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Yu H, Li C, Guo M, Yang Y, Gui Z, Chang Y. Age- and Gender-Specific Reference Intervals for the Fasting Serum Lipid Levels in a Pediatric Population Aged 0-<15 Years in Nanjing, China. J Atheroscler Thromb 2024; 31:1135-1148. [PMID: 38417901 PMCID: PMC11300788 DOI: 10.5551/jat.64270] [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: 03/28/2023] [Accepted: 01/09/2024] [Indexed: 03/01/2024] Open
Abstract
AIMS The lipid reference intervals (RIs) that are currently used for children in China are not based on studies of the local population and normally do not consider age or gender differences. This study aimed to establish age- and sex-specific RIs for the fasting serum lipid levels in the pediatric population aged 0 - 15 years in Nanjing, China. METHODS 5,866 children aged 3 days to <15 years were recruited to establish serum lipid RIs, and the triglyceride (TG), total cholesterol (TC), and high-density lipoprotein cholesterol (HDL-C) levels were analyzed using the Roche cobas702 automatic biochemical analyzer. Low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (nHDL-C) levels were calculated (LDL-C=TC-HDL-C-TG/5, and nHDL-C=TC-HDL-C). Smoothed percentile curves for the boys and girls were generated using the LMS method. Age- and sex-specific RIs were the determined according to the methods recommended by the Clinical and Laboratory Standards Institute EP28-A3c guidelines. RESULTS This study showed that the serum lipid levels varied considerably throughout childhood and adolescence, with sex differences, especially in infants aged less than 2 years and puberty. Based on the Harris-Boyd method, sex partitions were required for ages <6 months in the TC indicator and for ages ≤ 28 days in LDL-C and nHDL-C. Age partitions were also required for all serum lipid parameters. CONCLUSIONS We established age- and sex-specific RIs for TG, TC, HDL-C, LDL-C, and nHDL-C parameters in children aged 0 days to <15 years in Nanjing, China. These data are thus considered to be useful for the screening of dyslipidemia in children and adolescents.
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Affiliation(s)
- Hanqing Yu
- Department of Laboratory Medicine, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Chenli Li
- Department of Laboratory Medicine, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Min Guo
- Department of Laboratory Medicine, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Yanli Yang
- Department of Laboratory Medicine, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Zhen Gui
- Department of Laboratory Medicine, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Yong Chang
- Department of Laboratory Medicine, Children’s Hospital of Nanjing Medical University, Nanjing, China
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Peres M, Moreira-Rosário A, Padeira G, Gaspar Silva P, Correia C, Nunes A, Garcia E, Faria A, Teixeira D, Calhau C, Pereira-da-Silva L, Ferreira AC, Rocha JC. Biochemical and Anthropometric Outcomes in Paediatric Patients with Heterozygous Familial Hypercholesterolemia after COVID-19 Pandemic Lockdowns: An Exploratory Analysis. Nutrients 2024; 16:2170. [PMID: 38999917 PMCID: PMC11242984 DOI: 10.3390/nu16132170] [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: 05/10/2024] [Revised: 07/03/2024] [Accepted: 07/03/2024] [Indexed: 07/14/2024] Open
Abstract
The COVID-19 pandemic lockdowns affected the lifestyles of children and adolescents, leading to an increase in childhood obesity. Paediatric patients with familial hypercholesterolemia (FH) may be more susceptible to lockdown effects due to their increased cardiovascular risk. However, data are lacking. We investigated the effect of lockdowns on the metabolic profile of paediatric patients with FH. Blood lipids and anthropometry measured in September 2021-April 2022 were retrospectively compared with pre-pandemic values. Thirty participants were included (1-16 years; 57% female). From baseline to post-pandemic, median [P25, P75] blood LDL-C concentration was 125 [112, 150] mg/dL vs. 125 [100, 147] mg/dL (p = 0.894); HDL-C was 58 [52, 65] mg/dL vs. 56 [51, 61] mg/dL (p = 0.107); triglycerides were 64 [44, 86] mg/dL vs. 59 [42, 86] mg/dL (p = 0.178). The BMI z-score did not change significantly (0.19 [-0.58, 0.89] vs. 0.30 [-0.48, 1.10], p = 0.524). The lack of deterioration in metabolic profiles during lockdowns is positive, as some deterioration was expected. We speculate that patients and caregivers were successfully educated about healthy lifestyle and dietary habits. Our results should be interpreted with caution since the study sample was small and heterogeneous. Multicentre research is needed to better understand the impact of lockdowns on this population.
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Affiliation(s)
- Maria Peres
- Nutrition and Metabolism, NOVA Medical School, Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal
| | - André Moreira-Rosário
- Nutrition and Metabolism, NOVA Medical School, Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal
- CHRC-Comprehensive Health Research Centre, Nutrition Group, NOVA Medical School, Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal
- CINTESIS-Center for Health Technology and Services Research, NOVA Medical School, 1169-056 Lisboa, Portugal
| | - Gonçalo Padeira
- Reference Centre of Inherited Metabolic Diseases, Unidade Local de Saúde São José, Centro Clínico Académico de Lisboa, 1169-045 Lisboa, Portugal
| | - Patrícia Gaspar Silva
- Reference Centre of Inherited Metabolic Diseases, Unidade Local de Saúde São José, Centro Clínico Académico de Lisboa, 1169-045 Lisboa, Portugal
| | - Carla Correia
- Reference Centre of Inherited Metabolic Diseases, Unidade Local de Saúde São José, Centro Clínico Académico de Lisboa, 1169-045 Lisboa, Portugal
| | - Andreia Nunes
- Reference Centre of Inherited Metabolic Diseases, Unidade Local de Saúde São José, Centro Clínico Académico de Lisboa, 1169-045 Lisboa, Portugal
| | - Elisabete Garcia
- Reference Centre of Inherited Metabolic Diseases, Unidade Local de Saúde São José, Centro Clínico Académico de Lisboa, 1169-045 Lisboa, Portugal
| | - Ana Faria
- Nutrition and Metabolism, NOVA Medical School, Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal
- CHRC-Comprehensive Health Research Centre, Nutrition Group, NOVA Medical School, Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal
| | - Diana Teixeira
- Nutrition and Metabolism, NOVA Medical School, Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal
- CHRC-Comprehensive Health Research Centre, Nutrition Group, NOVA Medical School, Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal
| | - Conceição Calhau
- Nutrition and Metabolism, NOVA Medical School, Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal
- CHRC-Comprehensive Health Research Centre, Nutrition Group, NOVA Medical School, Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal
- CINTESIS-Center for Health Technology and Services Research, NOVA Medical School, 1169-056 Lisboa, Portugal
| | - Luís Pereira-da-Silva
- CHRC-Comprehensive Health Research Centre, Nutrition Group, NOVA Medical School, Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal
- Medicine of Woman, Childhood and Adolescence Academic Area, NOVA Medical School, Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal
| | - Ana Cristina Ferreira
- Reference Centre of Inherited Metabolic Diseases, Unidade Local de Saúde São José, Centro Clínico Académico de Lisboa, 1169-045 Lisboa, Portugal
| | - Júlio César Rocha
- Nutrition and Metabolism, NOVA Medical School, Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal
- CHRC-Comprehensive Health Research Centre, Nutrition Group, NOVA Medical School, Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal
- CINTESIS-Center for Health Technology and Services Research, NOVA Medical School, 1169-056 Lisboa, Portugal
- Reference Centre of Inherited Metabolic Diseases, Unidade Local de Saúde São José, Centro Clínico Académico de Lisboa, 1169-045 Lisboa, Portugal
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Ricarte JRO, Nogueira MDDA, Firmino MAD, de Oliveira LFN, Valentim AB, Martins GDS, Dantas ACP, Matias NSL, Rocha EVDS, Almondes KGDS, Maia CSC. Phase angle and anthropometric indicators of cardiometabolic risk in children and adolescents. Eur J Clin Nutr 2024; 78:639-646. [PMID: 38632332 DOI: 10.1038/s41430-024-01439-3] [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: 12/23/2023] [Revised: 04/04/2024] [Accepted: 04/05/2024] [Indexed: 04/19/2024]
Abstract
RATIONALE/OBJECTIVE The phase angle (PhA) is a measurement obtained from the resistance and reactance found in the bioelectrical impedance examination and is useful in assessing nutritional status and in assessing cardiometabolic diseases. Therefore, the objective was to correlate the phase angle to the anthropometric variables of cardiometabolic risk (CMR) in children and adolescents. SUBJECTS/METHODS Weight, height, body mass index (BMI), waist circumference (WC) and neck circumference (NC), waist-to-height ratio (WHtR), and PhA of 1231 children and adolescents aged between 5 and 18 years were assessed. PhA was assessed in tertiles and CMR was identified using the anthropometric variables BMI, WC, NC, and WHtR. Linear regression models were used to verify the association between PhA tertiles and CMR anthropometric variables, stratified by sex. RESULTS No relationship was found between PhA and CMR variables in children. In adolescents, lower values of NC (β = -0.019, p = 0.005) and BMI (β = -0.025, p = 0.023) were found in boys, WC (β = -0.017, p = 0.020), WHtR (β = -0.017, p = 0.020), NC (β = -0.011, p = 0.027) and BMI (β = -0.026, p = 0.009) in girls when they were in tertile 1 when compared to tertile 3 of the PhA, even after adjusting for age. CONCLUSION The PhA was directly associated with CMR in the assessed adolescents.
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Affiliation(s)
- Juliana Raissa Oliveira Ricarte
- Nutritionist. Master's degree. Ph.D student from the Graduate Program in Public Health, State University of Ceará, Fortaleza - CE, Brazil
| | - Maria Dinara de Araújo Nogueira
- Nutritionist. Master's degree. Ph.D student from the Graduate Program in Public Health, State University of Ceará, Fortaleza - CE, Brazil
| | - Matheus Aragão Dias Firmino
- Nutritionist. Master's student in the Graduate Program in Nutrition and Health, State University of Ceará, Fortaleza - CE, Brazil
| | - Luis Felipe Nunes de Oliveira
- Nutritionist. Master's student in the Graduate Program in Nutrition and Health, State University of Ceará, Fortaleza - CE, Brazil
| | - Ashley Brito Valentim
- Nutritionist. Master's student in the Graduate Program in Nutrition and Health, State University of Ceará, Fortaleza - CE, Brazil
| | - Géssica de Souza Martins
- Nutritionist. Master's degree. Ph.D student from the Graduate Program in Public Health, State University of Ceará, Fortaleza - CE, Brazil
| | - Ana Cecília Pereira Dantas
- Undergraduate Student in the Bachelor's program in Nutrition, State University of Ceará, Fortaleza - CE, Brazil
| | - Nayeli Silva Lima Matias
- Undergraduate Student in the Bachelor's program in Nutrition, State University of Ceará, Fortaleza - CE, Brazil
| | | | - Kaluce Gonçalves de Sousa Almondes
- Nutritionist. Ph.D. Researcher at the study and research Group on Micronutrients and Chronic Diseases, State University of Ceará, Fortaleza - CE, Brazil
| | - Carla Soraya Costa Maia
- Nutritionist. Ph.D. Faculty member in the Graduate Programs in Nutrition and Health, and Public Health, State University of Ceará, Fortaleza - CE, Brazil.
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Słomiński B, Skrzypkowska M, Myśliwiec M, Trzonkowski P. Associations of the obesity gene FTO variant with complications and comorbidities in patients with type 1 diabetes. Diabetes Res Clin Pract 2024; 211:111683. [PMID: 38663549 DOI: 10.1016/j.diabres.2024.111683] [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] [Received: 02/20/2024] [Revised: 04/18/2024] [Accepted: 04/22/2024] [Indexed: 04/30/2024]
Abstract
BACKGROUND AND AIMS Because FTO gene is connected with the risk of obesity, cardiovascular disease and hypertension, as well as type 2 diabetes, we hypothesize that the rs9939609 FTO polymorphism may affect type 1 diabetes (T1D) complications and comorbidities. METHODS We have investigated the associations of the FTO gene variant with the T1D and its complications and comorbidities, as well as the serum levels of pro- and anti-inflammatory markers and lipid profiles. RESULTS The key results of our study are as follows: (1) the rs9939609 FTO polymorphism does not predispose individuals to T1D; (2) AA genotype is associated with an increased risk of overweight and obesity, retinopathy, hypertension, dyslipidemia and celiac disease; (3) AT genotype is associated with a decreased risk of retinopathy and celiac disease, whereas TT genotype is connected with decreased risk of dyslipidemia; (4) the FTO rs9939609 polymorphism affects the inflammatory status as well as lipid profile in T1D patients. CONCLUSIONS Our results, for the first time, comprehensively indicate that the rs9939609 FTO polymorphism could be considered a genetic marker for increased susceptibility to T1D complications and comorbidities as well as suggests importance of FTO-mediated pathways in their etiology.
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Affiliation(s)
- Bartosz Słomiński
- Department of Medical Immunology, Faculty of Medicine, Medical University of Gdańsk, Dębinki 1, 80-211 Gdańsk, Poland.
| | - Maria Skrzypkowska
- Department of Medical Immunology, Faculty of Medicine, Medical University of Gdańsk, Dębinki 1, 80-211 Gdańsk, Poland
| | - Małgorzata Myśliwiec
- Chair & Clinics of Paediatrics, Diabetology and Endocrinology, Faculty of Medicine, Medical University of Gdańsk, Dębinki 7, 80-211 Gdańsk, Poland
| | - Piotr Trzonkowski
- Department of Medical Immunology, Faculty of Medicine, Medical University of Gdańsk, Dębinki 1, 80-211 Gdańsk, Poland
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Petito LC, McCabe ME, Pool LR, Krefman AE, Perak AM, Marino BS, Juonala M, Kähönen M, Lehtimäki T, Bazzano LA, Liu L, Pahkala K, Laitinen TT, Raitakari OT, Gooding HC, Daniels SR, Skinner AC, Greenland P, Davis MM, Wakschlag LS, Van Horn L, Hou L, Lloyd-Jones DM, Labarthe DR, Allen NB. A Proposed Pediatric Clinical Cardiovascular Health Reference Standard. Am J Prev Med 2024; 66:216-225. [PMID: 37751803 DOI: 10.1016/j.amepre.2023.09.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 09/19/2023] [Accepted: 09/19/2023] [Indexed: 09/28/2023]
Abstract
INTRODUCTION Clinical cardiovascular health is a construct that includes 4 health factors-systolic and diastolic blood pressure, fasting glucose, total cholesterol, and body mass index-which together provide an evidence-based, more holistic view of cardiovascular health risk in adults than each component separately. Currently, no pediatric version of this construct exists. This study sought to develop sex-specific charts of clinical cardiovascular health for age to describe current patterns of clinical cardiovascular health throughout childhood. METHODS Data were used from children and adolescents aged 8-19 years in six pooled childhood cohorts (19,261 participants, collected between 1972 and 2010) to create reference standards for fasting glucose and total cholesterol. Using the models for glucose and cholesterol as well as previously published reference standards for body mass index and blood pressure, clinical cardiovascular health charts were developed. All models were estimated using sex-specific random-effects linear regression, and modeling was performed during 2020-2022. RESULTS Models were created to generate charts with smoothed means, percentiles, and standard deviations of clinical cardiovascular health for each year of childhood. For example, a 10-year-old girl with a body mass index of 16 kg/m2 (30th percentile), blood pressure of 100/60 mm Hg (46th/50th), glucose of 80 mg/dL (31st), and total cholesterol of 160 mg/dL (46th) (lower implies better) would have a clinical cardiovascular health percentile of 62 (higher implies better). CONCLUSIONS Clinical cardiovascular health charts based on pediatric data offer a standardized approach to express clinical cardiovascular health as an age- and sex-standardized percentile for clinicians to assess cardiovascular health in childhood to consider preventive approaches at early ages and proactively optimize lifetime trajectories of cardiovascular health.
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Affiliation(s)
- Lucia C Petito
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Evanston, Illinois.
| | - Megan E McCabe
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Evanston, Illinois; Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Lindsay R Pool
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Evanston, Illinois
| | - Amy E Krefman
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Evanston, Illinois
| | - Amanda M Perak
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Evanston, Illinois; Department of Pediatrics, Lurie Children's Hospital, Chicago, Illinois
| | - Bradley S Marino
- Department of Pediatrics, Lurie Children's Hospital, Chicago, Illinois
| | - Markus Juonala
- Department of Medicine, University of Turku, Turku, Finland; Division of Medicine, Turku University Hospital, Turku, Finland
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital, Tampere, Finland; Finnish Cardiovascular Research Center-Tampere - FCRCT, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Terho Lehtimäki
- Finnish Cardiovascular Research Center-Tampere - FCRCT, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Department of Clinical Chemistry, Fimlab Laboratories, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Lydia A Bazzano
- Department of Epidemiology, School of Public Health & Tropical Medicine, Tulane University, New Orleans, Los Angeles
| | - Lei Liu
- Division of Biostatistics, Washington University School of Medicine, St. Louis, Missouri
| | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Paavo Nurmi Centre, Sports & Exercise Medicine Unit, Department of Health and Physical Activity, University of Turku, Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Tomi T Laitinen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Paavo Nurmi Centre, Sports & Exercise Medicine Unit, Department of Health and Physical Activity, University of Turku, Turku, Finland
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland; Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Holly C Gooding
- Division of General Pediatrics and Adolescent Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Stephen R Daniels
- Department of Pediatrics, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado
| | - Asheley C Skinner
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Philip Greenland
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Evanston, Illinois
| | - Matthew M Davis
- Department of Pediatrics, Lurie Children's Hospital, Chicago, Illinois
| | - Lauren S Wakschlag
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, Illinois
| | - Linda Van Horn
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Evanston, Illinois
| | - Lifang Hou
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Evanston, Illinois
| | - Donald M Lloyd-Jones
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Evanston, Illinois; Department of Pediatrics, Lurie Children's Hospital, Chicago, Illinois
| | - Darwin R Labarthe
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Evanston, Illinois
| | - Norrina B Allen
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Evanston, Illinois; Department of Pediatrics, Lurie Children's Hospital, Chicago, Illinois
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Arriaga-Cázares HE, Vega-Morales D, Moreno-Treviño CA, Juarez-Juarez JL, Pérez-Arizmendi CA, Martagón-Rosado AJ. Comparison of Two Strategies for Hypercholesterolemia Detection through Point-of-Care Testing. Diagnostics (Basel) 2024; 14:143. [PMID: 38248020 PMCID: PMC10814133 DOI: 10.3390/diagnostics14020143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/30/2023] [Accepted: 01/05/2024] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Childhood dyslipidemia is a common condition that can lead to atherosclerotic cardiovascular disease in adulthood. It is usually multifactorial. Screening for cholesterol disorders in children varies based on risk factors, with some guidelines recommending cascade screening for children with a clear family history of familial hypercholesterolemia, targeted screening for those with specific risk factors, and universal screening. Point-of-care testing (POCT) cholesterol tests offer potential advantages, including ease of use, portability, increased patient access, low cost, fewer medical or laboratory visits, and instant results. This study aimed to evaluate the effect of POCT cholesterol screening on the diagnosis of hypercholesterolemia in children in a family practice setting. METHODS We used a POCT cholesterol analyzer to perform two different (universal and targeted) screening approaches for dyslipidemia in children. We used the NCEP guidelines for the classification of the results. RESULTS We screened 183 children, 105 in the universal screening group and 78 in the targeted screening group. Eight patients in the targeted screening group had elevated cholesterol levels (p = 0.02). CONCLUSIONS All participants received instant feedback and recommendations. Using a targeted screening approach, POCT could be a practical and effective tool for identifying at-risk children with hypercholesterolemia.
