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Szczudlik E, Stępniewska A, Bik-Multanowski M, Brandt-Heunemann S, Flehmig B, Małecka-Tendera E, Mazur A, Petriczko E, Ranke MB, Wabitsch M, Zachurzok A, Wójcik M. The age of the obesity onset is a very important factor for the development of metabolic complications and cardiovascular risk in children and adolescents with severe obesity. Eur J Pediatr 2024; 183:3833-3841. [PMID: 38877324 PMCID: PMC11322218 DOI: 10.1007/s00431-024-05636-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Revised: 05/27/2024] [Accepted: 05/30/2024] [Indexed: 06/16/2024]
Abstract
Severe obesity defined as BMI value corresponding to an adult > 40 kg/m2 affects 1-5% of children and adolescents in Europe. The purpose of this study was to assess the occurrence of cardiovascular risk factors in children and adolescents with severe obesity. The analysis included 140 patients (75 female) at the mean age of 14 ± 2.1 SD (range 10-18) years (all recruited in 4 regional reference centers in Poland). Severe obesity was defined as BMI > 35 kg/m2 (children 6-14 years), and BMI > 40 kg/m2 (> 14 years). Fasting plasma samples have been obtained in all patients, and OGTT was performed in all patients. The metabolic risk factors were defined as high blood pressure (BP > 90 percentile for height, age, and sex), HDL cholesterol < 1.03 mmol/L, TG ≥ 1.7 mmol/L, and hyperglycemic state (fasting blood glucose > 5.6 mmol/L, or blood glucose 120' after oral glucose load > 7.8 mmol/L). Additionally, the MetS z-score was calculated using Metabolic Syndrome Severity Calculator. One hundred twenty-four (89%) participants presented with high BP, 117 (84%) with abnormal lipid profile, and 26 with the hyperglycemic. Only 12 (9%) were free of metabolic complications. More than 60% of patients had more than one cardiovascular risk factor. The high BP was significantly associated with the severity of obesity (F = 9.9, p = 0.002). Patients with at least one metabolic complication presented with significantly younger age of the onset of obesity (the mean age of the patients with no overt obesity complications was 10 years, while the mean age of those who presented at least one was 4.7 ± 3.5 SD years (p = 0.002)). A significant positive association between in the value of the Mets BMI z-score with age was observed (R = 0.2, p < 0.05). There were no differences between girls and boys regarding Mets BMI z-score (1.7 ± 0.8 vs 1.7 ± 0.7, p = 0.8).Conclusions: The most common metabolic risk factor in children and adolescents with severe obesity was high BP. The most important factor determining presence of obesity complications, and thus the total metabolic risk, seems to be younger (< 5 years) age of onset of obesity. What is Known? • It is estimated that 1-5% of children and adolescents in Europe suffer from severe obesity corresponding to an adult BMI > 40 kg/m2, and it is the fastest growing subcategory of childhood obesity. • Children with severe obesity face substantial health risk that may persist into adulthood, encompassing chronic conditions, psychological disorders and premature mortality. What is new: • The most common complication is high BP that is significantly associated with the severity of obesity (BMI z-score), contrary to dyslipidemia and hyperglycemic state, which do not depend on BMI z-score value. • The most important factor determining presence of obesity complications, and thus the total metabolic risk, seems to be younger (< 5 years) age of onset of obesity.
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Affiliation(s)
- Ewa Szczudlik
- Department of Pediatric and Adolescent Endocrinology, Pediatric Institute, Jagiellonian University Medical College, Cracow, Poland
| | - Anna Stępniewska
- Department of Pediatric and Adolescent Endocrinology, Pediatric Institute, Jagiellonian University Medical College, Cracow, Poland
| | - Mirosław Bik-Multanowski
- Department of Medical Genetics, Faculty of Medicine, Jagiellonian University Medical College, Cracow, Poland
- Institute of Human Genetics, University Hospital, LMU, Munich, Germany
| | - Stephanie Brandt-Heunemann
- Center for Rare Endocrine Diseases, Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, Ulm, Germany
| | | | - Ewa Małecka-Tendera
- Department of Pediatrics and Pediatric Endocrinology, Medical University of Silesia, School of Medicine in Katowice, Katowice, Poland
| | - Artur Mazur
- Department of Pediatrics, Pediatric Endocrinology and Diabetes, Medical Faculty, University of Rzeszów, Rzeszów, Poland
| | - Elżbieta Petriczko
- Department of Pediatrics, Endocrinology, Diabetology, Metabolic Disorders and Cardiology of Developmental Age, Pomeranian Medical University, Szczecin, Poland
| | - Michael B Ranke
- Children's Hospital, University of Tübingen, Tübingen, Germany
| | - Martin Wabitsch
- Center for Rare Endocrine Diseases, Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, Ulm, Germany
| | - Agnieszka Zachurzok
- Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Zabrze, Poland
| | - Małgorzata Wójcik
- Department of Pediatric and Adolescent Endocrinology, Pediatric Institute, Jagiellonian University Medical College, Cracow, Poland.
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de Brito JN, Pereira MA, Kelly AS, Erickson DJ, Sherwood NE, Mason SM, Loth KA, French SA, Evanoff NG, Dengel DR, Kunin-Batson AS. Body Mass Index Trajectories and Biomarkers of Cardiometabolic Risk in Children from Low-Income and Racially and Ethnically Diverse Households. Child Obes 2024; 20:243-253. [PMID: 37327058 PMCID: PMC11250839 DOI: 10.1089/chi.2022.0216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Background: This study examined the associations between BMI trajectories and emerging cardiometabolic risk (CMR) in children living in low-income and racially and ethnically diverse households in the United States. Methods: Data were drawn from NET-Works randomized intervention trial and NET-Works 2 prospective follow-up study (N = 338). BMI was measured across 6 follow-up visits and biomarkers of cardiometabolic risk (CMR) at the sixth visit. Group-based trajectory modeling identified child BMI trajectories. Adjusted multivariable linear regressions evaluated the associations between BMI trajectories and CMR. Results: We identified two BMI trajectories: 25% followed a trajectory of steep BMI increase, and 75% followed a moderate decreasing BMI trajectory over time. Relative to children in the moderate decreasing trajectory, children in the increasing trajectory had higher adjusted mean levels of C-reactive protein [CRP; 3.3; 95% confidence interval (CI): 1.6 to 5.0], leptin (63.1; 95% CI: 44.3 to 81.8), triglycerides (35.4; 95% CI: 22.1 to 48.6), triglyceride/high-density lipoprotein (HDL) ratio (1.2; 95% CI: 0.8 to 1.6), hemoglobin A1c (HbA1C; 0.1; 95% CI: 0.03 to 0.2), fasting glucose (1.8; 0.1 to 3.5) and insulin (8.8; 95% CI: 6.5 to 11.0), overall CMR score (0.7; 95% CI: 0.5 to 0.9), and lower adiponectin (-1.3; 95% CI: -2.5 to -0.1) and HDL (-10.8; 95% CI: -14.3 to -7.4). Conclusions: Children with high BMIs early in childhood were more likely to maintain an accelerated BMI trajectory throughout childhood, which was associated with adverse CMR in pre-adolescence. To advance health equity and support children's healthy weight and cardiovascular health trajectories, public health efforts are needed to address persistent disparities in childhood obesity and CMR.
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Affiliation(s)
- Junia N. de Brito
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Mark A. Pereira
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Aaron S. Kelly
- Center for Pediatric Obesity Medicine, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Darin J. Erickson
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Nancy E. Sherwood
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Susan M. Mason
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Katie A. Loth
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Simone A. French
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Nicholas G. Evanoff
- Center for Pediatric Obesity Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
- School of Kinesiology, University of Minnesota, Minneapolis, MN, USA
| | - Donald R. Dengel
- Center for Pediatric Obesity Medicine, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA
- School of Kinesiology, University of Minnesota, Minneapolis, MN, USA
| | - Alicia S. Kunin-Batson
- Center for Pediatric Obesity Medicine, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA
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3
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Cao C, Mo Z, Han Y, Luo J, Hu H, Yang D, He Y. Association between alanine aminotransferase to high-density lipoprotein cholesterol ratio and nonalcoholic fatty liver disease: a retrospective cohort study in lean Chinese individuals. Sci Rep 2024; 14:6056. [PMID: 38480862 PMCID: PMC10937981 DOI: 10.1038/s41598-024-56555-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 03/07/2024] [Indexed: 03/17/2024] Open
Abstract
There is limited research on the association between the alanine aminotransferase to high-density lipoprotein cholesterol ratio (ALT/HDL-C) ratio and nonalcoholic fatty liver disease (NAFLD). The purpose of the current research was to look into the connection between the ALT/HDL-C ratio and the risk of NAFLD in lean Chinese individuals. Between January 2010 and December 2014, 11,975 non-obese people participated in this prospective cohort research. The relationship between the ALT/HDL-C ratio and the risk of developing NAFLD was assessed using the Cox proportional-hazards regression model, Cox proportional hazards regression with cubic spline functions and smooth curve fitting, sensitivity analysis, and subgroup analyses. The ALT/HDL-C ratio's potential value as a NAFLD prognostic marker was to be evaluated using the receiver operating characteristic curve analysis. A total of 5419 (45.253%) women comprised the research's participant population, and the research participants' average age was 43.278 ± 14.941 years. The ALT/HDL-C ratio was 11.607 (7.973-17.422) at the median (interquartile ranges). 2087 (17.428%) patients had NAFLD diagnoses throughout a median follow-up of 24.967 months. The study's findings demonstrated a positive connection between the ALT/AHDL-C ratio and the incident NAFLD (HR = 1.037, 95% CI: 1.031-1.042) when adjusting for relevant factors. The ALT/HDL-C ratio and NAFLD risk had a nonlinear connection, with 12.963 as the ratio's inflection point. Effect sizes (HR) were 1.023 (95% CI: 1.017-1.029) and 1.204 (95% CI: 1.171-1.237), respectively, on the right and left sides of the inflection point. The sensitivity analysis also showed how reliable our findings were. According to subgroup analysis, those with BMI < 24 kg/m2 and DBP < 90 mmHg had a stronger correlation between the ALT/HDL-C ratio and NAFLD risk. The current study shows a positive and non-linear connection between the ALT/HDL-C ratio and NAFLD risk in lean Chinese individuals. When the ALT/HDL-C ratio is less than 12.963, it is significantly linked to NAFLD. Therefore, from a therapy standpoint, it is advised to keep the ALT/HDL-C ratio less than the inflection point.
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Affiliation(s)
- Changchun Cao
- Department of Rehabilitation, Shenzhen Dapeng New District Nan'ao People's Hospital, No. 6, Renmin Road, Dapeng New District, Shenzhen, 518000, Guangdong, China
| | - Zihe Mo
- Department of Physical Examination, DongGuan Tungwah Hospital, Dongguan, China
| | - Yong Han
- Department of Emergency, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518000, Guangdong, China
| | - Jiao Luo
- Department of Rehabilitation, Shenzhen Dapeng New District Nan'ao People's Hospital, No. 6, Renmin Road, Dapeng New District, Shenzhen, 518000, Guangdong, China.
| | - Haofei Hu
- Department of Nephrology, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518000, Guangdong, China.
| | - Dehua Yang
- Department of Pediatrics, Shenzhen Hengsheng Hospital, No. 20 Yintian Road, Xixiang Street, Baoan District, Shenzhen, 518000, Guangdong, China.
| | - Yongcheng He
- Department of Nephrology, Affiliated Hospital of North Sichuan Medical College, No. 1 Maoyuan South Road, Nanchong, 637000, Sichuan, China.
- Department of Nephrology, Guangdong Province, Shenzhen Hengsheng Hospital, No. 20 Yintian Road, Xixiang Street, Baoan District, Shenzhen, 518000, China.
