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Ferreira S, Mendes J, Couto D, Ferreira D, Rêgo C. Nonalcoholic Fatty Liver Disease and Continuous Metabolic Syndrome in Adolescents with Overweight/Obesity. ACTA MEDICA PORT 2024; 37:177-186. [PMID: 38330918 DOI: 10.20344/amp.19834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 07/10/2023] [Indexed: 02/10/2024]
Abstract
INTRODUCTION Nonalcoholic fatty liver disease is the leading cause of pediatric chronic liver disease. Although nonalcoholic fatty liver disease is closely associated with obesity, its relationship with metabolic syndrome in children is not fully understood. The main aim of this study was to evaluate the association between nonalcoholic fatty liver disease and a combination of cardiometabolic risk factors in adolescents with overweight/obesity, using a pediatric metabolic syndrome score (PsiMS) to predict metabolic syndrome. METHODS A retrospective cohort study was conducted. Subjects with overweight/obesity aged 10 to 17 followed at two clinical centers in Portugal (2018 - 2021) were enrolled. The independent association of nonalcoholic fatty liver disease with PsiMS, and of other potential predictors, was tested through multiple regression analyses. Receiver operator characteristic curve analysis was performed to estimate the optimal cutoff of PsiMS to discriminate metabolic syndrome. RESULTS Eighty-four subjects were included (median age at baseline 11.5 years). The prevalence rate of nonalcoholic fatty liver disease was 51% and the prevalence rate of metabolic syndrome was 7%. The mean PsiMS was 2.05 ± 0.48 at the first evaluation, and 2.11 ± 0.52 at the last evaluation (mean follow-up time was 15 months). The nonalcoholic fatty liver disease group had significantly (p < 0.05) higher weight and body mass index z-scores, higher rate of severe obesity and higher waist circumference percentile. PsiMS was highly accurate in predicting metabolic syndrome (area under the curve = 0.96), with an optimal cutoff of 2.46 (sensitivity 100%, specificity 89%). In the univariate analysis, no statistically significant association was observed between nonalcoholic fatty liver disease and PsiMS. In the multiple regression analysis, female sex had a negative association with PsiMS (first and last evaluation). Independent predictors of a higher PsiMS at first evaluation were: ≥ 2 metabolic syndrome criteria, body mass index z-score, insulin resistance and dyslipidemia. At the last evaluation, independent predictors of a higher PsiMS were: nonalcoholic fatty liver disease, baseline PsiMS and body mass index increase from baseline. CONCLUSION The results suggest a good performance of the PsiMS to assess metabolic syndrome and that nonalcoholic fatty liver disease is associated with PsiMS at follow-up.
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Affiliation(s)
- Sofia Ferreira
- Centro Hospitalar Universitário Cova da Beira. Covilhã; Faculty of Health Sciences. Universidade da Beira Interior. Covilhã. Portugal
| | - Joana Mendes
- Centro Hospitalar Universitário Cova da Beira. Covilhã. Portugal
| | - Daniela Couto
- Centro Hospitalar Universitário Cova da Beira. Covilhã. Portugal
| | - Dário Ferreira
- Department of Mathematics and Center of Mathematics and Applications. Universidade da Beira Interior. Covilhã. Portugal
| | - Carla Rêgo
- Hospital CUF Porto. Oporto; Center for Health Technology and Services Research (CINTESIS). Faculty of Medicine. Universidade do Porto. Oporto; Faculty of Biotechnology. Universidade Católica. Oporto. Portugal
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Wu JH, Liu XL, Lu N, Wang R, Yin FZ, Lu Q, Ma CM. Height-Corrected Definition of Metabolic Syndrome Is a Simple and Effective Method for Identifying Insulin Resistance and Low-Grade Inflammation in Adolescents: Metabolic Syndrome in Adolescents. Clin Pediatr (Phila) 2023; 62:1350-1360. [PMID: 36856151 DOI: 10.1177/00099228231156751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
The purpose of this study was to evaluate the feasibility of the height-corrected definition of metabolic syndrome(MetS) in adolescents. A retrospective study was conducted on US adolescents aged 12 to 17 years. Waist-to-height ratio and blood pressure-to-height ratio were substituted for waist circumference and blood pressure when defining MetS in adolescents. The proportions of insulin resistance of adolescents with 1 (30.1%), 2 (50.7%), and ≥3 components (77.8%) of MetS were 2.578 (P < .001), 6.882 (P < .001), and 23.992 (P < .001) times than the proportion of adolescents without the component of MetS (14.2%). The proportions of low-grade inflammation of adolescents with 1 (3.4%), 2 (5.3%), and ≥3 components (14.4%) of MetS were 2.050 (P = .106), 3.699 (P = .005), and 10.664 (P < .001) times than the proportion of adolescents without the component of MetS (1.7%). This study demonstrates that height-corrected definition of MetS is a simple and accurate method for identifying insulin resistance and low-grade inflammation in adolescents.