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Affiliation(s)
- Héctor Eliud Arriaga-Cázares
- Instituto Mexicano del Seguro Social, Hospital de Traumatología y Ortopedia N.º 21, Monterrey 64000, Mexico
- Escuela de Medicina, Instituto Tecnológico y de Estudios Superiores de Monterrey, Monterrey 64849, Mexico
| | - David Vega-Morales
- Instituto Mexicano del Seguro Social, Hospital General de Zona 17, Monterrey 64420, Mexico;
| | - Carlos Alberto Moreno-Treviño
- Instituto Mexicano del Seguro Social, Unidad de Medicina Familiar 26, Monterrey 64117, Mexico; (C.A.M.-T.); (C.A.P.-A.)
| | - Juana Lorena Juarez-Juarez
- Instituto Mexicano del Seguro Social, Unidad de Medicina Familiar 26, Monterrey 64117, Mexico; (C.A.M.-T.); (C.A.P.-A.)
| | - Carlos Azael Pérez-Arizmendi
- Instituto Mexicano del Seguro Social, Unidad de Medicina Familiar 26, Monterrey 64117, Mexico; (C.A.M.-T.); (C.A.P.-A.)
| | - Alexandro J. Martagón-Rosado
- Escuela de Medicina, Instituto Tecnológico y de Estudios Superiores de Monterrey, Monterrey 64849, Mexico
- Institute for Obesity Research, Instituto Tecnologico y de Estudios Superiores de Monterrey, Monterrey 64849, Mexico
- Unidad de Investigación de Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México 14080, Mexico
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Taghizadeh N, Mohammadi S, yousefi Z, Golpour P, Taheri A, Maleki MH, Nourbakhsh M, Nourbakhsh M, Azar MR. Assessment of global histone acetylation in pediatric and adolescent obesity: Correlations with SIRT1 expression and metabolic-inflammatory profiles. PLoS One 2023; 18:e0293217. [PMID: 37862340 PMCID: PMC10588878 DOI: 10.1371/journal.pone.0293217] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 10/07/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND Epigenetic modifications, particularly histone acetylation-deacetylation and its related enzymes, such as sirtuin 1 (SIRT1) deacetylase, may have substantial roles in the pathogenesis of obesity and its associated health issues. This study aimed to evaluate global histone acetylation status and SIRT1 gene expression in children and adolescents with obesity and their association with metabolic and anthropometric parameters. METHODS This study included 60 children and adolescents, 30 with obesity and 30 normal-weight. The evaluation consisted of the analysis of global histone acetylation levels and the expression of the SIRT1 gene in peripheral blood mononuclear cells, by specific antibody and real-time PCR, respectively. Additionally, insulin, fasting plasma glucose, lipid profile and tumor necrosis factor α (TNF-α) levels were measured. Insulin resistance was assessed using the homeostasis model assessment of insulin resistance (HOMA-IR). Metabolic syndrome was determined based on the diagnostic criteria established by IDF. RESULTS Individuals with obesity, particularly those with insulin resistance, had significantly higher histone acetylation levels compared to control group. Histone acetylation was positively correlated with obesity indices, TNF-α, insulin, and HOMA-IR. Additionally, a significant decrease in SIRT1 gene expression was found among obese individuals, which was negatively correlated with the histone acetylation level. Furthermore, SIRT1 expression levels showed a negative correlation with various anthropometric and metabolic parameters. CONCLUSION Histone acetylation was enhanced in children and adolescents with obesity, potentially resulting from down-regulation of SIRT1, and could play a role in the obesity-associated metabolic abnormalities and insulin resistance. Targeting global histone acetylation modulation might be considered as an epigenetic approach for early obesity management.
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Affiliation(s)
- Nima Taghizadeh
- Metabolic Disorders Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Soha Mohammadi
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zeynab yousefi
- Department of Clinical Biochemistry, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Pegah Golpour
- Department of Biochemistry, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Alemeh Taheri
- Department of Biochemistry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hasan Maleki
- Department of Biochemistry, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mitra Nourbakhsh
- Department of Biochemistry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Finetech in Medicine Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mona Nourbakhsh
- Hazrat Aliasghar Children Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Razzaghy Azar
- Metabolic Disorders Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Hazrat Aliasghar Children Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Picó C, Lurbe E, Keijer J, Kopecky J, Landrier JF, Álvarez-Pitti J, Martin JC, Oliver P, Palou A, Palou M, Zouhar P, Ribot J, Rodríguez AM, Sánchez J, Serra F, Bonet ML. Study protocol: Identification and validation of integrative biomarkers of physical activity level and health in children and adolescents (INTEGRActiv). Front Pediatr 2023; 11:1250731. [PMID: 37772038 PMCID: PMC10522911 DOI: 10.3389/fped.2023.1250731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 08/30/2023] [Indexed: 09/30/2023] Open
Abstract
Background Physical activity (PA) provides health benefits across the lifespan and improves many established cardiovascular risk factors that have a significant impact on overall mortality. However, discrepancies between self-reported and device-based measures of PA make it difficult to obtain consistent results regarding PA and its health effects. Moreover, PA may produce different health effects depending on the type, intensity, duration, and frequency of activities and individual factors such as age, sex, body weight, early life conditions/exposures, etc. Appropriate biomarkers relating the degree of PA level with its effects on health, especially in children and adolescents, are required and missing. The main objective of the INTEGRActiv study is to identify novel useful integrative biomarkers of PA and its effects on the body health in children and adolescents, who represent an important target population to address personalized interventions to improve future metabolic health. Methods/design The study is structured in two phases. First, biomarkers of PA and health will be identified at baseline in a core cohort of 180 volunteers, distributed into two age groups: prepubertal (n = 90), and postpubertal adolescents (n = 90). Each group will include three subgroups (n = 30) with subjects of normal weight, overweight, and obesity, respectively. Identification of new biomarkers will be achieved by combining physical measures (PA and cardiorespiratory and muscular fitness, anthropometry) and molecular measures (cardiovascular risk factors, endocrine markers, cytokines and circulating miRNA in plasma, gene expression profile in blood cells, and metabolomics profiling in plasma). In the second phase, an educational intervention and its follow-up will be carried out in a subgroup of these subjects (60 volunteers), as a first validation step of the identified biomarkers. Discussion The INTEGRActiv study is expected to provide the definition of PA and health-related biomarkers (PA-health biomarkers) in childhood and adolescence. It will allow us to relate biomarkers to factors such as age, sex, body weight, sleep behavior, dietary factors, and pubertal status and to identify how these factors quantitatively affect the biomarkers' responses. Taken together, the INTEGRActiv study approach is expected to help monitor the efficacy of interventions aimed to improve the quality of life of children/adolescents through physical activity. Clinical Trial Registration ClinicalTrials.gov, Identifier NCT05907785.
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Affiliation(s)
- Catalina Picó
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Group of Nutrigenomics, Biomarkers and Risk Evaluation), University of the Balearic Islands (UIB), Palma, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - Empar Lurbe
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain
- Department of Pediatrics (Innovation in Paediatrics and Technologies-iPEDITEC- research group), Fundación de Investigación, Consorcio Hospital General, University of Valencia, Valencia, Spain
| | - Jaap Keijer
- Human and Animal Physiology, Wageningen University, Wageningen, Netherlands
| | - Jan Kopecky
- Laboratory of Adipose Tissue Biology, Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic
| | | | - Julio Álvarez-Pitti
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain
- Department of Pediatrics (Innovation in Paediatrics and Technologies-iPEDITEC- research group), Fundación de Investigación, Consorcio Hospital General, University of Valencia, Valencia, Spain
| | | | - Paula Oliver
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Group of Nutrigenomics, Biomarkers and Risk Evaluation), University of the Balearic Islands (UIB), Palma, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - Andreu Palou
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Group of Nutrigenomics, Biomarkers and Risk Evaluation), University of the Balearic Islands (UIB), Palma, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - Mariona Palou
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Group of Nutrigenomics, Biomarkers and Risk Evaluation), University of the Balearic Islands (UIB), Palma, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - Petr Zouhar
- Laboratory of Adipose Tissue Biology, Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic
| | - Joan Ribot
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Group of Nutrigenomics, Biomarkers and Risk Evaluation), University of the Balearic Islands (UIB), Palma, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - Ana M. Rodríguez
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Group of Nutrigenomics, Biomarkers and Risk Evaluation), University of the Balearic Islands (UIB), Palma, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - Juana Sánchez
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Group of Nutrigenomics, Biomarkers and Risk Evaluation), University of the Balearic Islands (UIB), Palma, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - Francisca Serra
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Group of Nutrigenomics, Biomarkers and Risk Evaluation), University of the Balearic Islands (UIB), Palma, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - M. Luisa Bonet
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Group of Nutrigenomics, Biomarkers and Risk Evaluation), University of the Balearic Islands (UIB), Palma, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain
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Ouyang F, Wells JC, Zhang GH, Du K, Wang X, Shen L, Luo ZC, Zhang J. Maternal Prenatal Factors and Child Adiposity in Associations with Cardiometabolic Risk Factors in Term-Born Chinese Children at the Age of 2 Years. Nutrients 2023; 15:3342. [PMID: 37571278 PMCID: PMC10421441 DOI: 10.3390/nu15153342] [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: 06/09/2023] [Revised: 07/15/2023] [Accepted: 07/19/2023] [Indexed: 08/13/2023] Open
Abstract
Early growth has long-lasting associations with adult metabolic health. However, the association of adiposity with cardiometabolic risk factors in toddlers remains poorly understood. This study aimed to examine the association of maternal prenatal factors and child adiposity with child cardiometabolic risk factors among boys and girls aged 2 years. This was a birth cohort study of 549 term-born children in Shanghai, China, with follow-up data at the age of 2-years. Child anthropometric and adiposity measurements included weight, length, and skinfold thickness (triceps, subscapular, and abdominal). Child cardiometabolic risk factors included random morning plasma glucose, serum insulin, lipids, and systolic and diastolic blood pressure (SBP, DBP). At 2 years, overweight/obesity (weight-for-length z score, ZWFL > 2) was associated with 12.6 (95%CI 7.7, 17.4) mmHg higher SBP, and 7.9 (4.1, 11.8) mmHg higher DBP in boys, with similar results observed in girls. Maternal hypertensive disorders of pregnancy were associated with 3.0 (0.1, 5.8) higher SBP, 3.17 (0.90, 5.44) mmHg higher DBP, 0.24 (0.01,0.47) mmol/L higher plasma glucose, and 0.26 (0.01,0.51) mmol/L higher serum triglycerides after adjustment for child age, sex, and ZWFL. Maternal hypertensive disorders of pregnancy and child overweight/obesity were associated with higher SBP and DBP at the age of 2 years.
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Affiliation(s)
- Fengxiu Ouyang
- Ministry of Education and Shanghai Key Laboratory of Children’s Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Jonathan C. Wells
- Childhood Nutrition Research Centre, Population, Policy and Practice Research Department, Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Guang-Hui Zhang
- Department of Clinical Laboratory Test, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Kun Du
- Department of Clinical Laboratory Test, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Xia Wang
- Ministry of Education and Shanghai Key Laboratory of Children’s Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Lixiao Shen
- Ministry of Education and Shanghai Key Laboratory of Children’s Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Zhong-Cheng Luo
- Ministry of Education and Shanghai Key Laboratory of Children’s Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
- Department of Obstetrics and Gynecology, Prosserman Centre for Population Health Research, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada
| | - Jun Zhang
- Ministry of Education and Shanghai Key Laboratory of Children’s Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
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10
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Słomiński B, Skrzypkowska M, Myśliwiec M, Trzonkowski P. Variation in the Dopamine-4-Receptor Gene in Patients with Type 1 Diabetes. Neuroendocrinology 2023; 113:875-884. [PMID: 37080173 PMCID: PMC10389791 DOI: 10.1159/000530765] [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] [Received: 05/17/2022] [Accepted: 04/14/2023] [Indexed: 04/22/2023]
Abstract
INTRODUCTION Because dopaminergic signaling pathways are one of the regulators of autoimmunity, we hypothesize that the -521C>T DRD4 gene polymorphism may associate with the risk of diabetes mellitus type 1 (DM1) and its comorbidities. METHODS In this case-control study, we have examined 300 patients with DM1 in comparison to 300 healthy age-matched controls. Utilizing the amplification refractory mutation system-polymerase chain reaction method, we have analyzed the -521C>T polymorphism of dopamine D4 receptor-encoding gene. Obtained results have been evaluated according to diabetes comorbidities, inflammatory markers, CD14++CD16-, and CD14+CD16+ monocyte subsets as well as lipid profile. RESULTS The key results of our study are as follows: (1) CC genotype and C allele are associated with a reduced risk of DM1 development (OR = 0.593, p = 0.005 and OR = 0.725, p = 0.003, respectively), whereas TT genotype and T allele are associated with a higher risk of DM1 (OR = 1.408, p = 0.04 and OR = 1.380, p = 0.003, respectively); (2) CC genotype is associated with an increased risk of dyslipidemia and retinopathy in diabetic patients (OR = 2.376, p = 0.001 and OR = 2.111, p = 0.01, respectively); (3) CC genotype and C allele carriers had the highest frequency of pro-inflammatory CD16+ monocytes (p = 2*10-4 and 0.04, respectively); (4) the DRD4 -521C>T polymorphism modifies the inflammatory status as well as lipid profile in DM1 patients. CONCLUSION Our data imply that the dopaminergic signaling pathways may play an important role in the etiology of DM1 as well as its comorbidities and will provide a new insight into the DM1 risk management. The -521C>T DRD4 gene polymorphism could be considered a genetic marker to predict susceptibility to DM1 as well as retinopathy and dyslipidemia progress in patients with already established disease.
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Affiliation(s)
- Bartosz Słomiński
- Department of Medical Immunology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Maria Skrzypkowska
- Department of Medical Immunology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Małgorzata Myśliwiec
- Chair and Clinics of Paediatrics, Diabetology and Endocrinology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Piotr Trzonkowski
- Department of Medical Immunology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
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11
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Romaní-Romaní F, Pachacama Ramirez LF, Pichihua Grandez JD, Guevara Rodríguez DM, Cornejo Luyo V, Sheen Vargas CE, Ninatanta-Ortiz JA, Abanto Villar MV, Pérez Cieza KM, Chávez Farro RR, García Flores SA. Concordance between five criteria of metabolic syndrome in teenagers from a Peruvian high andes region. Rev Peru Med Exp Salud Publica 2023; 40:150-160. [PMID: 38232261 PMCID: PMC10953662 DOI: 10.17843/rpmesp.2023.402.12546] [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: 01/19/2023] [Accepted: 06/07/2023] [Indexed: 01/19/2024] Open
Abstract
OBJECTIVE. Motivation for the study. There are several criteria for metabolic syndrome in adolescents, each reporting different prevalence rates and not necessarily coinciding with each other. Main findings. We studied school children from the city of Cajamarca at 2750 meters above sea level. The five criteria for metabolic syndrome coincided in six of the 397 (1.5%) adolescents. The criteria generated prevalence rates ranging from 3.0% to 17.1%. The criteria with near perfect concordance were those from the American Heart Association criteria and those modified by Cook. Implications. The diagnosis of metabolic syndrome in adolescents is complex, even more so among those residing at high altitudes. . To determine the concordance between five diagnostic criteria for metabolic syndrome (MS) among teenagers from a Peruvian high Andes region. MATERIALS AND METHODS. A cross-sectional study was carried out with secondary data from an intervention study in two public schools in 2019. We included 397 teenagers who lived in the city of Cajamarca, in the Andean region of Peru. We applied the criteria from the Adult Treatment Panel III (ATP-III) modified by Cook, the International Diabetes Federation (IDF), the American Heart Association (AHA), Ferranti, and the World Health Organization (WHO). The point prevalence and interval prevalence were estimated with the five criteria. The Kappa concordance coefficient with an 95% confidence interval (95%CI) was estimated. RESULTS. The Ferranti criterion identified 17.1% (95%CI: 13.4 to 20.8) of teenagers with MS, followed by the ATP-III criterion with 4.3% (95%CI: 2.3 to 6.3); the other criteria identified a lower frequency. The best concordance was found between the AHA and ATP-III criteria (k = 0.905); the WHO and IDF criteria had a coefficient of 0.628. The five criteria coincided in classifying six adolescents (1.5%) as MS. CONCLUSIONS. The AHA and ATP-III criteria modified by Cook had almost perfect concordance, which was also found for both sexes. The ATP-III, Ferranti, IDF, AHA and WHO criteria agree in less than 2% when identifying MS in the same group of adolescents.