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Cheng Y, Zhang Q, Li H, Zhou G, Shi P, Zhang X, Guan L, Yan F, Xu C. Remnant cholesterol, stronger than triglycerides, is associated with incident non-alcoholic fatty liver disease. Front Endocrinol (Lausanne) 2023; 14:1098078. [PMID: 37214248 PMCID: PMC10198261 DOI: 10.3389/fendo.2023.1098078] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 03/23/2023] [Indexed: 05/24/2023] Open
Abstract
Introduction Non-alcoholic fatty liver disease (NAFLD) is characterized by excess accumulation of triglycerides within the liver. However, whether the circulating levels of triglycerides and cholesterol transported in triglyceride-rich lipoproteins (remnant cholesterol, remnant-C) are related to the occurrence of NAFLD has not yet been studied. This study aims to assess the association of triglycerides and remnant-C with NAFLD in a Chinese cohort of middle aged and elderly individuals. Methods All subjects in the current study are from the 13,876 individuals who recruited in the Shandong cohort of the REACTION study. We included 6,634 participants who had more than one visit during the study period with an average follow-up time of 43.34 months. The association between lipid concentrations and incident NAFLD were evaluated by unadjusted and adjusted Cox proportional hazard models. The potential confounders were adjusted in the models including age, sex, hip circumference (HC), body mass index (BMI), systolic blood pressure, diastolic blood pressure, fasting plasma glucose (FPG), diabetes status and cardiovascular disease (CVD) status. Results In multivariable-adjusted Cox proportional hazard model analyses, triglycerides (hazard ratio[HR], 95% confidence interval [CI]:1.080,1.047-1.113;p<0.001), high-density lipoprotein cholesterol (HDL-C) (HR, 95% CI: 0.571,0.487-0.670; p<0.001), and remnant-C (HR, 95% CI: 1.143,1.052-1.242; p=0.002), but not total cholesterol (TC) or low-density lipoprotein cholesterol (LDL-C), were associated with incident NAFLD. Atherogenic dyslipidemia (triglycerides>1.69 mmol/L, HDL-C<1.03 mmol/L in men or<1.29 mmol/L in women) was also associated with NAFLD (HR, 95% CI: 1.343,1.177-1.533; p<0.001). Remnant-C levels were higher in females than in males and increased with increasing BMI and in participants with diabetes and CVD compared with those without diabetes or CVD. After adjusting for other factors in the Cox regression models, we found that serum levels of TG and remnant-C, but not TC or LDL-C, were associated with NAFLD outcomes in women group, non-cardiovascular disease status, non-diabetes status and middle BMI categories (24 to 28 kg/m2). Discussion In the middle aged and elderly subset of the Chinese population, especially those who were women, non-CVD status, non-diabetes status and middle BMI status (24 to 28 kg/m2), levels of triglycerides and remnant-C, but not TC or LDL-C, were associated with NAFLD outcomes independent of other risk factors.
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Affiliation(s)
- Yiping Cheng
- Department of Endocrinology and Metabolism, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Department of Endocrinology and Metabolism, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Qiang Zhang
- Department of Critical Care Medicine, Zibo Central Hospital, Zibo, Shandong, China
| | - Haizhen Li
- Department of Endocrinology, Dongying City District People Hospital, Dongying, Shandong, China
| | - Guangshuai Zhou
- Department of Scientific Research and Cooperation, Zibo Central Hospital, Zibo, Shandong, China
| | - Ping Shi
- Department of Endocrinology and Metabolism, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Department of Endocrinology and Metabolism, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Xu Zhang
- Department of Endocrinology and Metabolism, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Department of Endocrinology and Metabolism, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Liying Guan
- Department of Health Examination Center, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Fang Yan
- Department of Pain Management, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Chao Xu
- Department of Endocrinology and Metabolism, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Department of Endocrinology and Metabolism, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
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Skinner AC, Staiano AE, Armstrong SC, Barkin SL, Hassink SG, Moore JE, Savage JS, Vilme H, Weedn AE, Liebhart J, Lindros J, Reilly EM. Appraisal of Clinical Care Practices for Child Obesity Treatment. Part II: Comorbidities. Pediatrics 2023; 151:190446. [PMID: 36622098 DOI: 10.1542/peds.2022-060643] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The objective of this technical report is to provide clinicians with actionable evidence-based information upon which to make treatment decisions. In addition, this report will provide an evidence base on which to inform clinical practice guidelines for the management and treatment of overweight and obesity in children and adolescents. To this end, the goal of this report was to identify all relevant studies to answer 2 overarching key questions: (KQ1) "What are effective clinically based treatments for obesity?" and (KQ2) "What is the risk of comorbidities among children with obesity?" See Appendix 1 for the conceptual framework and a priori Key Questions.
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Affiliation(s)
- Asheley C Skinner
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Amanda E Staiano
- Louisiana State University Pennington Biomedical Research Center, Baton Rouge, Louisiana
| | - Sarah C Armstrong
- Departments of Pediatrics and Population Health Sciences, Duke Clinical Research Institute, Duke University, Durham, North Carolina
| | - Shari L Barkin
- Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, Virginia
| | - Sandra G Hassink
- Medical Director, American Academy of Pediatrics, Institute for Healthy Childhood Weight, Wilmington, Delaware
| | - Jennifer E Moore
- Institute for Medicaid Innovation, University of Michigan Medical School, Ann Arbor, Michigan
| | - Jennifer S Savage
- Center for Childhood Obesity Research, Pennsylvania State University, Department of Nutritional Sciences, Pennsylvania State University, University Park, Pennsylvania
| | - Helene Vilme
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Ashley E Weedn
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
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Stinson SE, Jonsson AE, Andersen MK, Lund MAV, Holm LA, Fonvig CE, Huang Y, Stankevič E, Juel HB, Ängquist L, Sørensen TIA, Ongstad EL, Gaddipati R, Grimsby J, Rhodes CJ, Pedersen O, Christiansen M, Holm J, Hansen T. High Plasma Levels of Soluble Lectin-like Oxidized Low-Density Lipoprotein Receptor-1 Are Associated With Inflammation and Cardiometabolic Risk Profiles in Pediatric Overweight and Obesity. J Am Heart Assoc 2023; 12:e8145. [PMID: 36695299 PMCID: PMC9973661 DOI: 10.1161/jaha.122.027042] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Background Lectin-like oxidized low-density lipoprotein (ox-LDL) receptor-1 is a scavenger receptor for oxidized low-density lipoprotein. In adults, higher soluble lectin-like ox-LDL receptor-1 (sLOX-1) levels are associated with cardiovascular disease, type 2 diabetes, and obesity, but a similar link in pediatric overweight/obesity remains uncertain. Methods and Results Analyses were based on the cross-sectional HOLBAEK Study, including 4- to 19-year-olds from an obesity clinic group with body mass index >90th percentile (n=1815) and from a population-based group (n=2039). Fasting plasma levels of sLOX-1 and inflammatory markers were quantified, cardiometabolic risk profiles were assessed, and linear and logistic regression analyses were performed. Pubertal/postpubertal children and adolescents from the obesity clinic group exhibited higher sLOX-1 levels compared with the population (P<0.001). sLOX-1 positively associated with proinflammatory cytokines, matrix metalloproteinases, body mass index SD score, waist SD score, body fat %, plasma alanine aminotransferase, serum high-sensitivity C-reactive protein, plasma low-density lipoprotein cholesterol, triglycerides, systolic and diastolic blood pressure SD score, and inversely associated with plasma high-density lipoprotein cholesterol (all P<0.05). sLOX-1 positively associated with high alanine aminotransferase (odds ratio [OR], 1.16, P=4.1 E-04), insulin resistance (OR, 1.16, P=8.6 E-04), dyslipidemia (OR, 1.25, P=1.8 E-07), and hypertension (OR, 1.12, P=0.02). Conclusions sLOX-1 levels were elevated during and after puberty in children and adolescents with overweight/obesity compared with population-based peers and associated with inflammatory markers and worsened cardiometabolic risk profiles. sLOX-1 may serve as an early marker of cardiometabolic risk and inflammation in pediatric overweight/obesity. Registration The HOLBAEK Study, formerly known as The Danish Childhood Obesity Biobank, ClinicalTrials.gov identifier number NCT00928473, https://clinicaltrials.gov/ct2/show/NCT00928473 (registered June 2009).
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Affiliation(s)
- Sara E. Stinson
- Novo Nordisk Foundation Center for Basic Metabolic ResearchFaculty of Health and Medical Sciences, University of CopenhagenDenmark
| | - Anna E. Jonsson
- Novo Nordisk Foundation Center for Basic Metabolic ResearchFaculty of Health and Medical Sciences, University of CopenhagenDenmark
| | - Mette K. Andersen
- Novo Nordisk Foundation Center for Basic Metabolic ResearchFaculty of Health and Medical Sciences, University of CopenhagenDenmark
| | - Morten A. V. Lund
- The Children’s Obesity Clinic, Accredited European Centre for Obesity Management, Department of PediatricsHolbæk HospitalHolbækDenmark,Department of Biomedical Sciences, Faculty of Health and Medical SciencesUniversity of CopenhagenDenmark
| | - Louise Aas Holm
- Novo Nordisk Foundation Center for Basic Metabolic ResearchFaculty of Health and Medical Sciences, University of CopenhagenDenmark,The Children’s Obesity Clinic, Accredited European Centre for Obesity Management, Department of PediatricsHolbæk HospitalHolbækDenmark
| | - Cilius E. Fonvig
- Novo Nordisk Foundation Center for Basic Metabolic ResearchFaculty of Health and Medical Sciences, University of CopenhagenDenmark,The Children’s Obesity Clinic, Accredited European Centre for Obesity Management, Department of PediatricsHolbæk HospitalHolbækDenmark,Department of PediatricsKolding Hospital a part of Lillebælt HospitalKoldingDenmark
| | - Yun Huang
- Novo Nordisk Foundation Center for Basic Metabolic ResearchFaculty of Health and Medical Sciences, University of CopenhagenDenmark
| | - Evelina Stankevič
- Novo Nordisk Foundation Center for Basic Metabolic ResearchFaculty of Health and Medical Sciences, University of CopenhagenDenmark
| | - Helene Bæk Juel
- Novo Nordisk Foundation Center for Basic Metabolic ResearchFaculty of Health and Medical Sciences, University of CopenhagenDenmark
| | - Lars Ängquist
- Novo Nordisk Foundation Center for Basic Metabolic ResearchFaculty of Health and Medical Sciences, University of CopenhagenDenmark
| | - Thorkild I. A. Sørensen
- Novo Nordisk Foundation Center for Basic Metabolic ResearchFaculty of Health and Medical Sciences, University of CopenhagenDenmark,Department of Public Health, Faculty of Health and Medical SciencesUniversity of CopenhagenDenmark
| | - Emily L. Ongstad
- Research and Early DevelopmentCardiovascular, Renal and Metabolism, BioPharmaceuticals R&D, AstraZenecaGaithersburgMD
| | - Ranjitha Gaddipati
- Research and Early DevelopmentCardiovascular, Renal and Metabolism, BioPharmaceuticals R&D, AstraZenecaGaithersburgMD
| | - Joseph Grimsby
- Research and Early DevelopmentCardiovascular, Renal and Metabolism, BioPharmaceuticals R&D, AstraZenecaGaithersburgMD,Regeneron Pharmaceuticals, Inc.TarrytownNY
| | - Christopher J. Rhodes
- Research and Early DevelopmentCardiovascular, Renal and Metabolism, BioPharmaceuticals R&D, AstraZenecaGaithersburgMD
| | - Oluf Pedersen
- Novo Nordisk Foundation Center for Basic Metabolic ResearchFaculty of Health and Medical Sciences, University of CopenhagenDenmark
| | - Michael Christiansen
- The Children’s Obesity Clinic, Accredited European Centre for Obesity Management, Department of PediatricsHolbæk HospitalHolbækDenmark,Department for Congenital DisordersStatens Serum InstituteCopenhagenDenmark
| | - Jens‐Christian Holm
- Novo Nordisk Foundation Center for Basic Metabolic ResearchFaculty of Health and Medical Sciences, University of CopenhagenDenmark,The Children’s Obesity Clinic, Accredited European Centre for Obesity Management, Department of PediatricsHolbæk HospitalHolbækDenmark,Faculty of Health and Medical SciencesUniversity of CopenhagenDenmark
| | - Torben Hansen
- Novo Nordisk Foundation Center for Basic Metabolic ResearchFaculty of Health and Medical Sciences, University of CopenhagenDenmark
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Močnik M, Marčun Varda N. Lipid Biomarkers and Atherosclerosis-Old and New in Cardiovascular Risk in Childhood. Int J Mol Sci 2023; 24:ijms24032237. [PMID: 36768558 PMCID: PMC9916711 DOI: 10.3390/ijms24032237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/16/2023] [Accepted: 01/20/2023] [Indexed: 01/24/2023] Open
Abstract
Lipids are a complex group of molecules in the body, essential as structural, functional and metabolic components. When disbalanced, they are regarded as a cardiovascular risk factor, traditionally in cholesterol level evaluation. However, due to their complex nature, much research is still needed for a comprehensive understanding of their role in atherosclerosis, especially in the young. Several new lipid biomarkers are emerging, some already researched to a point, such as lipoproteins and apolipoproteins. Other lipid molecules are also being increasingly researched, including oxidized forms due to oxidative inflammation in atherosclerosis, and sphingolipids. For many, even those less new, the atherogenic potential is not clear and no clinical recommendations are in place to aid the clinician in using them in everyday clinical practice. Moreover, lipids' involvement in atherogenesis in children has yet to be elucidated. This review summarizes the current knowledge on lipids as biomarkers of cardiovascular risk in the paediatric population.
