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Peña-Espinoza BI, Torre-Horta E, Ortiz-López MG, Menjivar M. ABCA1 variant rs9282541 is associated with metabolic syndrome in Maya children. Ann Hum Genet 2024; 88:279-286. [PMID: 38192238 DOI: 10.1111/ahg.12546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 11/17/2023] [Accepted: 12/04/2023] [Indexed: 01/10/2024]
Abstract
INTRODUCTION Metabolic syndrome (MetS) is a metabolic disorder encompassing risk factors for cardiovascular disease and type 2 diabetes (T2D). In Mexico, the MetS is a national health problem in adults and children. Environmental and genetic factors condition the MetS. However, studies to elucidate the contribution of genetic factors to MetS in Mexico are scarce. A recent study showed that variant rs9282541 (A-allele) in ATP-binding cassette transporter A1 (ABCA1) was associated with T2D in the Maya population in addition to low levels of high-density lipoprotein cholesterol (HDL-C). Thus, this study aimed to determine whether the genetic variant of ABCA1 A-allele (rs9282541, NM_005502.4:c.688C > T, NP_005493.2:p.Arg230Cys) is associated with MetS and its components in Mexican Maya children. METHODS The study was conducted in 508 children aged 9-13 from the Yucatán Peninsula. MetS was identified according to the de Ferranti criteria. Genotyping was performed using TaqMan assay by real-time PCR. Evaluation of genetic ancestry group was included. RESULTS The frequency of MetS and overweight-obesity was 45.9% and 41.6%, respectively. The genetic variant rs9282541 was associated with low HDL-C and high glucose concentrations. Remarkably, for the first time, this study showed the association of ABCA1 rs9282541 with MetS in Maya children with an OR of 3.076 (95% CI = 1.16-8.13 p = 0.023). Finally, this study reveals a high prevalence of MetS and suggests that variant rs9282541 of the ABCA1 gene plays an important role in the developing risk of MetS in Maya children.
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Affiliation(s)
- Barbara I Peña-Espinoza
- Laboratorio de Genómica de la Diabetes, Facultad de Química en la Unidad Académica de Ciencia y Tecnología de la UNAM en Yucatán, Ciudad de Mexico, Mexico
| | | | - María G Ortiz-López
- Laboratorio de Endocrinología, Hospital Juárez de México, Mexico City, Mexico
| | - Marta Menjivar
- Laboratorio de Genómica de la Diabetes, Facultad de Química en la Unidad Académica de Ciencia y Tecnología de la UNAM en Yucatán, Ciudad de Mexico, Mexico
- Laboratorio de diabetes, Facultad de Química de la Universidad Nacional Autónoma de México, Mexico City, Mexico
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Singleton CMH, Brar S, Robertson N, DiTommaso L, Fuchs GJ, Schadler A, Radulescu A, Attia SL. Cardiometabolic risk factors in South American children: A systematic review and meta-analysis. PLoS One 2023; 18:e0293865. [PMID: 37992076 PMCID: PMC10664905 DOI: 10.1371/journal.pone.0293865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 10/20/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Cardiometabolic risk factors (impaired fasting glucose, abdominal obesity, high blood pressure, dyslipidemia) cluster in children, may predict adult disease burden, and are inadequately characterized in South American children. OBJECTIVES To quantify the burden of cardiometabolic risk factors in South American children (0-21 years) and identify knowledge gaps. METHODS We systematically searched PubMed, Google Scholar, and the Latin American and Caribbean Health Sciences Literature via Virtual Health Library from 2000-2021 in any language. Two independent reviewers screened and extracted all data. RESULTS 179 studies of 2,181 screened were included representing 10 countries (n = 2,975,261). 12.2% of South American children experienced obesity, 21.9% elevated waist circumference, 3.0% elevated fasting glucose, 18.1% high triglycerides, 29.6% low HDL cholesterol, and 8.6% high blood pressure. Cardiometabolic risk factor definitions varied widely. Chile exhibited the highest prevalence of obesity/overweight, low HDL, and impaired fasting glucose. Ecuador exhibited the highest prevalence of elevated blood pressure. Rural setting (vs. urban or mixed) and indigenous origin protected against most cardiometabolic risk factors. CONCLUSIONS South American children experience high rates of obesity, overweight, and dyslipidemia. International consensus on cardiometabolic risk factor definitions for children will lead to improved diagnosis of cardiometabolic risk factors in this population, and future research should ensure inclusion of unreported countries and increased representation of indigenous populations.
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Affiliation(s)
| | - Sumeer Brar
- University of Kentucky College of Medicine, Lexington, Kentucky, United States of America
| | - Nicole Robertson
- University of Kentucky College of Medicine, Lexington, Kentucky, United States of America
| | - Lauren DiTommaso
- University of Kentucky College of Medicine, Lexington, Kentucky, United States of America
| | - George J. Fuchs
- University of Kentucky College of Medicine Division of Pediatric Gastroenterology, Hepatology and Nutrition, Kentucky, United States of America
- University of Kentucky College of Public Health Department of Epidemiology, Kentucky, United States of America
| | - Aric Schadler
- University of Kentucky College of Medicine Department of Pediatrics, Kentucky, United States of America
| | - Aurelia Radulescu
- University of Kentucky College of Medicine Department of Pediatrics, Kentucky, United States of America
| | - Suzanna L. Attia
- University of Kentucky College of Medicine Division of Pediatric Gastroenterology, Hepatology and Nutrition, Kentucky, United States of America
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Campero MN, Scavuzzo CM, Andreo V, Mileo MS, Franzois MB, Oberto MG, Gonzalez Rodriguez C, Defagó MD. A geospatial analysis of cardiometabolic diseases and their risk factors considering environmental features in a midsized city in Argentina. GEOSPATIAL HEALTH 2023; 18. [PMID: 37873994 DOI: 10.4081/gh.2023.1212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 09/19/2023] [Indexed: 10/25/2023]
Abstract
New approaches to the study of cardiometabolic disease (CMD) distribution include analysis of built environment (BE), with spatial tools as suitable instruments. We aimed to characterize the spatial dissemination of CMD and the associated risk factors considering the BE for people attending the Non-Invasive Cardiology Service of Hospital Nacional de Clinicas in Córdoba City, Argentina during the period 2015-2020. We carried out an observational, descriptive, cross-sectional study performing non-probabilistic convenience sampling. The final sample included 345 people of both sexes older than 35 years. The CMD data were collected from medical records and validated techniques and BE information was extracted from Landsat-8 satellite products. A geographic information system (GIS) was constructed to assess the distribution of CMD and its risk factors in the area. Out of the people sampled, 41% showed the full metabolic syndrome and 22.6% only type-2 diabetes mellitus (DM2), a cluster of which was evidenced in north-western Córdoba. The risk of DM2 showed an association with high values of the normalized difference vegetation index (NDVI) (OR= 0.81; 95% CI: - 0.30 to 1.66; p=0.05) and low normalized difference built index (NDBI) values that reduced the probability of occurrence of DM2 (OR= -1.39; 95% CI: -2.62 to -0.17; p=0.03). Considering that the results were found to be linked to the environmental indexes, the study of BE should include investigation of physical space as a fundamental part of the context in which people develop medically within society. The novel collection of satellite-generated information on BE proved efficient.