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Affiliation(s)
- Franco Romaní-Romaní
- Faculty of Human Medicine, Universidad de Piura, Lima, Peru.Universidad Nacional de PiuraFaculty of Human MedicineUniversidad de PiuraLimaPeru
| | - Luis Fernando Pachacama Ramirez
- Faculty of Human Medicine, Universidad de Piura, Lima, Peru.Universidad Nacional de PiuraFaculty of Human MedicineUniversidad de PiuraLimaPeru
| | - Juan Diego Pichihua Grandez
- Faculty of Human Medicine, Universidad de Piura, Lima, Peru.Universidad Nacional de PiuraFaculty of Human MedicineUniversidad de PiuraLimaPeru
| | - Diego Maximiliano Guevara Rodríguez
- Faculty of Human Medicine, Universidad de Piura, Lima, Peru.Universidad Nacional de PiuraFaculty of Human MedicineUniversidad de PiuraLimaPeru
| | - Viviana Cornejo Luyo
- Faculty of Human Medicine, Universidad de Piura, Lima, Peru.Universidad Nacional de PiuraFaculty of Human MedicineUniversidad de PiuraLimaPeru
| | - Christian Eduardo Sheen Vargas
- Faculty of Human Medicine, Universidad de Piura, Lima, Peru.Universidad Nacional de PiuraFaculty of Human MedicineUniversidad de PiuraLimaPeru
| | - Juana Aurelia Ninatanta-Ortiz
- Academic Professional School of Nursing, Faculty of Health Sciences, Universidad Nacional de Cajamarca, Cajamarca, Perú.Universidad Nacional de CajamarcaAcademic Professional School of NursingFaculty of Health SciencesUniversidad Nacional de CajamarcaCajamarcaPeru
| | - Martha Vicenta Abanto Villar
- Academic Professional School of Nursing, Faculty of Health Sciences, Universidad Nacional de Cajamarca, Cajamarca, Perú.Universidad Nacional de CajamarcaAcademic Professional School of NursingFaculty of Health SciencesUniversidad Nacional de CajamarcaCajamarcaPeru
| | - Katia Maribel Pérez Cieza
- Academic Professional School of Nursing, Faculty of Health Sciences, Universidad Nacional de Cajamarca, Cajamarca, Perú.Universidad Nacional de CajamarcaAcademic Professional School of NursingFaculty of Health SciencesUniversidad Nacional de CajamarcaCajamarcaPeru
| | - Rosa Ricardina Chávez Farro
- Academic Professional School of Nursing, Faculty of Health Sciences, Universidad Nacional de Cajamarca, Cajamarca, Perú.Universidad Nacional de CajamarcaAcademic Professional School of NursingFaculty of Health SciencesUniversidad Nacional de CajamarcaCajamarcaPeru
| | - Segunda Aydeé García Flores
- Academic Professional School of Nursing, Faculty of Health Sciences, Universidad Nacional de Cajamarca, Cajamarca, Perú.Universidad Nacional de CajamarcaAcademic Professional School of NursingFaculty of Health SciencesUniversidad Nacional de CajamarcaCajamarcaPeru
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12
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Di Bonito P, Di Sessa A, Licenziati MR, Corica D, Wasniewska M, Umano GR, Morandi A, Maffeis C, Faienza MF, Mozzillo E, Calcaterra V, Franco F, Maltoni G, Valerio G. Is Metabolic Syndrome Useful for Identifying Youths with Obesity at Risk for NAFLD? CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020233. [PMID: 36832363 PMCID: PMC9955487 DOI: 10.3390/children10020233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/23/2023] [Accepted: 01/26/2023] [Indexed: 01/31/2023]
Abstract
The definition of metabolic syndrome (MetS) in childhood is controversial. Recently, a modified version of the International Diabetes Federation (IDF) definition was proposed using reference data from an international population for high waist circumference (WC) and blood pressure (BP), while the fixed cutoffs for lipids and glucose were not changed. We analyzed MetS prevalence using this modified definition (MetS-IDFm) and its association with non-alcoholic fatty liver disease (NAFLD) in 1057 youths (age 6-17 years) with overweight/obesity (OW/OB). A comparison with another modified definition of MetS according to the Adult Treatment Panel III (MetS-ATPIIIm) was performed. The prevalence of MetS-IDFm was 27.8% and 28.9% by MetS-ATPIIIm. The Odds (95% Confidence Intervals) of NAFLD was 2.70 (1.30-5.60) (p = 0.008) for high WC, 1.68 (1.25-2.26)(p = 0.001) for MetS, 1.54 (1.12-2.11)(p = 0.007) for low HDL-Cholesterol, 1.49 (1.04-2.13)(p = 0.032) for high triglycerides and 1.37 (1.03-1.82)(p = 0.033) for high BP. No substantial difference was found in the prevalence of MetS-IDFm and frequency of NAFLD compared to Mets-ATPIIIm definition. Our data demonstrate that one third of youths with OW/OB have MetS, whichever was the criterion. Neither definition was superior to some of their components in identifying youths with OW/OB at risk for NAFLD.
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Affiliation(s)
- Procolo Di Bonito
- Department of Internal Medicine, “S. Maria delle Grazie” Hospital, 80078 Pozzuoli, Italy
| | - Anna Di Sessa
- Department of Woman, Child and of General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Napoli, Italy
| | - Maria Rosaria Licenziati
- Neuro-Endocrine Diseases and Obesity Unit, Department of Neurosciences, Santobono-Pausilipon Children’s Hospital, 80122 Napoli, Italy
| | - Domenico Corica
- Department of Human Pathology in Adulthood and Childhood, University of Messina, 98122 Messina, Italy
| | - Malgorzata Wasniewska
- Department of Human Pathology in Adulthood and Childhood, University of Messina, 98122 Messina, Italy
| | - Giuseppina Rosaria Umano
- Department of Woman, Child and of General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Napoli, Italy
| | - Anita Morandi
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37134 Verona, Italy
| | - Claudio Maffeis
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, 37134 Verona, Italy
| | - Maria Felicia Faienza
- Department of Precision and Regenerative Medicine and Ionian Area, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Enza Mozzillo
- Department of Translational Medical Science, Section of Pediatrics, Regional Center of Pediatric Diabetes, University of Naples “Federico II”, 80131 Napoli, Italy
| | - Valeria Calcaterra
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy
- Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
| | - Francesca Franco
- Pediatric Department, Azienda Sanitaria Universitaria Friuli Centrale, Hospital of Udine, 33100 Udine, Italy
| | - Giulio Maltoni
- Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Giuliana Valerio
- Department of Movement Sciences and Wellbeing, University of Napoli “Parthenope”, 80133 Napoli, Italy
- Correspondence:
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13
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Jeans MR, Ghaddar R, Vandyousefi S, Landry MJ, Gray MJ, Leidy HJ, Whittaker TA, Bray MS, Davis JN. Distinct racial and ethnic metabolic syndrome characteristics: A comparative assessment in low-income children 7-10 years of age. Pediatr Obes 2022; 17:e12925. [PMID: 35560860 DOI: 10.1111/ijpo.12925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 02/28/2022] [Accepted: 04/13/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND Pediatric MetS prevalence varies due to lack of consensus on evaluative criteria and associated thresholds, with most not recommending a diagnosis <10 years. However, MetS risk components are becoming evident earlier in life and affect races and ethnicities disproportionately. OBJECTIVES To compare the prevalence of MetS based on existing definitions and elucidate racial- and ethnic-specific characteristics associated with MetS prevalence. METHODS The baseline and follow-up samples included 900 and 557 children 7-10 years, respectively. Waist circumference, BMI percentile, blood pressure, fasting plasma glucose (FPG), insulin, triglycerides, and high-density lipoprotein cholesterol (HDL-C) were measured. Agreement between MetS definitions was quantified via kappa statistics. MetS and risk factor prevalence and the predictability of metabolic parameters on MetS eight months later was evaluated via logistic regression. McFadden pseudo-R2 was reported as a measure of predictive ability, and the Akaike information criterion evaluated fit of each model. RESULTS The baseline sample was 55.0% male and 71.6% Hispanic, followed by non-Hispanic White (NHW) (17.3%) and non-Hispanic Black (NHB) (11.1%), with an average age of 9.2 years. MetS prevalence ranged from 7.6% to 21.4%, highest in Hispanic (9.0%-24.0%) and lowest in NHB children (4.0%-14.0%). Highest agreement was between Ford et al. and Cook et al. definitions (K = 0.88) and lowest agreements were consistently with the International Diabetes Federation criteria (K ≤ 0.57). Compared to NHW children, Hispanic children had higher odds for MetS (OR: 1.7; p = 0.03) and waist circumference, HDL-C, and FPG risk factors (p < 0.05), while NHB children had higher odds for the FPG risk factor (p ≤ 0.007) and lower odds for the plasma triglycerides risk factor (p = 0.002), across multiple MetS definitions. In longitudinal analyses, HDL-C was the strongest independent predictor of MetS in Hispanic and NHW children (p < 0.001 and p < 0.01, respectively), while plasma triglycerides was the strongest independent predictor of MetS in NHB children (p < 0.05). CONCLUSIONS MetS prevalence was high in children ≤10 years, and proposed criteria are susceptible to racial and ethnic bias, diagnosing some populations more than other populations with high cardiovascular risk. Earlier preventative measures should be imposed in clinical settings, accounting for racial and ethnic differences, to mitigate disease onset.
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Affiliation(s)
- Matthew R Jeans
- Department of Nutritional Sciences, College of Natural Sciences, The University of Texas at Austin, Austin, Texas, USA
| | - Reem Ghaddar
- Department of Nutritional Sciences, College of Natural Sciences, The University of Texas at Austin, Austin, Texas, USA
| | - Sarvenaz Vandyousefi
- Department of Medicine, New York University Grossman Medical Center, New York, New York, USA
| | - Matthew J Landry
- Stanford University, School of Medicine, Stanford Prevention Research Center, Palo Alto, California, USA
| | - Megan J Gray
- Department of Pediatrics, Dell Medical Center, The University of Texas at Austin, Austin, Texas, USA
| | - Heather J Leidy
- Department of Nutritional Sciences, College of Natural Sciences, The University of Texas at Austin, Austin, Texas, USA.,Department of Pediatrics, Dell Medical Center, The University of Texas at Austin, Austin, Texas, USA
| | - Tiffany A Whittaker
- Department of Educational Psychology, College of Education, The University of Texas at Austin, Austin, Texas, USA
| | - Molly S Bray
- Department of Nutritional Sciences, College of Natural Sciences, The University of Texas at Austin, Austin, Texas, USA
| | - Jaimie N Davis
- Department of Nutritional Sciences, College of Natural Sciences, The University of Texas at Austin, Austin, Texas, USA
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14
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Di Bonito P, Valerio G, Licenziati MR, Di Sessa A, Miraglia del Giudice E, Morandi A, Maffeis C, Baroni MG, Chiesa C, Pacifico L, Manco M. Uric acid versus metabolic syndrome as markers of fatty liver disease in young people with overweight/obesity. Diabetes Metab Res Rev 2022; 38:e3559. [PMID: 35728124 PMCID: PMC9787784 DOI: 10.1002/dmrr.3559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 03/23/2022] [Accepted: 06/03/2022] [Indexed: 12/30/2022]
Abstract
AIMS To compare the association of high serum uric acid (HUA) or metabolic syndrome (MetS) with fatty liver disease (FLD) in youths with overweight/obesity (OW/OB). MATERIALS AND METHODS Cross-sectional study of anthropometrics, biochemical variables, and liver ultrasound of 3104 individuals with OW/OB (age 5-17 years). Metabolic syndrome was defined by ≥ 3 criteria among (1) high waist circumference; (2) high triglycerides; (3) low high-density lipoproteins; (4) fasting glucose ≥100 mg/dl; (5) blood pressure ≥95th percentile in children, and ≥130/80 mmHg in adolescents. High serum uric acid was defined as serum UA value ≥ 75th percentile adjusted for sex. Fatty liver disease was determined by echography. RESULTS The sample was stratified in four categories: (1) no HUA, no MetS (reference category); (2) MetS; (3) HUA; (4) HUA and MetS (HUA + MetS). The prevalence of FLD increased across the four categories from 29.9%, 44.0%, 52.2%, to 67.1%, respectively (p < 0.0001). The ORs for the categorical variables were 1.33 (1.06-1.68) for MetS (p = 0.02), 3.19 (2.51-4.05) for HUA (p < 0.0001) and 3.72 (2.65-5.21) for HUA + MetS (p < 0.0001), versus the reference category regardless of the body mass index. CONCLUSIONS HUA represents a useful marker of FLD in youths with OW/OB, given its greater ability to identify those at increased risk of the disease compared to MetS. The ability of both to predict incident FLD must be investigated in longitudinal study.
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Affiliation(s)
- Procolo Di Bonito
- Department of Internal Medicine"S. Maria delle Grazie" HospitalPozzuoliItaly
| | - Giuliana Valerio
- Department of Movement Sciences and WellbeingUniversity "Parthenope"NaplesItaly
| | - Maria Rosaria Licenziati
- Department of NeuroscienceObesity and Endocrine Disease UnitSantobono‐Pausilipon Children's HospitalNaplesItaly
| | - Anna Di Sessa
- Department of Woman, Child and General and Specialized SurgeryUniversity of Campania "Luigi Vanvitelli"NaplesItaly
| | | | - Anita Morandi
- Pediatric Diabetes and Metabolic Disorders UnitUniversity of VeronaVeronaItaly
| | - Claudio Maffeis
- Pediatric Diabetes and Metabolic Disorders UnitUniversity of VeronaVeronaItaly
| | - Marco Giorgio Baroni
- Department of Clinical Medicine, Life, Health & Environmental SciencesUniversity of L'AquilaItaly
- Neuroendocrinology and Metabolic DiseasesIRCCS NeuromedPozzilliItaly
| | - Claudio Chiesa
- Institute of Translational PharmacologyNational Research CouncilRomeItaly
| | - Lucia Pacifico
- Department of PediatricsPoliclinico Umberto I Hospital"Sapienza" University of RomeRomeItaly
| | - Melania Manco
- Research Area for Multifactorial Disease and Complex PhenotypesChildren's Hospital Bambino GesùIRCCSRomeItaly
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15
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Guerrero RTL, Hattori-Uchima MP, Badowski G, Aflague TF, Wood K, Hammond K, Perez R. Pacific Islands Cohort on Cardiometabolic Health Study: rationale and design. BMC Public Health 2022; 22:1428. [PMID: 35897002 PMCID: PMC9326143 DOI: 10.1186/s12889-022-13783-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 07/11/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Pacific Islanders, including those residing in the US Affiliated Pacific Islands (USAPI), experience some of the highest mortality rates resulting from non-communicable diseases (NCDs) worldwide. The Pacific Island Health Officers' Association declared a Regional State of Health Emergency in 2010 due to the epidemic of NCDs in the USAPI. Obesity, a known risk factor for NCDs, has become an epidemic among both children and adults in Micronesia and other parts of the USAPI. There is some recent information about overweight and obesity (OWOB) among young children in the USAPI, but there is no data looking at the relationship between children and their biological parents. The Pacific Islands Cohort on Cardiometabolic Health (PICCAH) Study aims to collect data on NCD lifestyle factors from two generations of families (n = 600 child-parent dyads or 1,200 participants) living in Guam, Pohnpei, and Palau. METHODS The PICCAH Study is an epidemiological study using community-based convenience sampling to recruit participants in USAPI of Guam, Palau, and Pohnpei. The goal is to recruit participant dyads consisting of 1 child plus their biological parent in Guam (500 dyads or 1,000 participants), Pohnpei (50 dyads or 100 participants), and Palau (50 dyads or 100 participants). All participants are having the following information collected: demographic, health, and lifestyle information; anthropometry; diet; physical activity; sleep; acanthosis nigricans; blood pressure; and serum levels of fasting plasma glucose, fasting insulin, glycated hemoglobin, total cholesterol, triglycerides, LDL, and HDL. DISCUSSION The PICCAH Study is designed to establish the baseline of a generational epidemiologic cohort with an emphasis on cardiometabolic risk, and to better understand the extent of DM and CVD conditions and related risk factors of those living in the USAPI jurisdictions of Guam, Pohnpei, and Palau. This study also serves to further build research capacity in the underserved USAPI Region.
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Affiliation(s)
| | | | - Grazyna Badowski
- University of Guam, UOG Station, 303 University Drive, Mangilao, Guam, 96923
| | - Tanisha F Aflague
- University of Guam, UOG Station, 303 University Drive, Mangilao, Guam, 96923
| | - Kathryn Wood
- University of Guam, UOG Station, 303 University Drive, Mangilao, Guam, 96923
| | - Kristi Hammond
- University of Guam, UOG Station, 303 University Drive, Mangilao, Guam, 96923
| | - Remedios Perez
- University of Guam, UOG Station, 303 University Drive, Mangilao, Guam, 96923
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16
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Novotny R, Yamanaka AB, Butel J, Boushey CJ, Dela Cruz R, Aflague T, Coleman P, Shallcross L, Fleming T, Wilkens LR. Maintenance Outcomes of the Children's Healthy Living Program on Overweight, Obesity, and Acanthosis Nigricans Among Young Children in the US-Affiliated Pacific Region: A Randomized Clinical Trial. JAMA Netw Open 2022; 5:e2214802. [PMID: 35666503 PMCID: PMC9171559 DOI: 10.1001/jamanetworkopen.2022.14802] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 04/04/2022] [Indexed: 11/23/2022] Open
Abstract
Importance Few obesity prevention trials among children have demonstrated sustainable outcomes in the long term. Objectives To sustain a community-wide decrease in the prevalence of overweight and obesity among young children in the US-affiliated Pacific region. Design, Setting, and Participants In the Children's Healthy Living community-randomized clinical trial, hierarchical modeling comparing the change in intervention and control communities accounted for community randomization (community clustering with jurisdictions), and adjusted for the age and sex distribution of the assessed children in a cross-sectional design. The outcome measures were repeated in communities rather than among individual children. A total of 27 communities in 5 jurisdictions (Hawai'i, Alaska, Commonwealth of the Northern Mariana Islands, American Samoa, and Guam) of the US-affiliated Pacific region were included. Participants included children aged 2 to 8 years in the 27 selected communities from October 1, 2012 (4329 in time 1 [baseline]) to August 31, 2015 (4043 in time 2 [intervention end]) and from January 1, 2019, to April 30, 2020 (1469 in time 3 [maintenance period]). Study analysis was completed March 25, 2022. Interventions Nineteen activities addressed training, policies, systems, and environments of communities and 6 target behaviors of children (consumption of fruit and vegetables, water, and sugar-sweetened beverages; sleep; physical activity; and screen time) during a 2-year intervention period. Continued partnership with community coalitions, ongoing academic training of community partners, and use of trial data during a 6-year maintenance period. Main Outcomes and Measures The primary outcome was measured anthropometry; secondary outcomes were the presence of acanthosis nigricans, dietary intake derived from 2 days of food records, and survey questions on screen time and sleep disturbance. Results Among the 9840 children included in the analysis (4866 girls [49.5%] and 4974 boys [50.5%]; 6334 [64.4%] aged 2-5 years), the intervention group showed significant improvements compared with the control group from times 1 to 3 in prevalence of overweight plus obesity (d = -12.60% [95% CI, -20.92% to -4.28%]), waist circumference (d = -1.64 [95% CI, -2.87 to -0.41] cm), and acanthosis nigricans prevalence (d = -3.55% [95% CI, -6.17% to -0.92%]). Significant improvements were also observed from times 2 to 3 in prevalence of overweight plus obesity (d = -8.73% [95% CI, -15.86% to -1.60%]) but not in waist circumference (d = -0.81 [95% CI, -1.85 to 0.23] cm). Conclusions and Relevance This randomized clinical trial found that the outcomes of the Children's Healthy Living intervention were maintained and enhanced 6 years after the intervention among young children in the US-affiliated Pacific region. The prevalence of overweight, obesity, and acanthosis nigricans was further reduced in communities, suggesting that multilevel multicomponent interventions may help reduce child overweight and obesity in this region. Trial Registration ClinicalTrials.gov Identifier: NCT01881373.
