomarkers of nephropathy and subclinical atherosclerotic risk in pediatric patients with type 1 diabetes. J Diabetes Complications 2018; 32:185-192. [PMID: 29175120 DOI: 10.1016/j.jdiacomp.2017.10.014] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2017] [Revised: 10/23/2017] [Accepted: 10/28/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND Urinary microRNAs (miRNAs) play a role in the pathogenesis of chronic kidney disease (CKD). AIM To identify the expression of urinary miR-377 and miR-216a in 50 children and adolescents with type 1 diabetes (T1DM) compared with 50 healthy controls and assess their relation to the degree of albuminuria, glycemic control and carotid intimal thickness (CIMT) as an index of atherosclerosis. METHODS Diabetic subjects were divided into normoalbuminuric and microalbuminuric groups according to urinary albumin creatinine ration (UACR). Urinary miRNAs were assessed using real time polymerase chain reaction. CIMT was measured using high resolution carotid ultrasound. RESULTS The expression of urinary miR-377 was significantly higher in patients with microalbumiuria (median, 3.8) compared with 2.65 and 0.98 in normoalbuminic patients and healthy controls, respectively (p<0.05). Urinary miR-216a was significantly lower in all patients with type 1 diabetes and the lowest levels were among the microalbumiuric group. Significant positive correlations were found between urinary miR-377 and HbA1C, UACR and CIMT while urinary miR-216a was negatively correlated to these variables. CONCLUSIONS Urinary miR-377 and miR-216a can be considered early biomarkers of nephropathy in pediatric type 1 diabetes. Their correlation with CIMT provides insights on the subclinical atherosclerotic process that occurs in diabetic nephropathy.
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Affiliation(s)
| | - A A Adly
- Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| | | | - E A Ismail
- Clinical Pathology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | | | - Mohammed Salah Saad
- Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Sultan S, Dowling M, Kirton A, DeVeber G, Linds A, Elkind MSV. Dyslipidemia in Children With Arterial Ischemic Stroke: Prevalence and Risk Factors. Pediatr Neurol 2018; 78:46-54. [PMID: 29229232 PMCID: PMC5776751 DOI: 10.1016/j.pediatrneurol.2017.09.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 09/27/2017] [Accepted: 09/29/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND Risk factors for pediatric stroke are poorly understood and require study to improve prevention. Total cholesterol and triglyceride values peak to near-adult levels before puberty, a period of increased stroke incidence. The role of lipids in childhood arterial ischemic stroke has been minimally investigated. METHODS We performed a cross-sectional analysis of lipid and Lp(a) concentrations in children with arterial ischemic stroke in the International Pediatric Stroke Study to compare the prevalence of dyslipidemia and high- or low-ranking lipid values in our dataset with reported population values. We analyzed sex, body mass index, race, ethnicity, family history, and stroke risk factors for associations with dyslipidemia, high non-high-density lipoprotein cholesterol, and hypertriglyceridemia. RESULTS Compared with the National Health and Nutrition Examination Survey, a higher proportion of children ≥5 years with arterial ischemic stroke had dyslipidemia (38.4% versus 21%), high total cholesterol (10.6% versus 7.4%), high non-high-density lipoprotein cholesterol (23.1% versus 8.4%), and low high-density lipoprotein cholesterol (39.8% versus 13.4%). The lipid values that corresponded to one standard deviation above the mean (84th percentile) in multiple published national studies generally corresponded to a lower ranking percentile in children aged five years or older with arterial ischemic stroke. Dyslipidemia was more likely associated with an underweight, overweight, or obese body mass index compared with a healthy weight. Ethnic background and an acute systemic illness were also associated with abnormal lipids. CONCLUSIONS Dyslipidemia and hypertriglyceridemia may be more prevalent in children with arterial ischemic stroke compared with stroke-free children.
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Affiliation(s)
- Sally Sultan
- Department of Pediatrics, Columbia University Medical Center, New York, New York.
| | - Michael Dowling
- Department of Pediatrics and Neurology & Neurotherapeutics, Division of Pediatric Neurology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Adam Kirton
- Calgary Pediatric Stroke Program, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Gabrielle DeVeber
- Division of Neurology and Labatt Family Heart Centre, Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Alexandra Linds
- Division of Neurology, Child Health Evaluative Sciences Program, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Mitchell S V Elkind
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York
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Patel HP, Saland JM, Ng DK, Jiang S, Warady BA, Furth SL, Flynn JT. Waist Circumference and Body Mass Index in Children with Chronic Kidney Disease and Metabolic, Cardiovascular, and Renal Outcomes. J Pediatr 2017; 191:133-139. [PMID: 29173296 PMCID: PMC5728693 DOI: 10.1016/j.jpeds.2017.08.047] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 07/08/2017] [Accepted: 08/17/2017] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To describe the prevalence of obesity as estimated by waist circumference (WC) and body mass index (BMI) and compare associations of WC and BMI with indicators of metabolic, cardiovascular, and renal health in children with chronic kidney disease (CKD). STUDY DESIGN Cross-sectional analysis stratified by CKD etiology (nonglomerular or glomerular) of 737 subjects. The kappa statistic was used to assess agreement between the 2 measures of obesity. Linear regression models were performed using WC and BMI as separate independent variables. Dependent variables included lipid measures, insulin resistance, blood pressure, left ventricular mass index, proteinuria, and estimated glomerular filtration rate. Associations were scaled to SD and interpreted as the change in dependent variable associated with a 1-SD change in WC or BMI. RESULTS There was good agreement (kappa statistic = 0.68) between WC and BMI in identifying obesity. Approximately 10% of subjects had obesity by 1 measure but not the other. BMI was more strongly associated with estimated glomerular filtration rate than WC. BMI was more strongly associated with left ventricular mass index in the nonglomerular CKD group compared with WC, but both had significant associations. The associations between WC and BMI with the remainder of the dependent variables were not significantly different. CONCLUSIONS Measurement of WC added limited information to BMI in this cohort. Further longitudinal study is needed to determine how WC and BMI compare in predicting outcomes, particularly for children with CKD identified as having obesity by 1 measure but not the other.
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Affiliation(s)
- Hiren P Patel
- Department of Pediatrics, Ohio State University College of Medicine and Nationwide Children's Hospital, Columbus, OH.
| | - Jeffrey M Saland
- Department of Pediatrics, Icahn School of Medicine at Mount
Sinai
| | - Derek K Ng
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public
Health
| | - Shuai Jiang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public
Health
| | | | - Susan L Furth
- Department of Pediatrics, Perelman School of Medicine at the
University of Pennsylvania
| | - Joseph T Flynn
- Department of Pediatrics, University of Washington and Seattle
Children’s Hospital
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El-Samahy MH, Tantawy AAG, Adly AAM, Habeeb NM, Ismail EAR, Hamed GM, Eladawy R. Expression of CD4 + CD28 null T lymphocytes in children and adolescents with type 1 diabetes mellitus: Relation to microvascular complications, aortic elastic properties, and carotid intima media thickness. Pediatr Diabetes 2017; 18:785-793. [PMID: 28102614 DOI: 10.1111/pedi.12484] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Revised: 11/16/2016] [Accepted: 11/17/2016] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Cardiovascular risk in type 1 diabetes mellitus (T1DM) is associated with endothelial dysfunction, inflammation, and altered immunity. CD4+ CD28null T-cells are a subset of long-lived cytotoxic CD4+ T-lymphocytes with proatherogenic and plaque-destabilizing properties. We hypothesized that the frequency of CD4+ CD28null T-cells may be altered in T1DM and related to vascular complications. AIM To assess the percentage of CD4+ CD28null T-lymphocytes in children and adolescents with T1DM and their relation to vascular structure and glycemic control. METHODS Totally 100 patients with T1DM were divided into 2 groups according to the presence of microvascular complications and compared with 50 healthy controls. CD4+ CD28null T-lymphocytes were analyzed using flow cytometry. Aortic elastic properties and carotid intima media thickness (CIMT) were assessed. RESULTS Aortic stiffness index and CIMT were significantly higher among patients compared with healthy controls while aortic strain and distensibility were decreased. The percentage of CD4+ CD28null T-cells was significantly higher in patients with and without microvascular complications compared with controls. High frequency of CD4+ CD28null T-cells was found among patients with microalbuminuria or peripheral neuropathy. Patients with CD4+ CD28null T-cells ≥10% had higher HbA1c, urinary albumin creatinine ratio, aortic stiffness, and CIMT. CD4+ CD28null T-cells were positively correlated to HbA1c, aortic stiffness index, and CIMT. CONCLUSIONS Changes in aortic elastic properties and increased CIMT among young patients with T1DM may enable the recognition of preclinical cardiac impairment. The correlation between CD4+ CD28null T-cells and assessed parameters of vascular structure highlights the role of altered immune response in the occurrence of diabetic vascular complications.
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Affiliation(s)
- Mona H El-Samahy
- Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Azza A G Tantawy
- Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Amira A M Adly
- Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Nevin M Habeeb
- Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Eman A R Ismail
- Clinical Pathology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Gehan M Hamed
- Clinical Pathology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Rasha Eladawy
- Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Distinct Lipoprotein Curves in Normal Weight, Overweight, and Obese Children and Adolescents. J Pediatr Gastroenterol Nutr 2017; 65:673-680. [PMID: 28691976 DOI: 10.1097/mpg.0000000000001674] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVES Pediatric lipoprotein curves are based on population-based samples. As obesity, may alter lipoprotein levels, cutoffs not adjusted for body mass index (BMI) are potentially inappropriate. We aimed to develop distinct serum lipid curves based on sex- and BMI-percentiles for children and adolescents. METHODS Cross-sectional analysis included all healthy children and adolescents (age range 2-17 years) with available serum lipid concentrations (n = 152,820 of approximately 1.2 million children and adolescents per study year). These children and adolescents were categorized according to sex- and age-stratified BMI-percentiles: 100,375 normal weight (5th-85th percentile), 26,028 overweight (85th-95th percentile) and 26,417 obese (≥95th percentile) individuals. Excluded were individuals with hyperlipidemia, gastrointestinal disease, thyroid disease and lipid-lowering medications. Lambda-Mu-Sigma, smoothed percentile lipid curves were computed. RESULTS Obese children had a lipid profile pattern throughout childhood and adolescence similar to that of normal weight subjects but with a significant upward shift in total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), and triglycerides (TGs) and a downward shift in high-density lipoprotein-cholesterol (HDL-C). Obese boys had 13 mg/dL higher TC levels (P < 0.001), 11 mg/dL higher LDL-C levels, 15 mg/dL higher non-HDL-C levels, and 5 mg/dL lower HDL-C levels (P < 0.001). Obese girls had 6 mg/dL higher TC levels, 7 mg/dL higher LDL-C levels, 11 mg/dl higher non-HDL-C levels, and 6 mg/dL lower HDL-C levels (P < 0.001). CONCLUSIONS Across a large, nationally representative cohort of children and adolescents, lipoprotein levels were found to vary in relation to weight status. On the basis of these findings, it is suggested that when evaluating the lipid profile in the pediatric population, in addition to sex-based curves, clinical decision making may require consideration of BMI-stratified curves.
