Lipid and lipoprotein profiles and prevalence of dyslipidemia in Mexican adolescents

Glycemic Index, Glycemic Load and Dyslipidemia in Adolescents from Chiapas, Mexico

Cardiovascular disease risk throughout the life course is increased by abnormal blood lipid levels in youth. The dietary glycemic index (GI) and glycemic load (GL) during adolescence might be related to abnormal blood lipids. This study aimed to analyze the association between dietary GI, GL and dyslipidemia in adolescents from two marginalized regions of Chiapas, Mexico. A cross-sectional study was conducted with 213 adolescents. Food intake was assessed using 24 h recalls. The association between dyslipidemia and dietary GI or GL was tested by using logistic regression models. Low HDL-c was the most prevalent risk factor (47.4%), followed by hypertriglyceridemia (25.4%). In this population, overall dietary GI was not associated with dyslipidemia. A high dietary GL was associated with 2.39 higher odds of low HDL-c (95% CI: 1.21-4.74) when compared to low GL. Female adolescents with high dietary GL had 3.20 higher odds of hypertriglyceridemia (95% CI: 1.03-9.88), whereas no association was found for males. No associations were observed between overall dietary GL and total cholesterol or LDL-c. In adolescents from urban and rural communities in Chiapas, a high dietary GL was associated with a detrimental effect on HDL-c. In female adolescents, high GL was associated with hypertriglyceridemia.

Obese boys with low concentrations of high-density lipoprotein cholesterol are at greater risk of hepatosteatosis

PURPOSE

Non-alcoholic fatty liver disease (NAFLD) and associated morbidities have become a major public health problem, with a global three-fold increase in incidence among obese children over the last three decades. Although the gold standard for diagnosis of NAFLD is liver biopsy, it is not widely used in children. Imaging techniques, including magnetic resonance imaging (MRI) and ultrasound (US), can provide information on liver fat deposition, however, with variable sensitivity. A number of other predictors are therefore being investigated for pediatric screening and diagnostic purposes. The aim of this study was to assess easily measured parameters to prompt further investigation into NAFLD in obese children.

METHODS

Obese children/adolescents with a body mass index (BMI) percentile > 95 were enrolled in the study (n = 353). After a 12-hour fast, venous glucose, insulin, cholesterol, triglycerides (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and uric acid were measured and a full blood count was performed in all subjects. TG/LDL ratio, AST/platelet ratio index (APRI score), and homeostatic model of assessment for insulin resistance (HOMA-IR) were calculated. All patients underwent an abdominal US examination to assess hepatosteatosis.

RESULTS

Of 353 patients, median age 12.5 (range, 6-17.9) years, 210 patients (59%) had US-proven hepatosteatosis. Female gender reduced the risk of steatosis 2.08-fold (p = 0.005), a one-unit increase in HDL reduced the risk of steatosis 1.02-fold (p = 0.042), and a one-unit increase in BMI led to a 1.11-fold (p = 0.002) increase in the risk of steatosis.

CONCLUSION

Gender, BMI, and HDL were found to be predictors of steatosis. Male patients with low HDL and high BMI are at greater risk of steatosis and should be carefully examined for the presence of NAFLD.

Association of lipid profile and BMI Z-score in southern Iranian children and adolescents

Background Heart disease has been the leading cause of death for decades in the US population. Dyslipidemia is the most important risk factor for cardiovascular disease (CVD), and it often starts during childhood. Methods This cross-sectional study was performed in a growth assessment clinic in the city of Shiraz to determine the relation between body mass index (BMI) and dyslipidemia among children and teenagers aged 2-18 years. Nine hundred and eighty-nine children including 422 boys and 567 girls were selected. Results Adjusted for age and gender, total cholesterol (TC) (r = 0.172, p = 0.000), low-density lipoprotein cholesterol (LDL-c) (r = 0.176, p = 0.000), non-high-density lipoprotein cholesterol (non-HDL-c) (r = 0.227, p = 0.000) and triglycerides (TG) (r = 0.253, p = 0.000) showed a significant positive correlation with BMI Z-score, and HDL-c showed a significant negative correlation with BMI Z-score (r = -0.131, p = 0.000). Adjusted for age and gender, overweight and obese children were 1.882 times more likely to have high TC levels (p = 0.009), 2.236 times more likely to have high non-HDL-c levels (p = 0.000) and 3.176 times more likely to have high TG levels (p = 0.000) in comparison with children who had a healthy weight. Obese children had the highest percentage of isolated TG dyslipidemia (23.1%) and underweight children had the highest percentage of isolated HDL dyslipidemia (15.6%). Conclusions There is a strong link between atherosclerotic cardiovascular disease (ASCVD) and the level of blood lipids and between blood lipids and BMI Z-score. The first step in preventing ASCVD is the reduction of blood lipids, preventing weight gain and loss of extra weight.