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Affiliation(s)
- Rachel Novotny
- Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawai‘i at Mānoa, Honolulu
| | - Ashley B. Yamanaka
- Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawai‘i at Mānoa, Honolulu
| | - Jean Butel
- Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawai‘i at Mānoa, Honolulu
| | - Carol J. Boushey
- Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawai‘i at Mānoa, Honolulu
- Population Sciences in the Pacific Program, University of Hawai‘i Cancer Center, Honolulu
| | - Rica Dela Cruz
- Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawai‘i at Mānoa, Honolulu
| | - Tanisha Aflague
- Cooperative Extension and Outreach, College of Natural & Applied Sciences, University of Guam, Mangilao
| | - Patricia Coleman
- Cooperative Research, Extension, and Education Services, Northern Marianas College, Saipan
| | - Leslie Shallcross
- Health, Home and Family Development, Institute of Agriculture, Natural Resources and Extension, University of Alaska, Fairbanks
| | - Travis Fleming
- Community and Natural Resources Division (Land Grant Program), American Samoa Community College, Pago Pago
| | - Lynne R. Wilkens
- Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawai‘i at Mānoa, Honolulu
- Population Sciences in the Pacific Program, University of Hawai‘i Cancer Center, Honolulu
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17
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Shapiro LR, Kennedy KG, Dimick MK, Goldstein BI. Elevated atherogenic lipid profile in youth with bipolar disorder during euthymia and hypomanic/mixed but not depressive states. J Psychosom Res 2022; 156:110763. [PMID: 35193092 DOI: 10.1016/j.jpsychores.2022.110763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 02/10/2022] [Accepted: 02/13/2022] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Abnormal blood lipid levels are common in individuals with bipolar disorder (BD). Previous studies have revealed lipid-mood associations in adults with BD, but no data on this relationship is available in youth populations. This cross-sectional study examined the associations of lipid levels with mood states and symptoms in a cohort of youth with BD. METHODS Participants were youth with BD and healthy controls (HCs) between the ages of 13-20 years. We compared the levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), and TG/HDL-C ratio between 4 participant episode groups: BD-euthymic (n = 28), BD-depressed (n = 29) BD-hypomanic/mixed (n = 31), and HCs (n = 89). We also examined for dimensional associations of lipids with mania and depression scores in the overall BD group and within BD episode subgroups. RESULTS TG levels were significantly higher in the BD-euthymic group (p = 0.008, d = 0.59) and in the BD-mixed/hypomanic group (p = 0.03, d = 0.44) compared to the HC group. TG/HDL-C ratio was also higher in the BD-euthymic group compared to the HC group (p = 0.01, d = 0.51). No dimensional associations were found between lipids and mood symptom scores in the overall BD group. However, within the BD-mixed/hypomanic subgroup, higher mania scores were associated with higher TG (β = 0.42, p = 0.04), TG/HDL-C ratio (β = 0.59, p = 0.002), and lower HDL-C (β = 0.56 p = 0.002). CONCLUSIONS Youth with BD demonstrate atherogenic lipid profiles. Higher atherogenic lipids were associated with hypomanic but, contrasting adult BD studies, not depressive symptoms. Future prospective studies are warranted to evaluate the temporal association between lipids and mood among youth with BD.
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Affiliation(s)
- Lila R Shapiro
- Centre for Youth Bipolar Disorder, Centre for Addictions and Mental Health, Toronto, Canada; Department of Pharmacology, University of Toronto, Toronto, Canada
| | - Kody G Kennedy
- Centre for Youth Bipolar Disorder, Centre for Addictions and Mental Health, Toronto, Canada; Department of Pharmacology, University of Toronto, Toronto, Canada
| | - Mikaela K Dimick
- Centre for Youth Bipolar Disorder, Centre for Addictions and Mental Health, Toronto, Canada; Department of Pharmacology, University of Toronto, Toronto, Canada
| | - Benjamin I Goldstein
- Centre for Youth Bipolar Disorder, Centre for Addictions and Mental Health, Toronto, Canada; Department of Pharmacology, University of Toronto, Toronto, Canada.
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18
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Bloom MS, Commodore S, Ferguson PL, Neelon B, Pearce JL, Baumer A, Newman RB, Grobman W, Tita A, Roberts J, Skupski D, Palomares K, Nageotte M, Kannan K, Zhang C, Wapner R, Vena JE, Hunt KJ. Association between gestational PFAS exposure and Children's adiposity in a diverse population. ENVIRONMENTAL RESEARCH 2022; 203:111820. [PMID: 34343551 PMCID: PMC8616804 DOI: 10.1016/j.envres.2021.111820] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/21/2021] [Accepted: 07/29/2021] [Indexed: 05/05/2023]
Abstract
Perfluoroalkyl substances (PFAS) are widely distributed suspected obesogens that cross the placenta. However, few data are available to assess potential fetal effects of PFAS exposure on children's adiposity in diverse populations. To address the data gap, we estimated associations between gestational PFAS concentrations and childhood adiposity in a diverse mother-child cohort. We considered 6 PFAS in first trimester blood plasma, measured using ultra-high-performance liquid chromatography with tandem mass spectrometry, collected from non-smoking women with low-risk singleton pregnancies (n = 803). Body mass index (BMI), waist circumference (WC), fat mass, fat-free mass, and % body fat were ascertained in 4-8 year old children as measures of adiposity. We estimated associations of individual gestational PFAS with children's adiposity and overweight/obesity, adjusted for confounders. There were more non-Hispanic Black (31.7 %) and Hispanic (42.6 %) children with overweight/obesity, than non-Hispanic white (18.2 %) and Asian/Pacific Islander (16.4 %) children (p < 0.0001). Perfluorooctane sulfonate (PFOS; 5.3 ng/mL) and perfluorooctanoic acid (2.0 ng/mL) had the highest median concentrations in maternal blood. Among women without obesity (n = 667), greater perfluoroundecanoic acid (PFUnDA) was associated with their children having higher WC z-score (β = 0.08, 95%CI: 0.01, 0.14; p = 0.02), fat mass (β = 0.55 kg, 95%CI: 0.21, 0.90; p = 0.002), and % body fat (β = 0.01 %; 95%CI: 0.003, 0.01; p = 0.004), although the association of PFUnDA with fat mass attenuated at the highest concentrations. Among women without obesity, the associations of PFAS and their children's adiposity varied significantly by self-reported race-ethnicity, although the direction of the associations was inconsistent. In contrast, among the children of women with obesity, greater, PFOS, perfluorononanoic acid, and perfluorodecanoic acid concentrations were associated with less adiposity (n = 136). Our results suggest that specific PFAS may be developmental obesogens, and that maternal race-ethnicity may be an important modifier of the associations among women without obesity.
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Affiliation(s)
- Michael S Bloom
- Department of Global and Community Health, George Mason University, Fairfax, VA, USA.
| | - Sarah Commodore
- Department of Environmental and Occupational Health, Indiana University, Bloomington, IN, USA
| | - Pamela L Ferguson
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Brian Neelon
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - John L Pearce
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Anna Baumer
- Department of Biological Sciences, University at Albany, State University of New York, Albany, NY, USA
| | - Roger B Newman
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC, USA
| | - William Grobman
- Department of Obstetrics and Gynecology, Northwestern University, Chicago, IL, USA
| | - Alan Tita
- Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - James Roberts
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
| | - Daniel Skupski
- Department of Obstetrics and Gynecology, New York-Presbyterian Queens Hospital, Queens, New York, USA; Department of Obstetrics and Gynecology, Weill Cornell Graduate School of Medical Sciences, Cornell University, New York, NY, USA
| | - Kristy Palomares
- Department of Obstetrics and Gynecology, Saint Peter's University Hospital, New Brunswick, NJ, USA
| | - Michael Nageotte
- Department of Perinatology, Long Beach Memorial Medical Center, Long Beach, CA, USA
| | - Kurunthachalam Kannan
- Department of Pediatrics and Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Cuilin Zhang
- Division of Intramural Population Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD, USA
| | - Ronald Wapner
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, Columbia University, New York, NY, USA
| | - John E Vena
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Kelly J Hunt
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
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19
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Mårild S, Sjöberg A, Albertsson-Wikland K, Chaplin JE, Lissner L, Dahlgren J. Features of Childhood Growth, Lifestyle, and Environment Associated with a Cardiometabolic Risk Score in Young Adults. Obes Facts 2022; 15:170-179. [PMID: 34736266 PMCID: PMC9021617 DOI: 10.1159/000520661] [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] [Received: 03/17/2021] [Accepted: 10/20/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION In young adults, metabolic syndrome (MS) is rare. To better assess the risks for future cardiovascular disease (CVD), a cardiometabolic score can be used, ranking the disease risk in each subject. The score is a continuous variable, summarizing the individual z-scores for waist circumference, blood pressure, blood levels of glucose, triglycerides, and high-density-lipoprotein cholesterol. Our main aim was to assess the association between early childhood growth and the cardiometabolic score in young adults. METHODS Study participants were recruited among subjects in the longitudinal population-based GrowUp 1990 Gothenburg study. Those with information on weight and length at birth, as well as weight, height, waist circumference, and parental body mass index (BMI) at 10 years of age were invited to participate in a health survey at 18-20 years of age. Five hundred and thirteen young adults (female 51%) were included. Multivariable linear stepwise regression analysis was applied. RESULTS The mean (standard deviation) BMI was 22.2 (3.26) in males and 21.3 (2.69) kg/m2 in females; the cardiometabolic score was 0.24 (3.12) and -0.22 (3.18), respectively. A statistically significantly higher score (p < 0.001) was seen in individuals with MS, as defined by IDF. After controlling for adult lifestyle features, the BMI z-score at 10 years of age was a significant risk factor in both sexes for an elevated cardiometabolic score in early adulthood with mean [standard error] beta 0.47 [0.19], p = 0.014 in males, and 0.82 [017], p < 0.0001 in females. In males, a high maternal BMI and low age at adiposity rebound and in females, high birth weight were also associated with a statistically significant risk. Additionally, contraceptive use in females was a risk factor for an elevated cardiometabolic score and in males, a high lifestyle-related index score showed a protective association with the cardiometabolic score. CONCLUSION A high BMI z-score at 10 years of age is a risk factor for the cardiometabolic state in young adults, an outcome pointing to the preventive potential of monitoring BMI in 10-year-old schoolchildren. This finding must however be validated in a new large cohort. Moreover, in young adults in whom MS is rare, the cardiometabolic score seems to be a promising and more powerful tool to detect risks for CVD later in life than using MS categorization.
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Affiliation(s)
- Staffan Mårild
- Department of Paediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- *Staffan Mårild,
| | - Agneta Sjöberg
- Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden
| | - Kerstin Albertsson-Wikland
- Institute of Neuroscience and Physiology, Department of Physiology/Endocrinology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - John E. Chaplin
- Department of Paediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lauren Lissner
- Institute of Medicine, School of Public Health and Community Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jovanna Dahlgren
- Department of Paediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Sterol and lipid analyses identifies hypolipidemia and apolipoprotein disorders in autism associated with adaptive functioning deficits. Transl Psychiatry 2021; 11:471. [PMID: 34504056 PMCID: PMC8429516 DOI: 10.1038/s41398-021-01580-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 08/03/2021] [Accepted: 08/18/2021] [Indexed: 12/30/2022] Open
Abstract
An improved understanding of sterol and lipid abnormalities in individuals with autism spectrum disorder (ASD) could lead to personalized treatment approaches. Toward this end, in blood, we identified reduced synthesis of cholesterol in families with ≥2 children with ASD participating with the Autism Genetic Resource Exchange (AGRE), as well as reduced amounts of high-density lipoprotein cholesterol (HDL), apolipoprotein A1 (ApoA1) and apolipoprotein B (ApoB), with 19.9% of the subjects presenting with apolipoprotein patterns similar to hypolipidemic clinical syndromes and 30% with either or both ApoA1 and ApoB less than the fifth centile. Subjects with levels less than the fifth centile of HDL or ApoA1 or ApoA1 + ApoB had lower adaptive functioning than other individuals with ASD, and hypocholesterolemic subjects had apolipoprotein deficits significantly divergent from either typically developing individuals participating in National Institutes of Health or the National Health and Nutrition Examination Survey III.
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21
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Angiopoietin-Like Proteins 2 and 3 in Children and Adolescents with Obesity and Their Relationship with Hypertension and Metabolic Syndrome. Int J Hypertens 2021; 2021:6748515. [PMID: 34422408 PMCID: PMC8376435 DOI: 10.1155/2021/6748515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 07/29/2021] [Indexed: 11/17/2022] Open
Abstract
Background Angiopoietin-like protein 2 (ANGPTL2) is one of the adipocyte-derived inflammatory factors which connects obesity to insulin resistance. ANGPTL3 has a direct role in regulation of lipid metabolism. The objective of this study was to evaluate ANGPTL2 and ANGPTL3 in childhood obesity and their relationship with metabolic syndrome. Methods 70 children and adolescents, 35 obese and 35 normal-weight subjects, were enrolled in this research after complete clinical examination and anthropometric evaluations. Serum ANGPTL2 and ANGPTL3 and insulin were measured by enzyme-linked immunosorbent assay (ELISA). Homeostatic model assessment of insulin resistance (HOMA-IR) was calculated and used to estimate insulin resistance (IR). Colorimetric methods were used for the assessment of fasting plasma glucose (FPG), LDL-C, HDL-C, total cholesterol (TC), and triglyceride (TG). Results The levels of ANGPTL2 and ANGPTL3 were significantly higher in obese subjects than those in controls, but they did not differ significantly in subjects with or without IR. ANGPTL3 was found to be significantly elevated in obese children with metabolic syndrome (MetS) in comparison with those without MetS. Both of the studied ANGPTLs were positively correlated with BMI, systolic blood pressure (SBP), diastolic blood pressure (DBP), TC, and LDL-C. The correlation between ANGPTL3 and either TC or LDL-C remained significant after adjusting for BMI. Conclusion Serum ANGPTL2 and ANGPTL3 were elevated in obesity and associated with blood pressure and indices of metabolic syndrome, suggesting that they might be involved in the advancement of obesity-related hypertension and metabolic syndrome.
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Perng W, Francis EC, Schuldt C, Barbosa G, Dabelea D, Sauder KA. Pre- and Perinatal Correlates of Ideal Cardiovascular Health during Early Childhood: A Prospective Analysis in the Healthy Start Study. J Pediatr 2021; 234:187-194. [PMID: 33741366 PMCID: PMC8238850 DOI: 10.1016/j.jpeds.2021.03.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 01/05/2021] [Accepted: 03/10/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To characterize prevalence of ideal cardiovascular health (ICVH) during early childhood (4-7 years of age), and to identify pre- and perinatal biological, sociodemographic, metabolic, and behavioral correlates of ICVH. STUDY DESIGN Among 350 mother-child pairs in the Healthy Start Study, we defined ICVH as no exposure to second hand smoke; ≥1 hour/day of moderate-to-vigorous physical activity; body mass index ≤85th percentile; systolic and diastolic blood pressure <90th percentile; cholesterol <170 mg/dL, fasting glucose <100 mg/dL; and healthy diet, per the American Heart Association. Pre- and perinatal characteristics were obtained from questionnaires, medical records, and in-person visits. Because of low prevalence of ICVH, we focused on prevalence of meeting ≥6 metrics in the analysis. We examined bivariate associations of each characteristic with % meeting ≥6 metrics and included those that were significant (P < .05) in a multivariable logistic regression model. RESULTS ICVH prevalence at mean ± SD age 4.7±0.6 years was 6.9%; boys had twice the prevalence as girls (9% vs 4.4%). Most (>85%) children met criteria for second hand smoke, body mass index, blood pressure, cholesterol, and glucose, and only one-third met criteria for physical activity (31.4%) and diet (35.1%). In multivariable analyses, key correlates of ICVH were maternal weight status (ORoverweight/obese vs nonoverweight/obese = 0.41 [0.23, 0.73]) and offspring sex (ORmale vs female = 2.14 [1.22, 3.65]). CONCLUSIONS At age 4-7 years, ICVH prevalence is already low, with diet and adequate physical activity being the limiting factors. Healthy maternal weight prior to pregnancy and male sex are potential determinants of childhood ICVH. Additional work is required to explore associations of early-life ICVH with future health outcomes.