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Arab Sadeghabadi Z, Nourbakhsh M, Pasalar P, Emamgholipour S, Golestani A, Larijani B, Razzaghy-Azar M. Reduced gene expression of sirtuins and active AMPK levels in children and adolescents with obesity and insulin resistance. Obes Res Clin Pract 2017; 12:167-173. [PMID: 29150224 DOI: 10.1016/j.orcp.2017.10.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 09/18/2017] [Accepted: 10/10/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND Sirtuins, including SIRT1 and SIRT2, are longevity-associated deacetylase enzymes that modulate metabolic homeostasis in response to the cellular energy state. Adenosine monophosphate activated protein kinase (AMPK) and SIRT1 are interrelated and share several common target pathways. This study aimed to evaluate the SIRT1 and SIRT2 gene expression in peripheral blood mononuclear cells (PBMCs) as well as plasma levels of AMPK, in obese children and adolescents. MATERIALS AND METHODS Participants included 60 children and adolescents (30 obese and 30 age- and gender-matched control subjects). Real-time polymerase chain reaction (PCR) was used to assess the SIRT1 and SIRT2 gene expression in PBMCs. Serum phospho-AMPK and insulin were measured using enzyme-linked immunosorbent assay (ELISA), and insulin resistance (IR) was calculated by the Homeostasis Model of Assessment of Insulin Resistance (HOMA-IR). Glucose and lipid profile were also measured. RESULTS SIRT1 gene expression and phospho-AMPK plasma levels were significantly diminished in obese subjects compared to the control group, and both SIRT1 and SIRT2 were significantly lower in obese children with IR compared to those without IR. SIRT1 expression revealed significant negative correlations with body mass index and waist circumference as well as insulin and HOMA-IR and a positive correlation with AMPK. SIRT2 negatively correlated with SIRT1 and positively correlated with high density lipoprotein-cholesterol (HDL-C). CONCLUSION SIRT1 and SIRT2 expression and AMPK levels decrease in children with obesity and IR. Targeting SIRT1 can be valuable in preventing obesity-associated IR in childhood and adolescence.
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Affiliation(s)
- Zahra Arab Sadeghabadi
- Department of Biochemistry, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Metabolic Disorders Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Nourbakhsh
- Department of Biochemistry, Faculty of Medicine, Iran University of Medical Sciences, 1449614535 Tehran, Iran.
| | - Parvin Pasalar
- Department of Biochemistry, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Metabolic Disorders Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Solaleh Emamgholipour
- Department of Biochemistry, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Abolfazl Golestani
- Department of Biochemistry, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Razzaghy-Azar
- Metabolic Disorders Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; H. Aliasghar Children's Hospital, Iran University of Medical Sciences, Tehran, Iran
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Di Taranto MD, Benito-Vicente A, Giacobbe C, Uribe KB, Rubba P, Etxebarria A, Guardamagna O, Gentile M, Martín C, Fortunato G. Identification and in vitro characterization of two new PCSK9 Gain of Function variants found in patients with Familial Hypercholesterolemia. Sci Rep 2017; 7:15282. [PMID: 29127338 PMCID: PMC5681505 DOI: 10.1038/s41598-017-15543-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 10/30/2017] [Indexed: 11/16/2022] Open
Abstract
Familial hypercholesterolemia (FH) is an autosomal dominant disease caused by pathogenic variants in genes encoding for LDL receptor (LDLR), Apolipoprotein B and Proprotein convertase subtilisin/kexin type 9 (PCSK9). Among PCSK9 variants, only Gain-of- Function (GOF) variants lead to FH. Greater attention should be paid to the classification of variants as pathogenic. Two hundred sixty nine patients with a clinical suspect of FH were screened for variants in LDLR and the patients without pathogenic variants were screened for variants in PCSK9 and APOB. Functional characterization of PCSK9 variants was performed by assessment of protein secretion, of LDLR activity in presence of PCSK9 variant proteins as well as of the LDLR affinity of the PCSK9 variants. Among 81 patients without pathogenic variants in LDLR, 7 PCSK9 heterozygotes were found, 4 of whom were carriers of variants whose role in FH pathogenesis is still unknown. Functional characterization revealed that two variants (p.(Ser636Arg) and p.(Arg357Cys)) were GOF variants. In Conclusions, we demonstrated a GOF effect of 2 PCSK9 variants that can be considered as FH-causative variants. The study highlights the important role played by functional characterization in integrating diagnostic procedures when the pathogenicity of new variants has not been previously demonstrated.
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Affiliation(s)
- Maria Donata Di Taranto
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, Napoli and CEINGE S.C.a r.l. Biotecnologie Avanzate, Napoli, Italy
| | - Asier Benito-Vicente
- Biofisika Institute (CSIC, UPV/EHU) and Departamento de Bioquímica, Universidad del País Vasco, Apdo. 644, 48080, Bilbao, Spain
| | - Carola Giacobbe
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, Napoli and CEINGE S.C.a r.l. Biotecnologie Avanzate, Napoli, Italy
| | - Kepa Belloso Uribe
- Biofisika Institute (CSIC, UPV/EHU) and Departamento de Bioquímica, Universidad del País Vasco, Apdo. 644, 48080, Bilbao, Spain
| | - Paolo Rubba
- Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Napoli, Italy
| | - Aitor Etxebarria
- Biofisika Institute (CSIC, UPV/EHU) and Departamento de Bioquímica, Universidad del País Vasco, Apdo. 644, 48080, Bilbao, Spain
| | - Ornella Guardamagna
- Dipartimento di Scienze della Sanità Pubblica e Pediatriche, Università degli Studi di Torino, Torino, Italy
| | - Marco Gentile
- Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Napoli, Italy
| | - Cesar Martín
- Biofisika Institute (CSIC, UPV/EHU) and Departamento de Bioquímica, Universidad del País Vasco, Apdo. 644, 48080, Bilbao, Spain.
| | - Giuliana Fortunato
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, Napoli and CEINGE S.C.a r.l. Biotecnologie Avanzate, Napoli, Italy.
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Warner M, Ye M, Harley K, Kogut K, Bradman A, Eskenazi B. Prenatal DDT exposure and child adiposity at age 12: The CHAMACOS study. ENVIRONMENTAL RESEARCH 2017; 159:606-612. [PMID: 28917205 PMCID: PMC6380491 DOI: 10.1016/j.envres.2017.08.050] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 07/17/2017] [Accepted: 08/24/2017] [Indexed: 05/06/2023]
Abstract
OBJECTIVE Using data from the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS) birth cohort study, we assessed the association of in utero exposure to dichlorodiphenyltrichloroethane (DDT) and dichlorodiphenylethylene (DDE) with child adiposity at age 12. METHODS We included 240 children with o,p'-DDT, p,p'-DDT, and p,p'-DDE concentrations measured in maternal serum collected during pregnancy (ng/g lipid) and complete 12-year follow-up data. Age- and sex-specific body mass index (BMI) z-scores were calculated from CDC growth charts. Children with BMI z-scores ≥ 85th percentile were classified as overweight or obese. RESULTS At 12 years, BMI z-score averaged 1.09 (±1.03) and 55.4% of children were overweight or obese. Prenatal DDT and DDE exposure was associated with several adiposity measures in boys but not girls. Among boys, 10-fold increases in prenatal DDT and DDE concentrations were associated with increased BMI z-score (o,p'-DDT, adj-β=0.37, 95% CI: 0.08, 0.65; p,p'-DDT, adj-β = 0.26, 95% CI: 0.03, 0.48; p,p'-DDE, adj-β = 0.31, 95% CI: 0.02, 0.59). Results for girls were nonsignificant. The difference by sex persisted after considering pubertal status. CONCLUSIONS These results support the chemical obesogen hypothesis, that in utero exposure to DDT and DDE may increase risk of obesity in males later in life.
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Affiliation(s)
- Marcella Warner
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, CA, USA.
| | - Morgan Ye
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, CA, USA
| | - Kim Harley
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, CA, USA
| | - Katherine Kogut
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, CA, USA
| | - Asa Bradman
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, CA, USA
| | - Brenda Eskenazi
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, CA, USA
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Koskinen J, Magnussen CG, Sinaiko A, Woo J, Urbina E, Jacobs DR, Steinberger J, Prineas R, Sabin MA, Burns T, Berenson G, Bazzano L, Venn A, Viikari JSA, Hutri-Kähönen N, Raitakari O, Dwyer T, Juonala M. Childhood Age and Associations Between Childhood Metabolic Syndrome and Adult Risk for Metabolic Syndrome, Type 2 Diabetes Mellitus and Carotid Intima Media Thickness: The International Childhood Cardiovascular Cohort Consortium. J Am Heart Assoc 2017; 6:JAHA.117.005632. [PMID: 28862940 PMCID: PMC5586423 DOI: 10.1161/jaha.117.005632] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background There is paucity of knowledge concerning the specific age in youth when the associations of metabolic syndrome (MetS) begin to be operative. Thus, we investigated the relation of age to the associations of childhood MetS with adult MetS, type 2 diabetes mellitus and high carotid intima‐media thickness. Methods and Results Five thousand eight‐hundred three participants were analyzed in 4 cohort studies (Cardiovascular Risk in Young Finns, Bogalusa Heart Study, Princeton Lipid Research Study, Insulin Study). International cutoffs and previously used 75th percentile cutoffs were used for children to define MetS and its components. Mean follow‐up period was 22.3 years. Logistic regression was used to calculate risk ratios and 95% confidence intervals. Childhood MetS and overweight were associated with over 2.4‐fold risk for adult MetS from the age of 5 years onward. Risk for type 2 diabetes mellitus was increased from the age of 8 (risk ratio, 2.6–4.1; 95% confidence interval, 1.35–6.76 and 1.12–7.24, respectively) onward for the 2 childhood MetS criteria based on international cut‐off values and for childhood overweight. Risk for high carotid intima‐media thickness was significant at ages 11 to 18 years in relation to childhood MetS or overweight (risk ratio, 2.44–4.22; 95% confidence interval, 1.55–3.55 and 2.55–5.66, respectively). Continuous childhood MetS score was associated with adult MetS from the age of 5, with type 2 diabetes mellitus from the age of 14 and with high carotid intima‐media thickness from the age of 11 years onward. Conclusions Adult MetS was predicted by MetS in childhood beginning at age 5. However, adult type 2 diabetes mellitus and subclinical atherosclerosis were not predicted by childhood data until after age 8. Body mass index measurement alone at the same age points provided similar findings.