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Affiliation(s)
- Micaela Natalia Campero
- Centre for Research in Human Nutrition School of Nutrition, Faculty of Medical Sciences, National University of Cordoba" by "Centro de Investigaciones en Nutrición Humana, Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba Ciudad de Córdoba, Córdoba; Mario Gulich Institute for Advance Spatial Studies, National University of Cordoba, National Commision for Space Activities by Instituto de Altos Estudios Espaciales Mario Gulich, Comisión Nacional de Actividades Espaciales, Universidad Nacional de Córdob, Falda del Cañete, Córdoba; National Council for Scientific and Technical Research by Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires.
| | - Carlos Matías Scavuzzo
- Centre for Research in Human Nutrition School of Nutrition, Faculty of Medical Sciences, National University of Cordoba" by "Centro de Investigaciones en Nutrición Humana, Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba Ciudad de Córdoba, Córdoba; Mario Gulich Institute for Advance Spatial Studies, National University of Cordoba, National Commision for Space Activities by Instituto de Altos Estudios Espaciales Mario Gulich, Comisión Nacional de Actividades Espaciales, Universidad Nacional de Córdob, Falda del Cañete, Córdoba.
| | - Veronica Andreo
- Mario Gulich Institute for Advance Spatial Studies, National University of Cordoba, National Commision for Space Activities by Instituto de Altos Estudios Espaciales Mario Gulich, Comisión Nacional de Actividades Espaciales, Universidad Nacional de Córdob, Falda del Cañete, Córdoba; National Council for Scientific and Technical Research by Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires.
| | - María Sol Mileo
- Centre for Research in Human Nutrition School of Nutrition, Faculty of Medical Sciences, National University of Cordoba" by "Centro de Investigaciones en Nutrición Humana, Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba Ciudad de Córdoba, Córdoba.
| | - Micaela Belén Franzois
- Centre for Research in Human Nutrition School of Nutrition, Faculty of Medical Sciences, National University of Cordoba" by "Centro de Investigaciones en Nutrición Humana, Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba Ciudad de Córdoba, Córdoba.
| | - María Georgina Oberto
- Centre for Research in Human Nutrition School of Nutrition, Faculty of Medical Sciences, National University of Cordoba" by "Centro de Investigaciones en Nutrición Humana, Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba Ciudad de Córdoba, Córdoba.
| | - Carla Gonzalez Rodriguez
- Mario Gulich Institute for Advance Spatial Studies, National University of Cordoba, National Commision for Space Activities by Instituto de Altos Estudios Espaciales Mario Gulich, Comisión Nacional de Actividades Espaciales, Universidad Nacional de Córdob, Falda del Cañete, Córdoba; National Council for Scientific and Technical Research by Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires.
| | - María Daniela Defagó
- Centro de Investigaciones en Nutrición Humana (CenINH), Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba. Ciudad de Córdoba, Córdoba.
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Huang P, Tint MT, Lee M, Ngoh ZM, Gluckman P, Chong YS, Han W, Fu Y, Wee CL, Fortier MV, Ang KK, Lee YS, Yap F, Eriksson JG, Meaney MJ, Tan AP. Functional activity of the caudate mediates the relation between early childhood microstructural variations and elevated metabolic syndrome scores. Neuroimage 2023; 278:120273. [PMID: 37473977 DOI: 10.1016/j.neuroimage.2023.120273] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/10/2023] [Accepted: 07/11/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Metabolic syndrome score in children assesses the risk of developing cardiovascular disease in future. We aim to probe the role of the caudate in relation to the metabolic syndrome score. Furthermore, using both functional and structural neuroimaging, we aim to examine the interplay between functional and structural measures. METHODS A longitudinal birth cohort study with functional and structural neuroimaging data obtained at 4.5, 6.0 and 7.5 years and metabolic syndrome scores at 8.0 years was used. Pearson correlation and linear regression was used to test for correlation fractional anisotropy (FA) and fractional amplitude of low frequency fluctuations (fALFF) of the caudate with metabolic syndrome scores. Mediation analysis was used to test if later brain measures mediated the relation between earlier brain measures and metabolic syndrome scores. Inhibitory control was also tested as a mediator of the relation between caudate brain measures and metabolic syndrome scores. RESULTS FA at 4.5 years and fALFF at 7.5 years of the left caudate was significantly correlated with metabolic syndrome scores. Post-hoc mediation analysis showed that fALFF at 7.5 years fully mediated the relation between FA at 4.5 years and metabolic syndrome scores. Inhibitory control was significantly correlated with fALFF at 7.5 years, but did not mediate the relation between fALFF at 7.5 years and metabolic syndrome scores. CONCLUSIONS We found that variations in caudate microstructure at 4.5 years predict later variation in functional activity at 7.5 years. This later variation in functional activity fully mediates the relation between microstructural changes in early childhood and metabolic syndrome scores at 8.0 years.
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Affiliation(s)
- Pei Huang
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
| | - Mya Thway Tint
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
| | - Marissa Lee
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
| | - Zhen Ming Ngoh
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Peter Gluckman
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore; Centre for Human Evolution, Adaptation and Disease, Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore; Department of Obstetrics & Gynaecology, National University Hospital Singapore, Singapore
| | - Weiping Han
- Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), Singapore; Center for Neuro-Metabolism and Regeneration Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China; School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yu Fu
- Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Caroline Lei Wee
- Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Marielle V Fortier
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore; Department of Diagnostic and Interventional Radiology, KK Women's and Children's Hospital, Singapore
| | - Kai Keng Ang
- Institute for Infocomm Research, Agency for Science, Technology and Research (A*STAR), Singapore; School of Computer Science and Engineering, Nanyang Technological University, Singapore
| | - Yung Seng Lee
- Department of Paedatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Fabian Yap
- Department of Paediatrics, Endocrinology Service, KK Women's and Children's Hospital, Singapore, Singapore
| | - Johan G Eriksson
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore; Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland; Folkhälsan Research Center, Helsinki, Finland
| | - Michael J Meaney
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada; Brain - Body Initiative, Agency for Science and Technology (A*STAR), Singapore
| | - Ai Peng Tan
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore; Department of Diagnostic Imaging, National University Hospital Singapore, Singapore.
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5
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Abdallah HR, Youness ER, Bedeir MM, Abouelnaga MW, Ezzat WM, Elhosary Y, El-Hariri HM, Hussein MAEA, Ahmed HR, Eladawy R. Clinical and diagnostic characteristics of non-alcoholic fatty liver disease among Egyptian children and adolescents with type1 diabetes. Diabetol Metab Syndr 2023; 15:52. [PMID: 36941617 PMCID: PMC10029237 DOI: 10.1186/s13098-023-01029-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 03/12/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Type 1 diabetes mellitus (T1DM) patients are at an increased risk for non-alcoholic fatty liver disease (NAFLD). This study aimed to evaluate the clinical criteria associated with the diagnosis of Non-Alcoholic Fatty Liver Disease (NAFLD) among T1DM Egyptian children and adolescents. METHODS 74 T1DM patients aged 8-18 year were enrolled in this cross sectional study. Assessments of Clinical status, anthropometric measures, lipid profile, glycated haemoglobin (HbA1c) and liver enzymes were done. Abdominal Ultrasound evaluation of hepatic steatosis was done. Accordingly, patients were divided into two groups (NAFLD and normal liver group) and compared together. Assessment of liver fibrosis using acoustic radiation force impulse elastography (ARFI) was done. Statistical analysis included; independent t-test, Chi square and Fisher's Exact, Pearson and Spearman tests and Logistic regression models for factors associated with fatty liver were used when appropriate. RESULTS In this study; 74 patients were enrolled; 37 males (50%) and 37 females with mean age 14.3 ± 3.0 year. The mean insulin dose was 1.1 ± 0.4 U/kg and mean disease duration was 6.3 ± 3.0 year. NAFLD was detected in 46 cases while 28 cases had normal liver as diagnosed by abdominal ultrasound. Cases with NAFLD had statistically significant higher BMI-Z scores, waist/hip, waist/height and sum of skin fold thicknesses compared to those with normal liver (P < 0.05). The mean value of HbA1c % was significantly higher in NAFLD group (P = 0.003). Total cholesterol, triglycerides and LDL serum levels were significantly elevated (p < 0.05), while the HDL level was significantly lower in NAFLD cases (p = 0.001). Although, serum levels of liver enzymes; ALT and AST were significantly higher among cases with NAFLD than in normal liver group (p < 0.05), their means were within normal. Using the ARFI elastography; NAFLD cases exhibited significant fibrosis (F2, 3 and 4). BMI, patient age and female gender were among risk factors for NAFLD. CONCLUSIONS NAFLD represents a serious consequence in type 1 diabetic children and adolescents that deserves attention especially with poor glycemic control. NAFLD has the potential to evolve to fibrosis. This study demonstrated a very high prevalence of NAFLD in T1D children and adolescents using US which was (62.2%) with the percent of liver fibrosis among the NAFLD cases (F2-F4) using ARFI elastography was 26%. BMI, age of patients and female gender were detected as risk factors for NAFLD.