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Affiliation(s)
- Mirjam Močnik
- Department of Paediatrics, University Medical Centre Maribor, Ljubljanska Cesta 2, 2000 Maribor, Slovenia
- Correspondence:
| | - Nataša Marčun Varda
- Department of Paediatrics, University Medical Centre Maribor, Ljubljanska Cesta 2, 2000 Maribor, Slovenia
- Faculty of Medicine, University of Maribor, Taborska 8, 2000 Maribor, Slovenia
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8
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Hu H, Cao C, Han Y, He Y. Triglyceride affects the association between estimated glomerular filtration rate and the onset of non-alcoholic fatty liver disease: A second analysis of a Chinese cohort study. Front Med (Lausanne) 2022; 9:984241. [PMID: 36237544 PMCID: PMC9551029 DOI: 10.3389/fmed.2022.984241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 09/12/2022] [Indexed: 11/20/2022] Open
Abstract
Objective The role of triglyceride (TG) and estimated glomerular filtration rate (eGFR) effect modifiers on the risk of non-alcoholic fatty liver disease (NAFLD) is unknown. This study examined whether TG modifies the relationship between eGFR and incident NAFLD. Methods In a Chinese hospital from January 2010 to December 2014, 15,555 non-obese subjects were collected systematically for this retrospective cohort study. The target-independent and dependent variables were eGFR measured at baseline and NAFLD appearing during follow-up. The modified variable was TG measured at baseline. The multivariate Cox proportional hazards model was used to explore eGFR and TG’s association with NAFLD risk. We explored a priori interaction between eGFR and TG, and performed subgroup analyses to further assess whether the relationship between eGFR and incident NAFLD was modified by TG. We also explored the effect of TG and eGFR interaction on the risk of NAFLD. Results The mean age was 43.09 ± 14.92 years, and 8,131 (52.27%) were males. During a median follow-up time of 35.8 months, 2,077 (13.35%) individuals developed NAFLD. In the adjusted model, eGFR was negatively associated with incident NAFLD (HR = 0.984, 95% CI: 0.982, 0.987), while TG was positively related to NAFLD (HR = 1.582, 95% CI: 1.490, 1.681). TG could modify the relationship between eGFR and incident NAFLD. A stronger association between eGFR and NAFLD could be found in the participants without hypertriglyceridemia (HTG) (HR = 0.981, 95% CI: 0.978–0.984, P for interaction = 0.0139). In contrast, the weaker association was probed in the population with HTG (HR = 0.986, 95% CI: 0.983–0.989). At the same time, we also found an interaction between eGFR and TG in influencing NAFLD risk. In participants with decreased eGFR and HTG, the risk of NAFLD was significantly increased. Further, compared to non-HTG subjects with eGFR ≥ 116.56 ml/min/1.73 m2, participants with HTG and eGFR < 82.88 ml/min/1.73 m2 had about a fourfold increase in the risk (HR = 4.852 95% CI: 3.943–5.970) of NAFLD. Conclusion eGFR and TG is independently associated with NAFLD risk. The association of eGFR with incident NAFLD is likely to be modified by TG in the Chinese non-obese population. There was an interactive effect between eGFR and TG in affecting NAFLD risk. In participants with decreased eGFR and hypertriglyceridemia, the risk of NAFLD is significantly increased.
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Affiliation(s)
- Haofei Hu
- Department of Nephrology, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, China
- Department of Nephrology, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China
- Shenzhen University Health Science Center, Shenzhen, Guangdong, China
| | - Changchun Cao
- Department of Rehabilitation, Shenzhen Dapeng New District Nan’ao People’s Hospital, Shenzhen, Guangdong, China
| | - Yong Han
- Shenzhen University Health Science Center, Shenzhen, Guangdong, China
- Department of Emergency, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, China
- Department of Emergency, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China
- *Correspondence: Yong Han,
| | - Yongcheng He
- Department of Nephrology, Shenzhen Hengsheng Hospital, Shenzhen, Guangdong, China
- Department of Nephrology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China
- Yongcheng He,
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9
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Cen J, Han Y, Liu Y, Hu H. Evaluated Glomerular Filtration Rate Is Associated With Non-alcoholic Fatty Liver Disease: A 5-Year Longitudinal Cohort Study in Chinese Non-obese People. Front Nutr 2022; 9:916704. [PMID: 35782950 PMCID: PMC9244698 DOI: 10.3389/fnut.2022.916704] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 05/30/2022] [Indexed: 12/12/2022] Open
Abstract
ObjectiveEvidence regarding the association between evaluated glomerular filtration rate (eGFR) and non-alcoholic fatty liver disease (NAFLD) is still limited. On that account, the purpose of our research is to survey the link of evaluated eGFR on NAFLD.MethodsThis study is a retrospective cohort study. Which consecutively and non-selectively collected a total of 16,138 non-obese participants in a Chinese hospital from January 2010 to December 2014. We then used the Cox proportional-hazards regression model to explore the relationship between baseline eGFR and NAFLD risk. A Cox proportional hazards regression with cubic spline functions and smooth curve fitting (the cubic spline smoothing) was used to identify the non-linear relationship between eGFR and NAFLD. Additionally, we also performed a series of sensitivity analyses and subgroup analyses. Data had been uploaded to the DATADRYAD website.ResultsThe mean age of the included individuals was 43.21 ± 14.95 years old, and 8,467 (52.47%) were male. The mean baseline eGFR was 98.83 ± 22.80 mL/min per 1.73m2. During a median follow-up time of 35.8 months, 2,317 (14.36%) people experienced NAFLD. After adjusting covariates, the results showed that eGFR was negatively associated with incident NAFLD (HR = 0.983, 95%CI: 0.980, 0.985). There was also a non-linear relationship between eGFR and NAFLD, and the inflection point of eGFR was 103.489 mL/min per 1.73 m2. The effect sizes (HR) on the left and right sides of the inflection point were 0.988 (0.984, 0.991) and 0.971 (0.963, 0.979), respectively. And the sensitive analysis demonstrated the robustness of our results. Subgroup analysis showed that eGFR was more strongly associated with incident NAFLD in diastolic blood pressure (DBP) < 90 mmHg, fasting plasma glucose (FPG) ≤ 6.1 mmol/L, high-density lipoprotein cholesterol (HDL-c) < 1 mmol/L, and alanine aminotransferase (ALT) ≥ 40 U/L participants. In contrast, the weaker association was probed in those with DBP ≥ 90 mmHg, ALT < 40 U/L, FPG > 6.1 mmol/L, and HDL-c ≥ 1 mmol/L.ConclusionThis study demonstrates a negative and non-linear association between eGFR and incident NAFLD in the Chinese non-obese population. eGFR is strongly related to NAFLD when eGFR is above 103 mL/min per 1.73 m2. From a therapeutic perspective, it makes sense to maintain eGFR levels within the inflection point to 130 mL/min/1.73 m2.
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Affiliation(s)
- Ji Cen
- Department of Nephrology, Hechi People’s Hospital, Hechi, China
| | - Yong Han
- Department of Emergency, Shenzhen Second People’s Hospital, Shenzhen, China
- Department of Emergency, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
- Shenzhen University Health Science Center, Shenzhen, China
| | - Yufei Liu
- Shenzhen University Health Science Center, Shenzhen, China
- Department of Neurosurgery, Shenzhen Second People’s Hospital, Shenzhen, China
- Department of Neurosurgery, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Haofei Hu
- Shenzhen University Health Science Center, Shenzhen, China
- Department of Nephrology, Shenzhen Second People’s Hospital, Shenzhen, China
- Department of Nephrology, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
- *Correspondence: Haofei Hu,
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10
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Kyler KE, Lee BR, Glynn EF, Waddell JP, Hoffman MA, Goldman JL. Clinical Outcome and Antibiotic Dosing Differences by Weight in Children With Acute Osteomyelitis. Hosp Pediatr 2021; 11:1112-1120. [PMID: 34593567 DOI: 10.1542/hpeds.2021-005890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To evaluate for weight-based differences in clinical outcomes and antibiotic dosing variability for children hospitalized with acute hematogenous osteomyelitis (AHO). METHODS We performed a retrospective cohort study of children aged 2 to 17 years and hospitalized with a primary AHO International Classification of Diseases, Ninth Revision or International Classification of Diseases, 10th Revision diagnosis code between 2010 and 2017 using the Cerner Health Facts database. Weight categories (healthy, overweight, obesity) were determined by using Centers for Disease Control and Prevention age- and sex-specific BMI percentiles. Rates of procedures, complications, and length of stay (LOS) were compared between groups. Dosing variability between groups was assessed by comparing the initial milligrams per kilogram per day of prescribed antibiotics. RESULTS We identified 755 children with AHO for inclusion. Children with overweight and obesity were more likely to undergo surgical procedures (19% and 17%, respectively) compared with children with a healthy weight (10%; P = .009). They also had a longer LOS (5.7 and 5.8 days) than children with a healthy weight (4.9 days; P = .03). There were no differences in complication rates between weight categories. Mean weight-adjusted daily dose for the most frequently prescribed antibiotics was different by weight category, with children in higher weight categories more likely to receive lower weight-based doses. CONCLUSIONS Children with overweight and obesity hospitalized for AHO were more likely to undergo procedures, have longer LOS, and receive lower weight-based antibiotic dosing compared with children with a healthy weight. Our findings suggest that weight should be carefully considered when treating children with AHO.