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Affiliation(s)
- Juha Koskinen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Finland .,Heart Center, Turku University Hospital, Turku, Finland
| | - Costan G Magnussen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Finland.,Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Alan Sinaiko
- Department of Pediatrics, University of Minnesota, Minneapolis, MN
| | - Jessica Woo
- Division of Biostatistics and Epidemiology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH
| | - Elaine Urbina
- Division of Cardiology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati, Cincinnati, OH
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Julia Steinberger
- Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, MN
| | - Ronald Prineas
- Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Matthew A Sabin
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Australia.,Department of Pediatrics, University of Melbourne, Parkville, Australia
| | - Trudy Burns
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA
| | - Gerald Berenson
- Department of Epidemiology, Tulane Center for Cardiovascular Health, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
| | - Lydia Bazzano
- Departments of Epidemiology and Biostatistics and Bioinformatics, Tulane University Health Sciences Center, Tulane University, New Orleans, LA
| | - Alison Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Jorma S A Viikari
- Department of Medicine, University of Turku, Finland.,Division of Medicine, Turku University Hospital, Turku, Finland
| | - Nina Hutri-Kähönen
- Department of Pediatrics, University of Tampere School of Medicine and Tampere University Hospital, Tampere, Finland
| | - Olli Raitakari
- Department of Clinical Physiology and Nuclear Medicine, University of Turku and Turku University Hospital, Turku, Finland
| | - Terence Dwyer
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Australia.,Department of Pediatrics, University of Melbourne, Parkville, Australia
| | - Markus Juonala
- Department of Medicine, University of Turku, Finland.,Division of Medicine, Turku University Hospital, Turku, Finland
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Laurson KR, Saint-Maurice PF, Welk GJ, Eisenmann JC. Reference Curves for Field Tests of Musculoskeletal Fitness in U.S. Children and Adolescents: The 2012 NHANES National Youth Fitness Survey. J Strength Cond Res 2017; 31:2075-2082. [DOI: 10.1519/jsc.0000000000001678] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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77
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Fan Y, Zhang C, Bu J. Relationship between Selected Serum Metallic Elements and Obesity in Children and Adolescent in the U.S. Nutrients 2017; 9:nu9020104. [PMID: 28165362 PMCID: PMC5331535 DOI: 10.3390/nu9020104] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Revised: 01/10/2017] [Accepted: 01/12/2017] [Indexed: 02/04/2023] Open
Abstract
The prevalence of obesity has increased at an alarming rate worldwide. Metallic elements are involved in the pathogenesis of obesity and related diseases. To date, whether environmental exposure to metallic elements has effects on obesity in children and adolescents is still unclear. The aim of the current study was to investigate the association of blood metallic elements with obesity in U.S. children and adolescents. This cross-sectional study was performed with 5404 children and adolescents (6-19 years, 2745 males and 2659 females) who participated in the US National Health and Nutrition Examination Survey 2011-2014. Blood lead, mercury, selenium, manganese, copper, and zinc, as well as biochemical parameters including triglyceride (TG), cholesterol, low-density lipoprotein (LDL), and homeostasis model assessment of insulin resistance (HOMA-IR) were assessed for all subjects. Multivariate logistic regression and linear regression were applied to assess associations of metallic elements and overweight, obesity status, and serum metabolites as distinct outcomes adjusted for age, gender, ethnicity, and the poverty income ratio. When stratified by age and sex, significant associations were found between the highest quartile of copper concentrations in blood with obesity status (OR = 9.27, 95% CI: 5.43, 15.82, pfor trend < 0.001) and cholesterol (OR = 3.08, 95% CI: 1.43, 6.63, pfor trend < 0.001). The highest concentrations of manganese in the blood was associated with obesity in those aged 6-19 years (OR = 2.29, 95% CI: 1.74, 3.02, pfor trend < 0.001). Moreover, blood mercury and selenium showed positive relationships with cholesterol. Further, a negative association existed between blood zinc and obesity. The National Health and Nutrition Examination Survey data provide epidemiological evidence that blood metallic elements are positively associated with obesity in children and adolescents. However, the underlying mechanisms still need further exploration.
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Affiliation(s)
- Yun Fan
- State Key Laboratory of Reproductive Medicine, Institute of Toxicology, Nanjing Medical University, Nanjing 211166, Jiangsu, China.
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, Jiangsu, China.
| | - Chunlan Zhang
- State Key Laboratory of Reproductive Medicine, Institute of Toxicology, Nanjing Medical University, Nanjing 211166, Jiangsu, China.
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, Jiangsu, China.
| | - Jin Bu
- Editorial Department of Journals of Nanjing Medical University, Nanjing Medical University, Nanjing 211166, Jiangsu, China.
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Asghari G, Eftekharzadeh A, Hosseinpanah F, Ghareh S, Mirmiran P, Azizi F. Instability of different adolescent metabolic syndrome definitions tracked into early adulthood metabolic syndrome: Tehran Lipid and Glucose Study (TLGS). Pediatr Diabetes 2017; 18:59-66. [PMID: 26825860 DOI: 10.1111/pedi.12349] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 11/28/2015] [Accepted: 11/16/2015] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND AND OBJECTIVE There are substantial controversies about the clinical utility of adolescent metabolic syndrome (MetS). The current study examined the stability of adolescent MetS by assessing the agreement and discriminative abilities of four different definitions of adolescent MetS and the adult MetS definition during a 10.4-yr follow up. SUBJECTS AND METHODS For this study, 1424 adolescents (55.2% female), who participated in the framework of the Tehran Lipid and Glucose Study were included. Kappa was calculated for agreement between adolescent MetS definitions [Cook, de Ferranti, pediatric National Cholesterol Education Program (NCEP) and pediatric International Diabetes Federation (IDF)] and the adulthood MetS definition defined by the joint interim statement (JIS) criteria. MetS persistence, instability, and incidence were assessed, and for each of the four adolescent definitions, sensitivity, specificity, and area under receiver operating curve (AUC) for the counting of categorical adulthood MetS components was evaluated. RESULTS The agreement between the four adolescent MetS definitions and JIS was poor (κ = 0.094-0.255). All definitions showed low sensitivity and high specificity, except for de Ferranti's, which contrary to other definitions, had higher sensitivity and lower specificity. All four adolescent definitions revealed generally low AUCs (0.601-0.647). Compared with the pubertal group (11-14 yr), the predictive power was slightly higher in the late-pubertal group (15-18 yr). Cook's and de Ferranti's definitions showed fairly better predictive powers (0.647 and 0.644, respectively). Across all definitions, instability ranged between 5.4 and 19.6%. CONCLUSION The adolescent definitions show considerable amount of instability defined as poor agreement and low discriminative abilities tracked into early adulthood.
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Affiliation(s)
- Golaleh Asghari
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Anita Eftekharzadeh
- Obesity Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farhad Hosseinpanah
- Obesity Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sahar Ghareh
- Faculty of Medicine, Islamic Azad University, Mashhad Medical Branch, Mashhad, Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Guseman EH, Cauffman SP, Tucker JM, Smith L, Eisenmann JC, Stratbucker W. The Association Between Measures of Fitness and Metabolic Health in Treatment-Seeking Youth with Obesity. Metab Syndr Relat Disord 2016; 15:107-111. [PMID: 27869528 DOI: 10.1089/met.2016.0094] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Both cardiorespiratory fitness (CRF) and measures of muscular fitness are associated with metabolic syndrome in adults. However, limited information exists about these relationships in youth with severe obesity who are at increased risk of metabolic dysfunction. The purpose of this study was to examine the relationship between fitness and metabolic health in treatment-seeking youth with obesity. METHODS Data for this analysis were collected at the time of baseline visits at a stage 3 pediatric weight management center. Maximal voluntary contractions were obtained by using isometric hand-grip dynamometry, and CRF was obtained from a maximal treadmill test. Resting blood pressure and fasting measures of blood lipids, glucose, and insulin were used to calculate a continuous metabolic syndrome score (cMetS); homeostasis model assessment of insulin resistance (HOMA-IR) was calculated from fasting insulin and glucose. Relationships between measures of fitness and metabolic health were evaluated by using partial correlations adjusted for age. RESULTS Sixty-nine participants (21 boys, 48 girls) were included in this analysis. Of these, 46% (n = 32) met the criteria for metabolic syndrome. No differences were found between boys and girls for any variable analyzed. Muscular strength was positively associated with cMetS (r = 0.35), though this association weakened after adjustment for body mass index percentile. CRF was inversely associated with homeostasis model assessment of insulin resistance (HOMA-IR) (r = -0.26) and fasting insulin (r = -0.27). Body fat percentage was positively associated with insulin (r = 0.36). No significant relationship was found between CRF and cMetS. CONCLUSION Contrary to previous studies, CRF was not associated with metabolic syndrome in this group. Muscular strength, however, was associated with cMetS. Notably, CRF was associated with elevated HOMA-IR, which may be seen as a precursor to metabolic syndrome. These results suggest that CRF and muscular strength influence metabolic function independently.