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Affiliation(s)
- Wei Perng
- Lifcourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Denver Anschutz Medical Campus, Aurora, CO; Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver Anschutz Medical Campus, Aurora, CO.
| | - Ellen C Francis
- Lifcourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Denver Anschutz Medical Campus, Aurora, CO
| | - Caylor Schuldt
- Lifcourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Denver Anschutz Medical Campus, Aurora, CO
| | - Gregory Barbosa
- Lifcourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Denver Anschutz Medical Campus, Aurora, CO
| | - Dana Dabelea
- Lifcourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Denver Anschutz Medical Campus, Aurora, CO; Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver Anschutz Medical Campus, Aurora, CO; Department of Pediatrics, School of Medicine, University of Colorado Denver Anschutz Medical Campus, Aurora, CO
| | - Katherine A Sauder
- Lifcourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Denver Anschutz Medical Campus, Aurora, CO; Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver Anschutz Medical Campus, Aurora, CO; Department of Pediatrics, School of Medicine, University of Colorado Denver Anschutz Medical Campus, Aurora, CO
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Yamanaka AB, Davis JD, Wilkens LR, Hurwitz EL, Fialkowski MK, Deenik J, Leon Guerrero RT, Novotny R. Determination of Child Waist Circumference Cut Points for Metabolic Risk Based on Acanthosis Nigricans, the Children's Healthy Living Program. Prev Chronic Dis 2021; 18:E64. [PMID: 34166179 PMCID: PMC8269744 DOI: 10.5888/pcd18.210021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Waist circumference is a common anthropometric measure for predicting abdominal obesity and insulin resistance. We developed optimal waist circumference cut points for children aged 2 to 8 years in the US-Affiliated Pacific (USAP) region based on the relationship of waist circumference and acanthosis nigricans in this population. METHODS We conducted a cross-sectional analysis from the Children's Healthy Living Program's 2012-2013 data on 4,023 children. We used receiver-operating characteristic analysis to determine the sensitivity and specificity for acanthosis nigricans across waist circumference, by sex and age. We determined optimal waist circumference cutoff points corresponding to Youden index (J), (equal to [sensitivity + specificity] - 1), with acanthosis nigricans. We compared these cut points with the 90th percentile. RESULTS The 90th-percentile cut points for boys aged 2 to 5 years (58.15 cm) and 6 to 8 years (71.63 cm) were slightly higher than for girls in both age groups (aged 2-5 y, 57.97 cm; 6-8 y: 70.37 cm). The optimal cut points (corresponding to the highest sensitivity and specificity) were as follows: for boys aged 2 to 5 years, 90th percentile (58.25 cm; sensitivity, 48.0%; specificity, 91.5%); for boys aged 6 to 8 years, 78th percentile (63.59 cm; sensitivity, 86.8%; specificity, 82.8%); for girls aged 2 to 5 years, 62nd percentile (53.27 cm; sensitivity, 71.4%; specificity, 63.1%), and for girls aged 6 to 8 years, 80th percentile (63.63 cm; sensitivity, 55.4%; specificity, 82.9%). CONCLUSION Among USAP children, waist circumference was a reasonable predictor for acanthosis nigricans. Further analysis is warranted to examine causes of acanthosis nigricans at lower-than-expected waist circumference percentiles. The cut points can be used for early detection of metabolic risk.
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Affiliation(s)
- Ashley B Yamanaka
- Department of Human Nutrition, Food and Animal Science, College of Tropical Agriculture and Human Resources, University of Hawai'i at Mānoa, Honolulu, Hawai'i
- College of Tropical Agriculture and Human Resources, University of Hawai'i at Mānoa, 1955 East West Rd, Agricultural Sciences 216, Honolulu, Hawai'i 96822.
| | - James D Davis
- Department of Biostatistics and Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, Hawai'i
| | - Lynne R Wilkens
- Biostatistics and Informatics Shared Resource, University of Hawai'i Cancer Center, Honolulu, Hawai'i
| | - Eric L Hurwitz
- Office of Public Health Studies, Thompson School of Social Work and Public Health, University of Hawai'i at Mānoa, Honolulu, Hawai'i
| | - Marie K Fialkowski
- Department of Human Nutrition, Food and Animal Science, College of Tropical Agriculture and Human Resources, University of Hawai'i at Mānoa, Honolulu, Hawai'i
| | - Jonathan Deenik
- Department of Tropical Plant and Soil Sciences, College of Tropical Agriculture and Human Resources, University of Hawai'i at Mānoa, Honolulu, Hawai'i
| | | | - Rachel Novotny
- Department of Human Nutrition, Food and Animal Science, College of Tropical Agriculture and Human Resources, University of Hawai'i at Mānoa, Honolulu, Hawai'i
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Intensity-Modified Recreational Volleyball Training Improves Health Markers and Physical Fitness in 25-55-Year-Old Men. BIOMED RESEARCH INTERNATIONAL 2021; 2021:9938344. [PMID: 34239935 PMCID: PMC8235980 DOI: 10.1155/2021/9938344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/31/2021] [Accepted: 06/03/2021] [Indexed: 11/30/2022]
Abstract
The present study is aimed at determining the effects of intensity-modified recreational volleyball training on health markers and physical fitness in healthy middle-aged men. Thirty-four healthy untrained men aged 25–55 years were randomized to either a modified recreational volleyball group (MRV, n = 17) or a recreational volleyball group (RV, n = 17). Both groups performed volleyball training twice a week over 12 weeks, with participants in MRV playing a modified game with higher intensity due to shorter breaks between rallies. The small to moderate improvements of both groups were observed in SBP (MRV gav = −0.50 [-0.67, -0.33] vs. RV gav = −0.37 [-0.55, -0.20]) to a similar extent (p = 0.12). However, only the MRV significantly improved (p < 0.001) the mean body weight (gav = −0.35 [-0.52, -0.18]) and BMI (gav = −0.39 [-0.56, -0.22]) to a moderate extent and the YYIR1 performance (gav = 2.45 [2.22, 2.69]) to a large extent. Even though both groups significantly improved the rest HR, the mean change of rest HR was significantly greater in MRV as compared to the RV (p < 0.001, ŋp2 = 0.47). The study revealed that an intensity-modified type of recreational volleyball, involving shorter breaks between rallies, improves cardiorespiratory fitness and health markers for men aged 25–55 years.
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Skelly LE, Barbour-Tuck EN, Kurgan N, Calleja M, Klentrou P, Falk B, Josse AR. Neutral Effect of Increased Dairy Product Intake, as Part of a Lifestyle Modification Program, on Cardiometabolic Health in Adolescent Girls With Overweight/Obesity: A Secondary Analysis From a Randomized Controlled Trial. Front Nutr 2021; 8:673589. [PMID: 34095194 PMCID: PMC8175852 DOI: 10.3389/fnut.2021.673589] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 04/22/2021] [Indexed: 12/28/2022] Open
Abstract
Background: The presence of obesity and some cardiometabolic disease risk factors in childhood and adolescence track into adulthood. Intake of dairy products has been shown to be inversely related to adiposity and cardiometabolic variables in youth. However, limited research has examined cardiometabolic disease risk factors following increased dairy product consumption as part of a lifestyle modification intervention in youth with overweight/obesity. This secondary analysis aimed to determine whether 12 weeks of increased dairy consumption, as part of a lifestyle modification program, affects cardiometabolic variables in adolescent females (range: 10-18 years) with overweight/obesity (BMI > 85th centile). Methods: Participants were randomized into two groups: higher dairy intake (RDa; four servings/day [to reflect previous Canada's Food Guide recommendations]; n = 23) or low dairy intake (LDa; 0-2 servings/day; n = 23). Both RDa and LDa participated in a 12-week, eucaloric, lifestyle modification intervention consisting of exercise training, and nutritional counseling. Adiposity (percent body fat [%BF]), dietary intake, and measures of cardiometabolic health were measured pre- and post-intervention. Results: There were no significant changes over time within groups or differences over time between groups for triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL), TC/HDL ratio, low-density lipoprotein cholesterol (LDL), glucose, insulin, homeostatic model assessment of insulin resistance, adiponectin, and tumor necrosis factor alpha (TNF-α) (main effects of time and interactions, p > 0.05). Leptin decreased over the 12-week lifestyle intervention in both groups (main effect of time, p = 0.02). After combining the groups (n = 46), significant correlations were found between change in %BF and change in some cardiometabolic variables (HDL [r = -0.40], TC/HDL ratio [r = 0.42], LDL [r = 0.36], and TNF-α [r = 0.35], p < 0.05). After controlling for change in dairy product intake, the correlations were unchanged. Conclusion: Our findings demonstrate that increased dairy product consumption, as part of a lifestyle modification, weight management intervention, had a neutral effect on cardiometabolic disease risk factors in adolescent females with overweight/obesity. Change in dairy product intake did not influence the relationships between change in adiposity and change in cardiometabolic variables. Future research designed to primarily assess the effect of increased dairy product consumption on cardiometabolic disease risk factors in this population is warranted. Clinical Trial Registration: Clinicaltrials.gov; NCT#02581813.
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Affiliation(s)
- Lauren E Skelly
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, ON, Canada
| | - Erin N Barbour-Tuck
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, ON, Canada
| | - Nigel Kurgan
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada.,Centre for Bone and Muscle Health, Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada
| | - Melissa Calleja
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada
| | - Panagiota Klentrou
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada.,Centre for Bone and Muscle Health, Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada
| | - Bareket Falk
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada.,Centre for Bone and Muscle Health, Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada
| | - Andrea R Josse
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, ON, Canada.,Centre for Bone and Muscle Health, Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada
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26
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Słomiński B, Skrzypkowska M, Ryba-Stanisławowska M, Myśliwiec M, Trzonkowski P. Associations of TP53 codon 72 polymorphism with complications and comorbidities in patients with type 1 diabetes. J Mol Med (Berl) 2021; 99:675-683. [PMID: 33495869 PMCID: PMC8055568 DOI: 10.1007/s00109-020-02035-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 12/22/2020] [Accepted: 12/29/2020] [Indexed: 11/26/2022]
Abstract
Wild-type TP53 plays an important role in the regulation of immune response and systemic inflammation. In type 1 diabetes (T1D), TP53 pathways are upregulated and an increased susceptibility to apoptosis is observed. We hypothesize that TP53 codon 72 polymorphism could be associated with complications and comorbidities in patients with T1D. We have investigated the associations of the TP53 codon 72 polymorphism with the T1D complications and comorbidities (retinopathy, nephropathy, hypertension, dyslipidemia, autoimmune thyroiditis, and celiac disease) in 350 patients. The key results of our approach are as follows: (1) In diabetic subjects, the Pro/Pro genotype is associated with an increased risk of microvascular complications, dyslipidemia, and celiac disease; (2) the Arg/Arg variant is associated with a decreased risk of autoimmune thyroiditis and celiac disease; (3) the Pro allele is associated with an increased risk of dyslipidemia, autoimmune thyroiditis, and celiac disease. Although further studies are required, our results for the first time indicate that the TP53 codon 72 polymorphism could be considered a genetic marker to predict the increased susceptibility to some T1D complications and comorbidities. KEY MESSAGES: We analyzed the TP53 codon 72 polymorphism in patients with T1D. Pro/Pro genotype is associated with an increased risk of microvascular complications, dyslipidemia, and celiac disease. The Arg/Arg variant is associated with a decreased risk of autoimmune thyroiditis and celiac disease. The Pro allele is associated with an increased risk of dyslipidemia, autoimmune thyroiditis, and celiac disease.
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Affiliation(s)
- Bartosz Słomiński
- Department of Medical Immunology, Faculty of Medicine, Medical University of Gdańsk, ul. Dębinki 1, 80-211, Gdańsk, Poland.
| | - Maria Skrzypkowska
- Department of Medical Immunology, Faculty of Medicine, Medical University of Gdańsk, ul. Dębinki 1, 80-211, Gdańsk, Poland
| | - Monika Ryba-Stanisławowska
- Department of Medical Immunology, Faculty of Medicine, Medical University of Gdańsk, ul. Dębinki 1, 80-211, Gdańsk, Poland
| | - Małgorzata Myśliwiec
- Chair & Clinics of Paediatrics, Diabetology and Endocrinology, Faculty of Medicine, Medical University of Gdańsk, Dębinki 7, 80-211, Gdańsk, Poland
| | - Piotr Trzonkowski
- Department of Medical Immunology, Faculty of Medicine, Medical University of Gdańsk, ul. Dębinki 1, 80-211, Gdańsk, Poland
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Li Y, Ma Y, Luo J, Jing J, Zhang X, Luo C, Wang H, Zhao H, Pan D, Luo M. Identifying reference values for serum lipids in Chinese children and adolescents aged 6-17 years old: A national multicenter study. J Clin Lipidol 2021; 15:477-487. [PMID: 33931376 DOI: 10.1016/j.jacl.2021.02.001] [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: 07/06/2020] [Revised: 02/17/2021] [Accepted: 02/17/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Current reference values for pediatric dyslipidemia used in China were not developed based on local population studies and did not consider age and sex differences. OBJECTIVE In this study, we aimed to determine suitable reference values for total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), and non-high-density lipoprotein cholesterol (nonHDL-C) for Chinese children and adolescents using a national multicenter school-based study. METHODS A total of 15,830 students aged 6-17 years were recruited from seven provinces of China. Age- and sex-specific percentile values for each lipid indicator were derived based on levels measured in the fasting state, and percentile curves of each indicator were plotted using the LMS method. RESULTS Serum lipid levels varied considerably with age in both sexes. Among boys, the cut-off value for high TC, nonHDL-C, LDL-C, and TG, based on the value of the 95th percentiles, ranged from 4.58 to 5.39, 3.34 to 3.99, 2.69 to 3.31, and 1.22 to 1.83 mmol/L, respectively; among girls, the cut-off value for high TC, nonHDL-C, LDL-C, and TC ranged from 5.01 to 5.39, 3.66 to 3.97, 2.97 to 3.32, and 1.41 to 1.93 mmol/L, respectively. The cut-point for low HDL-C ranged from 0.84 to 1.08 mmol/L in boys and from 0.89 to 1.04 mmol/L in girls. CONCLUSION These findings may help to determine age- and sex-specific reference values for serum lipids among Chinese children and adolescents and provide valuable guidance for screening of dyslipidemia.
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Affiliation(s)
- Yamei Li
- Xiangya School of Public Health, Central South University, No.238 Shang Ma Yuan Ling Road, Changsha 410008, China.
| | - Yinghua Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China.
| | - Jiayou Luo
- Xiangya School of Public Health, Central South University, No.238 Shang Ma Yuan Ling Road, Changsha 410008, China.
| | - Jin Jing
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.
| | - Xin Zhang
- School of Public Health, Tianjin Medical University, Tianjin, China.
| | - Chunyan Luo
- Shanghai Municipal Center for Disease Control and Prevention & Shanghai Institutes of Preventive Medicine, Shanghai, China.
| | - Hong Wang
- Chongqing Medical University, Chongqing, China.
| | | | - Dehong Pan
- Liaoning Health Supervision Bureau, Shenyang, China.
| | - Miyang Luo
- Xiangya School of Public Health, Central South University, No.238 Shang Ma Yuan Ling Road, Changsha 410008, China.
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Lin CY, Lin CM. Occupational Assessments of Risk Factors for Cardiovascular Diseases in Labors: An Application of Metabolic Syndrome Scoring Index. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207539. [PMID: 33081282 PMCID: PMC7589171 DOI: 10.3390/ijerph17207539] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/14/2020] [Accepted: 10/15/2020] [Indexed: 12/14/2022]
Abstract
Unlike a traditional diagnosis of metabolic syndrome (MS), a numerical MS index can present individual fluctuations of health status over time. This study aimed to explore its value in the application of occupational health. Using a database of physiological and biochemical tests and questionnaires, data were collected from 7232 participants aged 20 to 64 years who received occupational health screenings at a health screening institution in 2018. Using confirmatory factor analysis, five components of MS were used to design an MS severity scoring index, which was then used to evaluate the risks of occupation factors. Waist circumference was the largest loading factor compared with the other MS components. Participants who worked in the traditional industrial, food processing, or electronic technology industries had higher MS severity than those in the logistics industry. Those who worked as a manager or over five years had a relatively high severity. The research showed that assessments based on an MS severity score are applicable when the risk factors of suboptimal health are involved. By monitoring the scores over time, healthcare professionals can propose preventive strategies in time, thus enhancing the effectiveness of occupational health examination services.
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Affiliation(s)
- Ching-Yuan Lin
- Department of Laboratory Medicine, Ten-Chan General Hospital, Chung Li, Taoyuan 320, Taiwan;
| | - Chih-Ming Lin
- Department of Healthcare Information and Management, Ming Chuan University, Taoyuan 333, Taiwan
- Correspondence: ; Tel.: +886-3-350-7001; Fax: +886-3-3593880
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Trajković N, Pajek M, Sporiš G, Petrinović L, Bogataj Š. Reducing Aggression and Improving Physical Fitness in Adolescents Through an After-School Volleyball Program. Front Psychol 2020; 11:2081. [PMID: 32903452 PMCID: PMC7435016 DOI: 10.3389/fpsyg.2020.02081] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 07/28/2020] [Indexed: 11/20/2022] Open
Abstract
This study aimed to determine the effects of an after-school volleyball program on aggression and physical fitness in 14–16 years old students. One hundred and seven participants were randomized to a small-sided volleyball (SSV) training group or a control group (CON). The SSV group completed 8 months of small-sided volleyball training twice a week after school in addition to the regular physical education classes. Yo-Yo Intermittent Recovery Level 1 test (YYIRT1), medicine ball throw (MED), vertical jump (VJ), and Buss and Perry’s aggression questionnaire were evaluated before and after 8 months of training. Results revealed a significant interaction effect (group × time) in total sample for physical aggression [F(1, 105) = 17.688; p < 0.001], verbal aggression [F(1, 105) = 4.973; p = 0.028], anger [F(1, 105) = 7.662; p = 0.007], medicine ball throw [F(1, 105) = 36.143; p < 0.001], and YYIRT1 [F(1, 105) = 12.508; p = 0.001]. After-school small-sided volleyball for adolescents was accompanied by a significant decrease in aggression compared to physical education classes only. Additionally, adolescents from SSV group showed better results in physical fitness compared to the control group. Our findings significantly contribute to the understanding of possible mechanisms for reducing adolescents’ aggression, which include enjoyment, motivation, and self-control through sport intervention.