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Affiliation(s)
- Kathryn E Kyler
- Children's Mercy Kansas City, Kansas City, Missouri .,Department of Pediatrics, School of Medicine, University of Missouri-Kansas City, Kansas City, Missouri
| | - Brian R Lee
- Children's Mercy Kansas City, Kansas City, Missouri
| | - Earl F Glynn
- Children's Mercy Kansas City, Kansas City, Missouri
| | | | - Mark A Hoffman
- Children's Mercy Kansas City, Kansas City, Missouri.,Department of Pediatrics, School of Medicine, University of Missouri-Kansas City, Kansas City, Missouri.,University of Kansas Medical Center, Kansas City, Kansas
| | - Jennifer L Goldman
- Children's Mercy Kansas City, Kansas City, Missouri.,Department of Pediatrics, School of Medicine, University of Missouri-Kansas City, Kansas City, Missouri
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11
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Kyler KE, Bettenhausen JL, Hall M, Glynn EF, Hoffman MA, Shakhnovich V, Smolderen K, Davis AM. Obesity and Corticosteroid Dosing Guideline Adherence in Children Hospitalized With Asthma. Hosp Pediatr 2021; 11:380-388. [PMID: 33664119 DOI: 10.1542/hpeds.2020-001420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Drug dosing recommendations for children with obesity remain limited. This may lead to variability in medication dosing among children with obesity. Therefore, our objective was to determine differences in the prevalence of guideline-nonadherent systemic corticosteroid orders by weight category in children hospitalized for asthma. METHODS We performed a retrospective cross-sectional study of children aged 2 to 17 years hospitalized with asthma and prescribed systemic corticosteroids between January 1, 2010, and December 31, 2017, using the Cerner Health Facts deidentified database. Weight categories ranging from underweight to class III obesity were defined on the basis of BMI percentiles by using CDC guidelines. Corticosteroid orders were categorized as guideline adherent or nonadherent on the basis of total body weight-based dosing guidelines from the National Heart, Lung, and Blood Institute. χ2 test and multivariable logistic regression models were used to determine differences in guideline adherence between weight categories. RESULTS We identified 21 488 children prescribed systemic corticosteroids during asthma hospitalizations. Most (54.2%) had a healthy weight, and 23.8% had obesity. Almost one-quarter received guideline-nonadherent orders (22.2%), with increasing prevalence among higher weight categories (19.4% of healthy weight children versus 36.0% of those with class III obesity; P < .001). After controlling for demographic and clinical covariates, weight category remained significantly associated with receiving a guideline-nonadherent order (P < .001). CONCLUSIONS The prevalence of guideline-nonadherent corticosteroid orders for children hospitalized with asthma increases linearly with weight category, disproportionately affecting children with severe obesity. Standardization of drug dosing guidelines for children with obesity may help reduce variability in drug doses prescribed that may increase risk of harm.
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Affiliation(s)
- Kathryn E Kyler
- Children's Mercy Hospital, Kansas City, Missouri; .,School of Medicine, University of Missouri-Kansas City, Kansas City, Missouri
| | - Jessica L Bettenhausen
- Children's Mercy Hospital, Kansas City, Missouri.,School of Medicine, University of Missouri-Kansas City, Kansas City, Missouri
| | - Matt Hall
- Children's Mercy Hospital, Kansas City, Missouri.,Children's Hospital Association, Lenexa, Kansas
| | - Earl F Glynn
- Children's Mercy Hospital, Kansas City, Missouri
| | - Mark A Hoffman
- Children's Mercy Hospital, Kansas City, Missouri.,School of Medicine, University of Missouri-Kansas City, Kansas City, Missouri
| | - Valentina Shakhnovich
- Children's Mercy Hospital, Kansas City, Missouri.,School of Medicine, University of Missouri-Kansas City, Kansas City, Missouri.,Center for Children's Healthy Lifestyles and Nutrition, Kansas City, Missouri; and
| | - Kim Smolderen
- School of Medicine, University of Missouri-Kansas City, Kansas City, Missouri
| | - Ann M Davis
- Center for Children's Healthy Lifestyles and Nutrition, Kansas City, Missouri; and.,University of Kansas Medical Center, Kansas City, Kansas
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12
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Razi O, Mohammadi M, Zamani N, Hackney AC, Tourny C, Zouita S, Laher I, Zouhal H. Walking exercise and lower-body blood flow restriction: Effects on systemic inflammation, lipid profiles and hematological indices in overweight middle-aged males. Res Sports Med 2021; 30:41-49. [PMID: 33593160 DOI: 10.1080/15438627.2021.1888100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The objective of present study is to investigate the effects of walk training with and without blood flow restriction (BFR and no-BFR) on lipid profiles, inflammatory and haematological factors in over-weighed men. Participants were divided into BFR (n = 9) or no-BFR (n = 9) groups. Both groups were exposed to 8-week walk training on a treadmill: 3 sessions/week at a speed of 50 m/min, 5 sets × 2 min/session. There were differences in pre- to post-levels of (TG) and fibrinogen in the BFR group (p ≤ 0.05) that were accompanied by changes in red blood cells (RBC), haemoglobin (HGB) and haematocrit (HCT) levels (p ≤ 0.05). RBC levels were increased in the BFR group (p ≤ 0.05). The groups differed in their mean corpuscular volume (MCV) and mean corpuscular haemoglobin concentration (MCHC). These findings suggest the efficiency of BFR walk training in individuals exposed to chronic diseases associated with overweight, such as metabolic syndrome.
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Affiliation(s)
- Omid Razi
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, Razi University, Kermanshah, Iran
| | - Mohammad Mohammadi
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, Razi University, Kermanshah, Iran
| | - Nastaran Zamani
- Department of Biology, Faculty of Science, Payame-Noor University, Tehran, Iran
| | - Anthony C Hackney
- Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC, United States
| | | | - Sghaeir Zouita
- ISSEP Ksar-Said, University of La Manouba, Tunis, Tunisia
| | - Ismail Laher
- Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, Canada
| | - Hassane Zouhal
- Univ Rennes, M2S (Laboratoire Mouvement, Sport, Santé) - EA 1274, Rennes, France
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13
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Oxidized-LDL inhibits testosterone biosynthesis by affecting mitochondrial function and the p38 MAPK/COX-2 signaling pathway in Leydig cells. Cell Death Dis 2020; 11:626. [PMID: 32796811 PMCID: PMC7429867 DOI: 10.1038/s41419-020-02751-z] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 07/03/2020] [Accepted: 07/06/2020] [Indexed: 12/18/2022]
Abstract
Abnormal lipid/lipoprotein metabolism induced by obesity may affect spermatogenesis by inhibiting testosterone synthesis in Leydig cells. It is crucial to determine which components of lipoproteins inhibit testosterone synthesis. Circulating oxidized low-density lipoprotein (oxLDL), the oxidized form of LDL, has been reported to be an independent risk factor for decreased serum testosterone levels. However, whether oxLDL has a damaging effect on Leydig cell function and the detailed mechanisms have been rarely studied. This study first showed the specific localization of oxLDL and mitochondrial structural damage in testicular Leydig cells of high-fat diet-fed mice in vivo. We also found that oxLDL reduced the mitochondrial membrane potential (MMP) by disrupting electron transport chain and inhibited testosterone synthesis-related proteins and enzymes (StAR, P450scc, and 3β‑HSD), which ultimately led to mitochondrial dysfunction and decreased testosterone synthesis in Leydig cells. Further experiments demonstrated that oxLDL promoted lipid uptake and mitochondrial dysfunction by inducing CD36 transcription. Meanwhile, oxLDL facilitated COX2 expression through the p38 MAPK signaling pathway in Leydig cells. Blockade of COX-2 attenuated the oxLDL-induced decrease in StAR and P450scc. Our clinical results clarified that the increased serum oxLDL level was associated with a decline in circulating testosterone levels. Our findings amplify the damaging effects of oxLDL and provide the first evidence that oxLDL is a novel metabolic biomarker of male-acquired hypogonadism caused by abnormal lipid metabolism.
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14
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Bendor CD, Bardugo A, Pinhas-Hamiel O, Afek A, Twig G. Cardiovascular morbidity, diabetes and cancer risk among children and adolescents with severe obesity. Cardiovasc Diabetol 2020; 19:79. [PMID: 32534575 PMCID: PMC7293793 DOI: 10.1186/s12933-020-01052-1] [Citation(s) in RCA: 130] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 06/08/2020] [Indexed: 02/08/2023] Open
Abstract
Severe obesity among children and adolescents is a significant global public health concern. The prevalence has markedly increased over the last decades, becoming common in many countries. Overwhelming rates of obesity among youth have prompted efforts to identify an evidence-based immediate- and long-term cardiometabolic risk factor profile in childhood-onset severe obesity, and to highlight gaps that require further investigation. The PubMed database was systematically searched in accordance with PRISMA guidelines. The search yielded 831 results, of which 60 fulfilled stringent criteria and were summarized in this review. The definition of severe obesity was variable, with only one half the publications using the definition BMI > 120% of the 95th percentile. Point estimates of the prevalence of at least one cardiometabolic risk factor in children with severe obesity reportedly range from 67 to 86%. Cross-sectional studies indicate that children and adolescents with severe obesity are at greater risk than those with mild obesity for type 2 diabetes, hypertension, fatty liver disease and dyslipidemia, already at childhood and adolescence. Robust epidemiological data on the long-term risk and actual point estimates in adulthood are lacking for these diseases as well as for other diseases (coronary heart disease, stroke, chronic kidney disease and cancer). Recent longitudinal studies indicate an increased risk for cardiomyopathy, heart failure, cardiovascular mortality and all-cause mortality in adulthood for adolescents with severe obesity compared to those with mild obesity. Given the alarming increase in the prevalence of severe obesity, the persistence of adiposity from childhood to adulthood and the precarious course of young adults with chronic comorbidities, the economic and clinical services burden on the healthcare system is expected to rise.
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Affiliation(s)
- Cole D Bendor
- Department of Military Medicine, Hebrew University of Jerusalem, Faculty of Medicine, Jerusalem, Israel
- Academy and Research Division, Surgeon General Headquarters, Israel Defense Forces, Medical Corps, Ramat Gan, Israel
| | - Aya Bardugo
- Department of Military Medicine, Hebrew University of Jerusalem, Faculty of Medicine, Jerusalem, Israel
- Academy and Research Division, Surgeon General Headquarters, Israel Defense Forces, Medical Corps, Ramat Gan, Israel
| | - Orit Pinhas-Hamiel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Institute of Endocrinology, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Arnon Afek
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Central Management, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Gilad Twig
- Department of Military Medicine, Hebrew University of Jerusalem, Faculty of Medicine, Jerusalem, Israel.
- Academy and Research Division, Surgeon General Headquarters, Israel Defense Forces, Medical Corps, Ramat Gan, Israel.
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
- Institute of Endocrinology, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
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15
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Morandi A, Corradi M, Piona C, Fornari E, Puleo R, Maffeis C. Systemic anti-oxidant capacity is inversely correlated with systolic blood pressure and pulse pressure in children with obesity. Nutr Metab Cardiovasc Dis 2020; 30:508-513. [PMID: 31791638 DOI: 10.1016/j.numecd.2019.10.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 10/01/2019] [Accepted: 10/10/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS Oxidative stress leading to endothelial dysfunction is a candidate driver of obesity-related hypertension. We aimed to assess whether the total anti-oxidant capacity (TAC) was associated with blood pressure in children/adolescents with obesity. METHODS AND RESULTS One hundred and fifty-two children/adolescents with obesity (79 boys; age 11.9+/-2.5 years) underwent blood drawing for the assessment of TAC, lipids and HOMA-IR. Blood pressure was measured and classified according to the latest American Academy of Pediatrics Guidelines. Serum TAC was measured by a commercial kit (Sigma-Aldrich). The average TAC was 1.11+/-0.4 mMol/Trolox equivalents. Systolic blood pressure was predicted by TAC (B = -5.8, p = 0.003), z-BMI (B = 2.39, p = 0.008), height [cm] (B = 0.38, p < 0.001) and diastolic blood pressure (B = 0.56, p < 0.001). Diastolic blood pressure was predicted by age [years] (B = 0.58, p = 0.001), log-HOMA-IR (B = 3.0, p = 0.002), and systolic blood pressure (B = 0.26, p < 0.001), but not by TAC. The pulse pressure was predicted only by TAC (B = - 6.6, p = 0.002), and height [cm] (B = 0.42, p < 0.001). Overall "elevated blood pressure + hypertension" or hypertension alone were not associated with TAC. However, systolic "elevated blood pressure + hypertension" was associated with TAC (OR = 0.4 [0.1-0.9], p = 0.037), and z-BMI (OR = 2.1 [1.3-3.6], p = 0.004). CONCLUSION The systemic anti-oxidant capacity is inversely associated with systolic blood pressure and pulse pressure in children and adolescents with obesity.