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Affiliation(s)
- Hanaa Reyad Abdallah
- Biological Anthropology Department, Medical Research and Clinical Studies Institute, National Research Centre, Cairo, Egypt.
| | - Eman Refaat Youness
- Medical Biochemistry Department, Medical Research and Clinical Studies Institute, National Research Centre, Cairo, Egypt
| | - Manar Maher Bedeir
- Child Health Department, Medical Research and Clinical Studies Institute, National Research Centre, Cairo, Egypt
| | - Marwa W Abouelnaga
- Child Health Department, Medical Research and Clinical Studies Institute, National Research Centre, Cairo, Egypt
| | - Wafaa M Ezzat
- Internal Medicine Department, Medical Research and Clinical Studies Institute, National Research Centre, Cairo, Egypt
| | - Yasser Elhosary
- Internal Medicine Department, Medical Research and Clinical Studies Institute, National Research Centre, Cairo, Egypt
| | - Hazem Mohamed El-Hariri
- Community Medicine Department, Medical Research and Clinical Studies Institute, National Research Centre, Cairo, Egypt
| | | | - Heba R Ahmed
- National Institute of Diabetes and Endocrinology, Cairo, Egypt
| | - Rasha Eladawy
- Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Wahb AMSE, Elsaid NBA, Abouzouna ZS, Habieb MSE, Arafat ESE. Vascular endothelial growth factor C gene expression and its serum level as potential biomarkers for obesity in Egyptian children. GENE REPORTS 2022. [DOI: 10.1016/j.genrep.2022.101670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Bizerea-Moga TO, Pitulice L, Pantea CL, Olah O, Marginean O, Moga TV. Extreme Birth Weight and Metabolic Syndrome in Children. Nutrients 2022; 14:nu14010204. [PMID: 35011079 PMCID: PMC8746946 DOI: 10.3390/nu14010204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 12/29/2021] [Accepted: 12/30/2021] [Indexed: 01/19/2023] Open
Abstract
Small and large birth weights (BWs) for gestational age (GA) represent extremes, but the correlation between extreme BW and metabolic syndrome (MetS) has not been fully elucidated. In this study, we examined this correlation in obese children based on changes in their metabolic profile from childhood to adolescence. A retrospective observational study was performed on 535 obese patients aged 0–18 years in the Clinical and Emergency Hospital for Children “Louis Turcanu” in Timisoara, Romania, based on clinical and biological data from January 2015 to December 2019. We emphasized the links between extreme BW and obesity, extreme BW and cardiometabolic risk, obesity and cardiometabolic risk, and extreme BW, obesity and MetS. Children born large for gestational age (LGA) predominated over those born small for gestational age (SGA). Our findings showed that BW has an independent effect on triglycerides and insulin resistance, whereas obesity had a direct influence on hypertension, impaired glucose metabolism and hypertriglyceridemia. The influences of BW and obesity on the development of MetS and its components are difficult to separate; therefore, large prospective studies in normal-weight patients are needed.
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Affiliation(s)
- Teofana Otilia Bizerea-Moga
- Department XI of Pediatrics—1st Pediatric Discipline, Center for Research on Growth and Developmental Disorders in Children, ‘Victor Babeș’ University of Medicine and Pharmacy Timișoara, Eftimie Murgu Sq no. 2, 300041 Timișoara, Romania; (T.O.B.-M.); (O.M.)
- 1st Pediatric Clinic, ‘Louis Țurcanu’ Children’s Clinical and Emergency Hospital, Iosif Nemoianu 2, 300011 Timișoara, Romania; (C.L.P.); (O.O.)
| | - Laura Pitulice
- Department of Biology-Chemistry, West University of Timişoara, Pestallozi 16, 300115 Timişoara, Romania
- Laboratory of Advanced Researches in Environmental Protection, Oituz 4, 300086 Timişoara, Romania
- Correspondence: ; Tel.: +40-744-517-275
| | - Cristina Loredana Pantea
- 1st Pediatric Clinic, ‘Louis Țurcanu’ Children’s Clinical and Emergency Hospital, Iosif Nemoianu 2, 300011 Timișoara, Romania; (C.L.P.); (O.O.)
| | - Orsolya Olah
- 1st Pediatric Clinic, ‘Louis Țurcanu’ Children’s Clinical and Emergency Hospital, Iosif Nemoianu 2, 300011 Timișoara, Romania; (C.L.P.); (O.O.)
- Department VIII of Neuroscience—Psychology Discipline, ‘Victor Babeș’ University of Medicine and Pharmacy Timișoara, Eftimie Murgu Sq no. 2, 300041 Timișoara, Romania
| | - Otilia Marginean
- Department XI of Pediatrics—1st Pediatric Discipline, Center for Research on Growth and Developmental Disorders in Children, ‘Victor Babeș’ University of Medicine and Pharmacy Timișoara, Eftimie Murgu Sq no. 2, 300041 Timișoara, Romania; (T.O.B.-M.); (O.M.)
- 1st Pediatric Clinic, ‘Louis Țurcanu’ Children’s Clinical and Emergency Hospital, Iosif Nemoianu 2, 300011 Timișoara, Romania; (C.L.P.); (O.O.)
| | - Tudor Voicu Moga
- Department VII of Internal Medicine—Gastroenterology Discipline, Advanced Regional Research Center in Gastroenterology and Hepatology, ‘Victor Babeș’ University of Medicine and Pharmacy Timișoara, Eftimie Murgu Sq no. 2, 300041 Timișoara, Romania;
- Gastroenterology and Hepatology Clinic, ‘Pius Brînzeu’ County Emergency Clinical Hospital, Liviu Rebreanu 156, 300723 Timișoara, Romania
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Hirschler V, Molinari C, Lapertosa S, Maccallini G, Gonzalez CD. Cardiometabolic markers among Argentinean normal weight and overweight children with and without central obesity. Endocr Connect 2021; 10:902-908. [PMID: 34261036 PMCID: PMC8346185 DOI: 10.1530/ec-21-0139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 07/14/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND The association between central obesity and cardiometabolic complications justifies exploring its association in normal-weight and overweight/obese (OW/OB) schoolchildren. OBJECTIVE To describe cardiometabolic markers in four groups according to BMI/WC categories: (i) normal weight with central OB; (ii) normal weight without central OB; (iii) OW/OB with central OB and (iv) OW/OB without central OB, in a sample of Argentinean schoolchildren. METHODS A cross-sectional study of 1264 Argentinean schoolchildren (624 F), aged 9.5 ± 2.2 years was performed between November 2013 and 2015. Children's anthropometric measures, blood pressure (BP), glucose, lipids, and insulin were measured. Children were divided into four groups: (i) normal weight with central OB; (ii) normal weight without central OB; (iii) OW/OB with central OB and (iv) OW/OB without central OB. RESULTS The prevalence of normal-weight children without central OB was 64.3% (796), normal weight with central OB 5% (66), OW/OB without central OB 11% (137), and OW/OB with central OB 21% (265). Normal weight with central OB had significantly higher triglycerides than normal-weight children without central OB (86 vs 70 mg/dL, respectively) and OW/OB children without central OB (81 vs 77 mg/dL). Multiple linear regression analyses showed that age, systolic BP, HDL-C, triglycerides, and maternal WC were significantly associated with children's WC; R2 = 0.50 as well as children's BMI; R2 = 0.37. CONCLUSION This study found that children with central OB might be at future higher cardiometabolic risk than those without central OB independently of the presence of OW/OB. However, future longitudinal studies should be performed to confirm these findings.