Association of change in waist circumference and dyslipidaemia risk: The rural Chinese cohort study

OBJECTIVE

To investigate the association of change in waist circumference (WC) and incidence of dyslipidaemia in a cohort study of a rural Chinese population.

METHODS

Change in WC (ΔWC) was defined as the value at follow-up minus the corresponding value at baseline. Risk of dyslipidaemia associated with ΔWC was assessed by odds ratios and 95% confidence intervals in a logistic regression model, and the odds ratios were transformed to relative risks (RRs).

RESULTS

Among 7691 participants without dyslipidaemia at baseline, 3213 (41.78%) showed dyslipidaemia at 6 year follow-up. Risk of dyslipidaemia was decreased for participants with the first quartile of ΔWC and normal baseline WC (adjusted RR [aRR] = 0.79 [95% confidence interval: 0.64-0.98]) and was increased with the fourth quartile of ΔWC and male gender, age 18 to 30 years, age 31 to 50 years, or normal baseline WC (aRR = 1.55 [1.19-2.03], 2.40 [1.16-4.95], 1.32 [1.06-1.64], and 1.66 [1.35-2.04], respectively). The risk of dyslipidaemia increased with change in WC from normal at baseline to abnormal at follow-up for both genders (aRR = 1.88 [1.39-2.55] for men and 1.60 [1.30-1.97] for women) and decreased with abnormal baseline WC changed to normal WC for women (aRR = 0.61 [0.45-0.83]).

CONCLUSIONS

Dynamic change in waist circumference was closely related to the incidence of dyslipidaemia in a rural Chinese population. Waist circumference reduction could decrease dyslipidaemia risk, whereas WC increase may increase the risk. Interventions to control or reduce WC to within the normal range are important for early prevention of dyslipidaemia.

Exposure to phthalates is associated with lipid profile in peripubertal Mexican youth

Animal models indicate that endocrine disrupting chemicals (EDCs) affect circulating lipid concentrations by interfering with hepatic fatty acid oxidation. Little is known of the relationship between EDC exposure and lipid profile in humans. We measured bisphenol A (BPA) and 9 phthalate metabolites in maternal urine collected at up to three time points during pregnancy as a measure of in utero exposure, and in the child's urine at 8-14 years as a measure of concurrent, peripubertal exposure among 248 participants of a Mexico City pre-birth cohort. We used linear regression to examine relations of BPA and phthalate exposure with peripubertal serum lipids, while also adjusting for child age, sex, and specific gravity. While in utero EDC exposure was not associated with lipid profile, higher concurrent levels of mono-3-carboxypropyl phthalate (MCPP), monoethyl phthalate (MEP), and dibutyl phthalate metabolites (DBP) corresponded with lower total cholesterol and low-density lipoprotein (LDL-C) in boys; e.g., an interquartile range increment in MCPP corresponded with 7.4% (2.0%, 12.8%) lower total cholesterol and 12.7% (3.8%, 21.6%) lower LDL-C. In girls, higher urinary di-2-ethylhexyl phthalate metabolites (ΣDEHP) correlated with lower LDL-C (-7.9% [-15.4%, -0.4%]). Additional longitudinal research is needed to determine whether these associations persist beyond adolescence.

Anthropometric and metabolic indices in assessment of type and severity of dyslipidemia

Background

It has been shown that obesity is associated with increased rates of dyslipidemia. The present work revisits the association between plasma lipid levels and classical indicators of obesity including body mass index (BMI). The significance of various anthropometric/metabolic variables in clinical assessment of type and severity of dyslipidemia was also determined. Recently described body indices, a body shape index (ABSI) and body roundness index (BRI), were also assessed in this context.

Methods

For the present cross-sectional analytical study, the participants (n = 275) were recruited from the patients visiting different health camps. Participants were anthropometrically measured and interviewed, and their fasting intravenous blood was collected. Plasma lipid levels were accordingly determined.

Results

The values for different anthropometric parameters are significantly different between dyslipidemic and non-dyslipidemic participants. Receiver operating characteristics curve analyses revealed that all the tested variables gave the highest area under the curve (AUC) values for predicting hypertriglyceridemia in comparison to other plasma lipid abnormalities. BRI gave slightly higher AUC values in predicting different forms of dyslipidemia in comparison to BMI, whereas ABSI gave very low values.

Conclusions

Several anthropometric/metabolic indices display increased predictive capabilities for detecting hypertriglyceridemia in comparison to any other form of plasma lipid disorders. The capacity of BRI to predict dyslipidemia was comparable but not superior to the classical indicators of obesity, whereas ABSI could not detect dyslipidemia.

Electronic supplementary material

The online version of this article (doi:10.1186/s40101-017-0134-x) contains supplementary material, which is available to authorized users.