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Affiliation(s)
- Jia-Hui Wu
- Department of Internal Medicine, Hebei North University, Zhangjiakou, China
| | - Xiao-Li Liu
- Department of Endocrinology, The First Hospital of Qinhuangdao, Qinhuangdao, China
| | - Na Lu
- Department of Endocrinology, The First Hospital of Qinhuangdao, Qinhuangdao, China
| | - Rui Wang
- Department of Endocrinology, The First Hospital of Qinhuangdao, Qinhuangdao, China
| | - Fu-Zai Yin
- Department of Endocrinology, The First Hospital of Qinhuangdao, Qinhuangdao, China
| | - Qiang Lu
- Department of Endocrinology, The First Hospital of Qinhuangdao, Qinhuangdao, China
| | - Chun-Ming Ma
- Department of Endocrinology, The First Hospital of Qinhuangdao, Qinhuangdao, China
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Moodley A, Womersley JS, Swart PC, van den Heuvel LL, Malan-Müller S, Seedat S, Hemmings SMJ. A network analysis investigating the associations between posttraumatic stress symptoms, markers of inflammation and metabolic syndrome. J Psychiatr Res 2023; 165:105-114. [PMID: 37487292 DOI: 10.1016/j.jpsychires.2023.07.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 06/22/2023] [Accepted: 07/15/2023] [Indexed: 07/26/2023]
Abstract
Chronic systemic inflammation has been implicated in trauma exposure, independent of a psychiatric diagnosis, and in posttraumatic stress disorder (PTSD) and its highly comorbid conditions, such as metabolic syndrome (MetS). The present study used network analysis to examine the interacting associations between pro-inflammatory cytokines, posttraumatic stress (PTS) symptoms and symptom clusters, and individual components of MetS, in a cohort of 312 participants (n = 139 PTSD cases, n = 173 trauma-exposed controls). Pro-inflammatory cytokines were measured in serum samples using immunoturbidimetric and multiplex assays. Three network models were assessed, and the decision on which model to use was guided by network stability estimates and denseness. Weak negative associations were observed between interleukin one beta (IL-1β) and detachment (D6) and irritability (E1); tumour necrosis factor alpha (TNFα) and hypervigilance (E3); and C-reactive protein (CRP) and emotional cue reactivity (B4), which could be due to high cortisol levels present in a female-majority cohort. Network models also identified positive associations between CRP and waist circumference, blood pressure, and high-density lipoprotein cholesterol (HDL-C). The strongest association was observed between CRP and waist circumference, providing evidence that central obesity is an important inflammatory component of MetS. Some networks displayed high instability, which could be due to the small pool of participants with viable cytokine data. Overall, this study provides evidence for associations between inflammation, PTS symptoms and components of MetS. Future longitudinal studies measuring pro-inflammatory cytokines in the immediate aftermath of trauma are required to gain better insight into the role of inflammation in trauma-exposure and PTSD.