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Affiliation(s)
- Anita Morandi
- Pediatric Diabetes and Metabolic Disorders Unit, Integrated University Hospital of Verona, Verona, Italy
| | - Massimiliano Corradi
- Pediatric Diabetes and Metabolic Disorders Unit, Integrated University Hospital of Verona, Verona, Italy
| | - Claudia Piona
- Pediatric Diabetes and Metabolic Disorders Unit, Integrated University Hospital of Verona, Verona, Italy
| | - Elena Fornari
- Pediatric Diabetes and Metabolic Disorders Unit, Integrated University Hospital of Verona, Verona, Italy
| | - Rossella Puleo
- Pediatric Diabetes and Metabolic Disorders Unit, Integrated University Hospital of Verona, Verona, Italy
| | - Claudio Maffeis
- Pediatric Diabetes and Metabolic Disorders Unit, Integrated University Hospital of Verona, Verona, Italy.
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16
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Dimova R, Chakarova N, Grozeva G, Kirilov G, Tankova T. The relationship between glucose variability and insulin sensitivity and oxidative stress in subjects with prediabetes. Diabetes Res Clin Pract 2019; 158:107911. [PMID: 31707004 DOI: 10.1016/j.diabres.2019.107911] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 10/13/2019] [Accepted: 10/28/2019] [Indexed: 12/21/2022]
Abstract
AIM The present study assessed the relationship between glucose variability (GV) and insulin levels, insulin resistance and oxidative stress at early stages of glucose intolerance. MATERIAL AND METHODS A total of 50 subjects - 12 males and 38 females, mean age 55.6 ± 9.7 years, mean BMI 28.4 ± 6.4 kg/m2, divided into 2 groups according to glucose tolerance: 32 with prediabetes and 18 with normal glucose tolerance were included. Glucose tolerance was assessed by OGTT according to WHO 2006 criteria. Plasma glucose and serum insulin were measured at fasting, 120-minute and 180-minute during the test; and oxLDL and 3-Nitrotyrosine - at fasting and 120-minute. HOMA-IR and OGIS indexes were calculated. HbA1c and lipid levels was assessed. Continuous glucose monitoring was performed with a blind sensor (FreeStyle Libre Pro) for a mean period of 13.6 ± 2.3 days. RESULTS Our results demonstrate significantly increased insulin resistance in subjects with prediabetes, whereas there is no difference in oxidative stress markers between the two groups. OxLDL and 3-NT correlate positively with insulin levels and HOMA-IR and negatively with OGIS in both groups. There is a positive association between oxidative stress markers and 120-minute glucose in the prediabetes group. Insulin levels and HOMA-IR are positively related to plasma glucose and reciprocally to CV and M-Value in prediabetes, since the latter association is with borderline significance after adjustment for hypertension and smoking. CONCLUSIONS Our results demonstrate a significant correlation between oxidative stress and insulin resistance at early stages of glucose intolerance. Both chronic hyperglycemia and GV seem to be related to insulin levels and insulin resistance, and just postload glycaemia to oxidative stress in prediabetes.
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Affiliation(s)
- Rumyana Dimova
- Department of Endocrinology, Medical University - Sofia, Bulgaria.
| | - Nevena Chakarova
- Department of Endocrinology, Medical University - Sofia, Bulgaria
| | - Greta Grozeva
- Department of Endocrinology, Medical University - Sofia, Bulgaria
| | - Georgi Kirilov
- Department of Endocrinology, Medical University - Sofia, Bulgaria
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17
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High high-sensitivity C-reactive protein/BMI ratio predicts future adverse outcomes in patients with acute coronary syndrome. Coron Artery Dis 2019; 30:448-454. [PMID: 31386638 DOI: 10.1097/mca.0000000000000719] [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: 11/25/2022]
Abstract
OBJECTIVE The prognostic value of high-sensitivity C-reactive protein (hsCRP) and obesity in patients with coronary artery disease is controversial. In previous studies, hsCRP was significantly associated with BMI. Thus, we integrated hsCRP and BMI to assess the predictive value in patients with acute coronary syndrome (ACS). METHODS AND RESULTS In this observational cohort study, 478 patients with ACS were enrolled in Fuwai Hospital from 2010 to 2011,with a mean follow-up of 4.2 years. The endpoint of major adverse cardiovascular events (MACE) was the composite of cardiovascular death, myocardial infarction, revascularization again, heart failure, or stroke. Compared with patients without MACE, we found that patients with MACE had higher hsCRP (3.86 ± 3.66 vs. 3.00 ± 3.17, P = 0.033). Furthermore, we identified that hsCRP was significantly correlated with BMI (r = 0.134, P = 0.005). Thus, hsCRP level was adjusted by BMI to further clarify its role in the prognosis of patients with ACS. According to the tertiles of hsCRP/BMI ratio, the rates of MACE in the lowest tertile group, the median tertile group, and the highest tertile group were 14.0% (21/150), 14.0% (21/150), and 26% (39/150) (P = 0.008), respectively. In multivariate analysis, hsCRP/BMI was independently and positively related to MACE. Similarly, according to risk category of hsCRP (low hsCRP group < 3.0 mg/l, high hsCRP group ≥ 3.0 mg/l) and BMI (< 24 and ≥ 24.0 kg/m), patients in the high hsCRP but normal or low weight group had the lowest MACE-free survival (log-rank P = 0.003) compared with other groups. CONCLUSION We confirmed that C-reactive protein level should be adjusted by BMI to reflect the prognosis of patients with ACS. High hsCRP/BMI ratio was associated with adverse outcomes. Patients with ACS with high hsCRP plus overweight had the same risk for MACE as those with lower hsCRP but normal weight.
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18
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Saner C, Harcourt BE, Pandey A, Ellul S, McCallum Z, Kao KT, Twindyakirana C, Pons A, Alexander EJ, Saffery R, Burgner DP, Juonala M, Sabin MA. Sex and puberty-related differences in metabolomic profiles associated with adiposity measures in youth with obesity. Metabolomics 2019; 15:75. [PMID: 31053959 DOI: 10.1007/s11306-019-1537-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 04/25/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Specific patterns of metabolomic profiles relating to cardiometabolic disease are associated with increased weight in adults. In youth with obesity, metabolomic data are sparse and associations with adiposity measures unknown. OBJECTIVES Primary, to determine associations between adiposity measures and metabolomic profiles with increased cardiometabolic risks in youth with obesity. Secondary, to stratify associations by sex and puberty. METHODS Participants were from COBRA (Childhood Overweight BioRepository of Australia; a paediatric cohort with obesity). Adiposity measures (BMI, BMI z-score, %truncal and %whole body fat, waist circumference and waist/height ratio), puberty staging and NMR metabolomic profiles from serum were assessed. Statistics included multivariate analysis (principal component analysis, PCA) and multiple linear regression models with false discovery rate adjustment. RESULTS 214 participants had metabolomic profiles analyzed, mean age 11.9 years (SD ± 3.1), mean BMI z-score 2.49 (SD ± 0.24), 53% females. Unsupervised PCA identified no separable clusters of individuals. Positive associations included BMI z-score and phenylalanine, total body fat % and lipids in medium HDL, and waist circumference and tyrosine; negative associations included total body fat % and the ratio of docosahexaenoic acid/total fatty acids and histidine. Stratifying by sex and puberty, patterns of associations with BMI z-score in post-pubertal males included positive associations with lipid-, cholesterol- and triglyceride-content in VLDL lipoproteins; total fatty acids; total triglycerides; isoleucine, leucine and glycoprotein acetyls. CONCLUSION In a paediatric cohort with obesity, increased adiposity measures, especially in post-pubertal males, were associated with distinct patterns in metabolomic profiles.
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Affiliation(s)
- Christoph Saner
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, VIC, Australia.
- Department of Endocrinology and Diabetes, The Royal Children's Hospital, Parkville, VIC, Australia.
- Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland.
| | - Brooke E Harcourt
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, VIC, Australia
- Department of Endocrinology and Diabetes, The Royal Children's Hospital, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Ahwan Pandey
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Susan Ellul
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, VIC, Australia
| | - Zoe McCallum
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, VIC, Australia
- Department of Endocrinology and Diabetes, The Royal Children's Hospital, Parkville, VIC, Australia
| | - Kung-Ting Kao
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, VIC, Australia
- Department of Endocrinology and Diabetes, The Royal Children's Hospital, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Celia Twindyakirana
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Anke Pons
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, VIC, Australia
| | - Erin J Alexander
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, VIC, Australia
- Department of Endocrinology and Diabetes, The Royal Children's Hospital, Parkville, VIC, Australia
| | - Richard Saffery
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, VIC, Australia
- Department of Endocrinology and Diabetes, The Royal Children's Hospital, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - David P Burgner
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
- Department of Paediatrics, Monash University, Clayton, VIC, Australia
| | - Markus Juonala
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, VIC, Australia
- Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland
| | - Matthew A Sabin
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, VIC, Australia
- Department of Endocrinology and Diabetes, The Royal Children's Hospital, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
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19
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Spinelli A, Buoncristiano M, Kovacs VA, Yngve A, Spiroski I, Obreja G, Starc G, Pérez N, Rito AI, Kunešová M, Sant'Angelo VF, Meisfjord J, Bergh IH, Kelleher C, Yardim N, Pudule I, Petrauskiene A, Duleva V, Sjöberg A, Gualtieri A, Hassapidou M, Hyska J, Burazeri G, Petrescu CH, Heinen M, Takacs H, Zamrazilová H, Bosi TB, Sacchini E, Pagkalos I, Cucu A, Nardone P, Gately P, Williams J, Breda J. Prevalence of Severe Obesity among Primary School Children in 21 European Countries. Obes Facts 2019; 12:244-258. [PMID: 31030201 PMCID: PMC6547273 DOI: 10.1159/000500436] [Citation(s) in RCA: 154] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 04/17/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The World Health Organization (WHO) European Childhood Obesity Surveillance Initiative (COSI) was established more than 10 years ago to estimate prevalence and monitor changes in overweight and obesity in children aged 6-9 years. Since then, there have been five rounds of data collection in more than 40 countries involving more than half a million children. To date, no comparative studies with data on severe childhood obesity from European countries have been published. OBJECTIVES The aim of this work was to present the prevalence of severe obesity in school-aged children from 21 countries participating in COSI. METHOD The data are from cross-sectional studies in 21 European WHO member states that took part in the first three COSI rounds of data collection (2007/2008, 2009/2010, 2012/2013). School-aged children were measured using standardized instruments and methodology. Children were classified as severely obese using the definitions provided by WHO and the International Obesity Task Force (IOTF). Analyses overtime, by child's age and mother's educational level, were performed in a select group of countries. RESULTS A total of 636,933 children were included in the analysis (323,648 boys and 313,285 girls). The prevalence of severe obesity varied greatly among countries, with higher values in Southern Europe. According to the WHO definition, severe obesity ranged from 1.0% in Swedish and Moldovan children (95% CI 0.7-1.3 and 0.7-1.5, respectively) to 5.5% (95% CI 4.9-6.1) in Maltese children. The prevalence was generally higher among boys compared to girls. The IOTF cut-offs lead to lower estimates, but confirm the differences among countries, and were more similar for both boys and girls. In many countries 1 in 4 obese children were severely obese. Applying the estimates of prevalence based on the WHO definition to the whole population of children aged 6-9 years in each country, around 398,000 children would be expected to be severely obese in the 21 European countries. The trend between 2007 and 2013 and the analysis by child's age did not show a clear pattern. Severe obesity was more common among children whose mother's educational level was lower. CONCLUSIONS Severe obesity is a serious public health issue which affects a large number of children in Europe. Because of the impact on educational, health, social care, and economic systems, obesity needs to be addressed via a range of approaches from early prevention of overweight and obesity to treatment of those who need it.