Serum Lipid Profile, Prevalence of Dyslipidaemia, and Associated Risk Factors Among Northern Mexican Adolescents

BACKGROUND

The increase in overweight and obese children and adolescents may be linked to increased rates of dyslipidaemia. The aim was to assess the serum lipid profile, the prevalence of dyslipidaemia, and associated risk factors among the North Mexican adolescent population.

METHODS

Two hundred and ninety-three subjects (47.8% girls) ages 11 to 16 years took part in the Nuevo León State Survey of Nutrition and Health 2011-2012. According to the 2011 Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents, dyslipidaemia was defined as a presence of ≥1 of the following levels (mg/dL): Total cholesterol ≥200, low-density lipoprotein cholesterol ≥130, non-high-density lipoprotein cholesterol <40, and triglyceride ≥130.

RESULTS

The overall frequency of dyslipidaemia was 48.8% with no differences between sexes. Adolescents with high body mass index were more likely to have at least 1 abnormal lipid level (overweight: odds ratio [OR]: 2.07; 95% confidence interval [CI]: 1.14-3.77, P < 0.05; obesity: OR: 2.21, 95% CI: 1.11-4.41, P < 0.05) than those with normal weight. Abdominally subjects with obesity were also more likely to have at least 1 abnormal lipid level (OR: 2.30; 95% CI: 1.35-3.91, P < 0.01) than their leaner counterparts.

CONCLUSIONS

Half of Mexican adolescents living in the State of Nuevo León have at least 1 abnormal lipid concentration. Low HDL-chol level was the most common dyslipidaemia. Body mass index and abdominal obesity were associated with the prevalence of at least 1 abnormal lipid level.

Leptin and metabolic syndrome in patients with Duchenne/Becker muscular dystrophy

OBJECTIVES

To determine whether patients with Duchenne/Becker muscular dystrophy (DMD/BMD) have components of metabolic syndrome (MetSy) and to evaluate whether leptin is associated with components of MetSy.

METHODS

This study included 78 patients (nine, <6 years of age; 54, 6 to <16 years of age; and 15 patients, ≥16 years of age). Obesity and body fat mass were determined by waist circumference and dual-energy X-ray absorptiometry, respectively. A 12-h fasting blood sample was collected in the morning. Patients were categorized into four groups according to the number of criteria for MetSy: group 0: none; group 1: one; group 2: two and group 3: three or more criteria.

RESULTS

All age groups showed components of MetSy. The concentration of these components was significantly higher in patients ≥16 years old. The prevalence of hypertriglyceridemia was from ~37% to 46% in all age groups. The prevalence of MetSy was 7.1% for patients from 6 to <16 years of age and 24% for patients ≥16 years of age. Serum leptin levels increased significantly (P < 0.05) with age; the highest (13.43 ± 9.4 ng/ml) value was observed in patients >16 years of age. Total leptin was correlated with the number of patients with MetSy (r = 0.383; P = 0.001).

CONCLUSIONS

Components of MetSy are significant in patients with DMD/BMD. A high prevalence of hypertriglyceridemia was observed. Younger patients with DMD/BMD have risk factors for MetSy. Although leptin increased according to different degrees of MetSy, this relation disappeared when the body fat was corrected by leptin; therefore, the association could be caused by a common risk factor-fat.

Dyslipidemia Prevalence in Iranian Adult Men: The Impact of Population-Based Screening on the Detection of Undiagnosed Patients

Purpose

Dyslipidemia has been established as one of the most important modifiable risk factors for cardiovascular disease. Due to the higher prevalence of dyslipidemia in males, this study aimed to estimate the prevalence of dyslipidemia in Iranian urban men.

Materials and Methods

A screening program was conducted in 845 Iranian men 25 years of age and older in 2014. A health interview survey was conducted to evaluate the prevalence of self-reported dyslipidemia and to collect demographic data, as well as serum lipid profile screening by a reference laboratory. Lipoprotein levels was categorized based on the Adult Treatment Panel III criteria and the data were analyzed using the chi-square test and analysis of variance.

Results

The overall prevalence of dyslipidemia was 51.8%, and the prevalence of various forms of dyslipidemia was as follows: hypercholesterolemia (≥240 mg/dL), 11.4%; hyper-low-density lipoprotein cholesterol (≥160 mg/dL), 9.6%; hypertriglyceridemia (≥200 mg/dL), 25%; and hypo-high-density lipoprotein (HDL) cholesterol (<40 mg/dL), 34.3%. With the exception of hypo-HDL, all forms of dyslipidemia were significantly less common in men over 65 years of age (p<0.05).

Conclusions

The prevalence of hypo-HDL and hypertriglyceridemia was higher than expected in Iranian adult men, with half of men 25 years of age and older affected by at least one form of dyslipidemia. A large gap in primary and secondary care was observed, because nearly 80% of patients with dyslipidemia were unaware of their status. Urgent preventive programs and lifestyle changes are necessary to reduce the prevalence of cardiovascular risk factors.