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Affiliation(s)
- Nebojša Trajković
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Maja Pajek
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Goran Sporiš
- Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia
| | | | - Špela Bogataj
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia.,Department of Nephrology, University Medical Centre, Ljubljana, Slovenia
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Santos JLF, Valério VP, Fernandes RN, Duarte L, Assumpção AC, Guerreiro J, Sickler AL, Lemos ÁAR, Goulart Filho JG, Cesar LAM, Pinto IM, Magalhães C, Hussid MF, Camacho C, Avezum A, Sangaleti CT, Consolim-Colombo FM. Waist Circumference Percentiles and Cut-Off Values for Obesity in a Large Sample of Students from 6 To 10 Years Old Of The São Paulo State, Brazil. Arq Bras Cardiol 2020; 114:530-537. [PMID: 32267326 PMCID: PMC7792724 DOI: 10.36660/abc.20190043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 06/18/2019] [Indexed: 02/06/2023] Open
Abstract
Fundamento A prevalência da obesidade vem aumentando sistematicamente na população, inclusive nas crianças e adolescentes, ao redor do mundo. Objetivos Descrever curvas percentílicas de referência para a circunferência abdominal (CA) nas crianças brasileiras e fornecer pontos de corte da CA para identificar crianças com risco de obesidade. Métodos Um estudo multicêntrico, prospectivo, tranversal foi realizado em crianças com idades entre 6 e 10 anos, matriculadas no ensino fundamental de escolas públicas e particulares de 13 cidades do estado de São Paulo. A estatura, o peso e a CA foram medidos em duplicata em 22.000 crianças (11.199 meninos). Para estabelecer o melhor ponto de corte da CA para o diagnóstico da obesidade, foram calculadas curvas ROC com crianças classificadas como com peso normal e obesas, de acordo com as curvas do IMC, estratificadas por gênero e idade, e o índice Youden foi utilizado como a eficácia potencial máxima desse biomarcador. Valores de p < 0,05 foram considerados estatisticamente significativos. Resultados Os valores da CA aumentaram com a idade, tanto nos meninos quanto nas meninas. A prevalência de obesidade em cada grupo variou de 17% (6 anos de idade) a 21,6 % (9 anos de idade), dentre os meninos, e de 14,1% (7 anos de idade) a 17,3 % (9 anos de idade), dentre as meninas. As análises ROC mostraram o percentil 75 como ponto de corte para o risco de obesidade, e o diagnóstico de obesidade está classificado no percentil 85 ou acima. Conclusão Curvas de referência da CA específicas para idade e sexo em crianças brasileiras e pontos de corte para o risco de obesidade podem ser usados em triagem nacional e estudos intervencionais para reduzir a carga da obesidade no Brasil. (Arq Bras Cardiol. 2020; 114(3):530-537)
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Affiliation(s)
| | | | | | - Ligia Duarte
- Sociedade de Cardiologia do Estado de São Paulo, São Paulo, SP - Brasil
| | | | - Jayme Guerreiro
- Sociedade de Cardiologia do Estado de São Paulo, São Paulo, SP - Brasil
| | - Antonio L Sickler
- Sociedade de Cardiologia do Estado de São Paulo, São Paulo, SP - Brasil
| | - Álvaro A R Lemos
- Sociedade de Cardiologia do Estado de São Paulo, São Paulo, SP - Brasil
| | | | | | | | | | | | | | - Alvaro Avezum
- Sociedade de Cardiologia do Estado de São Paulo, São Paulo, SP - Brasil
| | - Carine T Sangaleti
- Universidade Estadual do Centro-Oeste - Enfermagem, Guarapuava, PR - Brasil
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Perng W, Francis EC, Smith HA, Carey J, Wang D, Kechris KM, Dabelea D. Sex-Specific Metabolite Biomarkers of NAFLD in Youth: A Prospective Study in the EPOCH Cohort. J Clin Endocrinol Metab 2020; 105:5873863. [PMID: 32687159 PMCID: PMC7418446 DOI: 10.1210/clinem/dgaa467] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 07/15/2020] [Indexed: 12/16/2022]
Abstract
CONTEXT Nonalcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease in developed nations. There are currently no accurate biomarkers of NAFLD risk in youth. OBJECTIVE Identify sex-specific metabolomics biomarkers of NAFLD in a healthy cohort of youth. DESIGN/SETTING This prospective study included 395 participants of the EPOCH cohort in Colorado, who were recruited 2006-2009 ("T1 visit") and followed for 5 years ("T2 visit"). We entered 767 metabolites measured at T1 into a reduced rank regression model to identify the strongest determinants of hepatic fat fraction (HFF) at T2, separately for boys and girls. We compared the capacity of metabolites versus conventional risk factors (overweight/obesity, insulin, alanine transaminase, aspartate transaminase) to predict NAFLD (HFF ≥5%) and high HFF (fourth vs first quartile) using area under the receiver operating characteristic curve (AUC). RESULTS Prevalence of NAFLD was 7.9% (8.5% of boys, 7.1% of girls). Mean ± SD HFF was 2.5 ± 3.1%. We identified 13 metabolites in girls and 10 metabolites in boys. Metabolites were in lipid, amino acid, and carbohydrate metabolism pathways. At T1, the metabolites outperformed conventional risk factors in prediction of high HFF but not NAFLD. At T2, the metabolites were superior to conventional risk factors as predictors of high HFF (AUC for metabolites vs conventional risk factors for boys: 0.9565 vs 0.8851, P = 0.02; for girls: 0.9450 vs 0.8469, P = 0.02) with similar trends for NAFLD, although the differences were not significant. CONCLUSIONS The metabolite profiles identified herein are superior predictors of high HFF when assessed 5 years prior and concurrently in a general-risk setting.
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Affiliation(s)
- Wei Perng
- Lifcourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora Colorado
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Colorado
- Correspondence and Reprint Requests: Wei Perng, University of Colorado Denver, Anschutz Medical Campus, 12474 E. 19th Ave, Room 208, Aurora, CO 80045, USA. E-mail:
| | - Ellen C Francis
- Lifcourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora Colorado
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Colorado
| | - Harry A Smith
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - John Carey
- Lifcourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora Colorado
| | - Dongqing Wang
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Katerina M Kechris
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Dana Dabelea
- Lifcourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora Colorado
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Colorado
- Department of Pediatrics, University of Colorado School of Medicine, Aurora Colorado
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Leon Guerrero RT, Barber LR, Aflague TF, Paulino YC, Hattori-Uchima MP, Acosta M, Wilkens LR, Novotny R. Prevalence and Predictors of Overweight and Obesity among Young Children in the Children's Healthy Living Study on Guam. Nutrients 2020; 12:E2527. [PMID: 32825433 PMCID: PMC7551370 DOI: 10.3390/nu12092527] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 08/05/2020] [Accepted: 08/12/2020] [Indexed: 01/17/2023] Open
Abstract
This study is part of the Children's Healthy Living program in U.S. Affiliated Pacific region. The objectives were to estimate overweight and obesity (OWOB) prevalence and identify possible related risk factors among ethnic groups in Guam. In 2013, 865 children (2-8 years) were recruited via community-based sampling from select communities in Guam. Children's demographic and health behavior information; dietary intake; and anthropometric measurements were collected. Logistic regression, odds ratio, t-tests, and chi-square tests were used to determine differences and assess covariates of OWOB. The results indicate that 58% of children were living below the poverty level, 80% were receiving food assistance, and 51% experienced food insecurity. The majority of children surveyed did not meet recommendations for: sleep duration (59.6%), sedentary screen-time (83.11%), or fruit (58.7%) and vegetable (99.1%) intake, and consumed sugar sweetened beverages (SSB) (73.7%). OWOB affected 27.4% of children. Children affected by OWOB in this study were statistically more likely (p = 0.042) to suffer from sleep disturbances (p = 0.042) and consume marginally higher amounts (p value = 0.07) of SSB compared to children with healthy weight. Among Other Micronesians, children from families who considered themselves 'integrated' into the culture were 2.05 (CI 0.81-5.20) times more likely to be affected by OWOB. In conclusion, the OWOB prevalence among 2-8-year-olds in Guam was 27.4%; and compared with healthy weight children, children with OWOB were more likely to have educated caregivers and consume more SSBs. Results provide a basis for health promotion and obesity prevention guidance for children in Guam.
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Affiliation(s)
- Rachael T. Leon Guerrero
- Office of Research & Sponsored Programs, University of Guam, Mangilao, Guam 96923, USA; (L.R.B.); (T.F.A.); (Y.C.P.); (M.P.H.-U.); (M.A.)
| | - L. Robert Barber
- Office of Research & Sponsored Programs, University of Guam, Mangilao, Guam 96923, USA; (L.R.B.); (T.F.A.); (Y.C.P.); (M.P.H.-U.); (M.A.)
| | - Tanisha F. Aflague
- Office of Research & Sponsored Programs, University of Guam, Mangilao, Guam 96923, USA; (L.R.B.); (T.F.A.); (Y.C.P.); (M.P.H.-U.); (M.A.)
| | - Yvette C. Paulino
- Office of Research & Sponsored Programs, University of Guam, Mangilao, Guam 96923, USA; (L.R.B.); (T.F.A.); (Y.C.P.); (M.P.H.-U.); (M.A.)
| | - Margaret P. Hattori-Uchima
- Office of Research & Sponsored Programs, University of Guam, Mangilao, Guam 96923, USA; (L.R.B.); (T.F.A.); (Y.C.P.); (M.P.H.-U.); (M.A.)
| | - Mark Acosta
- Office of Research & Sponsored Programs, University of Guam, Mangilao, Guam 96923, USA; (L.R.B.); (T.F.A.); (Y.C.P.); (M.P.H.-U.); (M.A.)
| | | | - Rachel Novotny
- College of Tropical Agriculture and Human Resources, University of Hawaii At Manoa, Honolulu, HI 96822, USA;
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Lee JS, Song YH. Relationship between Waist Circumference and Cardiovascular Risk Factors in Adolescents: Analysis of the Korea National Health and Nutrition Examination Survey Data. Korean Circ J 2020; 50:723-732. [PMID: 32725980 PMCID: PMC7390717 DOI: 10.4070/kcj.2019.0329] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 03/23/2020] [Accepted: 04/16/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND AND OBJECTIVES High waist circumference (WC) is associated with increased cardiovascular risk (CVR) in adulthood. We investigated this association in adolescents. METHODS We performed a cross-sectional analysis of data for 10-18-year-olds included in the Korea National Health and Nutrition Examination Survey (KNHANES) (2005-2014). The association between WC and CVR factors was evaluated. We analyzed this relationship according to age. RESULTS We analyzed 8,153 participants (4,319 boys and 3,834 girls) from the KNHANES. High WC was associated with increased incidence of CVR factors: hypertension (odds ratio [OR], 3.5 in boys, 1.9 in girls), high total cholesterol (OR, 3.9 in boys, 1.9 in girls), high triglycerides (OR, 4.9 in boys, 3.2 in girls), high low-density lipoprotein (LDL) cholesterol (OR, 5.0 in boys, 1.8 in girls), low high-density lipoprotein (HDL) cholesterol (OR, 2.6 in boys, 3.0 in girls), and hyperglycemia (OR, 2.8 in girls). In boys, the association between high WC and hypertension, high triglycerides, and low HDL cholesterol was noted in early adolescence. High WC was associated with high total cholesterol and high LDL cholesterol in middle adolescence. In girls, high WC was correlated with high total cholesterol, high triglycerides, and low HDL cholesterol in early adolescence. High WC was shown to be associated with hyperglycemia in middle adolescence, and with hypertension and high LDL cholesterol in late adolescence. CONCLUSIONS High WC in adolescents is associated with increased CVR. The timing of this association differs according to sex and CVR factors.
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Affiliation(s)
- Jue Seong Lee
- Department of Pediatrics, Korea University Medical Center, Korea University College of Medicine, Seoul, Korea
| | - Young Hwan Song
- Division of Pediatric Cardiology, Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.
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Perng W, Rahman ML, Aris IM, Michelotti G, Sordillo JE, Chavarro JE, Oken E, Hivert MF. Metabolite Profiles of the Relationship between Body Mass Index (BMI) Milestones and Metabolic Risk during Early Adolescence. Metabolites 2020; 10:E316. [PMID: 32751947 PMCID: PMC7464362 DOI: 10.3390/metabo10080316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 07/24/2020] [Accepted: 07/28/2020] [Indexed: 11/16/2022] Open
Abstract
Early growth is associated with future metabolic risk; however, little is known of the underlying biological pathways. In this prospective study of 249 boys and 227 girls, we sought to identify sex-specific metabolite profiles that mark the relationship between age and magnitude of the infancy body mass index (BMI) peak, and the childhood BMI rebound with a metabolic syndrome z-score (MetS z-score) during early adolescence (median age 12.8 years). Thirteen consensus metabolite networks were generated between male and female adolescents using weighted correlation network analysis. In girls, none of the networks were related to BMI milestones after false discovery rate (FDR) correction at 5%. In boys, age and/or magnitude of BMI at rebound were associated with three metabolite eigenvector (ME) networks comprising androgen hormones (ME7), lysophospholipids (ME8), and diacylglycerols (ME11) after FDR correction. These networks were also associated with MetS z-score in boys after accounting for age and race/ethnicity: ME7 (1.43 [95% CI: 0.52, 2.34] units higher MetS z-score per 1 unit of ME7), ME8 (-1.01 [95% CI: -1.96, -0.07]), and ME11 (2.88 [95% CI: 2.06, 3.70]). These findings suggest that alterations in sex steroid hormone and lipid metabolism are involved in the relationship of early growth with future metabolic risk in males.
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Affiliation(s)
- Wei Perng
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver Anschutz Medical Campus, Aurora, CO 80045, USA
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Denver Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Mohammad L. Rahman
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA; (M.L.R.); (I.M.A.); (J.E.S.); (E.O.); (M.-F.H.)
| | - Izzuddin M. Aris
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA; (M.L.R.); (I.M.A.); (J.E.S.); (E.O.); (M.-F.H.)
| | | | - Joanne E. Sordillo
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA; (M.L.R.); (I.M.A.); (J.E.S.); (E.O.); (M.-F.H.)
| | - Jorge E. Chavarro
- Department of Nutrition, T. H. Chan Harvard School of Public Health, Boston, MA 02115, USA;
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA; (M.L.R.); (I.M.A.); (J.E.S.); (E.O.); (M.-F.H.)
- Department of Nutrition, T. H. Chan Harvard School of Public Health, Boston, MA 02115, USA;
| | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA; (M.L.R.); (I.M.A.); (J.E.S.); (E.O.); (M.-F.H.)
- Diabetes Unit, Massachusetts General Hospital, Boston, MA 02114, USA
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Ezzati-Mobaser S, Malekpour-Dehkordi Z, Nourbakhsh M, Tavakoli-Yaraki M, Ahmadpour F, Golpour P, Nourbakhsh M. The up-regulation of markers of adipose tissue fibrosis by visfatin in pre-adipocytes as well as obese children and adolescents. Cytokine 2020; 134:155193. [PMID: 32707422 DOI: 10.1016/j.cyto.2020.155193] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 06/25/2020] [Accepted: 07/04/2020] [Indexed: 01/01/2023]
Abstract
Adipocytes are surrounded by a three-dimensional network of extracellular matrix (ECM) proteins. Aberrant ECM accumulation and remodeling leads to adipose tissue fibrosis. Visfatin is one of the adipocytokines that is increased in obesity and is implicated in insulin resistance. The objective of this study was to investigate the effect of visfatin on major components of ECM remodeling. In this study, plasma levels of both endotrophin and visfatin in obese children and adolescents were significantly higher than those in control subjects and they showed a positive correlation with each other. Treatment of 3T3-L1 pre-adipocytes with visfatin caused significant up-regulation of Osteopontin (Opn), Collagen type VI (Col6), matrix metalloproteinases MMP-2 and MMP-9. By using inhibitors of major signaling pathways it was shown that visfatin exerted its effect on Col6a3 gene expression through PI3K, JNK, and NF-кB pathways, while induced Opn gene expression via PI3K, JNK, MAPK/ERK, and NOTCH1. Our conclusion is that, the relationship between visfatin, endotrophin and insulin resistance parameters in obesity as well as increased expression of ECM proteins by visfatin suggests adipose tissue fibrosis as a mechanism for devastating effects of visfatin in obesity.
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Affiliation(s)
- Samira Ezzati-Mobaser
- Department of Biochemistry, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Malekpour-Dehkordi
- Metabolic Disorders Research Center, Endocrinology and Metabolism Molecular -Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mona Nourbakhsh
- Hazrat Aliasghar Children's Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Masoumeh Tavakoli-Yaraki
- Department of Biochemistry, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Ahmadpour
- Department of Clinical Biochemistry, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Pegah Golpour
- Department of Biochemistry, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mitra Nourbakhsh
- Department of Biochemistry, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran; Finetech in Medicine Research Center, Iran University of Medical Sciences, Tehran, Iran.
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Lin CM. An Application of Metabolic Syndrome Severity Scores in the Lifestyle Risk Assessment of Taiwanese Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103348. [PMID: 32408571 PMCID: PMC7277177 DOI: 10.3390/ijerph17103348] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 05/07/2020] [Accepted: 05/08/2020] [Indexed: 12/22/2022]
Abstract
A metabolic syndrome (MS) diagnosis was made when the criteria for three or more of five MS components were met. Due to some limitations in the traditional MS criteria, however, different health care societies have sought to develop applicable MS scoring systems instead. Continuous MS scores can be of meaningful value in the prevention, diagnosis, and treatment of MS at different life stages. Relatedly, this study used a database for 27,748 subjects aged 20 to 64 years who received health checks at a health screening institution in Taiwan from 2010 to 2015 to a similar end. Five components of MS (waist circumference, fasting plasma glucose, blood pressure, fasting triglycerides, and high-density lipoprotein) were used to formulate an MS severity score in different gender and age stratums, which was then used to evaluate the risks of various lifestyle habits. Those estimates were then compared with the results for traditional MS diagnosis. The MS severity scores for some behaviors relating to smoking, drinking, physical activity, and sweetened beverage consumption were found to have changed from 0.03 to 0.2; however, a logistic regression analysis with dichotomous diagnosis did not indicate significant links between these behaviors and MS. The models established by the MS severity scores can identify the risk factors for MS in a more sensitive manner than the traditional MS diagnosis can, especially with respect to specific lifestyle habits. MS severity score can serve as an indicator to explore the potential risk factors for subclinical conditions in the early stages of MS.