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Affiliation(s)
- Angela Spinelli
- Istituto Superiore di Sanità (National Institute of Health), National Centre for Disease Prevention and Health Promotion, Rome, Italy,
| | - Marta Buoncristiano
- WHO European Office for the Prevention and Control of the NCDs, Moscow, Russian Federation
| | - Viktoria Anna Kovacs
- National Institute of Pharmacy and Nutrition, DG of Food and Nutrition Science, Budapest, Hungary
| | - Agneta Yngve
- Department of food studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
| | - Igor Spiroski
- Institute of Public Health of the Republic of Macedonia, Skopje, North Macedonia
| | - Galina Obreja
- State University of Medicine and Pharmacy, Chișinău, Moldova
| | - Gregor Starc
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Napoleón Pérez
- Spanish Observatory of Nutrition and Study of Obesity, Madrid, Spain
| | - Ana Isabel Rito
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - Marie Kunešová
- Obesity Management Centre, Institute of Endocrinology, Prague, Czechia
| | | | - Jørgen Meisfjord
- Department of Health and Inequality, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Ingunn Holden Bergh
- Department of Child Health and Development, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | | | | | - Iveta Pudule
- Centre for Disease Prevention and Control, Riga, Latvia
| | - Ausra Petrauskiene
- Department of Preventive Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Vesselka Duleva
- National Center of Public Health and Analyses, Sofia, Bulgaria
| | - Agneta Sjöberg
- Department of Food and Nutrition and Sport Science, University of Gothenburg, Gothenburg, Sweden
| | | | - Maria Hassapidou
- Department of Nutrition and Dietetics, Alexander Technological Educational Institute of Thessaloniki, Thessaloniki, Greece
| | | | | | | | | | - Hajnalka Takacs
- Semmelweis University, Karoly Racz School of PhD Studies, Budapest, Hungary
| | - Hana Zamrazilová
- Obesity Management Centre, Institute of Endocrinology, Prague, Czechia
| | | | | | - Ioannis Pagkalos
- Department of Nutrition and Dietetics, Alexander Technological Educational Institute of Thessaloniki, Thessaloniki, Greece
| | | | - Paola Nardone
- Istituto Superiore di Sanità (National Institute of Health), National Centre for Disease Prevention and Health Promotion, Rome, Italy
| | - Paul Gately
- Centre for Applied Obesity Research, Leeds Beckett University, Leeds, United Kingdom
| | - Julianne Williams
- WHO European Office for the Prevention and Control of the NCDs, Moscow, Russian Federation
| | - João Breda
- WHO European Office for the Prevention and Control of the NCDs, Moscow, Russian Federation
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20
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Popp TJ, Henshaw MH, Carter J, Thomas TN, Chowdhury SM. Racial differences in myocardial deformation in obese children: Significance of inflammatory state. Nutr Metab Cardiovasc Dis 2019; 29:378-382. [PMID: 30850223 PMCID: PMC6492271 DOI: 10.1016/j.numecd.2019.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 01/21/2019] [Accepted: 01/24/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIMS The association between racial differences in myocardial deformation and cardiometabolic risk factors is unknown in obese children. Our objective was to: 1) investigate for racial differences in myocardial deformation between white and black obese children and 2) identify biomarkers associated with these observed racial differences. We hypothesized that decreased myocardial deformation observed in black obese children could be accounted for by the differences in the markers of metabolic syndrome between the groups. METHODS AND RESULTS Obese children were recruited prospectively. All clinical and laboratory tests for the metabolic syndrome were conducted during a single assessment using a standardized protocol. Speckle-tracking echocardiography was performed to obtain longitudinal and circumferential measures of deformation. 310 patients were included in the analysis; 158 (51%) white and 152 (49%) black. The median age was 11.3 years (IQR 5.9). Blacks demonstrated worse longitudinal strain (-14.7 ± 2.7% vs. -15.4 ± 2.9%, p = 0.04). There was no difference in circumferential strain between the groups. Multivariable linear regression showed a significant relationship between longitudinal strain and hsCRP (β = 0.16, p = 0.03) and HOMA-IR (β = 0.15, p = 0.04); there was no independent association between longitudinal strain and race. CONCLUSION Black subjects demonstrated worse longitudinal strain than whites. Only hsCRP and HOMA-IR levels, not race, had an independent association with longitudinal strain, suggesting that the observed racial differences in longitudinal strain may be secondary to differences in inflammation and insulin resistance between the groups.
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Affiliation(s)
- T J Popp
- Department of Pediatrics, Division of Cardiology, Medical University of South Carolina, 165 Ashley Ave, MSC 915, Charleston, SC, 29425, USA
| | - M H Henshaw
- Department of Pediatrics, Division of Cardiology, Medical University of South Carolina, 165 Ashley Ave, MSC 915, Charleston, SC, 29425, USA
| | - J Carter
- Department of Pediatrics, Division of Cardiology, Medical University of South Carolina, 165 Ashley Ave, MSC 915, Charleston, SC, 29425, USA
| | - T N Thomas
- Department of Pediatrics, Division of Cardiology, Medical University of South Carolina, 165 Ashley Ave, MSC 915, Charleston, SC, 29425, USA
| | - S M Chowdhury
- Department of Pediatrics, Division of Cardiology, Medical University of South Carolina, 165 Ashley Ave, MSC 915, Charleston, SC, 29425, USA.
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21
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Rao X, Zhao S, Braunstein Z, Mao H, Razavi M, Duan L, Wei Y, Toomey AC, Rajagopalan S, Zhong J. Oxidized LDL upregulates macrophage DPP4 expression via TLR4/TRIF/CD36 pathways. EBioMedicine 2019; 41:50-61. [PMID: 30738832 PMCID: PMC6441950 DOI: 10.1016/j.ebiom.2019.01.065] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 01/31/2019] [Accepted: 01/31/2019] [Indexed: 12/17/2022] Open
Abstract
Background We and others have shown that dipeptidyl peptidase-IV (DPP4) expression is increased in obesity/atherosclerosis and is positively correlated with atherosclerotic burden. However, the mechanism by which DPP4 expression is regulated in obesity remains unclear. In this study, we investigated the pathways regulating the expression of DPP4 on macrophages. Methods Flowsight® Imaging Flow Cytometry was employed for the detection of DPP4 and immunophenotyping. DPP4 enzymatic activity was measured by a DPPIV-Glo™ Protease Assay kit. Findings Human monocytes expressed a moderate level of membrane-bound DPP4. Obese patients with body mass index (BMI) ≥ 30 had a higher level of monocyte DPP4 expression, in parallel with higher levels of HOMA-IR, blood glucose, triglycerides, and non-HDL cholesterol, compared to those in the non-obese (BMI < 30) patients. Oxidized low-density lipoprotein (oxLDL), but not native LDL, up-regulated DPP4 expression on macrophages with a preferential increase in CD36+ cells. OxLDL mediated DPP4 up-regulation was considerably diminished by Toll-like receptor-4 (TLR4) knockdown and CD36 deficiency. TRIF deficiency, but not MyD88 deficiency, attenuated oxLDL-induced DPP4 increase. Interpretation Our study suggests a key role for oxLDL and downstream CD36/TLR4/TRIF in regulating DPP4 expression. Increased DPP4 in response to oxidized lipids may represent an integrated mechanism linking post-prandial glucose metabolism to lipoprotein abnormality-potentiated atherosclerosis.
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Affiliation(s)
- Xiaoquan Rao
- Cardiovascular Research Institute, Case Western Reserve University, Cleveland, OH, USA; Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR, USA
| | - Shi Zhao
- Department of Endocrinology, Wuhan Central Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - Zachary Braunstein
- Department of Internal Medicine, Wexnel Medical Center, The Ohio State University, Columbus, OH, USA
| | - Hong Mao
- Department of Endocrinology, Wuhan Central Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Michael Razavi
- Cardiovascular Research Institute, Case Western Reserve University, Cleveland, OH, USA
| | - Lihua Duan
- Cardiovascular Research Institute, Case Western Reserve University, Cleveland, OH, USA
| | - Yingying Wei
- Cardiovascular Research Institute, Case Western Reserve University, Cleveland, OH, USA
| | - Amelia C Toomey
- Department of Health Sciences, University of Missouri, Columbia, MO, USA
| | - Sanjay Rajagopalan
- Cardiovascular Research Institute, Case Western Reserve University, Cleveland, OH, USA
| | - Jixin Zhong
- Cardiovascular Research Institute, Case Western Reserve University, Cleveland, OH, USA.
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22
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Kelly AS, Marcus MD, Yanovski JA, Yanovski SZ, Osganian SK. Working toward precision medicine approaches to treat severe obesity in adolescents: report of an NIH workshop. Int J Obes (Lond) 2018; 42:1834-1844. [PMID: 30283078 PMCID: PMC6461397 DOI: 10.1038/s41366-018-0231-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 08/16/2018] [Accepted: 09/11/2018] [Indexed: 02/06/2023]
Abstract
Adolescent severe obesity is a prevalent, chronic, and serious disease with few effective and safe treatment options. To address this issue, a National Institutes of Health-sponsored workshop entitled "Developing Precision Medicine Approaches to the Treatment of Severe Obesity in Adolescents," was convened, bringing together a multidisciplinary group of experts to review the current state of the science and identify (1) what is known regarding the epidemiology and biopsychosocial determinants of severe obesity in adolescents, (2) what is known regarding effectiveness of treatments for severe obesity in adolescents and predictors of response, and (3) gaps and opportunities for future research to develop more effective and targeted treatments for adolescents with severe obesity. Major topical areas discussed at the workshop included: appropriate BMI metrics, valid measures of phenotypes and predictors, mechanisms associated with the development of severe obesity, novel treatments informed by biologically and psychosocially plausible mechanisms, biopsychosocial phenotypes predicting treatment response, standardization of outcome measures and results reporting in research, and improving clinical care. Substantial gaps in knowledge were identified regarding the basic behavioral, psychosocial, and biological mechanisms driving the development of severe obesity and the influence of these factors on treatment response. Additional exploratory and observational studies are needed to better understand the heterogeneous etiology of severe obesity and explain the high degree of variability observed with interventions. Tailored treatment strategies that may be developed by achieving a better understanding of individual differences in genetic endowment, clinical, metabolic, psychological, and behavioral phenotypes, and response to environmental exposures need to be tested. It is anticipated that these recommendations for future research, including strategies to enhance methodological rigor, will advance precision medicine approaches to treat severe obesity in adolescents more effectively.
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Affiliation(s)
- Aaron S Kelly
- Department of Pediatrics, Center for Pediatric Obesity Medicine, University of Minnesota Medical School, Minneapolis, MN, USA.
| | - Marsha D Marcus
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jack A Yanovski
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Susan Z Yanovski
- Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Stavroula K Osganian
- Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
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23
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de Freitas MCP, Fernandez DGE, Cohen D, Figueiredo-Neto AM, Maranhão RC, Damasceno NRT. Oxidized and electronegative low-density lipoprotein as potential biomarkers of cardiovascular risk in obese adolescents. Clinics (Sao Paulo) 2018; 73:e189. [PMID: 30365817 PMCID: PMC6172975 DOI: 10.6061/clinics/2018/e189] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 03/13/2018] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To evaluate biomarkers associated with early cardiometabolic risk in obese adolescents. METHODS This cross-sectional study included 137 adolescents of both sexes aged 10 to 19 years divided into a normal weight group (NW) (n=69) and an obese group (OB) (n=68). RESULTS As expected, obesity showed positive associations with homeostatic model assessment for insulin resistance (HOMA-IR), triacylglycerol, insulin, plasma levels of non-esterified fatty acids, and cholesterol ester transfer protein activity and negative associations with plasma antioxidant levels. Plasma oxidized low-density lipoprotein (oxLDL) and electronegative low-density lipoprotein [LDL(-)] levels were significantly higher in the OB group. Higher tertiles of oxLDL were associated with increased values of body mass index; waist circumference; fatty mass percentage (%FM); and the atherogenic lipids non-high-density-lipoprotein cholesterol (non-HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein B and triacylglycerol. Higher tertiles of LDL(-) were robustly associated with body mass index and waist circumference. Logistic regression models (odds ratios) confirmed that increased values of lipids and apolipoprotein B were associated with increased risk of oxLDL. For LDL(-), these associations were not significant, suggesting that another mechanism is involved in generating this particle in obese adolescents. CONCLUSIONS Obese adolescents showed increased plasma LDL(-) and oxLDL, and obese girls had more LDL(-) than obese boys. Therefore, oxLDL is strongly and independently associated with classical cardiovascular risk factors, while increased levels of LDL(-) were influenced by body mass index, waist circumference and demographic parameters in obese adolescents.