Serum lipid levels and dyslipidaemia prevalence among 2-10 year-old Northern Mexican children

Background and Aims

The increase in overweight and obese children may be linked to increased rates of dyslipidaemia. The aim was to assess the prevalence of dyslipidaemia and associated risk factors among the Northern Mexican child population.

Methods and Results

Four hundred and fifty-one subjects aged between 2 and 10 (47.5% girls) took part in the Nuevo León State Survey of Nutrition and Health 2011–2012. According to the 2011 Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents, serum lipid levels (mg/dL) were categorized into three subgroups (acceptable, borderline-high/low or high/low) as follows: TChol: acceptable <170, borderline-high 170–199, high ≥200; LDL-chol: acceptable <110, borderline-high 110–129, high ≥130; non-HDL-chol: acceptable <120, borderline-high 120–144, high ≥145; HDL-chol: acceptable >45, borderline-low 40–45, low <40; and TG: acceptable <75, borderline-high 75–99, high ≥100 in ≤9 year-old children, and acceptable <90, borderline-high 90–129, and high ≥130 in 10 year-old children. The overall prevalence of borderline-high + high TG, non-HDL-chol, TChol, and LDL-chol was 63.0%, 44.1%, 43.5%, and 29.9%, respectively. The overall prevalence of borderline-low + low HDL-chol was 46.3%. The overall frequency of dyslipidaemia was 54.3%. Thirteen children (2.9%) had all five symptoms of dyslipidaemia. The most common dyslipidaemia was high TG in combination (26.2%) and in isolation (10.6%).

Conclusions

Half of the children had at least one abnormal lipid concentration. A high TG level was the most frequent dyslipidaemia. Obesity was associated with the occurrence of at least one abnormal lipid level. These findings emphasize the need to pay further attention to the prevention of cardiovascular disease and obesity from an early age.

The association between dyslipidemia and anthropometric indicators in black and white adolescents residing in Tlokwe Municipality, North-West Province, South Africa: the PAHL study

BACKGROUND

The dyslipidemia associated with excess weight is a risk for cardiovascular disease. Worldwide and in South Africa adolescent obesity has been reported.

OBJECTIVES

To determine the association between dyslipidemia and anthropometric indices in black and white adolescents.

METHODS

The study involved 129 black and 69 white adolescents aged 12 to 16 years. Data collected included height, weight, waist circumference (WC) and skinfolds, blood pressure and blood for glucose, insulin, total cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL), triglycerides (Trig) and C - reactive protein (CRP).

RESULTS

WC correlated negatively with HDL in both blacks (p=0.042) and whites (p=0.008) and in whites it correlated positively with LDL (p=0.006); TC/HDL (p=<0.001) and LDL/HDL ratio (p<0.0001). WC/Hgt correlated negatively with HDL (p=0.028) and positively with LDL/HDL (p=0.026 and p<0.0001) in both races. In whites positive correlations were between WC/Hgt and TC (p=0.049); LDL (p=0.003) and TC/HDL (p<0.0001). BAZ correlated positively with TC/HDL ratio (p=0.004) and LDL/HDL ratio (p=0.002). The most common abnormalities were HDL and LDL.

CONCLUSION

Whites exhibited more associations between dyslipidemia and anthropometric indicators as compared to Blacks, suggesting that there might be differences in the lipid metabolism or even susceptibility to risk factors in adolescents.

Effect of childhood obesity prevention programmes on blood lipids: a systematic review and meta-analysis

We aimed to assess the effects of childhood obesity prevention programmes on blood lipids in high-income countries. We searched MEDLINE®, Embase, PsychInfo, CINAHL®, clinicaltrials.gov, and the Cochrane Library up to 22 April 2013 for relevant randomized controlled trials, quasi-experimental studies and natural experiments published in English. Studies were included if they implemented diet and/or physical activity intervention(s) with ≥1 year follow-up (or ≥6 months for school-based intervention studies) in 2-18-year-olds, and were excluded if they targeted only overweight/obese children, or those with a pre-existing medical condition. Seventeen studies were finally included. For total cholesterol, the pooled intervention effect was -0.97 mg dL(-1) [95% confidence interval (CI): -3.26, 1.32; P = 0.408]; for low-density lipoprotein cholesterol (LDL-C), -6.06 mg dL(-1) (95% CI: -11.09, -1.02; P = 0.018); for high-density lipoprotein cholesterol (HDL-C), 1.87 mg dL(-1) (95% CI: 0.39, 3.34; P = 0.013); and for triglycerides, -1.95 mg dL(-1) (95% CI: -4.94, 1.04; P = 0.202). Most interventions (70%) showed similar significant or no effects on adiposity- and lipids outcomes: 15% interventions improved both adiposity- and lipids outcomes; 55% had no significant effects on either. Childhood obesity prevention programmes had a significant desirable effect on LDL-C and HDL-C. Two-thirds of interventions showed similar significant or no effects in adiposity- and lipids outcomes. Assessing lipids outcomes provide additional useful information on obesity prevention programme benefits.