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Affiliation(s)
- Emily Hill Guseman
- 1 Division of Kinesiology and Health, College of Health Sciences, University of Wyoming , Laramie, Wyoming
| | - Samuel P Cauffman
- 2 Department of Human Studies, University of Alabama at Birmingham , Birmingham, Alabama
| | - Jared M Tucker
- 3 Healthy Weight Center , Helen DeVos Children's Hospital, Grand Rapids, Michigan.,4 Department of Pediatrics and Human Development, Michigan State University , East Lansing, Michigan
| | - Lucie Smith
- 3 Healthy Weight Center , Helen DeVos Children's Hospital, Grand Rapids, Michigan
| | - Joey C Eisenmann
- 5 Department of Radiology, College of Osteopathic Medicine, Michigan State University , East Lansing, Michigan
| | - William Stratbucker
- 3 Healthy Weight Center , Helen DeVos Children's Hospital, Grand Rapids, Michigan
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The Impact of Nonalcoholic Fatty Liver Disease on Renal Function in Children with Overweight/Obesity. Int J Mol Sci 2016; 17:ijms17081218. [PMID: 27472326 PMCID: PMC5000616 DOI: 10.3390/ijms17081218] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Revised: 07/10/2016] [Accepted: 07/21/2016] [Indexed: 02/06/2023] Open
Abstract
The association between nonalcoholic fatty liver disease (NAFLD) and chronic kidney disease has attracted interest and attention over recent years. However, no data are available in children. We determined whether children with NAFLD show signs of renal functional alterations, as determined by estimated glomerular filtration rate (eGFR) and urinary albumin excretion. We studied 596 children with overweight/obesity, 268 with NAFLD (hepatic fat fraction ≥5% on magnetic resonance imaging) and 328 without NAFLD, and 130 healthy normal-weight controls. Decreased GFR was defined as eGFR < 90 mL/min/1.73 m2. Abnormal albuminuria was defined as urinary excretion of ≥30 mg/24 h of albumin. A greater prevalence of eGFR < 90 mL/min/1.73 m2 was observed in patients with NAFLD compared to those without liver involvement and healthy subjects (17.5% vs. 6.7% vs. 0.77%; p < 0.0001). The proportion of children with abnormal albuminuria was also higher in the NAFLD group compared to those without NAFLD, and controls (9.3% vs. 4.0% vs. 0; p < 0.0001). Multivariate logistic regression analysis revealed that NAFLD was associated with decreased eGFR and/or microalbuminuria (odds ratio, 2.54 (confidence interval, 1.16–5.57); p < 0.05) independently of anthropometric and clinical variables. Children with NAFLD are at risk for early renal dysfunction. Recognition of this abnormality in the young may help to prevent the ongoing development of the disease.
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Shim YS, Baek JW, Kang MJ, Oh YJ, Yang S, Hwang IT. Reference Values for The Triglyceride to High-Density Lipoprotein Cholesterol Ratio and Non-High-Density Lipoprotein Cholesterol in Korean Children and Adolescents: The Korean National Health and Nutrition Examination Surveys 2007-2013. J Atheroscler Thromb 2016; 23:1334-1344. [PMID: 27373984 PMCID: PMC5221496 DOI: 10.5551/jat.35634] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: Cholesterol levels vary throughout childhood and adolescence. The aim of the present study was to evaluate and identify age- and gender-specific reference values for serum lipid concentrations including non-high-density lipoprotein cholesterol (non-HDL-C) and the triglyceride to HDL-C ratio (TG/HDL-C ratio) in apparently healthy Korean children and adolescents. Methods: A total of 6197 participants aged 10 to 19 years old from the 2007–2013 Korean National Health and Nutrition Examination Survey were analyzed. Serum lipid concentrations were evaluated according to age and gender. Results: The overall mean concentration of non-HDL-C was 105.5 ± 25.6 mg/dL, with a significant gender difference: 103.3 ± 26.1 mg/dL in boys and 107.9 ± 24.7 mg/dL in girls (p = 0.028). The median values of non-HDL-C concentrations in boys and girls, respectively, were 111 and 112 mg/dL in the 10-year-old age group, 95 and 103 mg/dL in the 15-year-old age group, and 109 and 103 mg/dL in the 19-year-old age group. The overall mean TG/HDL-C ratio was 1.74 ± 1.22, and there were no significant gender differences: 1.77 ± 1.25 in boys and 1.72 ± 1.22 in girls (p = 0.183). The median values of the TG/HDL-C ratio in boys and girls were 1.16 and 1.00 in the 10-year-olds, 1.54 and 0.95 in the 15-year-olds, and 1.74 and 0.84 in the 19-year-olds, respectively. Conclusions: Age- and gender-specific reference values for non-HDL-C and for the TG/HDL-C ratio in children and adolescents could provide valuable information for individualized interpretations of lipid profiles and interventions as well as for strategies to prevent and manage childhood and adolescent dyslipidemia.
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Affiliation(s)
- Young Suk Shim
- Department of Pediatrics, Hallym University, College of Medicine
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82
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Razzaghy-Azar M, Nourbakhsh M, Pourmoteabed A, Nourbakhsh M, Ilbeigi D, Khosravi M. An Evaluation of Acylated Ghrelin and Obestatin Levels in Childhood Obesity and Their Association with Insulin Resistance, Metabolic Syndrome, and Oxidative Stress. J Clin Med 2016; 5:jcm5070061. [PMID: 27348010 PMCID: PMC4961992 DOI: 10.3390/jcm5070061] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 05/16/2016] [Accepted: 06/01/2016] [Indexed: 12/27/2022] Open
Abstract
Background: Ghrelin is a 28-amino acid peptide with an orexigenic property, which is predominantly produced by the stomach. Acylated ghrelin is the active form of this hormone. Obestatin is a 23-amino acid peptide which is produced by post-translational modification of a protein precursor that also produces ghrelin. Obestatin has the opposite effect of ghrelin on food intake. The aim of this study was to evaluate acylated ghrelin and obestatin levels and their ratio in obese and normal-weight children and adolescents, and their association with metabolic syndrome (MetS) parameters. Methods: Serum acyl-ghrelin, obestatin, leptin, insulin, fasting plasma glucose (FPG), lipid profile, and malondialdehyde (MDA) were evaluated in 73 children and adolescents (42 obese and 31 control). Insulin resistance was calculated by a homeostasis model assessment of insulin resistance (HOMA-IR). MetS was determined according to IDF criteria. Results: Acyl-ghrelin levels were significantly lower in obese subjects compared to the control group and lower in obese children with MetS compared to obese subjects without MetS. Obestatin was significantly higher in obese subjects compared to that of the control, but it did not differ significantly among those with or without MetS. Acyl-ghrelin to obestatin ratio was significantly lower in obese subjects compared to that in normal subjects. Acyl-ghrelin showed significant negative and obestatin showed significant positive correlations with body mass index (BMI), BMI Z-score, leptin, insulin, and HOMA-IR. Acyl-ghrelin had a significant negative correlation with MDA as an index of oxidative stress. Conclusion: Ghrelin is decreased and obestatin is elevated in obesity. Both of these hormones are associated with insulin resistance, and ghrelin is associated with oxidative stress. The balance between ghrelin and obestatin seems to be disturbed in obesity.
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Affiliation(s)
- Maryam Razzaghy-Azar
- Metabolic Disorders Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, 1411715851 Tehran, Iran.
- H. Aliasghar Hospital, Iran University of Medical Sciences, 1449614535 Tehran, Iran.
| | - Mitra Nourbakhsh
- Department of Biochemistry, School of Medicine, Iran University of Medical Sciences, 1449614535 Tehran, Iran.
| | | | - Mona Nourbakhsh
- H. Aliasghar Hospital, Iran University of Medical Sciences, 1449614535 Tehran, Iran.
| | - Davod Ilbeigi
- Department of Biochemistry, School of Medicine, Tehran University of Medical Sciences, 1417614418 Tehran, Iran.
| | - Mohsen Khosravi
- Department of Biochemistry, School of Medicine, Iran University of Medical Sciences, 1449614535 Tehran, Iran.
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83
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Perito ER, Lustig RH, Rosenthal P. Metabolic Syndrome Components After Pediatric Liver Transplantation: Prevalence and the Impact of Obesity and Immunosuppression. Am J Transplant 2016; 16:1909-16. [PMID: 26751054 PMCID: PMC4874932 DOI: 10.1111/ajt.13714] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 12/04/2015] [Accepted: 12/29/2015] [Indexed: 01/25/2023]
Abstract
Metabolic syndrome is associated with long-term morbidity and mortality after adult liver transplantation (LT). Whether pediatric LT recipients have a higher prevalence of metabolic syndrome remains controversial. In a cross-sectional study, we evaluated pediatric LT recipients aged 8-30 years using National Health and Nutrition Examination Survey (NHANES) protocols. LT recipients were matched by gender, race/ethnicity, and age with controls from NHANES. Pediatric LT recipients (n = 83), after adjusting for overweight/obesity and glucocorticoid use, had increased prevalence of prehypertension and hypertension, impaired glucose tolerance (IGT; 2-h glucose after oral glucose tolerance test ≥140 mg/dL), and low high-density lipoprotein compared to matched NHANES controls (n = 235) despite a lower prevalence of overweight/obesity. Among LT recipients, the adjusted odds of IGT doubled for every 7.5 years taking calcineurin inhibitors (odds ratio = 2.10, 95% confidence interval 1.06-4.17 per 7.5 years taking calcineurin inhibitors, p = 0.03). Among all subjects with IGT, LT recipients had a lower prevalence of overweight/obesity and less insulin resistance (homeostatic model assessment of insulin resistance) than did controls with IGT. Among normal weight subjects, LT recipients were significantly more likely than controls to have prehypertension/hypertension, IGT, low high-density lipoprotein, and metabolic syndrome. Pediatric LT recipients have unique metabolic syndrome profiles and risk factors and will require tailored screening and management protocols.
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Affiliation(s)
- Emily R. Perito
- Department of Pediatrics, UCSF Benioff Children’s Hospital, University of California, San Francisco, San Francisco, CA
- Department of Epidemiology and Biostatistics, UCSF Benioff Children’s Hospital, University of California, San Francisco, San Francisco, CA
| | - Robert H. Lustig
- Department of Pediatrics, UCSF Benioff Children’s Hospital, University of California, San Francisco, San Francisco, CA
| | - Philip Rosenthal
- Department of Pediatrics, UCSF Benioff Children’s Hospital, University of California, San Francisco, San Francisco, CA
- Department of Surgery, UCSF Benioff Children’s Hospital, University of California, San Francisco, San Francisco, CA
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84
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Boone-Heinonen J, Markwardt S, Fortmann SP, Thornburg KL. Overcoming birth weight: can physical activity mitigate birth weight-related differences in adiposity? Pediatr Obes 2016; 11:166-73. [PMID: 25988588 PMCID: PMC4653090 DOI: 10.1111/ijpo.12040] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Revised: 04/10/2015] [Accepted: 04/13/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Individuals born at low or high birth weight (BW) have elevated adiposity. The extent to which physical activity can mitigate this risk is unknown. OBJECTIVES The aim of this study was to determine if associations between BW and adiposity vary by self-reported moderate-to-vigorous physical activity (MVPA) among adolescents. METHODS We used data on adolescents in the National Health and Nutrition Examination Survey (1999-2006; 12-15 years; n = 4064). Using gender-stratified linear regression, we modelled body mass index (BMI) and waist circumference (WC) z-scores as a function of low, normal and high BW, MVPA (weekly Metabolic Equivalent of Task hours) and MVPA*BW cross-product terms, adjusting for sociodemographics, diet and, in WC models, BMI. RESULTS Among girls with low MVPA, those born with high BW had greater BMI than normal BW; this difference diminished with greater MVPA (coefficient [95% confidence interval]: low MVPA: 0.72 [0.29, 1.14]; high MVPA: -0.04 [-0.48, 0.39]; P for interaction = 0.05). Among boys, MVPA did not modify the associations between BW and BMI. WC was unrelated to BW, regardless of MVPA. CONCLUSIONS Findings suggest that effects of high BW in total adiposity can be more easily modified with MVPA in adolescent girls than in boys.