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Affiliation(s)
- Chih-Ming Lin
- Department of Healthcare Information and Management, Ming Chuan University, Taoyuan 333, Taiwan
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Wang HH, Lee DK, Liu M, Portincasa P, Wang DQH. Novel Insights into the Pathogenesis and Management of the Metabolic Syndrome. Pediatr Gastroenterol Hepatol Nutr 2020; 23:189-230. [PMID: 32483543 PMCID: PMC7231748 DOI: 10.5223/pghn.2020.23.3.189] [Citation(s) in RCA: 116] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 04/17/2020] [Accepted: 04/21/2020] [Indexed: 02/06/2023] Open
Abstract
The metabolic syndrome, by definition, is not a disease but is a clustering of individual metabolic risk factors including abdominal obesity, hyperglycemia, hypertriglyceridemia, hypertension, and low high-density lipoprotein cholesterol levels. These risk factors could dramatically increase the prevalence of type 2 diabetes and cardiovascular disease. The reported prevalence of the metabolic syndrome varies, greatly depending on the definition used, gender, age, socioeconomic status, and the ethnic background of study cohorts. Clinical and epidemiological studies have clearly demonstrated that the metabolic syndrome starts with central obesity. Because the prevalence of obesity has doubly increased worldwide over the past 30 years, the prevalence of the metabolic syndrome has markedly boosted in parallel. Therefore, obesity has been recognized as the leading cause for the metabolic syndrome since it is strongly associated with all metabolic risk factors. High prevalence of the metabolic syndrome is not unique to the USA and Europe and it is also increasing in most Asian countries. Insulin resistance has elucidated most, if not all, of the pathophysiology of the metabolic syndrome because it contributes to hyperglycemia. Furthermore, a major contributor to the development of insulin resistance is an overabundance of circulating fatty acids. Plasma fatty acids are derived mainly from the triglycerides stored in adipose tissues, which are released through the action of the cyclic AMP-dependent enzyme, hormone sensitive lipase. This review summarizes the latest concepts in the definition, pathogenesis, pathophysiology, and diagnosis of the metabolic syndrome, as well as its preventive measures and therapeutic strategies in children and adolescents.
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Affiliation(s)
- Helen H. Wang
- Department of Medicine and Genetics, Division of Gastroenterology and Liver Diseases, Marion Bessin Liver Research Center, Einstein-Mount Sinai Diabetes Research Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Dong Ki Lee
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Min Liu
- Department of Pathology and Laboratory Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Piero Portincasa
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari Medical School, Bari, Italy
| | - David Q.-H. Wang
- Department of Medicine and Genetics, Division of Gastroenterology and Liver Diseases, Marion Bessin Liver Research Center, Einstein-Mount Sinai Diabetes Research Center, Albert Einstein College of Medicine, Bronx, NY, USA
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Perng W, Hockett CW, Sauder KA, Dabelea D. In utero exposure to gestational diabetes mellitus and cardiovascular risk factors in youth: A longitudinal analysis in the EPOCH cohort. Pediatr Obes 2020; 15:e12611. [PMID: 31920001 PMCID: PMC8311655 DOI: 10.1111/ijpo.12611] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 10/21/2019] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To examine associations of maternal gestational diabetes mellitus (GDM) with offspring cardiovascular biomarkers from late childhood through adolescence. METHODS We used mixed effects linear regression models to examine associations of maternal GDM (n = 92 cases of 597) with average offspring levels of serum lipids (total cholesterol, high-density lipoprotein [HDL], low-density lipoprotein [LDL], and triglycerides) and systolic blood pressure (SBP) across two research visits spanning approximately 10.6 and 16.9 years of age. In sex-stratified analysis, we evaluated the impact of adjustment for sociodemographic characteristics, pubertal status, physical activity and total energy intake, maternal body mass index (BMI), GDM treatment, and child's BMI. RESULTS After adjusting for child's age, pubertal status, race/ethnicity, and maternal education and smoking, GDM exposure was associated with higher total (0.38 [95% CI, 0.16-0.61] mmol/L) and LDL cholesterol (0.34 [95% CI, 0.14-0.53] mmol/L) in girls. These estimates were robust to adjustment for lifestyle characteristics and maternal BMI but were attenuated after accounting for GDM treatment with no appreciable change following further adjustment for current BMI. In boys, maternal GDM corresponded with 4.50 (1.90-7.10) mmHg higher SBP. This association persisted after accounting for sociodemographic/lifestyle characteristics, maternal BMI, and GDM treatment but was attenuated after adjusting for current BMI. CONCLUSIONS Maternal GDM is related to offspring lipid profile and SBP in a sex-specific manner.
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Affiliation(s)
- Wei Perng
- Lifcourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado,Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado,Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Christine W. Hockett
- Lifcourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Katherine A. Sauder
- Lifcourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado,Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
| | - Dana Dabelea
- Lifcourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado,Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado,Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
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Pacifico L, Perla FM, Andreoli G, Grieco R, Pierimarchi P, Chiesa C. Nonalcoholic Fatty Liver Disease Is Associated With Low Skeletal Muscle Mass in Overweight/Obese Youths. Front Pediatr 2020; 8:158. [PMID: 32351917 PMCID: PMC7174581 DOI: 10.3389/fped.2020.00158] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 03/20/2020] [Indexed: 12/18/2022] Open
Abstract
Background: Recent studies in adult non-elderly and elderly individuals have reported a link between nonalcoholic fatty liver disease (NAFLD) and sarcopenia. Nonetheless, whether this relationship would be found outside these populations it is still unknown. Hence, we evaluated the relationship between NAFLD and skeletal muscle mass in children and adolescents with overweight/obesity. Methods: Two-hundred and thirty-four overweight/obese youths were enrolled. NAFLD was diagnosed by ultrasononography, after exclusion of infectious and metabolic disorders. Forty of the patients with NAFLD had also liver biopsy. Total and regional lean body mass and total fat mass measurements were obtained by dual-energy X-ray absorptiometry. The relative muscle mass (RMM) was defined as the percent of muscle mass (kg) relative to the sum of muscle and fat (kg) mass. Appendicular skeletal muscle mass (ASM) was calculated by the sum of muscle masses of the four limbs (kg), and expressed as percent of body weight. Results: Subjects were stratified according to tertiles of RMM. The prevalence of abdominal obesity, dyslipidemia, insulin resistance, metabolic syndrome, NAFLD as well as biopsy-proven nonalcoholic steatohepatitis (NASH) was significantly increased in the lowest tertile of RMM. After controlling for age, sex and Tanner stage, children in the lowest tertile of RMM had an increased risk for NAFLD (OR= 2.80, 95% CI=1.57-5.02) compared to those in the other two tertiles. This association persisted after additional adjustments for clinical and metabolic variables. Similarly, the risk of NAFLD in the lowest tertile of ASM/weight index was significantly higher compared to those in the other two tertiles after adjustment for the above confounders. Conclusions: This is the first study to establish an independent association between low muscle mass and NAFLD/NASH in overweight/obese youths. Considering the worldwide increase of pediatric obesity, measurements of muscle mass may serve as useful method of identifying among obese children those at high metabolic risk who may need intensive lifestyle interventions to prevent NAFLD and its progression.
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Affiliation(s)
- Lucia Pacifico
- Department of Pediatrics, Sapienza University of Rome, Rome, Italy
| | | | | | - Rosangela Grieco
- Department of Pediatrics, Sapienza University of Rome, Rome, Italy
| | | | - Claudio Chiesa
- Institute of Translational Pharmacology, National Research Council, Rome, Italy
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Maciejczyk M, Taranta-Janusz K, Wasilewska A, Kossakowska A, Zalewska A. A Case-Control Study of Salivary Redox Homeostasis in Hypertensive Children. Can Salivary Uric Acid be a Marker of Hypertension? J Clin Med 2020; 9:E837. [PMID: 32204502 PMCID: PMC7141280 DOI: 10.3390/jcm9030837] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 03/12/2020] [Accepted: 03/18/2020] [Indexed: 12/23/2022] Open
Abstract
Oxidative stress plays a critical role in the pathogenesis of hypertension; however, there are no data on salivary redox homeostasis and salivary gland function in children with hypertension. A total of 53 children with hypertension and age- and sex-matched controls were classified for the study. The antioxidant barrier and oxidative/nitrosative stress were evaluated in non-stimulated (NWS) and stimulated (SWS) whole saliva, plasma, and erythrocytes, with Student's t-test and Mann-Whitney U-test used for statistical analysis. We demonstrated that the activities of superoxide dismutase, catalase, and peroxidase were significantly higher in NWS, SWS, and erythrocytes of children with hypertension, similar to oxidative damage in proteins (advanced glycation end products) and lipids (malondialdehyde) as well as nitrosative stress markers (peroxynitrite and nitrotyrosine). The level of uric acid (UA) was significantly higher in NWS, SWS, and plasma of children with hypertension. UA concentration in SWS correlated positively with systolic and diastolic blood pressure and UA content in plasma. This parameter differentiates children with hypertension from healthy controls (AUC = 0.98) with a high degree of sensitivity (94%) and specificity (94%). Stimulated salivary flow was significantly lower in the hypertension group, similar to total protein content and salivary amylase activity. In summary, childhood hypertension is associated with hyposalivation as well as disturbances in antioxidant defense and enhanced oxidative/nitrosative damage both in the plasma/erythrocytes as well as saliva. Salivary UA may be a potential biomarker of hypertension in children.
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Affiliation(s)
- Mateusz Maciejczyk
- Department of Hygiene, Epidemiology and Ergonomics, Medical University of Bialystok, 2c Mickiewicza Street, 15-233 Bialystok, Poland
| | - Katarzyna Taranta-Janusz
- Department of Pediatrics and Nephrology, Medical University of Bialystok, 24a M. Sklodowskiej-Curie Street, 15-274 Bialystok, Poland; (K.T.-J.); (A.W.)
| | - Anna Wasilewska
- Department of Pediatrics and Nephrology, Medical University of Bialystok, 24a M. Sklodowskiej-Curie Street, 15-274 Bialystok, Poland; (K.T.-J.); (A.W.)
| | - Agnieszka Kossakowska
- Experimental Dentistry Laboratory, Medical University of Bialystok, 24a M. Sklodowskiej-Curie Street, 15-274 Bialystok, Poland; (A.K.); (A.Z.)
| | - Anna Zalewska
- Experimental Dentistry Laboratory, Medical University of Bialystok, 24a M. Sklodowskiej-Curie Street, 15-274 Bialystok, Poland; (A.K.); (A.Z.)
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Klaver M, de Mutsert R, van der Loos MATC, Wiepjes CM, Twisk JWR, den Heijer M, Rotteveel J, Klink DT. Hormonal Treatment and Cardiovascular Risk Profile in Transgender Adolescents. Pediatrics 2020; 145:peds.2019-0741. [PMID: 32102929 DOI: 10.1542/peds.2019-0741] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/02/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The effects of endocrinological treatment on cardiovascular risk profile in transgender adolescents are unknown. In this retrospective cohort study, we aim to investigate these effects and assess obesity and dyslipidemia prevalence in transgender adolescents at 22 years compared with peers. METHODS Changes in BMI, systolic blood pressure (SBP), diastolic blood pressure (DBP), glucose, homeostatic model assessment for insulin resistance (HOMA-IR), and lipid values during treatment, along with the prevalence of obesity and dyslipidemia at 22 years, were recorded in 71 transwomen and 121 transmen who started gonadotropin-releasing hormone agonists in their adolescence (15 years), with a subsequent addition of sex hormones (17 years). RESULTS In transwomen, changes in BMI (+3.0; 95% confidence interval [CI] 1.6 to 4.4), SBP (-2 mm Hg; 95% CI -7 to 3), DBP (+10 mm Hg; 95% CI 7 to 14), glucose (0.0 mmol/L; 95% CI -0.2 to 0.2), HOMA-IR (+0.6; 95% CI -0.6 to 1.9), and lipid values were similar or more favorable compared with peers. The same was true for transmen regarding changes in BMI (+2.3; 95% CI 1.7 to 2.9), SBP (+7 mm Hg; 95% CI 3 to 10), DBP (+7 mm Hg; 95% CI 5 to 10), glucose (+0.1 mmol/L; 95% CI -0.1 to 0.3), HOMA-IR (-0.2; 95% CI -0.8 to 0.3), and lipid values. At age 22, obesity prevalence was 9.9% in transwomen, 6.6% in transmen, 2.2% in ciswomen, and 3.0% in cismen. CONCLUSIONS Generally, endocrinological treatment in transgender adolescents is safe regarding cardiovascular risk. Because obesity is more prevalent in transgender adolescents compared with peers, body weight management should be important during the medical trajectory.
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Affiliation(s)
- Maartje Klaver
- Amsterdam University Medical Center, Amsterdam, Netherlands
| | | | | | | | - Jos W R Twisk
- Amsterdam University Medical Center, Amsterdam, Netherlands
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Clinical and metabolic effect of a multidisciplinary intervention through a comprehensive care program for children and adolescents with obesity. ACTA ACUST UNITED AC 2020; 40:166-184. [PMID: 32220172 PMCID: PMC7357374 DOI: 10.7705/biomedica.4593] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Indexed: 11/25/2022]
Abstract
Introducción. La obesidad infantil requiere una atención con programas multidisciplinarios que integren todas sus dimensiones. Objetivo. Describir los cambios clínicos y metabólicos en pacientes con obesidad después de su participación en un programa de atención integral en obesidad infantil. Materiales y métodos. Se hizo un estudio observacional y analítico retrospectivo de una cohorte de pacientes de 6 a 17 años de edad atendidos en el programa de obesidad del Hospital Universitario de San Vicente Fundación (2012-2015), el cual incluyó la atención multidisciplinaria y una intervención educativa. Se evaluaron variables antropométricas y de laboratorio en el momento del ingreso al programa y en la última evaluación. Se exploraron las diferencias según el tiempo de seguimiento. Resultados. Se evaluaron 53 pacientes con una edad promedio de 11 ± 2 años, 52,8 % de los cuales eran hombres. El seguimiento de los pacientes fue de 18 ± 6 meses, aunque en el 30 % de ellos fue de 31 a 36 meses. Se encontró una disminución del índice de masa corporal (IMC; puntaje Z) entre el ingreso (2,75 ± 0,58) y el último control (2,32 ± 0,63) con un valor de p de 0,000 (IC95% 0,27-0,58). El 79,25 % de los pacientes redujo el puntaje Z del IMC. Esta disminución fue significativa independientemente del tiempo de seguimiento. La proporción de pacientes con un puntaje Z del IMC mayor de 3 pasó del 33,4 al 14,6 %. El número de criterios positivos para el síndrome metabólico disminuyó en el seguimiento. Los niveles de triglicéridos y de hemoglobina A1c (HbA1c) mejoraron significativamente. Conclusiones. El manejo de la obesidad infantil con una intervención multidisciplinaria asociada a apoyo educativo grupal continuo puede influir significativamente en los cambios clínicos y metabólicos. Es necesario prolongar el tiempo de seguimiento para prevenir las recaídas.
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Perng W, Rifas-Shiman SL, Sordillo J, Hivert MF, Oken E. Metabolomic Profiles of Overweight/Obesity Phenotypes During Adolescence: A Cross-Sectional Study in Project Viva. Obesity (Silver Spring) 2020; 28:379-387. [PMID: 31876390 PMCID: PMC6980913 DOI: 10.1002/oby.22694] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 09/21/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The purpose of this article is to characterize metabolomic profiles of four overweight/obesity (OWOB) and metabolic risk (MetRisk) phenotypes among 524 adolescents aged approximately 13 years. METHODS A four-level phenotype variable (non-OWOB and low MetRisk, non-OWOB and high MetRisk, OWOB and low MetRisk, and OWOB and high MetRisk) was created using BMI percentile to define OWOB, and high versus low MetRisk was derived as the fourth versus first to third quartiles of a z score calculated as the average of five externally standardized z scores for waist circumference, homeostatic model assessment of insulin resistance, high-density lipoprotein, triglycerides, and systolic blood pressure. Then associations of nine metabolite patterns derived from principal components analysis with phenotype after accounting for age, sex, race, and pubertal status were evaluated. RESULTS Five metabolite patterns differed with respect to phenotype: factor 1 consisted of long-chain fatty acids and was lower among non-OWOB and high MetRisk (-0.90 [95% CI: -1.39 to -0.42]) versus non-OWOB and low MetRisk (referent); factors 5 (branched-chain amino acids), 8 (diacylglycerols), and 9 (steroid hormones) were highest among OWOB and high MetRisk; and factor 7 (long-chain acylcarnitines) was higher among non-OWOB and high MetRisk (0.47 [95% CI: 0.04 to 0.91]) and lower among OWOB and low MetRisk (-0.36 [95% CI: -0.68 to -0.04]). CONCLUSIONS Long-chain fatty acids, branched-chain amino acids, acylcarnitines, diacylglycerols, and steroid hormones differed by weight status and metabolic phenotype.