Prevalence of dyslipidaemia and associated risk factors among Balearic Islands adolescents, a Mediterranean region

BACKGROUND/OBJECTIVES

The increase in overweight and obese children and adolescents may be linked to increased rates of dyslipidaemia. The aim was to assess the prevalence of dyslipidaemia and associated risk factors among the Balearic Islands' adolescent population.

SUBJECTS/METHODS

A random sample (n=362, 143 boys and 219 girls, aged 12-17 years) was interviewed, anthropometrically measured and fasting blood samples taken. According to the 2011 Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents, dyslipidaemia was defined as the presence of one or more of the following levels (mg/dl): total cholesterol (TChol)⩾200, low-density lipoprotein cholesterol (LDL-chol)⩾130, non-high-density lipoprotein cholesterol (non-HDL-chol)⩾145, high-density lipoprotein cholesterol (HDL-chol)<40 and tryglicerides (TG)⩾130.

RESULTS

The overall prevalence of borderline-high+high TChol, LDL-chol, non-HDL-chol and TG was 24.3, 10.4, 13.3 and 14.9%, respectively. The TChol prevalence was higher among girls (27.8%) than the boys (19.1%). The overall prevalence of borderline-low+low HDL-chol was 12.2% (boys 20.7%; girls 6.3%). The overall prevalence of dyslipidaemia was 13.7% (boys 14.9%; girls 12.9%). Low HDL-chol levels were the most prevalent dyslipidaemia in boys (6.4%) and high TChol in girls (9.1%). Overweight/obese subjects were more likely to have at least one abnormal lipid concentration (odds ratio (OR): 2.10; 95% confidence interval (CI): 1.06-4.15) and subjects with abdominal obesity were more likely to have at least one abnormal lipid level (OR: 3.17; 95% CI: 1.04-9.66).

CONCLUSIONS

One in ten Balearic Islands' adolescents has at least one abnormal lipid concentration. Body mass index status and waist-to-height ratio were associated with the prevalence of at least one abnormal lipid level.

Factors affecting carotid intima media thickness predicts early atherosclerosis in overweight and obese adolescents

SUMMARY

OBJECTIVE

Aims of this study were to compare serum leptin levels, atherosclerotic markers and carotid intima media thickness (IMT) among the overweight, obese and normal weight healthy adolescents and to investigate the association of carotid IMT with leptin and atherosclerotic markers in adolescence.

METHODS

Seventy obese-overweight adolescents (27 of them obese, 43 of them overweight) and 72 two normal weight adolescents aged 14-18 years were included in this study. Leptin and homocysteine levels and lipid profiles were determined and carotid IMT were measured in all adolescents. Subjects were evaluated as obese-overweight and normal weight and obese, overweight and normal weight.

RESULTS

Carotid IMT was significantly different among the overweight adolescents, obese adolescents and the control group (p < 0.001). Leptin levels were significantly higher in obese-overweight adolescents compared to the control group (p < 0.001). Apolipoprotein (Apo) B levels were significantly higher in obese adolescents than the overweight ones and the control group (p < 0.016). There were significantly positive correlations of carotid IMT with leptin, homocysteine and Apo B levels (p < 0.05, r = 0.33, 0.28, 021, respectively). The factors associated with carotid IMT were leptin and ApoB levels (β = 0.632, p < 0.04, β = 0.264, p = 0.019, respectively).

CONCLUSION

Subclinical atherosclerosis determined by carotid IMT begins in overweight adolescents. Elevated leptin and Apo B levels are independent predictors of subclinical atherosclerosis. Leptin resistance, which is related to subclinical atherosclerosis, also begins in overweight adolescents. High Apo B levels, which promote development of atherosclerosis are more prominent in obese adolescents than other groups. For these reasons, all necessary precautions should be taken in overweight adolescents to prevent atherosclerosis as well as in obese adolescents.

Omega-3 polyunsaturated fatty acids reduce insulin resistance and triglycerides in obese children and adolescents

BACKGROUND

Approximately 50% of obese children are insulin resistant. It has been suggested that pharmacological and nutritional options should be considered to improve the management of insulin resistance (IR).

OBJECTIVE

To assess the effect of metformin (Met) or omega-3 (ω-3) polyunsaturated fatty acids (PUFA) on the homeostasis model assessment-estimated insulin resistance (HOMA-IR) index, lipid profile, and body mass index (BMI) of obese children.