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Affiliation(s)
- Janne Boone-Heinonen
- Department of Public Health and Preventive Medicine, Oregon Health & Science University; Portland, OR, USA
| | - Sheila Markwardt
- Department of Public Health and Preventive Medicine, Oregon Health & Science University; Portland, OR, USA
| | | | - Kent L. Thornburg
- Bob and Charlee Moore Institute for Nutrition and Wellness, Oregon Health & Science University; Portland, OR, USA
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85
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El-Beblawy NMS, Andrawes NG, Ismail EAR, Enany BES, El-Seoud HSA, Erfan MA. Serum and Urinary Orosomucoid in Young Patients With Type 1 Diabetes: A Link Between Inflammation, Microvascular Complications, and Subclinical Atherosclerosis. Clin Appl Thromb Hemost 2016; 22:718-726. [PMID: 26975878 DOI: 10.1177/1076029616637185] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Orosomucoid is an acute-phase serum protein that is upregulated in urine samples of patients with diabetic nephropathy. We assessed serum and urinary orosomucoid levels in children and adolescents with type 1 diabetes and their relation to microvascular complications and carotid intima-media thickness (CIMT). Sixty patients with type 1 diabetes were divided into 2 groups according to the presence of microvascular complications and compared with 60 healthy controls. High-sensitivity C-reactive protein (hs-CRP), hemoglobin A1c (HbA1c), urinary albumin-creatinine ratio (UACR), serum and urinary orosomucoid, and CIMT were assessed. Both serum and urinary orosomucoid levels were significantly increased in patients with and without microvascular complications compared with controls, and the highest levels were in patients with complications (P < .001). Serum and urinary orosomucoid were higher in patients with microalbuminuria than normoalbuminuric group (P < .001). The cutoff value of urinary orosomucoid at 2825 ng/mL could differentiate patients with and without microvascular complications. Serum and urinary orosomucoid were positively correlated. Multiple regression analysis showed that HbA1c, UACR, hs-CRP, and CIMT were independently related to orosomucoid. We suggest that orosomucoid is a significant independent factor for diabetic microvascular complications and can be considered as an early marker of renal injury. High orosomucoid levels in type 1 diabetes reflect endothelial dysfunction and subclinical atherosclerosis.
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Affiliation(s)
| | | | | | | | | | - Marwa A Erfan
- Department of Pediatrics, Ain Shams University, Cairo, Egypt
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86
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Innes S, Abdullah KL, Haubrich R, Cotton MF, Browne SH. High Prevalence of Dyslipidemia and Insulin Resistance in HIV-infected Prepubertal African Children on Antiretroviral Therapy. Pediatr Infect Dis J 2016; 35:e1-7. [PMID: 26421804 PMCID: PMC4707556 DOI: 10.1097/inf.0000000000000927] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Data describing the true extent of antiretroviral therapy (ART)-induced dyslipidemia and insulin resistance in perinatally infected children on ART in Africa are sparse. METHODS Fasting total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, insulin and glucose were performed on the first 100 of 190 pediatric ART clinic attendees. Diet assessment was performed by a trained dietician. Lipoatrophy was formally graded by consensus between 2 expert HIV pediatricians. Durations of previous ART exposures, clinical stage, pre-ART viral load, nadir and current CD4 were recorded. Dual-energy X-ray absorptiometry was performed on a subset of 42 patients selected semi-randomly. RESULTS Prevalences of insulin resistance, abnormal total cholesterol, LDL, HDL and triglyceride were 10%, 13%, 12%, 13% and 9%, respectively. Overall, 40% had at least 1 lipid abnormality or insulin resistance. Adjusted mean LDL cholesterol increased by 0.24 mmol/L for each additional year of cumulative lopinavir/r exposure (P = 0.03) after correcting for age, gender, body mass index, previous stavudine exposure, age at ART initiation, dietary fat and refined carbohydrate, whereas adjusted mean LDL cholesterol was 0.9 mmol/L higher in children exposed to efavirenz within the previous 6 months (P = 0.02). Adjusting for age, gender and ethnicity, dual-energy X-ray absorptiometry revealed that greater trunk fat and lower peripheral subcutaneous fat were associated with elevated triglycerides but not with total cholesterol, LDL, HDL or homeostatic model assessment. Similarly, the presence of visually obvious lipoatrophy was associated with elevated triglycerides but not with total cholesterol, LDL, HDL, homeostatic model assessment or lactate. CONCLUSIONS Prevalences of insulin resistance and dyslipidemia were high. Cumulative lopinavir is an independent risk factor for dyslipidemia, with efavirenz exposure having only transitory effect.
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Affiliation(s)
- Steve Innes
- Children's Infectious Disease Clinical Research Unit, Stellenbosch University and Tygerberg Children’s Hospital, Cape Town, South Africa
| | - Kameelah L. Abdullah
- Department of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, Ca
| | - Richard Haubrich
- Department of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, Ca
| | - Mark F. Cotton
- Children's Infectious Disease Clinical Research Unit, Stellenbosch University and Tygerberg Children’s Hospital, Cape Town, South Africa
| | - Sara H. Browne
- Department of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, Ca
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87
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LMS tables for waist-circumference and waist-height ratio Z-scores in children aged 5-19 y in NHANES III: association with cardio-metabolic risks. Pediatr Res 2015; 78:723-9. [PMID: 26331767 DOI: 10.1038/pr.2015.160] [Citation(s) in RCA: 128] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Accepted: 05/22/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND In adults, anthropometric measures of central adiposity, such as waist-height ratio (WHtR) and waist circumference (WC), are more strongly associated with cardio-metabolic risks than BMI. METHODS To provide similar quantitative tools for North American children, we created smoothed centile charts and LMS tables for WHtR and WC based on data from the US National Health and Nutrition Survey, cycle III (NHANES III, N = 11,930 aged 2-24 y 1988-1994). RESULTS Applying these reference charts to subsequent NHANES survey cycles, 1999-2012) demonstrated a significant mean increase in both Z-scores of approximately 0.30 SD. In measuring the strength of the association between anthropometric measures and cardio-metabolic risk factors, a unit change in Z-scores for WHtR, WC, and BMI significantly increased the odds of an adverse outcome in all cases (1.18-2.03, P < 0.0001). Z-scores for both measures of central adiposity were significantly more strongly associated with cardio-metabolic comorbidities than BMI-Z. CONCLUSION Since Z-scores permit standardized comparisons across ages and genders, they are useful measures of central adiposity in both clinical or research settings. By providing LMS tables for children and adolescents based on North American reference data, we hope to provide quantitative tools for the study of obesity and its complications.
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88
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Bauer KW, Marcus MD, El ghormli L, Ogden CL, Foster GD. Cardio-metabolic risk screening among adolescents: understanding the utility of body mass index, waist circumference and waist to height ratio. Pediatr Obes 2015; 10:329-37. [PMID: 25515620 PMCID: PMC4470887 DOI: 10.1111/ijpo.267] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Revised: 07/25/2014] [Accepted: 08/12/2014] [Indexed: 01/14/2023]
Abstract
BACKGROUND Few studies have assessed how well body mass index (BMI), waist circumference (WC), or waist to height ratio (WtHR) perform in identifying cardio-metabolic risk among youth. OBJECTIVE The objective of this study was to evaluate the utility of BMI and WC percentiles and WtHR to distinguish adolescents with and without cardio-metabolic risk. METHODS A cross-sectional analysis of data from 6097 adolescents aged 10-13 years who participated in the HEALTHY study was conducted. Receiver operating characteristic curves determined the discriminatory ability of BMI and WC percentiles and WtHR. RESULTS The discriminatory ability of BMI percentile was good (area under the curve [AUC] ≥ 0.80) for elevated insulin and clustering of ≥3 risk factors, with optimal cut-points of 96 and 95, respectively. BMI percentile performed poor to fair (AUC = 0.57-0.75) in identifying youth with the majority of individual risk factors examined (elevated glucose, total cholesterol, low-density lipoprotein, blood pressure, triglycerides and high-density lipoprotein). WC percentile and WtHR performed similarly to BMI percentile. CONCLUSIONS The current definition of obesity among US children performs well at identifying adolescents with elevated insulin and a clustering of ≥3 cardio-metabolic risk factors. Evidence does not support WC percentile or WtHR as superior screening tools compared with BMI percentile for identifying cardio-metabolic risk.