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Affiliation(s)
- Valeria Hirschler
- University of Buenos Aires, Buenos Aires, Argentina
- Correspondence should be addressed to V Hirschler:
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Abstract
<abstract>
<p>Overweight and obesity have grown in children in the last decades and are now an epidemic, leading to significant public health issues in developed and underdeveloped nations. Obese children have a higher prevalence of skin lesions than normal weight children. The present study is an updated-on state of the art of studies describing the association between childhood obesity and related skin lesions. The most frequent obesity-associated dermatological complications in children are acanthosis nigricans and acrochordons, atopic dermatitis, skin infections, and endocrinological changes including hyperinsulinism and hyperandrogenism. Other common skin manifestations associated with obesity are striae distensae and plantar hyperkeratosis. Although the causes of the majority of the skin lesions associated with obesity are not known, the larger mass of adipose tissue and the secretion of peptides (cytokines, hormones, etc.) from enlarged fat cells due to obesity could lead to skin lesions. Therefore, the prevention of obesity is essential to avoid most skin-associated lesions.</p>
</abstract>
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Hirschler V, Edit S, Miorin C, Guntsche Z, Maldonado N, Garcia C, Lapertosa S, Gonzalez CD. Association Between High Birth Weight and Later Central Obesity in 9-Year-Old Schoolchildren. Metab Syndr Relat Disord 2020; 19:213-217. [PMID: 33290153 DOI: 10.1089/met.2020.0127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Background and Objective: Studies have suggested that birth weight (BW) is associated with body mass index (BMI), but its association with waist circumference (WC) in children should be further explored. To determine the association between central obesity (OB) in 9-year-old Argentinean schoolchildren and high BW. Methods: Schoolchildren (n = 2567, 1157 males) aged 8.7 ± 2.1 years from 10 elementary schools in 5 states in Argentina were examined between April 2017 and September 2019. Mothers submitted children's BW information. Pediatricians assessed anthropometric measures and blood pressure (BP). Central OB was defined for children as WC ≥90th percentile for age and gender. Results: The prevalence of overweight (OW) and OB (OW/OB) was 42.7% (1095) and that of central OB was 34.8% (856) in 9-year-old children. The prevalence of low BW (<2500 grams) and high BW (>4000 grams) was 6.6% (n = 169) and 7.4% (n = 190), respectively. BW (3.25 vs. 3.36 kg), weight (31.38 vs. 42.88 kg), BMI (17.29 vs. 22.25 kg/m2), BMI z-scores (z-BMI; 0.25 vs. 1.63), systolic BP (96 vs. 98 mmHg), and diastolic BP (59 vs. 60 mmHg) were significantly lower in 9-year-old children without central OB than in those with central OB, respectively. Multiple logistic regression analysis using central OB as the dependent variable showed that high BW [odds ratio, 1.98 (95% confidence interval 1.44-2.73)] was associated with central OB, adjusted for age, gender, and systolic and diastolic BP. Conclusion: This study shows that central OB in 9-year-old children was associated with high BW. Future longitudinal studies should be performed to confirm this finding. Clinical Registration number, IATIMET-08102019.
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Affiliation(s)
- Valeria Hirschler
- Department of Nutrition and Diabetes, University of Buenos Aires, Buenos Aires, Argentina
| | - Scaiola Edit
- Department of Nutrition and Diabetes, University of Buenos Aires, Buenos Aires, Argentina
| | - Cecilia Miorin
- Department of Nutrition and Diabetes, University of La Plata, La Plata, Argentina
| | - Zelmira Guntsche
- Department of Nutrition and Diabetes, University of Cuyo, Mendoza, Argentina
| | - Natacha Maldonado
- Department of Nutrition and Diabetes, University of Rosario, Rosario, Argentina
| | - Concepcion Garcia
- Department of Nutrition and Diabetes, University of Buenos Aires, Buenos Aires, Argentina
| | - Silvia Lapertosa
- Department of Nutrition and Diabetes, University of Buenos Aires, Buenos Aires, Argentina
| | - Claudio D Gonzalez
- Department of Nutrition and Diabetes, University of Buenos Aires, Buenos Aires, Argentina
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11
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Bendor CD, Bardugo A, Pinhas-Hamiel O, Afek A, Twig G. Cardiovascular morbidity, diabetes and cancer risk among children and adolescents with severe obesity. Cardiovasc Diabetol 2020; 19:79. [PMID: 32534575 PMCID: PMC7293793 DOI: 10.1186/s12933-020-01052-1] [Citation(s) in RCA: 118] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 06/08/2020] [Indexed: 02/08/2023] Open
Abstract
Severe obesity among children and adolescents is a significant global public health concern. The prevalence has markedly increased over the last decades, becoming common in many countries. Overwhelming rates of obesity among youth have prompted efforts to identify an evidence-based immediate- and long-term cardiometabolic risk factor profile in childhood-onset severe obesity, and to highlight gaps that require further investigation. The PubMed database was systematically searched in accordance with PRISMA guidelines. The search yielded 831 results, of which 60 fulfilled stringent criteria and were summarized in this review. The definition of severe obesity was variable, with only one half the publications using the definition BMI > 120% of the 95th percentile. Point estimates of the prevalence of at least one cardiometabolic risk factor in children with severe obesity reportedly range from 67 to 86%. Cross-sectional studies indicate that children and adolescents with severe obesity are at greater risk than those with mild obesity for type 2 diabetes, hypertension, fatty liver disease and dyslipidemia, already at childhood and adolescence. Robust epidemiological data on the long-term risk and actual point estimates in adulthood are lacking for these diseases as well as for other diseases (coronary heart disease, stroke, chronic kidney disease and cancer). Recent longitudinal studies indicate an increased risk for cardiomyopathy, heart failure, cardiovascular mortality and all-cause mortality in adulthood for adolescents with severe obesity compared to those with mild obesity. Given the alarming increase in the prevalence of severe obesity, the persistence of adiposity from childhood to adulthood and the precarious course of young adults with chronic comorbidities, the economic and clinical services burden on the healthcare system is expected to rise.
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Affiliation(s)
- Cole D Bendor
- Department of Military Medicine, Hebrew University of Jerusalem, Faculty of Medicine, Jerusalem, Israel
- Academy and Research Division, Surgeon General Headquarters, Israel Defense Forces, Medical Corps, Ramat Gan, Israel
| | - Aya Bardugo
- Department of Military Medicine, Hebrew University of Jerusalem, Faculty of Medicine, Jerusalem, Israel
- Academy and Research Division, Surgeon General Headquarters, Israel Defense Forces, Medical Corps, Ramat Gan, Israel
| | - Orit Pinhas-Hamiel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Institute of Endocrinology, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Arnon Afek
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Central Management, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Gilad Twig
- Department of Military Medicine, Hebrew University of Jerusalem, Faculty of Medicine, Jerusalem, Israel.
- Academy and Research Division, Surgeon General Headquarters, Israel Defense Forces, Medical Corps, Ramat Gan, Israel.
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
- Institute of Endocrinology, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
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12
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Agostinis-Sobrinho C, Rosário R, Santos R, Norkiene S, Mota J, Rauckienė-Michaelsson A, González-Ruíz K, Izquierdo M, Garcia-Hermoso A, Ramírez-Vélez R. Higher Cardiorespiratory Fitness Levels May Attenuate the Detrimental Association between Weight Status, Metabolic Phenotype and C-Reactive Protein in Adolescents-A Multi-Cohort Study. Nutrients 2020; 12:E1461. [PMID: 32443557 PMCID: PMC7284377 DOI: 10.3390/nu12051461] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 05/12/2020] [Accepted: 05/13/2020] [Indexed: 12/31/2022] Open
Abstract
Results from several studies show that only obese, unfit subjects, but not obese, fit subjects, are at higher mortality risk than are normal-weight fit subjects. The aim of the study was two-fold: (1) to examine the differences in C-reactive protein levels across different metabolic phenotypes (healthy and unhealthy) of weight status and (2) ascertain whether high levels of cardiorespiratory fitness (CRF) attenuate the association of C-reactive protein and metabolic phenotypes of weight status. This was a pooled study, which included data from three cross-sectional projects (1706 youth (921 girls) aged 12-18 years). We used a Shuttle run test to assess CRF. Adolescents were classified into six metabolic phenotypes (healthy and unhealthy) of weight status (non-overweight, overweight and obese), based on age- and sex-specific cutoff points for triglycerides, systolic blood pressure, HDL-cholesterol, glucose and body mass index. High-sensitivity assays were used to obtain the C-reactive protein as inflammatory biomarker. After adjustment for potential confounders (age, sex, pubertal stage and country), the analysis of covariance (ANCOVA) shows that C-reactive protein is directly associated with metabolic phenotypes of weight status. Subjects with obesity, regardless of their metabolic profile, had higher levels of C-reactive protein Z-score. In addition, (after adjustments for potential confounders) a two-way ANCOVA showed that high levels of CRF attenuated the associations of C-reactive protein levels in metabolic healthy non-overweight and in adolescents with obesity. In conclusion, higher CRF levels may attenuate the detrimental association between obesity and C-reactive protein independently of metabolic phenotype. Findings from this study are important for prevention, clinical practice on issues associated with adiposity and metabolic disorders.