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Affiliation(s)
- Wei Perng
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
| | - Sheryl L Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Joanne Sordillo
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, MA, USA
- Diabetes Unit, Massachusetts General Hospital, Boston, MA
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, MA, USA
- Diabetes Unit, Massachusetts General Hospital, Boston, MA
- Department of Nutrition, T. H. Chan Harvard School of Public Health, Boston, MA, USA
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Pacifico L, Perla FM, Tromba L, Carbotta G, Lavorato M, Pierimarchi P, Chiesa C. Carotid Extra-Media Thickness in Children: Relationships With Cardiometabolic Risk Factors and Endothelial Function. Front Endocrinol (Lausanne) 2020; 11:574216. [PMID: 33071981 PMCID: PMC7541844 DOI: 10.3389/fendo.2020.574216] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 08/25/2020] [Indexed: 12/26/2022] Open
Abstract
Background: Emerging evidence suggests that structural adventitial modifications and perivascular adipose tissue (PAT) may have a role in early atherogenesis. In a cohort of children and adolescents, we explored (1) the association of carotid extra-media thickness (cEMT), an ultrasound measure whose main determinants are arterial adventitia and PAT, with obesity and its cardiometabolic complications; and (2) the interplay between cEMT and endothelial function. Methods: The study participants included 286 youths (age, 6-16 years; 154 boys, and 132 girls). Anthropometric and laboratory parameters, liver ultrasound, vascular structure measures [cEMT and carotid intima-media thickness (cIMT)], endothelial function [brachial artery flow-mediated dilation (FMD)] were obtained in all subjects. Non-alcoholic fatty liver disease (NAFLD) was diagnosed in the presence of hepatic fat on ultrasonography, in the absence of other causes of liver disease. Diagnosis of metabolic syndrome (MetS) was established on the basis of three or more of the following cardiovascular disease (CVD) risk variables: abdominal obesity, high triglycerides, low high-density lipoprotein cholesterol, elevated blood pressure (BP), and impaired fasting glucose. Results: cEMT demonstrated significant associations with body-mass index (BMI) and waist circumference (WC), BP, insulin resistance, NAFLD, and inflammation. No association was found between cEMT and lipid values, and between cEMT and MetS. A stepwise multivariate linear regression analysis indicated that WC (β coefficient, 0.35; P < 0.0001) was the only determinant of cEMT, independently of other major cardiometabolic risk factors. Further adjustment for cIMT did not significantly alter this association. FMD was correlated to age, Tanner stage, total and abdominal obesity, BP, NAFLD, and cEMT. The association between FMD and cEMT was independent of age, sex, Tanner stage, WC, and BMI (β coefficient, -0.14; P = 0.027). After controlling for CVD risk factors and basal brachial artery diameter, cEMT remained associated with FMD (β coefficient, -0.11; P = 0.049). Conclusions: In youths, cEMT is associated with abdominal fat, a well-established body fat depot with important implications for cardiovascular diseases. Furthermore, cEMT is related to FMD, suggesting that arterial adventitia and PAT may be involved in the early changes in endothelial function.
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Affiliation(s)
- Lucia Pacifico
- Department of Mother and Child Health, Sapienza University of Rome, Rome, Italy
- *Correspondence: Lucia Pacifico
| | | | - Luciana Tromba
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | - Giovanni Carbotta
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | - Michela Lavorato
- Department of Mother and Child Health, Sapienza University of Rome, Rome, Italy
| | | | - Claudio Chiesa
- Institute of Translational Pharmacology, National Research Council, Rome, Italy
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Saland JM, Kupferman JC, Pierce CB, Flynn JT, Mitsnefes MM, Warady BA, Furth SL. Change in Dyslipidemia with Declining Glomerular Filtration Rate and Increasing Proteinuria in Children with CKD. Clin J Am Soc Nephrol 2019; 14:1711-1718. [PMID: 31712386 PMCID: PMC6895497 DOI: 10.2215/cjn.03110319] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 10/09/2019] [Indexed: 01/12/2023]
Abstract
BACKGROUND AND OBJECTIVES Dyslipidemia, a risk factor for cardiovascular disease, is common in CKD but its change over time and how that change is influenced by concurrent progression of CKD have not been previously described. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS In the CKD in Children study we prospectively followed children with progressive CKD and utilized multivariable, linear mixed-effects models to quantify the longitudinal relationship between within-subject changes in lipid measures (HDL cholesterol, non-HDL cholesterol, triglycerides) and within-subject changes in GFR, proteinuria, and body mass index (BMI). RESULTS A total of 508 children (76% nonglomerular CKD, 24% glomerular CKD) had 2-6 lipid measurements each, with a median follow-up time of 4 (interquartile range [IQR], 2.1-6.0) years. Among children with nonglomerular CKD, dyslipidemia was common at baseline (35%) and increased significantly as children aged; 43% of children with glomerular CKD had dyslipidemia at baseline and demonstrated persistent levels as they aged. Longitudinal increases in proteinuria were independently associated with significant concomitant increases in non-HDL cholesterol (nonglomerular: 4.9 [IQR, 3.4-6.4] mg/dl; glomerular: 8.5 [IQR, 6.0-11.1] mg/dl) and triglycerides (nonglomerular: 3% [IQR, 0.8%-6%]; glomerular: 5% [IQR, 0.6%-9%]). Decreases in GFR over follow-up were significantly associated with concomitant decreases of HDL cholesterol in children with nonglomerular CKD (-1.2 mg/dl; IQR, -2.1 to -0.4 mg/dl) and increases of non-HDL cholesterol in children with glomerular CKD (3.9 mg/dl; IQR, 1.4-6.5 mg/dl). The effects of increased BMI also affected multiple lipid changes over time. Collectively, glomerular CKD displayed stronger, deleterious associations between within-subject change in non-HDL cholesterol (9 mg/dl versus 1.2 mg/dl; P<0.001) and triglycerides (14% versus 3%; P=0.004), and within-subject change in BMI; similar but quantitatively smaller differences between the two types of CKD were noted for associations of within-subject change in lipids to within-subject change in GFR and proteinuria. CONCLUSIONS Dyslipidemia is a common and persistent complication in children with CKD and it worsens in proportion to declining GFR, worsening proteinuria, and increasing BMI.
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Affiliation(s)
- Jeffrey M Saland
- Division of Pediatric Nephrology, Icahn School of Medicine at Mount Sinai, New York, New York;
| | - Juan C Kupferman
- Division of Pediatric Nephrology, Maimonides Medical Center, Brooklyn, New York
| | - Christopher B Pierce
- Division of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Joseph T Flynn
- Department of Pediatrics, University of Washington, Seattle, Washington.,Division of Nephrology, Seattle Children's Hospital, Seattle, Washington
| | - Mark M Mitsnefes
- Division of Pediatric Nephrology, Cincinnati Children's Hospital, Cincinnati, Ohio
| | - Bradley A Warady
- Division of Pediatric Nephrology, Children's Mercy Kansas City, Kansas City, Missouri
| | - Susan L Furth
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; and.,Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
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Warner M, Rauch S, Ames J, Mocarelli P, Brambilla P, Signorini S, Eskenazi B. In utero dioxin exposure and cardiometabolic risk in the Seveso Second Generation Study. Int J Obes (Lond) 2019; 43:2233-2243. [PMID: 30659254 PMCID: PMC6639155 DOI: 10.1038/s41366-018-0306-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 11/08/2018] [Accepted: 12/06/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND/OBJECTIVES In utero exposure to endocrine-disrupting compounds such as 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) may alter risk of obesity and related metabolic disease later in life. We examined the relationship of prenatal exposure to TCDD with obesity and metabolic syndrome (MetS) in children born to a unique cohort of TCDD-exposed women resulting from a 1976 explosion in Seveso, Italy. SUBJECTS/METHODS In 2014, nearly 40 years after the explosion, we enrolled 611 post-explosion offspring, 2 to 39 years of age, in the Seveso Second Generation Study. In utero TCDD exposure was defined primarily as TCDD concentration measured in maternal serum collected soon after the explosion and alternately as TCDD estimated at pregnancy. We measured height, weight, waist circumference, body fat, blood pressure, and fasting blood levels of lipids and glucose, which were combined to assess body mass index (BMI) and MetS. RESULTS Children (314 female, 297 male) averaged 23.6 (±6.0) years of age. Among the 431 children ≥18 years, a 10-fold increase in initial maternal TCDD concentration was inversely associated with BMI in daughters (adj-β = -0.99 kg/m2; 95% CI -1.86, -0.12), but not sons (adj-β = 0.41 kg/m2; 95% CI -0.35, 1.18) (p-int = 0.02). A similar relationship was found in the younger children (2-17 years); a 10-fold increase in initial maternal TCDD was inversely associated with BMI z-score (adj-β = -0.59 kg/m2; 95% CI -1.12, -0.06) among daughters, but not sons (adj-β = 0.04 kg/m2; 95% CI -0.34, 0.41) (p-int = 0.03). In contrast, in sons only, initial maternal TCDD was associated with increased risk for MetS (adj-RR = 2.09, 95% CI 1.09, 4.02). Results for TCDD estimated at pregnancy were comparable. CONCLUSIONS These results suggest prenatal TCDD exposure alters cardiometabolic endpoints in a sex-specific manner. In daughters, in utero TCDD is inversely associated with adiposity measures. In sons, in utero TCDD is associated with increased risk for MetS.
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Affiliation(s)
- Marcella Warner
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California at Berkeley, Berkeley, CA, USA.
| | - Stephen Rauch
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California at Berkeley, Berkeley, CA, USA
| | - Jennifer Ames
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California at Berkeley, Berkeley, CA, USA
| | - Paolo Mocarelli
- Department of Laboratory Medicine, School of Medicine, Hospital of Desio, University of Milano-Bicocca, Desio-Milano, Italy
| | - Paolo Brambilla
- Department of Laboratory Medicine, School of Medicine, Hospital of Desio, University of Milano-Bicocca, Desio-Milano, Italy
| | - Stefano Signorini
- Department of Laboratory Medicine, School of Medicine, Hospital of Desio, University of Milano-Bicocca, Desio-Milano, Italy
| | - Brenda Eskenazi
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California at Berkeley, Berkeley, CA, USA
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Teo KK, Rafiq T, Anand SS, Schulze KM, Yusuf S, McDonald SD, Wahi G, Abdalla N, Desai D, Atkinson SA, Morrison KM. Associations of cardiometabolic outcomes with indices of obesity in children aged 5 years and younger. PLoS One 2019; 14:e0218816. [PMID: 31276512 PMCID: PMC6611590 DOI: 10.1371/journal.pone.0218816] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 06/10/2019] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Childhood obesity is a world-wide concern due to its growing prevalence and association with cardiometabolic risk factors in childhood and subsequent adult cardiovascular disease. In young pre-school children, there is uncertainty regarding which of the commonly used anthropometric measures of childhood obesity is best associated with cardiometabolic risk factors. This study compared the utility of common measures used in identifying obesity in these young children. METHODS The four commonly used metrics for identifying obesity in children: body fat percentage ≥ 90th percentile, waist circumference ≥ 90th percentile, BMI z score > 2 SD and waist-to-height ratio (WHtR) ≥ 0.5, were measured in a cohort of children born singleton, at full term and followed from birth (n = 761) to 5 years of age (n = 513). The utility of each in identifying cardiometabolic risk factors (fasting lipid profile, fasting blood glucose and blood pressure) was examined. RESULTS At age 5 years, children with percent body fat ≥ 90th percentile or waist circumference ≥ 90th percentile, were associated with higher levels of triglycerides, glucose, and systolic and diastolic blood pressures than those < 90th percentile, respectively. Such differences were not obvious at age 3 years or at birth. A BMI z-score > 2 SD was associated with higher levels of triglycerides and systolic and diastolic blood pressure but not glucose at age 5 years. Differences in HDL cholesterol, fasting glucose and systolic blood pressure were observed in children with BMI z score > 2 SD at age 3 years but not with the other indices of obesity. As almost all children had WHtR ≥ 0.5 at birth, ages 1 and 3 years, this measure could not differentiate increased cardiometabolic risk. At age 5 years, the differences were much more obvious, with significant differences in triglycerides and systolic and diastolic blood pressures between those with WHtR ≥ 0.5 and those with < 0.5. CONCLUSION Each of the four commonly used measures of childhood obesity shows moderate associations with cardiometabolic risk factors at 5 years, with no advantage of one measure over the other. These associations were less consistent at 3 years of age or younger. These observations have not been reported previously.
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Affiliation(s)
- Koon K. Teo
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- * E-mail:
| | - Talha Rafiq
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Sonia S. Anand
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Chanchlani Research Centre, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
| | - Karleen M. Schulze
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Salim Yusuf
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Sarah D. McDonald
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Obstetrics & Gynecology, McMaster University, Hamilton, Ontario, Canada
- Department of Radiology, McMaster University, Hamilton, Ontario, Canada
| | - Gita Wahi
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Nora Abdalla
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Dipika Desai
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
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Heyden JCVD, Birnie E, Bovenberg SA, Dekker P, Veeze HJ, Mul D, Aanstoot HJ. Losing Track of Lipids in Children and Adolescents with Type 1 Diabetes: Towards Individualized Patient Care. Exp Clin Endocrinol Diabetes 2019; 129:510-518. [PMID: 31272109 DOI: 10.1055/a-0950-9677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
AIM To assess 1) the prevalence of children and adolescents with type 1 diabetes (T1D) changing from low-risk into borderline-high-risk lipid levels or from borderline-high-risk into high-risk lipid levels ('lose track of lipids') and 2) the power of a risk score including the determinants HbA1c, body mass index (BMI), gender, age, diabetes duration and ethnicity in predicting which patients lose track of lipids. METHODS 651 children and adolescents with T1D were included in this longitudinal retrospective cohort study. Lipid dynamics and the impact of the risk score on losing track of lipids were evaluated. Kaplan-Meier analysis was used to estimate screening intervals. RESULTS 31-43% percent of the patients had lost track of one or more lipids at the next lipid measurement. This happened more frequently in patients with a low-risk lipid level at start. Depending on the lipid parameter, 5% of patients with low-risk lipid levels lost track of lipids after 13-23 months. The risk score based on concomitant information on the determinants was moderately able to predict which patients would lose track of lipids on the short term. CONCLUSIONS A considerable number of children and adolescents with T1D loses track of lipids and does so within a 2-year screening interval. The predictive power of a risk score including age, BMI, gender, HbA1c, diabetes duration and ethnicity is only moderate. Future research should focus on another approach to the determinants used in this study or other determinants predictive of losing track of lipids on the short term.
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Affiliation(s)
- Josine C van der Heyden
- Diabeter, Center for Pediatric and Adolescent Diabetes Care and Research, Rotterdam, The Netherlands.,Department of Pediatrics, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands
| | - Erwin Birnie
- Diabeter, Center for Pediatric and Adolescent Diabetes Care and Research, Rotterdam, The Netherlands.,Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Sarah A Bovenberg
- Diabeter, Center for Pediatric and Adolescent Diabetes Care and Research, Rotterdam, The Netherlands
| | - Pim Dekker
- Diabeter, Center for Pediatric and Adolescent Diabetes Care and Research, Rotterdam, The Netherlands
| | - Henk J Veeze
- Diabeter, Center for Pediatric and Adolescent Diabetes Care and Research, Rotterdam, The Netherlands
| | - Dick Mul
- Diabeter, Center for Pediatric and Adolescent Diabetes Care and Research, Rotterdam, The Netherlands
| | - Henk-Jan Aanstoot
- Diabeter, Center for Pediatric and Adolescent Diabetes Care and Research, Rotterdam, The Netherlands
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Abstract
OBJECTIVE Observational studies have indicated that high levels of serum uric acid are associated with the risk of cardiovascular disease. The aim of the present study is to investigate the association of uric acid with individual cardiometabolic risk factors, as well as their degree of clustering, in overweight and moderate obese youth. METHODS Three hundred and thirty-three Caucasians of both sexes (149 women), from 5-18 years of age from those who underwent an assessment of overweight/obesity. Anthropometric parameters, office and 24-h blood pressure measurements and metabolic profile, including HDL-cholesterol, triglycerides, insulin, HOMA index and uric acid were assessed. RESULTS Uric acid was significantly higher in boys than in girls. A positive significant association between uric acid, and office, daytime and night-time SBP, insulin and triglycerides was observed. When boys and girls were grouped by sex-specific uric acid tertiles, a progressive increment was observed in BMI, BMI z-score and waist circumference as well as fasting insulin and HOMA index. In boys, this was also present in office and ambulatory SBP. Likewise, the number of abnormal metabolic risk factors also increases with the uric acid values and the higher the number of metabolic components the higher the uric acid values. Moreover, in a multiple regression analysis, uric acid was significantly related with male sex, waist circumference, both office and night-time SBP and birth weight. CONCLUSION The present study found a positive association between uric acid and blood pressure, insulin and triglycerides. As uric acid levels increase there is a relevant clustering of metabolic risk factors, whereas elevated blood pressure is the risk factor less frequently present. Further studies need to assess the mechanistic link between uric acid and the cardiometabolic risk factors.
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50
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Nyati LH, Pettifor JM, Norris SA. The prevalence of malnutrition and growth percentiles for urban South African children. BMC Public Health 2019; 19:492. [PMID: 31046727 PMCID: PMC6498578 DOI: 10.1186/s12889-019-6794-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 04/09/2019] [Indexed: 11/12/2022] Open
Abstract
Background Low- and middle-income countries (LMIC) are experiencing a double-burden of malnutrition characterised by high prevalence of both under- and over-nutrition. We set out using data from the mixed-longitudinal Birth-to-Twenty Plus (Bt20+) birth cohort, to evaluate the patterns of malnutrition and growth in a large South African (SA) city by; (i) assessing the prevalence of undernutrition from birth to 5 years of age and overweight and obesity from ages 2 to 21 years in black and white, male and female children, and (ii) determining percentiles for height, weight, BMI, waist and hip circumferences and comparing the centiles to American and Dutch references. Methods Height, weight, waist and hip circumferences were measured on urban black and white SA children from the Bt20+. A total of 3273 children born between April and June 1990 in the Greater Johannesburg Metropolitan area were included in the cohort. Z-scores were derived using the WHO 2006 child growth standards (0–5 years), for defining stunting, underweight and wasting. The International Obesity Task Force (IOTF) references were used to define overweight and obesity. Percentiles were developed using the lambda mu sigma (LMS) method and compared to American and Dutch references. Results Black children were consistently shorter and black males lighter than white children and American references. The prevalence of stunting peaked at 2 years and was significantly higher in males than females and in black than white children. Black females had a greater prevalence of overweight and obesity than black males from 10 to 17 years. The percentiles for black females for weight and BMI were similar to those of South African white and American references but both black and white South African females had lower waist circumferences than American references. Conclusion The growth percentiles show that young South African urban black females are experiencing general but not central obesity due to a secular change which is faster in weight than height. High levels of undernutrition persist alongside high levels of over-nutrition with adolescence being a critical period for the upsurge in obesity in females. Early intervention is needed to combat the rise in obesity. Electronic supplementary material The online version of this article (10.1186/s12889-019-6794-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lukhanyo H Nyati
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, 7 York Rd, Parktown, Johannesburg, 2193, South Africa.
| | - John M Pettifor
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, 7 York Rd, Parktown, Johannesburg, 2193, South Africa
| | - Shane A Norris
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, 7 York Rd, Parktown, Johannesburg, 2193, South Africa
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