METHODS

We included 201 obese and insulin-resistant children and adolescents. Ninety-eight of them received 500 mg of Met, and 103 received 1.8 g of ω-3 PUFA for 12 wk. This was an open-label study with assignment of treatment based on which school the child attended. At the baseline and at the end of study, the following parameters were measured: weight, height, waist circumference, blood pressure, insulin, glucose, lipid profile, and HOMA-IR index. There were no lifestyle interventions.

RESULTS

At baseline, the age, BMI, and IR in children of both groups were comparable. The treatment assigned for each group was well tolerated. Metabolic changes were adjusted for age, sex, and change in BMI. Concerning the IR profile at the end of intervention, ω-3 significantly decreased the concentrations of glucose and insulin while reducing HOMA-IR values; meanwhile, Met negligibly affected insulin levels. Regarding lipids, Met increased high density lipoprotein cholesterol (HDL-C) and decreased low density lipoprotein cholesterol (LDL-C), but triglycerides were not affected; in contrast, triglycerides were decreased significantly by ω-3. The effects on BMI were marginal under Met but were significant with ω-3.

CONCLUSION

The results of this work suggest that ω-3 may be useful as an adjuvant therapy in obese children and adolescents with IR.

VNN1 gene expression levels and the G-137T polymorphism are associated with HDL-C levels in Mexican prepubertal children

BACKGROUND

VNN1 gene expression levels and the G-137T polymorphism have been associated with high density lipoprotein cholesterol (HDL-C) levels in Mexican American adults. We aim to evaluate the contribution of VNN1 gene expression and the G-137T variant to HDL-C levels and other metabolic traits in Mexican prepubertal children.

METHODOLOGY/PRINCIPAL FINDINGS

VNN1 mRNA expression levels were quantified in peripheral blood leukocytes from 224 unrelated Mexican-Mestizo children aged 6-8 years (107 boys and 117 girls) and were genotyped for the G-137T variant (rs4897612). To account for population stratification, a panel of 10 ancestry informative markers was analyzed. After adjustment for admixture, the TT genotype was significantly associated with lower VNN1 mRNA expression levels (P = 2.9 × 10(-5)), decreased HDL-C levels (β = -6.19, P = 0.028) and with higher body mass index (BMI) z-score (β = 0.48, P = 0.024) in the total sample. In addition, VNN1 expression showed a positive correlation with HDL-C levels (r = 0.220; P = 0.017) and a negative correlation with BMI z-score (r = -0.225; P = 0.015) only in girls.

CONCLUSION/SIGNIFICANCE

Our data suggest that VNN1 gene expression and the G-137T variant are associated with HDL-C levels in Mexican children, particularly in prepubertal girls.

Metabolic syndrome components in obese Egyptian children

BACKGROUND AND OBJECTIVES

Obesity is one of the most serious global health issues. The aim of this study was to assess the association between obesity and different components of metabolic syndrome among obese school children aged 7 to 9 years, and to identify associated clinical and biochemical characteristics.

DESIGN AND SETTING

Case-control study among children attending Al-Zahraa Hospital Outpatient Clinic March 2010.

SUBJECTS AND METHODS

The study included 60 obese children (28 boys and 32 girls) and 50 non-obese controls (25 boys and 25 girls). Anthropometry, fasting glucose, insulin concentrations, total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), triglycerides, systolic and diastolic blood pressure (BP) were measured. Insulin resistance was determined by Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). Subcutaneous and visceral fat thicknesses were measured ultrasonographically. Metabolic syndrome (MS) was defined according to the Cook criteria.

RESULTS

MS was found in 25% of obese cases. Obese children showed significantly higher values in waist circumference, waist-to-hip ratio, levels of systolic and diastolic BP, insulin, HOMA-IR and LDL compared to their lean controls. HDL was significantly lower in obese children compared to controls. Obese children with MS had significantly higher values of body mass index standard deviation score (SDS), skinfold thickness, visceral fat thickness, waist circumference, systolic and diastolic BP, HOMA-IR, insulin and triglycerides compared to obese children without MS, whereas HDL was significantly lower. Obese children with MS had a high prevalence of hypertension and dyslipidemia compared to children without MS. Results showed positive relationships between visceral fat and waist circumference as well as with insulin level in obese children (P < .05).

CONCLUSIONS

The prevalence of the MS is considerable among obese Egyptian children. Abdominal obesity and high HOMA-IR values were the most frequent components of this syndrome among obese children. The study suggests that increased degree of insulin resistance is associated with a heightened risk of suffering MS.

Prevalence and socioeconomic differences of risk factors of cardiovascular disease in Ecuadorian adolescents

PURPOSE

The aim of this paper is to report the prevalence of cardiovascular risk factors and socioeconomic differences in school-going Ecuadorian adolescents.