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Affiliation(s)
- Cesar Agostinis-Sobrinho
- Faculty of Health and Sciences, Klaipeda University, 92294 Klaipeda, Lithuania; (C.A.-S.); (S.N.); (A.R.-M.)
| | - Rafaela Rosário
- School of Nursing, University of Minho, 4710 Braga, Portugal;
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3000-232 Coimbra, Portugal
| | - Rute Santos
- Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, 4200-450 Porto, Portugal; (R.S.); (J.M.)
| | - Sigute Norkiene
- Faculty of Health and Sciences, Klaipeda University, 92294 Klaipeda, Lithuania; (C.A.-S.); (S.N.); (A.R.-M.)
| | - Jorge Mota
- Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, 4200-450 Porto, Portugal; (R.S.); (J.M.)
| | - Alona Rauckienė-Michaelsson
- Faculty of Health and Sciences, Klaipeda University, 92294 Klaipeda, Lithuania; (C.A.-S.); (S.N.); (A.R.-M.)
| | - Katherine González-Ruíz
- Grupo de Ejercicio Físico y Deportes, Vicerrectoría de Investigaciones, Universidad Manuela Beltrán, Bogotá 110231, Colombia;
| | - Mikel Izquierdo
- Department of Health Sciences, Public University of Navarra, Navarrabiomed-IdiSNA, Complejo Hospitalario de Navarra (CHN), 31008 Pamplona, Spain; (M.I.); (A.G.-H.)
- CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Antonio Garcia-Hermoso
- Department of Health Sciences, Public University of Navarra, Navarrabiomed-IdiSNA, Complejo Hospitalario de Navarra (CHN), 31008 Pamplona, Spain; (M.I.); (A.G.-H.)
- CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Facultad de Ciencias Médicas, Universidad de Santiago de Chile, USACH, Santiago 7500618, Chile
| | - Robinson Ramírez-Vélez
- Department of Health Sciences, Public University of Navarra, Navarrabiomed-IdiSNA, Complejo Hospitalario de Navarra (CHN), 31008 Pamplona, Spain; (M.I.); (A.G.-H.)
- CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, 28029 Madrid, Spain
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13
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Hirschler V, Lapertosa S, Raquel Scaiola E, Garcia C, Maldonado N, Guntsche Z, Miorin C, Obeziuk A, Molinari C, Gonzalez CD. Adiposity, lifestyle behaviors, and cardiometabolic markers in Argentinean schoolchildren. Clin Chim Acta 2020; 507:280-285. [PMID: 32387636 DOI: 10.1016/j.cca.2020.05.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/02/2020] [Accepted: 05/04/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND We determined the association between schoolchildren's OW/OB with age, sex, lifestyle behaviors, and cardiometabolic markers. METHODS Age, sex, anthropometric measures, and BP (blood pressure) were recorded in 1249 (554 M) schoolchildren. OW/OB was defined as BMI > 85%ile and BMI > 95%ile respectively. A validated questionnaire for lifestyle behaviors was performed. We offered free laboratory testing to a subgroup of 168 children. RESULTS Schoolchildren aged 8.8 ± 2.1 y from 9 elementary schools in 4 areas of Argentina were examined between April and September 2019. 265 (21.2%) of the children were OW, 265 (21.2%) were OB, and 425 (35%) had central OB. OW/OB was associated with low milk intake (OR = 1.92; 95% CI, 1.1-3.3), skipping breakfast (OR = 2.00; 95% CI, 1.2-3.4), a family history of hypertension (OR = 1.74; 95% CI, 1.1-2.9), and systolic BP (OR = 1.03; 95% CI, 1.01-1.05); adjusted for confounding variables. The subgroup analysis showed that OW/OB children had lower iron (83 vs. 94 ug/dl, respectively) and HDL-C (43 vs. 47 mg/dl) levels, but higher non-HDL-C (107 vs. 99 mg/dl) levels than normal-weight children. Multiple logistic regression analysis showed that OW/OB was inversely associated with iron (OR = 0.99; 95% CI, 0.98-0.998) and HDL-C (OR = 0.94; 95% CI, 0.91-0.97) levels; adjusted for confounding variables. CONCLUSION Adiposity in schoolchildren was associated with unhealthy lifestyle behaviors, higher atherogenic risk, and lower iron concentrations, suggesting that OW/OB children are at increased risk for anemia and cardiometabolic disease.
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Affiliation(s)
| | | | | | | | | | | | - Cecilia Miorin
- Universidad of Cuyo, Argentina; University of La Plata, Argentina
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14
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Bitew ZW, Alemu A, Ayele EG, Tenaw Z, Alebel A, Worku T. Metabolic syndrome among children and adolescents in low and middle income countries: a systematic review and meta-analysis. Diabetol Metab Syndr 2020; 12:93. [PMID: 33117455 PMCID: PMC7590497 DOI: 10.1186/s13098-020-00601-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 10/19/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is a clustering of cardiovascular risk factors, which is rising in the low and middle income countries (LMICs). There are various studies with inconsistent findings that are inconclusive for policy makers and program planners. Thus, this systematic review and meta-analysis aimed at estimating the pooled prevalence of MetS and its components in LMICs. METHODS Electronic searches were conducted in international databases including PubMed, Web of Science, EMBASE (Elsevier), Scopus, CINAHL (EBSCOhost), Science direct (Elsevier), Food Science and Technology Abstracts (FSTA), Global Health and Medline, and other sources (World Cat, Google Scholar, and Google). The pooled estimates were computed in the random effect model. The pooled prevalence was computed using the three diagnostic methods (IDF, ATP III and de Ferranti). Publication bias was verified using funnel plot and Egger's regression test. Subgroup and sensitivity analysis were performed to identify the possible sources of heterogeneity among the included studies. RESULT In this study, 142,142 children and adolescents from 76 eligible articles were included to compute the pooled prevalence of MetS and its components in LMCIs. MeTs among overweight and obese population was computed from 20 articles with the pooled prevalence of 24.09%, 36.5%, and 56.32% in IDF, ATP III and de Ferranti criteria, respectively. Similarly, a total of 56 articles were eligible to compute the pooled prevalence of MetS in the general population of children and adolescents. Hence, Mets was found in 3.98% (IDF), 6.71% (ATP III) and 8.91% (de Ferranti) of study subjects. Regarding the components of MetS, abdominal obesity was the major component in overweight and obese population and low HDL-C was the most common component in the general population. This study also revealed that males were highly affected by MetS than females. CONCLUSION This study illustrates that MetS among children and adolescents is an emerging public health challenge in LMICs, where the prevalence of obesity is on the move. Preventive strategies such as community and school based intervention need to be designed. Promoting physical activities and healthy eating behaviors could avert this problem.