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Affiliation(s)
- Allegra Moodley
- Department of Psychiatry, Stellenbosch University, Tygerberg, Cape Town, South Africa; Department of Biomedical Sciences, Stellenbosch University, Tygerberg, Cape Town, South Africa; South African Medical Research Council/Stellenbosch University Extramural Unit on the Genomics of Brain Disorders, Department of Psychiatry, Stellenbosch University, Tygerberg, Cape Town, South Africa
| | - Jacqueline S Womersley
- Department of Psychiatry, Stellenbosch University, Tygerberg, Cape Town, South Africa; South African Medical Research Council/Stellenbosch University Extramural Unit on the Genomics of Brain Disorders, Department of Psychiatry, Stellenbosch University, Tygerberg, Cape Town, South Africa
| | - Patricia C Swart
- Department of Psychiatry, Stellenbosch University, Tygerberg, Cape Town, South Africa; South African Medical Research Council/Stellenbosch University Extramural Unit on the Genomics of Brain Disorders, Department of Psychiatry, Stellenbosch University, Tygerberg, Cape Town, South Africa
| | - Leigh L van den Heuvel
- Department of Psychiatry, Stellenbosch University, Tygerberg, Cape Town, South Africa; South African Medical Research Council/Stellenbosch University Extramural Unit on the Genomics of Brain Disorders, Department of Psychiatry, Stellenbosch University, Tygerberg, Cape Town, South Africa
| | - Stefanie Malan-Müller
- Department of Psychiatry, Stellenbosch University, Tygerberg, Cape Town, South Africa; South African Medical Research Council/Stellenbosch University Extramural Unit on the Genomics of Brain Disorders, Department of Psychiatry, Stellenbosch University, Tygerberg, Cape Town, South Africa; Department of Pharmacology and Toxicology, Faculty of Medicine, University Complutense Madrid (UCM), Madrid, Spain; Biomedical Network Research Center of Mental Health (CIBERSAM), Institute of Health Carlos III, Madrid, Spain; Neurochemistry Research Institute UCM, Hospital 12 de Octubre Research Institute (Imas12), Madrid, Spain
| | - Soraya Seedat
- Department of Psychiatry, Stellenbosch University, Tygerberg, Cape Town, South Africa; South African Medical Research Council/Stellenbosch University Extramural Unit on the Genomics of Brain Disorders, Department of Psychiatry, Stellenbosch University, Tygerberg, Cape Town, South Africa
| | - Sian M J Hemmings
- Department of Psychiatry, Stellenbosch University, Tygerberg, Cape Town, South Africa; South African Medical Research Council/Stellenbosch University Extramural Unit on the Genomics of Brain Disorders, Department of Psychiatry, Stellenbosch University, Tygerberg, Cape Town, South Africa.
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Baspinar B, Güldaş M. Traditional plain yogurt: a therapeutic food for metabolic syndrome? Crit Rev Food Sci Nutr 2020; 61:3129-3143. [PMID: 32746616 DOI: 10.1080/10408398.2020.1799931] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Dairy products have an important role in a healthy diet due to their high-quality protein and rich micronutrients. Yogurt, a fermented milk product, has a similar composition to milk but is a more concentrated product in terms of group B vitamins, minerals, and proteins. It is known that bioactive metabolites and live enzymes that occur by fermentation and digestion, affect the health positively by improving gut microbiota. In recent years, the prevalence of metabolic syndrome, which threatens public health, is increasing rapidly. As with other noninfectious diseases, the diet has an important effect on the prevention and treatment of metabolic syndrome. It has been demonstrated that yogurt has a high-quality amino acid pattern, reduces energy intake by stimulating satiety, and regulates blood glucose level. In addition to the rich protein variety, yogurt also contains peptides that positively affect blood pressure. Unlike milk, increased acidity during the fermentation of yogurt positively affects calcium absorption. Calcium plays an important role in the control of blood glucose and energy metabolism through insulin-dependent and non-insulin-dependent routes. In addition to reducing inflammation, calcium has a positive effect on the regulation of the blood lipid profile by increasing fecal fat excretion. There are many lipid and lipoid nutrients such as saturated fatty acids, phospholipids, sphingolipids, and conjugated linoleic acid that may affect the blood lipid profile in yogurt positively or negatively. There are seen very few randomized controlled studies that are focused on the relationship between yogurt and metabolic syndrome, and these are based on contradictory results. In this review, based on the clinical studies conducted to date, and the nutrient content of yogurt, possible mechanisms of these contradictory results are investigated.