METHODS

A cross-sectional study was performed from January 2008 until April 2009 in 770 adolescents aged 10 to 16 years old, who attend secondary schools in an urban (Cuenca), and rural area (Nabón) in Ecuador. Data collected for the overall sample included anthropometric variables (weight, height and waist circumference), blood pressure and socio-demographic characteristics. Fasting blood glucose and lipid profile determinations were collected in a subsample of 334 adolescents.

RESULTS

The most prevalent cardiovascular risk factors were dyslipidemia (34.2%), abdominal obesity (19.7%) and overweight (18.0%). The prevalence of the remaining cardiovascular risk factors were high levels of blood pressure (6.2%) and obesity (2.1%). Boys were 3.3 times (P < 0.001) more likely to have risk levels of blood pressure. Compared to their peers from lower socioeconomic groups, children from better off socioeconomic strata were 1.5 times (P = 0.048) more likely to be overweight/obese and 1.5 times (P = 0.046) more likely to have abdominal obesity. Overweight and obese children were 4.4 times more likely to have dyslipidemia (P < 0.001). Children living in the rural area were 2.8 times (P = 0.002) more likely to have dyslipidemia than those from the urban area.

CONCLUSIONS

Our results demonstrate the advanced levels of the nutrition transition in this Ecuadorian adolescent population. Primary health care should monitor and take actions to address this public health problem in adolescents.

Metabolic predictors for early identification of fatty liver using doppler and B-mode ultrasonography in overweight and obese adolescents

(1) to evaluate the frequency of asymptomatic fatty liver disease (FLD) using both Doppler and B-mode ultrasound (US) in overweight and obese adolescents; (2) to compare metabolic findings of fatty liver (FL) assessed by two methods; and (3) to evaluate metabolic predictors of FL shown by these methods. Fifty-nine overweight and obese adolescents aged between 9.0 and 17.0 years and 41 non-obese healthy adolescents were included in this study. B-mode and right hepatic vein Doppler ultrasonography (US) were performed and anthropometric indices, lipid profiles, and adiponectin levels were evaluated in all adolescents. HDL-C levels were significantly lower in patients with FL detected by Doppler US compared to patients without FL (p < 0.05). HDL-C levels were inversely correlated with presence of FL assessed by two methods (r = -0.285, p = 0.004; r = -0.328, p = 0.001, respectively) and adiponectin levels were correlated with presence of FL only detected by B-mode US (r = -0.263, p = 0.008). Adiponectin levels were significantly lower in patients with FL than those without FL assessed by B-Mode US (p = 0.049). Multiple regression analysis revealed that HDL-C levels was the most important predictor of FL assessed by Doppler US (p = 0.027), while body mass index was the determinant of FL assessed by two methods (p < 0.001) in asymptomatic overweight and obese adolescents. It was found that FLD, identified by both B-mode and Doppler US, is seen frequently in asymptomatic overweight and obese adolescents. Elevated BMI is associated with increased risk of FL assessed by two ultrasonographic methods. When using Doppler US, low HDL-C levels can be used as a good predictor for presence of FLD in overweight and obese adolescents.

Insulin resistance and its association with the components of the metabolic syndrome among obese children and adolescents

Background

Insulin resistance is the primary metabolic disorder associated with obesity; yet little is known about its role as a determinant of the metabolic syndrome in obese children. The aim of this study is to assess the association between the degree of insulin resistance and the different components of the metabolic syndrome among obese children and adolescents.

Methods

An analytical, cross-sectional and population-based study was performed in forty-four public primary schools in Campeche City, Mexico. A total of 466 obese children and adolescents between 11-13 years of age were recruited. Fasting glucose and insulin concentrations, high density lipoprotein cholesterol, triglycerides, waist circumference, systolic and diastolic blood pressures were measured; insulin resistance and metabolic syndrome were also evaluated.

Results

Out of the total population studied, 69% presented low values of high density lipoprotein cholesterol, 49% suffered from abdominal obesity, 29% had hypertriglyceridemia, 8% presented high systolic and 13% high diastolic blood pressure, 4% showed impaired fasting glucose, 51% presented insulin resistance and 20% metabolic syndrome. In spite of being obese, 13% of the investigated population did not present any metabolic disorder. For each one of the components of the metabolic syndrome, when insulin resistance increased so did odds ratios as cardiometabolic risk factors.

Conclusions

Regardless of age and gender an increased degree of insulin resistance is associated with a higher prevalence of disorders in each of the components of the metabolic syndrome and with a heightened risk of suffering metabolic syndrome among obese children and adolescents.

Association of R230C ABCA1 gene variant with low HDL-C levels and abnormal HDL subclass distribution in Mexican school-aged children

BACKGROUND

The effect of ABCA1 genetic variation on HDL-C levels has been widely documented, although studies in children are scarce. We recently found a frequent non-synonymous ABCA1 variant (R230C) exclusive to populations with Native American ancestry, associated with low HDL-C levels and other metabolic traits in adults.