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Affiliation(s)
| | | | | | - Zelalem Tenaw
- College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Anmut Alebel
- College of Health Science, Debremarkose University, Debre Markos, Ethiopia
- Australian Centre for Public and Population Health Research, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW Australia
| | - Teshager Worku
- College of Health and Medical Sciences, School of Nursing and Midwifery, Haramaya University, Harar, Ethiopia
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15
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Zaki M, Kamal S, Kholousi S, El-Bassyouni HT, Yousef W, Reyad H, Mohamed R, Basha WA. Serum soluble receptor of advanced glycation end products and risk of metabolic syndrome in Egyptian obese women. EXCLI JOURNAL 2017; 16:973-980. [PMID: 28900377 PMCID: PMC5579397 DOI: 10.17179/excli2017-275] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 06/19/2017] [Indexed: 01/04/2023]
Abstract
Obesity is one of the diagnostic criteria of metabolic syndrome (MS). It is correlated with insulin resistance (IR) and high vascular risk as well. Advanced glycation end products (AGEs) and their receptor (RAGE) play an important role in abnormal metabolic components in obese women. This study aimed to explore the serum levels of sRAGE in Egyptian obese women and compare with healthy non-obese controls and investigate the relationship between serum sRAGE, metabolic parameters, and obesity complications. The soluble form of receptor for advanced glycation end products (sRAGE), anthropometry, metabolic and biochemical biomarkers were measured in 100 obese women and 100 age-matched healthy control non-obese women. The homeostasis model assessment estimate of insulin resistance (HOMA-IR) has been determined from serum insulin and glucose values. Serum sRAGE levels were significantly lower in obese cases than controls and inversely correlated with obesity and metabolic parameters. Results of univariate and multivariate analyses for determinants of serum sRAGE levels in obese cases showed that parameters statistically and significantly related were body mass index (BMI), waist circumference (WC), LDL-C, TG, BP, HOMA-IR, ALT and AST. sRAGE is a novel biomarker for metabolic dysfunction in Egyptian obese women and might predict the future cardio-metabolic events.
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Affiliation(s)
- Moushira Zaki
- Biological Anthropology Department, National Research Centre, Cairo, Egypt
| | - Sanaa Kamal
- Biological Anthropology Department, National Research Centre, Cairo, Egypt
| | - Shams Kholousi
- Immunogenetics Department, Human Genetics and Genome Research Division, National Research Centre, Giza, Egypt
| | | | - Walaa Yousef
- Biological Anthropology Department, National Research Centre, Cairo, Egypt
| | - Hanaa Reyad
- Biological Anthropology Department, National Research Centre, Cairo, Egypt
| | - Ramy Mohamed
- Biological Anthropology Department, National Research Centre, Cairo, Egypt
| | - Walaa A Basha
- Biological Anthropology Department, National Research Centre, Cairo, Egypt
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16
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Zaki M, Kamal S, Ezzat W, Hassan N, Yousef W, Ryad H, Mohamed R, Youness E, Basha W, Elhosary Y. Serum apelin levels and metabolic risk markers in obese women. J Genet Eng Biotechnol 2017; 15:423-429. [PMID: 30647682 PMCID: PMC6296620 DOI: 10.1016/j.jgeb.2017.05.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 04/06/2017] [Accepted: 05/27/2017] [Indexed: 12/25/2022]
Abstract
Background Adipose tissue hormones, Adipokines, play an important role in obesity-associated complications. Apelin has recently been added to the family of adipokines. The aim of this study was to evaluate the relationship between serum apelin levels and metabolic abnormal parameters in Egyptian obese women. Materials and methods The study included 400 unrelated women; they were 200 obese women and 200 non- obese matched healthy women. All participants underwent clinical, anthropometric and biochemical examinations. Insulin resistance (IR) was determined by the homeostasis model assessment of insulin resistance (HOMA-IR). Serum apelin levels and obesity biomarkers were measured using enzyme-linked immunoassay (ELISA) kits. Fat mass was measured by Tanita Body Composition Analyzer. Results Obese women showed significant higher levels of serum apelin, leptin, triglycerides, LDL-C, total cholesterol, fasting insulin HOMA-IR and blood pressure levels than controls. Significant positive correlations between apelin and leptin levels with abnormal metabolic markers were noted in obese women. Conclusion The present study suggests the significant role that might be mediated by apelin for developing abnormal metabolic parameters among Egyptian obese women.
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Affiliation(s)
- Moushira Zaki
- Biological Anthropology Department, Medical Research Division, Giza, Egypt
| | - Sanaa Kamal
- Biological Anthropology Department, Medical Research Division, Giza, Egypt
| | - Wafaa Ezzat
- Internal Medicine Department, Medical Research Division, Giza, Egypt
| | - Naglaa Hassan
- Biological Anthropology Department, Medical Research Division, Giza, Egypt
| | - Walaa Yousef
- Biological Anthropology Department, Medical Research Division, Giza, Egypt
| | - Hanaa Ryad
- Biological Anthropology Department, Medical Research Division, Giza, Egypt
| | - Ramy Mohamed
- Biological Anthropology Department, Medical Research Division, Giza, Egypt
| | - Eman Youness
- Medical Biochemistry Department, Medical Research Division, National Research Centre, Giza, Egypt
| | - Walaa Basha
- Biological Anthropology Department, Medical Research Division, Giza, Egypt
| | - Yasser Elhosary
- Internal Medicine Department, Medical Research Division, Giza, Egypt
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17
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Peña-Espinoza BI, Granados-Silvestre MDLÁ, Sánchez-Pozos K, Ortiz-López MG, Menjivar M. Metabolic syndrome in Mexican children: Low effectiveness of diagnostic definitions. ACTA ACUST UNITED AC 2017; 64:369-376. [PMID: 28745608 DOI: 10.1016/j.endinu.2017.04.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 04/14/2017] [Accepted: 04/19/2017] [Indexed: 01/19/2023]
Abstract
BACKGROUND Early identification of children with metabolic syndrome (MS) is essential to decrease the risk of developing diabetes and cardiovascular disease in adulthood. Detection of MS is however challenging because of the different definitions for diagnosis; as a result, preventive actions are not taken in some children at risk. The study objective was therefore to compare prevalence of MS in children according to the IDF, NCEP-ATP-III, Cook, de Ferranti and Weiss definitions, considering insulin resistance (IR) markers such as HOMA-IR and/or metabolic index (MI). METHODS A total of 508 Mexican children (aged 9 to 13 years) from seven schools were enrolled in a cross-sectional study. Somatometric, biochemical, and hormonal measurements were evaluated. RESULTS Frequency of MS was 2.4-45.9% depending on the definition used. Frequency of IR in children not diagnosed with MS was 12.4-25.2% using HOMA-IR and 4.0-16.3% using MI. When HOMA-IR or MI was included in each of the definitions, frequency of MS was 8.5-50.2% and 7.7-46.9% respectively. The kappa value including HOMA-IR and/or MI was greater than 0.8. CONCLUSIONS This study demonstrated the poor effectiveness of the current criteria used to diagnose MS in Mexican children, as shown by the variability in the definitions and by the presence of IR in children who not diagnosed with MS. Inclusion of HOMA-IR and/or MI in definitions of MS (thus increasing agreement between them) decreases the chance of excluding children at risk and allows for MS prevalence between populations.
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Affiliation(s)
- Barbara Itzel Peña-Espinoza
- Laboratorio de Genómica de la Diabetes, Facultad de Química en la Unidad Académica de Ciencia y Tecnología de la UNAM, Yucatán, Mérida, Yucatán, México
| | | | - Katy Sánchez-Pozos
- Laboratorio de diabetes, Facultad de Química, Universidad Nacional Autónoma de México, Ciudad de México, México
| | | | - Marta Menjivar
- Laboratorio de Genómica de la Diabetes, Facultad de Química en la Unidad Académica de Ciencia y Tecnología de la UNAM, Yucatán, Mérida, Yucatán, México; Laboratorio de diabetes, Facultad de Química, Universidad Nacional Autónoma de México, Ciudad de México, México.