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Affiliation(s)
- Busra Baspinar
- Nutrition and Dietetics, Ankara Universitesi, Ankara, Turkey
| | - Metin Güldaş
- Nutrition and Dietetics, Uludag University, Görükle, Bursa, Turkey
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Su L, Arshi A, Beck JJ. Extensive Atraumatic Heterotopic Ossification of the Achilles Tendon in an Adolescent with Metabolic Syndrome: A Case Report. JBJS Case Connect 2020; 10:e0394. [PMID: 32224651 DOI: 10.2106/jbjs.cc.19.00394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CASE A 15-year-old boy with type 1 diabetes mellitus, hypertension, and obesity presented with atraumatic posterior ankle pain and stiffness due to extensive heterotopic ossification (HO) of the Achilles tendon. The ossification was successfully surgically resected and tendon primarily repaired. Wound dehiscence was noted at the first preoperative visit, managed conservatively by local wound care, and healed uneventfully by secondary intention. One-year follow-up showed no recurrence of HO, return to baseline activities, yet low Oxford scores. CONCLUSION HO of the Achilles tendon is a rare clinical entity. We report an atraumatic case in an adolescent patient with metabolic syndrome, which may demonstrate systemic inflammation because of metabolic syndrome as a risk factor for HO.
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Affiliation(s)
- Lisa Su
- Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Armin Arshi
- Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Jennifer J Beck
- Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California.,Center for Sports Medicine, Orthopedic Institute for Children, Los Angeles, California
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Saeed W, AL-Habori M, Saif-Ali R, Al-Eryani E. Metabolic Syndrome and Prediabetes Among Yemeni School-Aged Children. Diabetes Metab Syndr Obes 2020; 13:2563-2572. [PMID: 32765035 PMCID: PMC7381798 DOI: 10.2147/dmso.s260131] [Citation(s) in RCA: 3] [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: 04/27/2020] [Accepted: 06/28/2020] [Indexed: 12/22/2022] Open
Abstract
PURPOSE In view of the high rate of obesity and physical inactivity as well as the rising incidence of Type 2 DM among children in the neighboring Gulf countries and Middle East region; the aim of this study was, therefore, to determine the prevalence of metabolic syndrome (MetS) and prediabetes in Yemeni school-aged children. PATIENTS AND METHODS In this study, 1402 school children aged 12-13 years old (grade 7) were recruited from public schools in the capital Sana'a during the period April-May 2013. Anthropometric measurements and BP were recorded and BMI was calculated. Fasting venous blood (5 mL) was collected for biochemical analysis including FBG, HbA1c, insulin and lipids profile. Insulin resistance (HOMA-IR) and β-cell function (HOMA-β) were calculated. RESULTS The prevalence of prediabetes (as defined by impaired fasting glucose) and MetS (as classified by the IDF 2007) were 0.86% and 0.5%, respectively. Our results also showed 5.21% and 20.26% of the children to have two or one factor(s) of the MetS criteria fulfilled, respectively, with low HDL-c (17%) being the most prevalent MetS component, followed by metabolic glucose (8%), raised TG (5.3%), DBP (1.4%), and high WC (0.5%). Moreover, the prevalence of overweight and obesity was 4.2% and 2.8%, respectively; and about 1.2% of children had abnormal high insulin levels. Children with impaired fasting glucose (IFG) had increased HOMA-IR (p = 0.016) and SBP (p = 0.042) and decreased HDL-c (p = 0.034) and HOMA-β (p < 0.001); whereas obese children had increased WC (p < 0.001) and TG (p = 0.049). CONCLUSION The main finding of this study is that Yemeni children are at potential risk of obesity, metabolic syndrome and prediabetes despite their low prevalences. These results highlight the need for early identification and close monitoring of children at risk of later Type 2 DM as an important primary care strategy that can effectively prevent or delay the onset of such condition.