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Affiliation(s)
- Katherine W. Bauer
- Center for Obesity Research and Education, Temple University, Philadelphia, PA,Department of Public Health, Temple University, Philadelphia, PA
| | - Marsha D. Marcus
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Laure El ghormli
- The Biostatistics Center, George Washington University, Rockville, Maryland
| | - Cynthia L. Ogden
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD
| | - Gary D. Foster
- Center for Obesity Research and Education, Temple University, Philadelphia, PA
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89
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Adly AAM, Ismail EA, Tawfik LM, Ebeid FSE, Hassan AAS. Endothelial monocyte activating polypeptide II in children and adolescents with type 1 diabetes mellitus: Relation to micro-vascular complications. Cytokine 2015; 76:156-162. [PMID: 26142824 DOI: 10.1016/j.cyto.2015.06.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 04/12/2015] [Accepted: 06/08/2015] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Endothelial monocyte-activating polypeptide II (EMAP II) is a multifunctional polypeptide with proinflammatory and antiangiogenic activity. Hyperglycemia and dyslipidemia appears to be significant factors contributing to increased EMAP-II levels. We determined serum EMAP II in children and adolescents with type 1 diabetes as a potential marker for micro-vascular complications and assessed its relation to inflammation and glycemic control. METHODS Eighty children and adolescents with type 1 diabetes were divided into 2 groups according to the presence of micro-vascular complications and compared with 40 healthy controls. High-sensitivity C-reactive protein (hs-CRP), hemoglobin A1c (HbA1c) and EMAP II levels were assessed. RESULTS Serum EMAP II levels were significantly increased in patients with micro-vascular complications (1539 ± 321.5 pg/mL) and those without complications (843.6 ± 212.6 pg/mL) compared with healthy controls (153.3 ± 28.3 pg/mL; p<0.001). EMAP II was increased in patients with microalbuminuria than normoalbuminuric group (p<0.001). Significant positive correlations were found between EMAP II levels and body mass index, fasting blood glucose, HbA1c, serum creatinine, triglycerides, total cholesterol, urinary albumin creatinine ratio (UACR) and hs-CRP (p<0.05). A cutoff value of EMAP II at 1075 pg/mL could differentiate diabetic patients with and without micro-vascular complications with a sensitivity of 93% and specificity of 82%. CONCLUSIONS We suggest that EMAP II is elevated in type 1 diabetic patients, particularly those with micro-vascular complications. EMAP II levels are related to inflammation, glycemic control, albuminuria level of patients and the risk of micro-vascular complications.
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Affiliation(s)
- Amira A M Adly
- Pediatric Department, Faculty of Medicine, Ain Shams University, Egypt.
| | - Eman A Ismail
- Clinical Pathology Department, Faculty of Medicine, Ain Shams University, Egypt
| | - Lamis M Tawfik
- Clinical Pathology Department, Faculty of Medicine, Ain Shams University, Egypt
| | - Fatma S E Ebeid
- Pediatric Department, Faculty of Medicine, Ain Shams University, Egypt
| | - Asmaa A S Hassan
- Pediatric Department, Faculty of Medicine, Ain Shams University, Egypt
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90
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El-Asrar MA, Andrawes NG, Ismail EA, Salem SMH. Kallistatin as a marker of microvascular complications in children and adolescents with type 1 diabetes mellitus: Relation to carotid intima media thickness. Vasc Med 2015; 20:509-17. [DOI: 10.1177/1358863x15591089] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
In diabetes, angiogenesis is disturbed, contributing to proliferative retinopathy, nephropathy and neuropathy. Kallistatin, a serine proteinase inhibitor, has anti-angiogenic effects. We assessed serum kallistatin in children and adolescents with type 1 diabetes as a potential marker for microvascular complications and its relation to carotid intima media thickness (CIMT). Sixty patients with type 1 diabetes were divided into two groups according to the presence of microvascular complications and compared with 30 healthy controls. High-sensitivity C-reactive protein (hs-CRP), HbA1c, urinary albumin creatinine ratio (UACR), kallistatin levels and CIMT were assessed. Kallistatin levels were significantly higher in patients with microvascular complications (9.9 ± 2.38 ng/mL) and those without complications (5.0 ± 1.5 ng/mL) than in healthy controls (1.39 ± 0.55 ng/mL; p<0.001). Kallistatin was increased in patients with microalbuminuria compared with the normoalbuminuric group ( p<0.001). Positive correlations were found between kallistatin and disease duration, fasting blood glucose, HbA1c, triglycerides, total cholesterol, hs-CRP, UACR and CIMT ( p<0.05). A kallistatin cut-off value at 6.1 ng/mL could differentiate patients with and without microvascular complications, with a sensitivity of 96.87% and specificity of 93.75%. Increased kallistatin levels in type 1 diabetes and its relation with CIMT may reflect vascular dysfunction and suggest a link between micro- and macro-angiopathy.
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Affiliation(s)
- Mohamed A El-Asrar
- Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Nevine G Andrawes
- Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Eman A Ismail
- Clinical Pathology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Shaimaa MH Salem
- Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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91
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Rodday AM, Parsons SK, Mankiw C, Correll CU, Robb AS, Zima BT, Saunders TS, Leslie LK. Child and adolescent psychiatrists' reported monitoring behaviors for second-generation antipsychotics. J Child Adolesc Psychopharmacol 2015; 25:351-61. [PMID: 25918843 PMCID: PMC4442598 DOI: 10.1089/cap.2014.0156] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The number of children and adolescents (hereafter referred to as "children") who have been prescribed second-generation antipsychotics (SGAs) has increased over the last decade, but little is known about monitoring practices in pediatric patients who are vulnerable to adverse effects. We examined factors associated with psychiatrists' self-reported monitoring of children who were prescribed SGAs. METHODS A survey was mailed to a national, randomly selected sample of 1600 child and adolescent psychiatrists from the American Medical Association mailing list. Using logistic regression, we tested whether psychiatrist characteristics, attitudes, and practice characteristics were associated with monitoring (baseline and/or periodic) the following: Patient history, height and weight, blood pressure, waist circumference, lipid and glucose levels, and electrocardiogram. RESULTS Among the analytic sample of 308, at least two thirds reported monitoring patient history, height and weight, blood pressure, and fasting plasma lipids and glucose; 23% reported monitoring waist circumference; and 12% reported conducting an electrocardiogram. More than one third stated that they routinely monitored thyroid levels and more than half reported monitoring complete blood count and electrolytes/blood urea nitrogen. Psychiatrists reporting that they were able to measure vital signs on site were more likely to measure height and weight. Those who reported feeling comfortable conducting a physical examination were more likely to measure blood pressure. Those answering that the risk of metabolic syndrome was low were less likely to measure blood pressure and waist circumference. Being board certified and able to measure vital signs on site were associated with more monitoring of glucose and lipid levels. Conversely, years in practice and feeling that patients were nonadherent with blood work were associated with less monitoring of glucose and lipid levels. CONCLUSIONS In this sample, inconsistent monitoring patterns of children prescribed SGAs were found. Efforts to communicate guidelines' evidence base and improve office capacity to measure and track adverse effects are needed to increase appropriate adverse effect monitoring in children who have been prescribed SGAs.
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Affiliation(s)
- Angie Mae Rodday
- The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts.,Tufts University School of Medicine, Boston, Massachusetts
| | - Susan K. Parsons
- The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts.,Tufts University School of Medicine, Boston, Massachusetts
| | - Catherine Mankiw
- The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts
| | - Christoph U. Correll
- The Zucker Hillside Hospital, North Shore-LIJ Health System, Glen Oaks, New York
| | - Adelaide S. Robb
- Center for Clinical and Community Research, Children's National Health System, Washington, DC
| | - Bonnie T. Zima
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, California
| | - Tully S. Saunders
- The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts
| | - Laurel K. Leslie
- The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts.,Tufts University School of Medicine, Boston, Massachusetts.,Floating Hospital for Children, Tufts Medical Center, Boston, Massachusetts
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92
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Di Bonito P, Valerio G, Grugni G, Licenziati MR, Maffeis C, Manco M, Miraglia del Giudice E, Pacifico L, Pellegrin MC, Tomat M, Baroni MG. Comparison of non-HDL-cholesterol versus triglycerides-to-HDL-cholesterol ratio in relation to cardiometabolic risk factors and preclinical organ damage in overweight/obese children: the CARITALY study. Nutr Metab Cardiovasc Dis 2015; 25:489-494. [PMID: 25813687 DOI: 10.1016/j.numecd.2015.01.012] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 01/12/2015] [Accepted: 01/27/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS Lipid ratios to estimate atherosclerotic disease risk in overweight/obese children are receiving great attention. We aimed to compare the performance of non-high-density lipoprotein-cholesterol (HDL-C) versus triglycerides-to-HDL-C ratio (Tg/HDL-C) in identifying cardiometabolic risk factors (CMRFs) or preclinical signs of organ damage in outpatient Italian overweight/obese children. METHODS AND RESULTS In this retrospective, cross-sectional study, 5505 children (age 5-18 years) were recruited from 10 Italian centers for the care of obesity, of which 4417 (78%) showed obesity or morbid obesity. Anthropometric, biochemical, and blood pressure variables were analyzed in all children. Liver ultrasound scan, carotid artery ultrasound, and echocardiography were performed in 1257, 601, and 252 children, respectively. The entire cohort was divided based on the 75th percentile of non-HDL-C (≥130 mg/dl) or Tg/HDL-C ratio (≥2.2). The odds ratio for insulin resistance, high blood pressure, metabolic syndrome, presence of liver steatosis, increased levels of carotid intima-media thickness (cIMT) and concentric left ventricular hypertrophy (cLVH) was higher in children with high levels of Tg/HDL-C with respect to children with high levels of non-HDL-C. CONCLUSIONS In an outpatient setting of overweight/obese children, Tg/HDL-C ratio discriminated better than non-HDL-C children with CMRFs or preclinical signs of liver steatosis, and increased cIMT and cLVH.
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Affiliation(s)
- P Di Bonito
- Department of Internal Medicine, Pozzuoli Hospital (Napoli), Naples, Italy
| | - G Valerio
- Department of Movement Sciences and Wellness, Parthenope University, Naples, Italy.
| | - G Grugni
- Division of Auxology, Italian Auxological Institute, Verbania, Italy
| | - M R Licenziati
- Department of Pediatrics, AORN Santobono-Pausilipon, Naples, Italy
| | - C Maffeis
- Pediatric Diabetes and Metabolic Disorders Unit, Department of Life & Reproduction Sciences, University of Verona, Verona, Italy
| | - M Manco
- Bambino Gesù Children's Hospital, Rome, Italy
| | - E Miraglia del Giudice
- Department of Woman, Child and General and Specialized Surgery, Second University of Napoli, Naples, Italy
| | - L Pacifico
- Department of Pediatrics and Child Neuropsychiatry, Sapienza University of Rome, Rome, Italy
| | - M C Pellegrin
- Department of Pediatrics, University of Trieste, Trieste, Italy
| | - M Tomat
- Pediatric Unity, AOU Udine, Udine, Italy
| | - M G Baroni
- Endocrinology and Diabetes, Department of Medical Sciences, University of Cagliari, Cagliari, Italy; Department of Experimental Medicine, Sapienza University of Roma, Rome, Italy
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93
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Bustamante A, Freitas D, Pan H, Katzmarzyk PT, Maia J. Centile curves and reference values for height, body mass, body mass index and waist circumference of Peruvian children and adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:2905-22. [PMID: 25761169 PMCID: PMC4377942 DOI: 10.3390/ijerph120302905] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Revised: 02/27/2015] [Accepted: 03/02/2015] [Indexed: 11/17/2022]
Abstract
This study aimed to provide height, body mass, BMI and waist circumference (WC) growth centile charts for school-children, aged 4-17 years, from central Peru, and to compare Peruvian data with North-American and Argentinean references. The sample consisted of 8753 children and adolescents (4130 boys and 4623 girls) aged 4 to 17 years, from four Peruvian cities: Barranco, La Merced, San Ramón and Junín. Height, body mass and WC were measured according to standardized techniques. Centile curves for height, body mass, BMI and WC were obtained separately for boys and girls using the LMS method. Student t-tests were used to compare mean values. Overall boys have higher median heights than girls, and the 50th percentile for body mass increases curvilinearly from 4 years of age onwards. In boys, the BMI and WC 50th percentiles increase linearly and in girls, the increase presents a curvilinear pattern. Peruvian children are shorter, lighter and have higher BMI than their counterparts in the U.S. and Argentina; in contrast, age and sex-specific WC values are lower. Height, body mass and WC of Peruvian children increased with age and variability was higher at older ages. The growth patterns for height, body mass, BMI and WC among Peruvian children were similar to those observed in North-American and Argentinean peers.