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18
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Gamboa-Meléndez MA, Galindo-Gómez C, Juárez-Martínez L, Gómez FE, Diaz-Diaz E, Ávila-Arcos MA, Ávila-Curiel A. Novel association of the R230C variant of the ABCA1 gene with high triglyceride levels and low high-density lipoprotein cholesterol levels in Mexican school-age children with high prevalence of obesity. Arch Med Res 2015; 46:495-501. [PMID: 26256050 DOI: 10.1016/j.arcmed.2015.07.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Accepted: 07/31/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND AIMS Metabolic syndrome (MetS) is a disorder that includes a cluster of several risk factors for the development of type 2 diabetes and cardiovascular disease. The R230C variant of the ABCA1 gene has been associated with low HDL-cholesterol in several studies, but its association with MetS in children remains to be determined. The aim of this study was to analyze the association of the R230C variant with MetS and other metabolic traits in school-aged Mexican children. METHODS The study was performed in seven urban primary schools in the State of Mexico. Four hundred thirty-two Mexican school-age children 6-13 years old were recruited. MetS was identified using the International Diabetes Federation definition. The R230C variant of the ABCA1 gene was genotyped to seek associations with MetS and other metabolic traits. RESULTS The prevalence of MetS was 29% in children aged 10-13 years. The R230C variant was not associated with MetS (OR = 1.65; p = 0.139). Furthermore, in the whole population, the R230C variant was associated with low HDL-cholesterol levels (β coefficient = -3.28, p <0.001). Interestingly, in the total population we found a novel association of this variant with high triglyceride levels (β coefficient = 14.34; p = 0.027). CONCLUSIONS We found a new association of the R230C variant of the ABCA1 gene with high triglyceride levels. Our findings also replicate the association of this variant with low HDL-cholesterol levels in Mexican school-age children.
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Affiliation(s)
| | - Carlos Galindo-Gómez
- Dirección de Nutrición, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, D.F., Mexico
| | - Liliana Juárez-Martínez
- Dirección de Nutrición, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, D.F., Mexico
| | - F Enrique Gómez
- Departamento de Fisiología de la Nutrición, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, D.F., Mexico
| | - Eulises Diaz-Diaz
- Departamento de Biología de la Reproducción, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, D.F., Mexico
| | - Marco Antonio Ávila-Arcos
- Dirección de Nutrición, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, D.F., Mexico
| | - Abelardo Ávila-Curiel
- Dirección de Nutrición, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, D.F., Mexico.
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Samsell L, Regier M, Walton C, Cottrell L. Importance of android/gynoid fat ratio in predicting metabolic and cardiovascular disease risk in normal weight as well as overweight and obese children. J Obes 2014; 2014:846578. [PMID: 25302115 PMCID: PMC4181515 DOI: 10.1155/2014/846578] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 09/02/2014] [Indexed: 11/17/2022] Open
Abstract
Numerous studies have shown that android or truncal obesity is associated with a risk for metabolic and cardiovascular disease, yet there is evidence that gynoid fat distribution may be protective. However, these studies have focused on adults and obese children. The purpose of our study was to determine if the android/gynoid fat ratio is positively correlated with insulin resistance, HOMA2-IR, and dislipidemia in a child sample of varying body sizes. In 7-13-year-old children with BMI percentiles ranging from 0.1 to 99.6, the android/gynoid ratio was closely associated with insulin resistance and combined LDL + VLDL-cholesterol. When separated by sex, it became clear that these relationships were stronger in boys than in girls. Subjects were stratified into BMI percentile based tertiles. For boys, the android/gynoid ratio was significantly related to insulin resistance regardless of BMI tertile with and LDL + VLDL in tertiles 1 and 3. For girls, only LDL + VLDL showed any significance with android/gynoid ratio and only in tertile 2. We conclude that the android/gynoid fat ratio is closely associated with insulin resistance and LDL + VLDL-, "bad," cholesterol in normal weight boys and may provide a measurement of metabolic and cardiovascular disease risk in that population.
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Affiliation(s)
- Lennie Samsell
- Department of Pediatrics, School of Medicine, West Virginia University, Morgantown, WV 9214, USA
| | - Michael Regier
- Department of Biostatistics, School of Public Health, West Virginia University, Morgantown, WV 6057, USA
| | - Cheryl Walton
- Department of Pediatrics, School of Medicine, West Virginia University, Morgantown, WV 9214, USA
| | - Lesley Cottrell
- Department of Pediatrics, School of Medicine, West Virginia University, Morgantown, WV 9214, USA
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Al-Isa AN. Comparing Socio-Demographic, Health-Related, and Biochemical Factors Associated with Metabolic Syndrome (MetS) between Adolescents from Two Arab Countries. Health (London) 2014. [DOI: 10.4236/health.2014.68098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Nambiar S, Truby H, Davies PSW, Baxter K. Use of the waist-height ratio to predict metabolic syndrome in obese children and adolescents. J Paediatr Child Health 2013; 49:E281-7. [PMID: 23521181 DOI: 10.1111/jpc.12147] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/28/2012] [Indexed: 01/19/2023]
Abstract
AIM To demonstrate that the waist-height ratio (WHtR) is a simple and effective screening tool that could be used to identify obese children with the metabolic syndrome. METHODS Data from 109 obese boys and girls, aged 10.00-16.50 years, who were recruited as part of the Eat Smart study were analysed. Systolic (SBP) and diastolic (DBP) blood pressure, blood lipids (total cholesterol, triglycerides (TG), high- and low-density lipoproteins), insulin, glucose, height, weight and waist circumference (WC) were collected. These measurements were used to calculate WHtR, body mass index (BMI), Z-scores for BMI, WC, weight and homeostatic model assessment for insulin resistance (HOMA-IR). Correlations between anthropometric measures and blood pressure, lipids, insulin, glucose and HOMA-IR were assessed. Binary logistic regression was used to test which anthropometric measure was a significant predictor of the metabolic syndrome. RESULTS Among boys, WHtR was negatively correlated with glucose (P < 0.05); WHtR and BMI Z-score were positively correlated with insulin, HOMA-IR and TG (P < 0.05) and WC Z-score was significantly correlated with age. Among girls, WHtR, BMI Z-score and WC Z-score were positively correlated with insulin and HOMA-IR and negatively correlated with high-density lipoprotein-cholesterol (P < 0.05), whereas BMI Z-score was significantly correlated with SBP and DBP Z-scores. Twenty per cent of subjects were classified as having the metabolic syndrome, with WHtR, BMI Z-score and HOMA-IR being significant predictors. CONCLUSION The WHtR is a significant predictor of the metabolic syndrome in obese youth. The WHtR is the simplest index to calculate and interpret, making it an ideal non-invasive screening tool to use in clinical practice.
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Affiliation(s)
- Smita Nambiar
- Children's Nutrition Research Centre, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
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Abstract
BACKGROUND AND OBJECTIVES Obesity is one of the most serious global health issues. The aim of this study was to assess the association between obesity and different components of metabolic syndrome among obese school children aged 7 to 9 years, and to identify associated clinical and biochemical characteristics. DESIGN AND SETTING Case-control study among children attending Al-Zahraa Hospital Outpatient Clinic March 2010. SUBJECTS AND METHODS The study included 60 obese children (28 boys and 32 girls) and 50 non-obese controls (25 boys and 25 girls). Anthropometry, fasting glucose, insulin concentrations, total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), triglycerides, systolic and diastolic blood pressure (BP) were measured. Insulin resistance was determined by Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). Subcutaneous and visceral fat thicknesses were measured ultrasonographically. Metabolic syndrome (MS) was defined according to the Cook criteria. RESULTS MS was found in 25% of obese cases. Obese children showed significantly higher values in waist circumference, waist-to-hip ratio, levels of systolic and diastolic BP, insulin, HOMA-IR and LDL compared to their lean controls. HDL was significantly lower in obese children compared to controls. Obese children with MS had significantly higher values of body mass index standard deviation score (SDS), skinfold thickness, visceral fat thickness, waist circumference, systolic and diastolic BP, HOMA-IR, insulin and triglycerides compared to obese children without MS, whereas HDL was significantly lower. Obese children with MS had a high prevalence of hypertension and dyslipidemia compared to children without MS. Results showed positive relationships between visceral fat and waist circumference as well as with insulin level in obese children (P < .05). CONCLUSIONS The prevalence of the MS is considerable among obese Egyptian children. Abdominal obesity and high HOMA-IR values were the most frequent components of this syndrome among obese children. The study suggests that increased degree of insulin resistance is associated with a heightened risk of suffering MS.