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Affiliation(s)
| | - Diana Gabriela Estevez Fernandez
- Programa de Interunidades em Nutricao Humana Aplicada, Faculdade de Ciencias Farmaceuticas da Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Danielle Cohen
- Programa de Interunidades em Nutricao Humana Aplicada, Faculdade de Ciencias Farmaceuticas da Universidade de Sao Paulo, Sao Paulo, SP, BR
| | | | - Raul Cavalcante Maranhão
- Laboratorio de Metabolismo de Lipides do Instituto do Coracao, Hospital das Clinicas, Faculdade de Medicina da Universidade de Sao Paulo, SP, BR
- Departamento de Analises Clinicas, Faculdade de Ciencias Farmaceuticas da Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Nágila Raquel Teixeira Damasceno
- Departamento de Nutricao, Faculdade de Saude Publica da Universidade de Sao Paulo, Sao Paulo, SP, BR
- Programa de Interunidades em Nutricao Humana Aplicada, Faculdade de Ciencias Farmaceuticas da Universidade de Sao Paulo, Sao Paulo, SP, BR
- *Corresponding author. E-mail:
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24
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Furtado JM, Almeida SM, Mascarenhas P, Ferraz ME, Ferreira JC, Vilanova M, Monteiro MP, Ferraz FP. Anthropometric features as predictors of atherogenic dyslipidemia and cardiovascular risk in a large population of school-aged children. PLoS One 2018; 13:e0197922. [PMID: 29856786 PMCID: PMC5983423 DOI: 10.1371/journal.pone.0197922] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 05/10/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Autopsy studies reveal that atherosclerosis lesions can be found as early as two years of age. To slow the development of this early pathology, obesity and dyslipidemia prevention should start from childhood making it urgent to explore new ways to evaluate dyslipidemia risk in children that can be applied widely, such as the non-invasive anthropometric evaluation. OBJECTIVE Assess the metabolic profile of a pediatric population at a specific age to describe the association between anthropometric and biochemical cardiovascular disease risk factors; and evaluate selected anthropometric variables as potential predictors for dyslipidemic cardiovascular risk. DESIGN AND METHODS Anthropometric features, bioimpedance parameters and fasting clinical profile were assessed in Lisbon and the Tagus Valley region pre-pubertal nine-year-old children (n = 1.496) from 2009-2013 in a descriptive, cross-sectional study. Anthropometric variables predictive power was evaluated through regression analysis. RESULTS At least one abnormal lipid parameter was found in 65% of "normal weight", 73% of "overweight" and 81% of "obese" children according to the International Obesity Task Force (IOTF) standards. Dyslipidemia was present in 67.8% of children. Waist-hip ratio (WHR) explained 0.4% of total cholesterol (TC) variance. Waist circumference (WC) explained 2.8% of apolipoprotein (APO) A1 variance. Waist-circumference-to-height-ratio (WHtR) explained 2.7%, 2.8% and 1.9% of low-density lipoprotein cholesterol (LDL-c), APO B, and N_HDL-c variance, respectively. Children with abnormally high WHR levels had an increase in risk of 4.49, 3.40 and 5.30 times, respectively, for developing cardiovascular disease risk factors measured as high-risk levels of TC, LDL-c and non-HDL-c (N_HDL-c) (p<0.05). Only 29.9% of "normal weight" children had no anthropometric, bioimpedance or biochemical parameters associated with CV risk. CONCLUSION A large proportion of school age children have at least one lipid profile abnormality. BMI, zBMI, calf circumference (CC), hip circumference (HC), WC, and WHR are directly associated with dyslipidemia, whereas HC and calf circumference (CC) adjusted to WC, and mid-upper arm circumference (MUAC), are all inversely associated with dyslipidemia. Selected anthropometric variables are likely to help predict increased odds of having CV risk factors.
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Affiliation(s)
- José M. Furtado
- Centro de Genética Médica e Nutrição Pediátrica Egas Moniz, Campus Universitário, Monte da Caparica, Portugal
- Instituto Universitário Egas Moniz, Campus Universitário, Monte da Caparica, Portugal
| | - Sílvia M. Almeida
- Centro de Genética Médica e Nutrição Pediátrica Egas Moniz, Campus Universitário, Monte da Caparica, Portugal
- Instituto Universitário Egas Moniz, Campus Universitário, Monte da Caparica, Portugal
| | - Paulo Mascarenhas
- Centro de Genética Médica e Nutrição Pediátrica Egas Moniz, Campus Universitário, Monte da Caparica, Portugal
- Instituto Universitário Egas Moniz, Campus Universitário, Monte da Caparica, Portugal
| | - Maria E. Ferraz
- Centro de Genética Médica e Nutrição Pediátrica Egas Moniz, Campus Universitário, Monte da Caparica, Portugal
| | - José C. Ferreira
- Centro de Genética Médica e Nutrição Pediátrica Egas Moniz, Campus Universitário, Monte da Caparica, Portugal
- Department of Obstetrics and Gynecology of University of Medicine of Warsaw, Warsaw, Poland
| | - Manuel Vilanova
- Instituto de Investigação e Inovação em Saúde, and IBMC–Instituto de Biologia Molecular e Celular, Universidade do Porto, Porto, Portugal
- Instituto de Ciências Biomédicas de Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Mariana P. Monteiro
- Clinical and Experimental Endocrinology Group, Unit for Multidisciplinary Research in Biomedicine UMIB, ICBAS, University of Porto, Porto, Portugal
| | - Fernando P. Ferraz
- Centro de Genética Médica e Nutrição Pediátrica Egas Moniz, Campus Universitário, Monte da Caparica, Portugal
- Instituto Universitário Egas Moniz, Campus Universitário, Monte da Caparica, Portugal
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Oxidative stress in obese children and adolescents with and without type 2 diabetes mellitus is not associated with obstructive sleep apnea. Sleep Breath 2018; 23:117-123. [PMID: 29804216 DOI: 10.1007/s11325-018-1670-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 05/06/2018] [Accepted: 05/08/2018] [Indexed: 12/27/2022]
Abstract
PURPOSE Obesity, obstructive sleep apnea (OSA), and type 2 diabetes mellitus (T2DM) are associated with chronic low-grade inflammation and oxidative stress. In adults, increased lipid peroxidation, a marker of oxidative stress, was found in both metabolic syndrome and OSA. Studies on oxidative stress in children with T2DM and OSA are scarce. METHODS Plasma oxidized low-density lipoprotein (Ox-LDL) levels were evaluated in obese children and adolescents with/without T2DM, and the contribution of OSA to oxidative stress was investigated. RESULTS Ten patients with T2DM, 8 with impaired glucose tolerance (IGT), and 20 body mass index-standard deviation score (BMI-SDS)-matched non-diabetic children (controls) were studied. They all underwent overnight polysomnography. Fasting plasma concentrations of Ox-LDL were measured and compared to the glycemic status and to the presence of OSA. Fourteen patients (36%) were diagnosed with OSA and 21 (55%) with hypertension. There were no significant group differences in plasma Ox-LDL levels or between patients with/without OSA. Plasma Ox-LDL levels were significantly higher among patients with hypertension compared to controls (P = 0.01), while they correlated with homeostasis model assessment (P = 0.02), BMI-SDS (P = 0.049), and systolic blood pressure (P = 0.002). CONCLUSIONS The findings of this pilot study suggest that increased lipid peroxidation is associated with insulin resistance and hypertension in obese children and adolescents, while OSA has most likely minor influence.
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Fyfe-Johnson AL, Ryder JR, Alonso A, MacLehose RF, Rudser KD, Fox CK, Gross AC, Kelly AS. Ideal Cardiovascular Health and Adiposity: Implications in Youth. J Am Heart Assoc 2018; 7:JAHA.117.007467. [PMID: 29654202 PMCID: PMC6015406 DOI: 10.1161/jaha.117.007467] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND The American Heart Association set 2020 Strategic Impact Goals that defined cardiovascular risk factors to be included in the concept of ideal cardiovascular health (ICH). The prevalence of ICH among differing levels of adiposity in youth, especially severe obesity, is uncertain. METHODS AND RESULTS The cross-sectional study measured ICH metrics in 300 children and adolescents stratified by adiposity: normal weight, overweight/obese, and severely obese. ICH incorporates 7 behavioral and health metrics, and was characterized as poor, intermediate, or ideal. Individual ICH metrics were transformed into standardized sample z-scores; a summary ICH sample z-score was also calculated. Multivariable linear regression models were used to estimate differences in ICH sample z-scores by adiposity status. Of the 300 participants, 113 were classified as having normal weight, 87 as having overweight/obesity, and 100 as having severe obesity (mean age 12.8 years, SD 2.7; 48% female). No participants met the criteria for ICH; 80% of those classified as having normal weight, 81% of those with overweight/obesity, and all of those with severe obesity were in poor cardiovascular health. After multivariable adjustment, those with overweight/obesity (sample z-score: -1.35; 95% confidence interval, -2.3, -1.1) and severe obesity (sample z-score: -1.45; 95% confidence interval, -2.9, -0.92) had lower overall ICH sample z-scores compared with participants with normal weight. Results were similar for individual ICH metrics. CONCLUSIONS Poor cardiovascular health was highly prevalent in youth; ICH sample z-scores increased across levels of adiposity. Youth with obesity, particularly those with severe obesity, remain a rich target for primary prevention efforts. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT01508598.
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Affiliation(s)
- Amber L Fyfe-Johnson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN .,College of Medicine, Washington State University, Seattle, WA
| | - Justin R Ryder
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN
| | - Alvaro Alonso
- Rollins School of Public Health, Emory University, Atlanta, GA
| | - Richard F MacLehose
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Kyle D Rudser
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Claudia K Fox
- Department of Medicine, University of Minnesota Medical School, Minneapolis, MN
| | - Amy C Gross
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN
| | - Aaron S Kelly
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN.,Department of Medicine, University of Minnesota Medical School, Minneapolis, MN
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Cho WK, Han K, Ahn MB, Park YM, Jung MH, Suh BK, Park YG. Metabolic risk factors in Korean adolescents with severe obesity: Results from the Korea National Health and Nutrition Examination Surveys (K-NHANES) 2007-2014. Diabetes Res Clin Pract 2018; 138:169-176. [PMID: 29427699 PMCID: PMC6221804 DOI: 10.1016/j.diabres.2018.01.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 12/06/2017] [Accepted: 01/26/2018] [Indexed: 02/06/2023]
Abstract
AIMS To investigate the metabolic risk factors according to the degree of obesity in Korean adolescents. METHODS Among 7197 subjects aged 10-18 years who participated in the 2007-2014 K-NHANES, 1326 adolescents (M = 744, F = 582) with age and sex specific body mass index (BMI) ≥85th percentile were included. These adolescents with obesity were classified as: overweight, obesity, severe obesity, and extreme severe obesity. For assessing central obesity, the subjects were further-classified as: normal waist obese, abdominal obesity I, abdominal obesity II and abdominal obesity III. RESULTS The prevalence of overweight, obesity, severe obesity and extreme severe obesity were 5.6%, 6.2%, 5.9% and 0.9% in Korean adolescents. With increasing levels of obese category, the incidence of metabolic risk factors such as HDL-C < 40 mg/dL or <50 mg/dL in girls older than 16 years-old (20.2%, 18.5%, 34.4%, 43.6%, P < .0001), TG ≥ 150 mg/dL (15.3%, 16.7%, 26.5%, 30.9%, P < .003), HbA1C ≥ 5.8% (12.8%, 13.5%, 21.9%, 42.2%, P < .006), SBP ≥ 130 mg/dL (3.5%, 6.4%, 8.1%, 19.5%, P < .003) significantly increased. With increasing levels of central obese category, the incidence of metabolic risk factors such as HDL-C < 40 mg/dL or <50 mg/dL in girls older than 16 years-old (20.2%, 26.2%, 37.9%, 35.7%, P < .0007), TG ≥ 150 mg/dL (16.1%, 21.2%, 25.8%, 29.8%, P < .004), glucose ≥ 100 mg/dL (7.7%, 7.3%, 11.7%, 17.4%, P < .009) and SBP ≥ 130 mg/dL (5.1%, 7.1%, 3.0%, 13.9%, P < .002) significantly increased. CONCLUSION Adolescents with severe obesity have more metabolic risk factors compared to adolescents with less severe degree of obesity.