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Affiliation(s)
- Walid Saeed
- Department of Biochemistry and Molecular Biology, Faculty of Medicine and Health Sciences, University of Sana`a, Sana`a, Yemen
| | - Molham AL-Habori
- Department of Biochemistry and Molecular Biology, Faculty of Medicine and Health Sciences, University of Sana`a, Sana`a, Yemen
- Correspondence: Molham AL-Habori Email
| | - Riyadh Saif-Ali
- Department of Biochemistry and Molecular Biology, Faculty of Medicine and Health Sciences, University of Sana`a, Sana`a, Yemen
| | - Ekram Al-Eryani
- Department of Biochemistry and Molecular Biology, Faculty of Medicine and Health Sciences, University of Sana`a, Sana`a, Yemen
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Yang X, Xu C, Wang Y, Cao C, Tao Q, Zhan S, Sun F. Risk prediction model of dyslipidaemia over a 5-year period based on the Taiwan MJ health check-up longitudinal database. Lipids Health Dis 2018; 17:259. [PMID: 30447693 PMCID: PMC6240269 DOI: 10.1186/s12944-018-0906-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 11/08/2018] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE This study aimed to provide an epidemiological model to evaluate the risk of developing dyslipidaemia within 5 years in the Taiwanese population. METHODS A cohort of 11,345 subjects aged 35-74 years and was non-dyslipidaemia in the initial year 1996 and followed in 1997-2006 to derive a risk score that could predict the occurrence of dyslipidaemia. Multivariate logistic regression was used to derive the risk functions using the check-up centre of the overall cohort. Rules based on these risk functions were evaluated in the remaining three centres as the testing cohort. We evaluated the predictability of the model using the area under the receiver operating characteristic (ROC) curve (AUC) to confirm its diagnostic property on the testing sample. We also established the degrees of risk based on the cut-off points of these probabilities after transforming them into a normal distribution by log transformation. RESULTS The incidence of dyslipidaemia over the 5-year period was 19.1%. The final multivariable logistic regression model includes the following six risk factors: gender, history of diabetes, triglyceride level, HDL-C (high-density lipoprotein cholesterol), LDL-C (low-density lipoprotein cholesterol) and BMI (body mass index). The ROC AUC was 0.709 (95% CI: 0.693-0.725), which could predict the development of dyslipidaemia within 5 years. CONCLUSION This model can help individuals assess the risk of dyslipidaemia and guide group surveillance in the community.
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Affiliation(s)
- Xinghua Yang
- School of Public Health, Capital Medical University, 10 Xitoutiao, Youanmen, Beijing, 100069, China.
- Beijing Municipal Key Laboratory of Clinical Epidemiology, 10 Xitoutiao, Youanmen, Beijing, 100069, China.
| | - Chaonan Xu
- School of Public Health, Capital Medical University, 10 Xitoutiao, Youanmen, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, 10 Xitoutiao, Youanmen, Beijing, 100069, China
| | - Yunfeng Wang
- School of Public Health, Capital Medical University, 10 Xitoutiao, Youanmen, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, 10 Xitoutiao, Youanmen, Beijing, 100069, China
| | - Chunkeng Cao
- MJ Health Management Organizations, Taipei, Taiwan
| | - Qiushan Tao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, No. 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Siyan Zhan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, No. 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Feng Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, No. 38 Xueyuan Road, Haidian District, Beijing, 100191, China
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