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Affiliation(s)
- Alcibíades Bustamante
- National University of Education Enrique Guzmán y Valle, Av. Guzmán y Valle s/n La Cantuta-Chosica, Lima, Peru.
- CIFI2D, Kinanthropometry Lab, Faculty of Sport, University of Porto, Rua Dr. Plácido Costa 91, Porto 4200-450, Portugal.
| | - Duarte Freitas
- Department of Physical Education and Sports, University of Madeira, Colégio dos Jesuítas-Rua dos Ferreiros, Funchal 9000-082, Portugal.
| | - Huiqi Pan
- MCR Centre of Epidemiology for Child Health, UCL Institute of Child Health 30 Guilford Street London WC1N 1EH, UK.
| | - Peter T Katzmarzyk
- Pennington Biomedical Research Center, Louisiana State University, 6400 Perkins Rd., Baton Rouge, LA 70808, USA.
| | - José Maia
- CIFI2D, Kinanthropometry Lab, Faculty of Sport, University of Porto, Rua Dr. Plácido Costa 91, Porto 4200-450, Portugal.
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94
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Buitrago-Lopez A, van den Hooven EH, Rueda-Clausen CF, Serrano N, Ruiz AJ, Pereira MA, Mueller NT. Socioeconomic status is positively associated with measures of adiposity and insulin resistance, but inversely associated with dyslipidaemia in Colombian children. J Epidemiol Community Health 2015; 69:580-7. [PMID: 25691273 DOI: 10.1136/jech-2014-204992] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 01/13/2015] [Indexed: 12/16/2022]
Abstract
BACKGROUND Low socioeconomic status (SES) has been associated with higher risk of cardiometabolic diseases in developed societies, but investigation of SES and cardiometabolic risk in children in less economically developed populations is sparse. We aimed to examine associations among SES and cardiometabolic risk factors in Colombian children. METHODS We used data from a population-based study of 1282 children aged 6-10 years from Bucaramanga, Colombia. SES was classified according to household wealth, living conditions and access to public utilities. Anthropometric and biochemical parameters were measured at a clinic visit. Cardiometabolic risk factors were analysed continuously using linear regression and as binary outcomes-according to established paediatric cut points-using logistic regression to calculate OR and 95% CIs. RESULTS Mean age of the children was 8.4 (SD 1.4) and 51.1% of the sample were boys. Odds of overweight/obesity, abdominal obesity and insulin resistance were greater among higher SES. Compared with the lowest SES stratum, children in the highest SES had higher odds of overweight/obesity (OR=3.25, 95% CI 1.89 to 5.57), abdominal obesity (OR=2.74, 95% CI 1.41 to 5.31) and insulin resistance (OR=2.60, 95% CI 1.81 to 3.71). In contrast, children in the highest SES had lower odds of hypertriglyceridaemia (triglycerides ≥90th centile; OR=0.28, 95% CI 0.14 to 0.54) and low (≤10th centile) high-density lipoprotein (HDL) cholesterol (OR=0.35, 95% CI 0.15 to 0.78). CONCLUSIONS In Colombian children, SES is directly associated with obesity and insulin resistance, but inversely associated with dyslipidaemia (hypertriglyceridaemia and low HDL cholesterol). Our findings highlight the need to analyse cardiometabolic risk factors separately in children and to carefully consider a population's level of economic development when studying their social determinants of cardiometabolic disease.
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Affiliation(s)
- Adriana Buitrago-Lopez
- Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Edith H van den Hooven
- Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Christian F Rueda-Clausen
- Department of Medicine, University of Alberta, Li Ka Shing Centre for Heath Research Innovation, University of Alberta, Edmonton, Alberta, Canada
| | - Norma Serrano
- Division of Research, Fundacion Cardiovascular de Colombia, Floridablanca, Santander, Colombia
| | - Alvaro J Ruiz
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogota DC, Colombia
| | - Mark A Pereira
- Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Noel T Mueller
- Department of Epidemiology, Mailman School of Public Health, Columbia University Medical Center, New York, New York, USA Institute of Human Nutrition and Department of Medicine, College of Physicians and Surgeons, Columbia University Medical Center, New York, New York, USA
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95
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El-Samahy MH, Adly AAM, Ismail EA, Salah NY. Regulatory T cells with CD62L or TNFR2 expression in young type 1 diabetic patients: relation to inflammation, glycemic control and micro-vascular complications. J Diabetes Complications 2015; 29:120-6. [PMID: 25113439 DOI: 10.1016/j.jdiacomp.2014.07.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2014] [Revised: 06/19/2014] [Accepted: 07/09/2014] [Indexed: 12/13/2022]
Abstract
BACKGROUND Alteration of regulatory T cells (Tregs) may contribute to ineffective suppression of proinflammatory cytokines in type 1 diabetes. AIM We determined the percentage of Tregs expressing CD62L or tumor necrosis factor receptor type 2 (TNFR2) in 70 young type 1 diabetic patients compared with 30 controls and assessed their relation to inflammation, glycemic control and micro-vascular complications. METHODS High-sensitivity C-reactive protein (hs-CRP), hemoglobin A1c (HbA1c), tumor necrosis factor alpha (TNF-α) and interleukin-10 (IL-10) were assessed with flow cytometric analysis of Tregs, Tregs expressing CD62L or TNFR2. RESULTS The percentage of CD4(+)CD25(high) T cells and CD4(+)CD25(high)CD62L(high) cells were significantly decreased while CD4(+)CD25(high)TNFR2(+) T cells were elevated in patients with micro-vascular complications than those without and controls (p<0.001). ROC curve revealed that the cutoff values of Tregs, Tregs expressing CD62L and Tregs expressing TNFR2 (7.46%, 24.2% and 91.9%, respectively) could detect micro-vascular complications. Significant negative correlations were observed between Tregs expressing CD62L and disease duration, FBG, HbA1c, urinary albumin excretion and hs-CRP, whereas, positive correlations were found between Tregs expressing TNFR2 and these variables (p<0.05). TNF-α was significantly increased while IL-10 was decreased among patients with micro-vascular complications than those without (p<0.05). CONCLUSIONS Alteration in the frequency of Tregs and Tregs expressing CD62L or TNFR2 in type 1 diabetes is associated with increased inflammation, poor glycemic control and risk of micro-vascular complications.
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Affiliation(s)
- Mona H El-Samahy
- Pediatrics Department, Faculty of Medicine, Ain Shams University
| | - Amira A M Adly
- Pediatrics Department, Faculty of Medicine, Ain Shams University
| | - Eman A Ismail
- Clinical Pathology Department, Faculty of Medicine, Ain Shams University.
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96
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Reference curves of anthropometric indices in two national studies conducted among Iranian children in 2003-2004 and 2009-2010: The Caspian study. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2014; 19:709-14. [PMID: 25422654 PMCID: PMC4235089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2013] [Revised: 02/26/2014] [Accepted: 08/20/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Reference percentile curves are usually used as a screening tool to determine growth disorders. Anthropometric indices are population-dependent and may differ according to ethnicity, dietary pattern and lifestyle habits. This study aims to compare the curves of anthropometric measures obtained in two national studies conducted among Iranian children and adolescents in 2003-2004 and 2009-2010. MATERIALS AND METHODS Anthropometric measures obtained in two nationwide surveys conducted in 10-18-year-old Iranian students were compared. Lambda-mu-sigma (LMS) Chart Maker Pro program was used to develop age- and gender-specific percentiles and to smooth and fit the model. RESULTS In 2003-2004, the mean and standard deviation (SD) of body mass index (BMI) and waist circumference (WC) were 18.98 ± 3.81 kg/m(2) and 67.50 ± 11.05 cm in boys; and 19.44 ± 3.78 kg/m(2) and 66.55 ± 9.89 cm in girls, respectively. In 2009-2010, the corresponding figures were 19.16 ± 4.07 kg/m(2), 69.42 ± 11.43 cm, 19.63 ± 4.11 kg/m(2), and 67.29 ± 9.69 cm, respectively. Height curves did not show considerable changes in two studies. Comparison of two series of studies showed that the weight, BMI, WC, and waist-to-height ratio were lower in adolescent girls than boys especially in higher percentiles. Moreover, in both genders, weight, BMI, and WC percentiles decreased. CONCLUSION The growth charts of Iranian children and adolescents aged 10-18 years have changed over 5 years. The reference growth curves change over time in the pediatric age group, repeated surveys should be conducted to update the age- and gender-specific reference curves in different populations.