METHODS

We genotyped R230C variant in 1253 healthy unrelated Mexican school-aged children aged 6-15 years (595 boys and 658 girls) to seek associations with HDL-C levels and other metabolic traits. HDL subclass distribution was analyzed in a subgroup of 81 age, gender and BMI-matched children.

RESULTS

Individuals carrying the C230 allele showed a significantly lower HDL-C levels (P=2.9x10(-8)), and higher TC/HDL-C ratio, BMI, BMI z-score and percent fat mass (P=0.001, 0.049, 0.032 and 0.039, respectively). HDL size was smaller in R230C heterozygotes as compared to R230R homozygotes (P<0.05). Moreover, the proportion of HDL(2b) was lower, while the proportion of HDL(3a) and HDL(3b) particles was higher in R230C heterozygous and/or C230C homozygous individuals as compared to R230R homozygotes (P<0.05).

CONCLUSIONS

Our data suggest that the R230C ABCA1 gene variant plays an important role in HDL-C level regulation and HDL subclass distribution in healthy Mexican school-aged children.

High prevalence of low high-density lipoprotein cholesterol concentrations and other dyslipidemic phenotypes in an Iranian population

OBJECTIVE

This study was designed to determine the prevalence of different atherogenic dyslipidemic phenotypes, especially decreased serum high-density lipoprotein cholesterol (HDL-C) in an Iranian population and its relationship to other coronary artery disease (CAD) risk factor.

METHODS

The prevalence of lipid abnormalities was assessed in 2941 people, including 1396 males and 1545 females, aged more than 20 years. The population is representative of Iranian urban adults living in northwestern Iran. In addition to isolated forms of hypertriglyceridemia, hypercholesterolemia, and hypoalphalipoproteinemia, some dyslipidemic phenotypes including hypertriglyceridemia/low high-density lipoprotein (HDL) combination, mixed dyslipidemias, and severe dyslipidemias were assessed.

RESULTS

The most prevalent abnormality was low HDL cholesterol (HDL-C; 73% including 63% for men and 93.3% for women). Hypertriglyceridemia (>150 mg/dL) was the second most prevalent abnormality (40.6%). Increased total cholesterol (>200 mg/dL) was observed in 35.4% of the subjects. The combination of hypertriglyceridemia and low HDL-C was observed in 9.9% of the population. Fifty eight percent of the low HDL-C cases were not accompanied with hypertriglyceridemia, and 24.4% of hypertriglyceridemic subjects had low HDL-C. Among subjects younger than 30 years, 19% had hypercholesterolemia, 13% had isolated low HDL-C less than 35 mg/dL, and 63% had HDL-C less than 40 mg/dL. Unexpectedly, except for the hypertriglyceridemia/low HDL-C pattern, which was more common in males, the other abnormal lipid profiles were more common in females.

CONCLUSION

The prevalence of dyslipidemia, especially low HDL cholesterol, in Iranian adults is very high. Urgent preventive programs and changes in lifestyle are needed in this area.

High-density lipoprotein subclasses distribution and composition in Mexican adolescents with low HDL cholesterol and/or high triglyceride concentrations, and its association with insulin and C-reactive protein

We tested whether low high-density lipoprotein cholesterol (HDL-C) and/or high triglycerides are associated to abnormal HDL subclasses distribution and composition, and their relationships with fasting insulin and C-reactive protein (CRP). Four groups of adolescents were studied: group 1 (HDL-C< or =35 mg/dl+TG> or =150 mg/dl; n=16); group 2 (isolated HDL-C< or =35 mg/dl; n=31); group 3 (isolated TG> or =150 mg/dl; n=20); and group 4 (CT<200 mg/dl, HDL-C>35 mg/dl, LDL-C<130 mg/dl, and TG<150 mg/dl; n=39). Tanner score-adjusted proportions of large subspecies (HDL(2b), HDL(2a)) were lower, and small (HDL(3b), HDL(3c)) were higher in groups 1, 2 and 3 than in group 4. As a result, HDL particle size in the three dyslipidemic groups was smaller than in group 4 (p<0.001). HDL CE, FC, PL, and apo AI percent contents were lower, whereas HDL TG percent content was higher in groups 1, 2 and 3 compared to group 4. CRP median values were also significantly higher in the three groups with dyslipidemia than in normolipidemic subjects (group 4). Fasting Insulin concentration and HOMA-IR were significantly higher in group 1 than in the other three groups. In stepwise multivariate analysis HDL subclass distribution and composition were independently associated only with HDL-C and waist circumference. As reported in adults, adolescents with low HDL-C and/or high TG have abnormalities in HDL subclasses distribution and lipid composition, which may render their HDL dysfunctional. In addition, these subjects have high CRP and insulin levels suggesting the presence of chronic low-grade inflammation.