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Affiliation(s)
- Moushira Erfan Zaki
- Biological Anthropology Department, Medical Research Division, National Research Centre, NRC, Pediatric Department, Faculty of Medicine (Girls), Al-Azhar University, cImmunogenetics Department, Human Genetics and Genome Research Division, National Research Center, Giza, Egypt
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Hirschler V, Acebo HLP, Fernandez GB, Ferradas S, Oestreicher K. Association between left atrial size and measures of adiposity among normal adolescent boys. Pediatr Cardiol 2012; 33:245-51. [PMID: 21952879 DOI: 10.1007/s00246-011-0123-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2011] [Accepted: 09/12/2011] [Indexed: 12/12/2022]
Abstract
Obesity (OB) in adults is associated with insulin resistance, hypertension, and left atrial (LA) enlargement. This study aimed to determine the association between LA size and (1) different components of the metabolic syndrome (body mass index [BMI], waist circumference [WC], insulin levels, lipid levels, and blood pressure), and (2) left ventricular (LV) diameters and diastolic function. Data were collected cross-sectionally from 142 healthy adolescent boys age 16.8 ± 2.0 years in 2009. Measurements of BMI, WC, blood pressure, lipid profile, and insulin were performed. Mode M, two-dimensional Doppler echocardiography was performed. Measurements of LA area, LV end diastolic diameter (EDD), end systolic diameter (ESD), posterior wall, interventricular septum (IVS), and shortening fraction were performed. Tisular Doppler of the diastolic mitral annular E wave (DTE) and A wave (DTA) and the ratio of maximal early diastolic filling wave velocity to maximal early diastolic myocardial velocity (E/e') were recorded. The study group included 38 OB boys (26.8%) and 32 overweight boys (22.5%). Significant univariate association was found between LA area and BMI (r = 0.61), WC (r = 0.56), systolic blood pressure (r = 0.21), insulinemia (r = 0.28), high-density lipoprotein-cholesterol (HDL-C) (r = -0.24), triglycerides (r = 0.20), EDD (r = 0.25), LV posterior wall (r = 0.25), IVS (r = 0.25), DTE (r = 0.27), DTA (r = 0.30), and E/e' (r = -0.28). Multiple linear regression analysis showed that LA area was associated with BMI (B = 0.61; R (2) = 0.47) adjusted for confounding variables. In adolescents, BMI and WC were significantly associated with LA, suggesting that OB could be associated with LA enlargement as early as adolescence.
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Papoutsakis C, Yannakoulia M, Ntalla I, Dedoussis GV. Metabolic syndrome in a Mediterranean pediatric cohort: prevalence using International Diabetes Federation-derived criteria and associations with adiponectin and leptin. Metabolism 2012; 61:140-5. [PMID: 21816444 DOI: 10.1016/j.metabol.2011.06.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2011] [Revised: 06/03/2011] [Accepted: 06/08/2011] [Indexed: 10/17/2022]
Abstract
The aims of the study were to determine the prevalence of metabolic syndrome (MS) components and examine associations with adipokine concentrations in a healthy pediatric cohort. A cross-sectional study of 1138 children (53% girls; mean age of all participants, 11.2 ± 0.7 years) was performed. Anthropometric and medical information was obtained; and a fasting blood sample was used to measure glucose, insulin, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, leptin, and adiponectin serum concentrations. Insulin resistance was assessed by the insulin resistance homeostasis model assessment. Body weight status (normal, overweight, and obese) was determined according to the International Obesity Task Force. Estimation of the MS was based on the International Diabetes Federation definition. The prevalence of the MS was 0.7% of children, all of whom were obese. Frequency of abdominal obesity, high fasting glucose, elevated triglycerides, low high-density-lipoprotein cholesterol, and elevated blood pressure was 4.8%, 4.7%, 0, 12.3%, and 33%, respectively. Body mass index (BMI) and z-BMI score increased significantly as the number of cardiometabolic risk factors increased. Regression analysis revealed that adiponectin (β = -0.501, P = .003) and leptin (β = 0.184, P < .0001) independently predicted the number of MS features. This finding was no longer significant after adjustment for BMI. In the present study, we provide the first estimate of the prevalence of the MS among healthy periadolescents in Greece using the International Diabetes Federation criteria. The MS prevalence was low, with elevated blood pressure being the most dominant feature. Finally, associations with adipokines are mediated by BMI.
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Relationship of body fat and cardiorespiratory fitness with cardiovascular risk in Chinese children. PLoS One 2011; 6:e27896. [PMID: 22114722 PMCID: PMC3218065 DOI: 10.1371/journal.pone.0027896] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2011] [Accepted: 10/27/2011] [Indexed: 11/19/2022] Open
Abstract
Backgrounds/Objectives Cardiorespiratory fitness (CRF) and body fat play an important role in elevated risk for cardiovascular disease (CVD). However, the combined effects of CRF and obesity on metabolic health in Chinese children are unclear. The purpose of this study was to investigate the independent and combined associations between body fat, CRF, and CVD risk in Chinese schoolchildren. Methods The study subjects comprised 676 schoolchildren (392 boys and 284 girls, aged 9.6±0.7 yrs old) in Wuhan, China. Their body mass index (BMI), waist circumference (WC), CRF, blood pressure (BP), lipids, glucose, and pubertal status were assessed. Children were categorized into different groups based on their BMI, WC, and CRF using Chinese obesity cut-off points and CRF sex-specific median points. Metabolic Risk Score (MRS) was computed based on the standardized scores of BP, lipids, and glucose. Results Multiple linear regression models showed that, in the separate models, body fat was positively associated with MRS while CRF was inversely associated with MRS (p<0.001). However, when assessed simultaneously, only body fat had a significant association with MRS (p<0.001). In general, low-fit children had a lower MRS compared to their counterparts, and a significant difference between the two extreme groups was observed (low CRF and high fat vs. high CRF and low fat, p<0.001). Conclusions These findings suggest that both body fat and CRF should be considered when interpreting CVD risk in Chinese children, while body fat may be correlated with CVD risk more than CRF.
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Hirschler V, Molinari C, Maccallini G, Aranda C, Oestreicher K. Comparison of different anthropometric indices for identifying dyslipidemia in school children. Clin Biochem 2011; 44:659-64. [PMID: 21349259 DOI: 10.1016/j.clinbiochem.2011.02.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2010] [Revised: 01/31/2011] [Accepted: 02/08/2011] [Indexed: 01/20/2023]
Abstract
BACKGROUND Anthropometric indices have been associated with dyslipidemia. OBJECTIVE To compare the abilities of BMI, waist circumference (WC) and WC/height to identify children's dyslipidemia. METHODS Students 1261 (639 male) age 9.5±2.1 years. were examined for anthropometry and lipid levels. Triglycerides ≥1.69 mmol/L and high-density lipoprotein cholesterol (HDL-C) <0.91 mmol/L were considered abnormal per American Heart Association. RESULTS The prevalence of abnormal triglycerides was 4.1% and HDL-C 8.1%. The areas under the receiver operator curves (ROC) were: BMI=0.87, WC=0.83, and WC/height=0.84 in predicting both low HDL-C and high triglycerides. Multiple regression analyses showed that the odds ratios (OR) were highest for WC [6.5], followed by WC/height [5.4], and BMI [4.9], for dyslipidemia. CONCLUSIONS The results suggest that WC, WC/height, and BMI similarly predicted dyslipidemia, using ROC analyses. However, regression analyses showed that WC followed by WC/height was most predictive of dyslipidemia.
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Affiliation(s)
- Valeria Hirschler
- Nutrition and Diabetes Department, Hospital Durand, Buenos Aires, Argentina.
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Current world literature. Curr Opin Endocrinol Diabetes Obes 2011; 18:83-98. [PMID: 21178692 DOI: 10.1097/med.0b013e3283432fa7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Impact of Unhealthy Lifestyle Behaviors and Obesity on Cholesteryl Ester Transfer Protein Among Adolescent Males. Arch Med Res 2011; 42:53-9. [DOI: 10.1016/j.arcmed.2010.11.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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