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97
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Schumacher TL, Burrows TL, Cliff DP, Jones RA, Okely AD, Baur LA, Morgan PJ, Callister R, Boggess MM, Collins CE. Dietary Intake Is Related to Multifactor Cardiovascular Risk Score in Obese Boys. Healthcare (Basel) 2014; 2:282-98. [PMID: 27429277 PMCID: PMC4934591 DOI: 10.3390/healthcare2030282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 06/21/2014] [Accepted: 07/03/2014] [Indexed: 01/21/2023] Open
Abstract
Cardiovascular disease (CVD) originates in childhood and early identification of risk factors provides an early intervention opportunity. The aim was to identify children at higher risk using a CVD risk score, developed from factors known to cluster in childhood. Risk was scored as very high (≥97.5th centile), high (≥95th), moderate (≥90th) or threshold (<90th) using normal pediatric reference ranges for 10 common biomedical risk factors. These were summed in a multifactor CVD risk score and applied to a sample of 285 observations from 136 overweight Australian children (41% male, aged 7-12 years). Strength of associations between CVD risk score and individual biomedical and dietary variables were assessed using univariate logistic regression. High waist circumference (Odds Ratio: 5.48 [95% CI: 2.60-11.55]), body mass index (OR: 3.22 [1.98-5.26]), serum insulin (OR: 3.37 [2.56-4.42]) and triglycerides (OR: 3.02 [2.22-4.12]) were all significantly related to CVD risk score. High intakes of total fat (OR: 4.44 [1.19-16.60]), sugar (OR: 2.82 [1.54-5.15]) and carbohydrate (OR 1.75 [1.11-2.77]) were significantly related to CVD risk score in boys only. This multifactor CVD risk score could be a useful tool for researchers to identify elevated risk in children. Further research is warranted to examine sex-specific dietary factors related to CVD risk in children.
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Affiliation(s)
- Tracy L Schumacher
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW 2308, Australia.
- Priority Research Center in Physical Activity and Nutrition, University of Newcastle, Newcastle, NSW 2308, Australia.
| | - Tracy L Burrows
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW 2308, Australia.
- Priority Research Center in Physical Activity and Nutrition, University of Newcastle, Newcastle, NSW 2308, Australia.
| | - Dylan P Cliff
- Early Start Research Institute, School of Education, Faculty of Social Science, University of Wollongong, Wollongong, NSW 2522, Australia.
| | - Rachel A Jones
- Early Start Research Institute, School of Education, Faculty of Social Science, University of Wollongong, Wollongong, NSW 2522, Australia.
| | - Anthony D Okely
- Early Start Research Institute, School of Education, Faculty of Social Science, University of Wollongong, Wollongong, NSW 2522, Australia.
| | - Louise A Baur
- The Children's Hospital at Westmead Clinical School, Sydney Medical School, University of Sydney, Sydney, NSW 2145, Australia.
| | - Philip J Morgan
- Priority Research Center in Physical Activity and Nutrition, University of Newcastle, Newcastle, NSW 2308, Australia.
- School of Education, Faculty of Education and Arts, University of Newcastle, Newcastle, NSW 2308, Australia.
| | - Robin Callister
- Priority Research Center in Physical Activity and Nutrition, University of Newcastle, Newcastle, NSW 2308, Australia.
- School of Biomedical Science and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW 2308, Australia.
| | - May M Boggess
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW 2308, Australia.
- School of Mathematical and Statistical Sciences, Arizona State University, Tempe, AZ 85287, USA.
| | - Clare E Collins
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW 2308, Australia.
- Priority Research Center in Physical Activity and Nutrition, University of Newcastle, Newcastle, NSW 2308, Australia.
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Warner M, Wesselink A, Harley KG, Bradman A, Kogut K, Eskenazi B. Prenatal exposure to dichlorodiphenyltrichloroethane and obesity at 9 years of age in the CHAMACOS study cohort. Am J Epidemiol 2014; 179:1312-22. [PMID: 24722999 DOI: 10.1093/aje/kwu046] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
In-utero exposure to endocrine-disrupting compounds, including dichlorodiphenyltrichloroethane (DDT) and its metabolite dichlorodiphenylethylene (DDE), has been hypothesized to increase the risk of obesity later in life. We examined the associations of maternal serum concentrations of DDT and DDE during pregnancy with body mass index, obesity, waist circumference, and percentage of body fat in 9-year-old children (n = 261) in the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS) Study, a longitudinal birth cohort study in the Salinas Valley, California (2000-2010). We found associations between prenatal exposure to DDT and DDE and several measures of obesity at 9 years of age in boys but not in girls. For example, among boys, 10-fold increases in prenatal DDT and DDE concentrations were associated with increased odds of becoming overweight or obese (for o,p'-DDT, adjusted odds ratio (OR) = 2.5, 95% confidence interval (CI): 1.0, 6.3; for p,p'-DDT, adjusted OR = 2.1, 95% CI: 1.0, 4.5; and for p,p'-DDE, adjusted OR = 1.97, 95% CI: 0.94, 4.13). The odds ratios for girls were nonsignificant. Results were similar for body mass index z score, waist circumference z score, and odds of increased waist circumference but were less consistent for percentage of body fat. The difference by sex persisted after considering pubertal status. These results provide support for the chemical obesogen hypothesis.
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99
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Villalobos Reyes M, Mederico M, Paoli de Valeri M, Briceño Y, Zerpa Y, Gómez-Pérez R, Camacho N, Martínez JL, Valeri L, Arata-Bellabarba G. Metabolic syndrome in children and adolescents from Mérida city, Venezuela: Comparison of results using local and international reference values (CREDEFAR study). ACTA ACUST UNITED AC 2014; 61:474-85. [PMID: 24840131 DOI: 10.1016/j.endonu.2014.03.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Revised: 03/13/2014] [Accepted: 03/18/2014] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To obtain local reference values for blood lipids and blood pressure (BP), and to determine the prevalence of metabolic syndrome (MS) in children and adolescents from Mérida, Venezuela, and to compare results using local and international cut-off values. MATERIALS AND METHODS The study enrolled 916 participants of both sexes aged 9-18 years of age from educational institutions. Demographic, anthropometric, and BP data were collected. Fasting blood glucose and lipid profile were measured. Percentile distribution of lipid and BP values was done by age group and sex. Prevalence of MS was estimated based on the NCEP-ATPIII classification (as modified by Cook et al.) and the classification of the International Diabetes Federation, using percentiles of Mérida and the USA as cut-off points. Agreement between both classifications was estimated using the kappa test (κ). RESULTS Prevalence of MS was 2.2% by Cook-Merida percentiles, as compared to 1.8% by Cook-USA percentiles, a moderate agreement (κ=0.54). Agreement between Cook et al. and IDF using Merida percentiles was weak (κ=0.28). There was a higher frequency of abdominal obesity, hypertriglyceridemia and hypertension, and a lower frequency of low HDL-C using Mérida percentiles. The risk (odds ratio) of having MS is greater if abdominal obesity exists (OR: 98.63, CI: 22.45-433.35, p=0.0001). MS was significantly more common in obese subjects (18.3%, p=0.0001). CONCLUSIONS Prevalence of MS in this sample of children and adolescents was 2.2%. Lipid and BP values were lower in Venezuelan as compared to US, European, and Asian children and adolescents, and similar to those in Latin-American references. Own reference values are required for accurate diagnosis of MS, as well as a worldwide consensus on its diagnostic criteria.
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Affiliation(s)
- Marjorie Villalobos Reyes
- Unidad de Endocrinología, Instituto Autónomo Hospital Universitario de los Andes, Universidad de Los Andes, Mérida, Venezuela
| | - Maracelly Mederico
- Unidad de Endocrinología, Instituto Autónomo Hospital Universitario de los Andes, Universidad de Los Andes, Mérida, Venezuela
| | - Mariela Paoli de Valeri
- Unidad de Endocrinología, Instituto Autónomo Hospital Universitario de los Andes, Universidad de Los Andes, Mérida, Venezuela.
| | - Yajaira Briceño
- Unidad de Endocrinología, Instituto Autónomo Hospital Universitario de los Andes, Universidad de Los Andes, Mérida, Venezuela
| | - Yajaira Zerpa
- Unidad de Endocrinología, Instituto Autónomo Hospital Universitario de los Andes, Universidad de Los Andes, Mérida, Venezuela
| | - Roald Gómez-Pérez
- Unidad de Endocrinología, Instituto Autónomo Hospital Universitario de los Andes, Universidad de Los Andes, Mérida, Venezuela
| | - Nolis Camacho
- Servicio de Nutrición, Crecimiento y Desarrollo Infantil, Instituto Autónomo Hospital Universitario de los Andes, Universidad de Los Andes, Mérida, Venezuela
| | - José Luis Martínez
- Servicio de Nutrición, Crecimiento y Desarrollo Infantil, Instituto Autónomo Hospital Universitario de los Andes, Universidad de Los Andes, Mérida, Venezuela
| | - Lenín Valeri
- Unidad de Endocrinología, Instituto Autónomo Hospital Universitario de los Andes, Universidad de Los Andes, Mérida, Venezuela
| | - Gabriela Arata-Bellabarba
- Laboratorio de Neuroendocrinología y Reproducción, Departamento de Fisiopatología, Universidad de Los Andes, Mérida, Venezuela
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Cliff DP, Jones RA, Burrows TL, Morgan PJ, Collins CE, Baur LA, Okely AD. Volumes and bouts of sedentary behavior and physical activity: associations with cardiometabolic health in obese children. Obesity (Silver Spring) 2014; 22:E112-8. [PMID: 24788574 DOI: 10.1002/oby.20698] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Accepted: 12/17/2013] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To examine associations of volumes and bouts of sedentary behavior (SED) and moderate-to-vigorous physical activity (MVPA) with individual and clustered cardio-metabolic outcomes in overweight/obese children. METHODS Cross-sectional data from 120 overweight/obese children (8.3 ± 1.1 years, 62% girls, 74% obese) with SED and MVPA assessed using accelerometry. Children were categorized into quartiles of mean bouts per day of SED (10, 20, and 30 min) and MVPA (5, 10, and 15 min). Associations with triglycerides, HDL cholesterol, glucose, insulin, systolic/diastolic blood pressure, and clustered cardio-metabolic risk (cMet) were examined using linear regression, adjusted for confounders. RESULTS Independent of MVPA, SED volume was inversely associated with HDL cholesterol (β [95% CI] = -0.29 [-0.52, -0.05]). MVPA volume was inversely associated with diastolic blood pressure, independent of SED (β = -0.22 [-0.44, -0.001]), and cMet (β = -0.19 [-0.36, -0.01]) although not after adjustment for SED (β = -0.14 [-0.33, 0.06]). Independent of MVPA and SED volumes, participants in the highest quartile of 30 min bouts per day of SED had 12% lower HDL cholesterol than those in the lowest quartile (d = 0.53, P = 0.046, Ptrend = 0.11). CONCLUSIONS In addition to increasing MVPA, targeting reduced SED and limiting bouts of SED to <30 min may contribute to improved HDL cholesterol levels and cardio-metabolic health in overweight/obese children.
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Affiliation(s)
- Dylan P Cliff
- Interdisciplinary Educational Research Institute, Faculty of Social Sciences, School of Education, University of Wollongong, Wollongong, NSW, Australia
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