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Affiliation(s)
- Won Kyoung Cho
- Department of Pediatrics, College of Medicine, St. Vincent's Hospital, The Catholic University of Korea, Republic of Korea
| | - Kyungdo Han
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Republic of Korea
| | - Moon Bae Ahn
- Department of Pediatrics, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Republic of Korea
| | - Yong-Moon Park
- Epidemiology Branch, National Institute of Environmental, Health Sciences, National Institutes of Health, 111 T.W. Alexander Dr., Research Triangle Park, NC 27709, USA
| | - Min Ho Jung
- Department of Pediatrics, College of Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, Republic of Korea.
| | - Byung-Kyu Suh
- Department of Pediatrics, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Republic of Korea
| | - Yong-Gyu Park
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Republic of Korea.
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Abstract
Prehypertension (pHTN) and metabolic syndrome (MetS) are both lifestyle diseases that are potentiated by increased adiposity, as both disease processes are closely related to weight. In the case of pHTN, increased adiposity causes dysregulation of the renin-angiotensin-aldosterone-system (RAAS) as well as adipokine- and leptin-associated increases in adrenergic tone. In MetS, excess weight potentiates hyperglycemia and insulin resistance which causes positive feedback into the RAAS system, activates an inflammatory cascade that potentiates atherosclerosis, and causes lipid dysregulation which together contribute to cardiovascular disease, especially coronary heart disease (CHD) and heart failure (HF). The relationship with all-cause mortality is not as clear-cut in part because of some protective effects associated with the obesity paradox in chronic diseases such as CHD and HF. However, in healthy populations, the absence of excess weight and its associated effects on prehypertension and MetS are associated with a longer absolute and disease-free lifespan.
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Suwannasual U, Lucero J, McDonald JD, Lund AK. Exposure to traffic-generated air pollutants mediates alterations in brain microvascular integrity in wildtype mice on a high-fat diet. ENVIRONMENTAL RESEARCH 2018; 160:449-461. [PMID: 29073573 PMCID: PMC5705467 DOI: 10.1016/j.envres.2017.10.029] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 10/16/2017] [Accepted: 10/17/2017] [Indexed: 05/03/2023]
Abstract
Air pollution-exposure is associated with detrimental outcomes in the central nervous system (CNS) such as cerebrovascular disorders, including stroke, and neurodegenerative diseases. While the mechanisms of these CNS-related outcomes involved have not been fully elucidated, exposure to traffic-generated air pollutants has been associated with altered blood brain barrier (BBB) integrity and permeability. The current study investigated whether inhalation exposure to mixed vehicle emissions (MVE) alters cerebral microvascular integrity in healthy 3 mo old C57BL/6 mice, as well as whether exposure-mediated effects were exacerbated by a high-fat (HF) vs. low-fat (LF) diet. Mice on each diet were randomly assigned to be exposed to either filtered air (FA) or MVE [100PM/m3 vehicle emissions mixture: 30µg PM/m3 gasoline engine + 70µg PM/m3 diesel engine emissions; median size ~ 60nm; particle mass size distribution median of ~ 1µm (range: < 0.5-20µm)] for 6h/d, 7d/wk, for 30d. Using sodium fluorescein as a tracer, we observed a significant increase in BBB permeability in both HF + MVE exposed and HF + FA animals, compared to LF + FA controls. Exposure to HF + MVE also led to a significant increase plasma ox-LDL and ox-LDL scavenger receptors (LOX-1 and CD-36) expression in the cerebral vasculature. Histological analysis revealed decreased expression of TJ protein, claudin-5, associated with increased matrix metalloproteinase (MMP)-9 activity and oxidative stress in the cerebral vasculature of HF + MVE mice, compared to LF + MVE. Such findings indicate that inhalation exposure to traffic-generated pollutants, coupled with a HF diet, results in altered BBB integrity and increased ox-LDL signaling in the cerebral vasculature in a wildtype animal model.
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Affiliation(s)
- Usa Suwannasual
- Advanced Environmental Research Institute, Department of Biological Sciences, University of North Texas, Denton, TX 76201, USA
| | - JoAnn Lucero
- Advanced Environmental Research Institute, Department of Biological Sciences, University of North Texas, Denton, TX 76201, USA
| | - Jacob D McDonald
- Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM 87108, USA
| | - Amie K Lund
- Advanced Environmental Research Institute, Department of Biological Sciences, University of North Texas, Denton, TX 76201, USA.
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Lopez-Sandoval J, Sanchez-Enriquez S, Rivera-Leon EA, Bastidas-Ramirez BE, Garcia-Garcia MR, Gonzalez-Hita ME. CARDIOVASCULAR RISK FACTORS IN ADOLESCENTS: ROLE OF INSULIN RESISTANCE AND OBESITY. ACTA ENDOCRINOLOGICA-BUCHAREST 2018; 14:330-337. [PMID: 31149280 DOI: 10.4183/aeb.2018.330] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Introduction Childhood obesity is a public health problem characterized by early insulin resistance (IR), inflammation, and oxidative stress. The presence of an uninterrupted low-grade inflammatory state impairs metabolic and cardiovascular health. The population is particularly susceptible to develop metabolic disorders related to increased body fat. Methods Eighty-three adolescents were recruited and grouped according to HOMA-IR and BMI in either with or without IR and obese or normal-weight respectively. Anthropometric, biochemical, immunological and hormonal variables were determined. Transverse Analytical Study. Results Obesity, dyslipidemia, IL-6, and C-reactive protein were significantly higher in the IR group than in the non-IR group. Obese adolescents showed increased insulin levels, HOMA-IR, inflammatory markers, and triglycerides; while having lower HDL-C, and adiponectin when compared to normal-weight adolescents. As expected, obesity-related anthropometric markers positively correlated with IR and inflammatory markers while negatively correlated with adiponectin levels. Conclusions Early IR, subclinical inflammation, dyslipidemia, and hypoadiponectinemia characterize obesity in adolescents. These factors may increase the risk of future coronary heart disease (CHD) and diabetes mellitus development (DM) in early adulthood.
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Affiliation(s)
- J Lopez-Sandoval
- "Fray Antonio Alcalde" Hospital Civil de Guadalajara, Department of Pediatric Endocrinology, Universidad de Guadalajara Centro Universitario de Ciencias de la Salud, Jalisco, Mexico
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Gajewska J, Ambroszkiewicz J, Weker H, Chełchowska M. Relations between oxidized low-density lipoproteins and fat-soluble vitamin concentrations in obese children - preliminary study. DEVELOPMENTAL PERIOD MEDICINE 2017; 21. [PMID: 29077566 PMCID: PMC8522945 DOI: 10.34763/devperiodmed.20172103.266271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Although lipid peroxidation products are formed during normal cell metabolism, they appear mostly in pathological conditions via producing an excess of free radicals that can react with unsaturated fatty acids, in particular low-density lipoprotein (LDL). The aim of this study was to investigate the relations between oxidized LDL (oxLDL), the fat-soluble vitamin status and the anthropometric parameters in prepubertal obese children. MATERIAL AND METHODS Thirty-two obese (SDS-BMI >2) and 25 non-obese children (SDS-BMI <-1+1>) were included in the study. The concentration of oxLDL was determined in the serum by the ELISA assay. Vitamin A and E were measured by the high-pressure liquid chromatography method. Total cholesterol, LDL- and HDL-cholesterol, and triglyceride levels were determined by enzymatic methods. RESULTS The concentrations of oxLDL and vitamin A were higher in obese children than in normalweight controls by about 50% (p=0.01) and 40% (p=0.001), respectively. In obese children the significant positive correlation was found between oxLDL and vitamin A concentrations (<0.05). In addition, oxLDL correlated positively with BMI values (<0.05) and the amount of fat mass (kg) (<0.02) in these patients. Concentrations of vitamins A and E correlated with the level of total cholesterol (<0.05; <0.01, respectively).Moreover, a positive correlation between vitamin E and LDL-cholesterol was observed (<0.05). CONCLUSIONS Our preliminary study shows that oxLDL starts early during the prepubertal period and may precede atherosclerotic lesions. We suggest there is an occurrence of relationships between vitamin A and oxidized LDL in prepubertal obese children. Vitamin A and E concentrations are also associated with dyslipidemia in these patients.
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Affiliation(s)
- Joanna Gajewska
- Screening Department Institute of Mother and Child in Warsaw, WarsawPoland,Joanna Gajewska Screening Department Institute of Mother and Child Kasprzaka 17a, 01-211 Warsaw tel, (048 22) 32-77-260
| | | | - Halina Weker
- Department of Nutrition Institute of Mother and Child in Warsaw, WarsawPoland
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Abstract
OBJECTIVE Severe obesity in adolescents is increasing and few effective treatments exist. Bariatric surgery is one option, but the extent to which surgery influences cardiovascular risk factors over time in youth is not clear. We hypothesized that Roux-en Y gastric bypass (RYGB) would be associated with sustained improvements in lipids over time (>5 years). PARTICIPANTS/METHODS Youth who underwent RYGB from 2001 to 2007 were recruited for the Follow-up of Adolescent Bariatric Surgery-5+ (FABS-5+) in 2011-2014. Baseline body mass index (BMI) and lipids were abstracted from medical records. Follow-up data were obtained at a research visit. Analyses included paired t-tests to assess changes in BMI and lipids over time. General linear models were used to evaluate predictors of high-density lipoprotein (HDL) and non-HDL-cholesterol at follow-up. A non-operative group was recruited for comparison. RESULTS Surgical participants (n=58) were a mean±s.d. age of 17±2 years at baseline and 25±2 years at long-term follow-up. Eighty-six percent were Caucasian and 64% were female. At long-term follow-up BMI decreased by 29% and all lipids (except total cholesterol) significantly improved (P<0.01). Female sex was a significant predictor of non-HDL-cholesterol level at 1 year, while change in BMI from 1 year to long-term follow-up was a significant predictor of non-HDL-cholesterol and HDL-cholesterol during the same interval (P<0.05). In the non-operative group, BMI increased by 8% and lipid parameters were unchanged. CONCLUSIONS This is the longest and most complete follow-up of youth following RYGB. Weight loss maintenance over time was significantly associated with improvements in lipid profile over 5 years.
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Ma E, Ingram KH, Milne GL, Garvey WT. F2-Isoprostanes Reflect Oxidative Stress Correlated With Lean Mass and Bone Density but Not Insulin Resistance. J Endocr Soc 2017; 1:436-448. [PMID: 29264499 PMCID: PMC5686621 DOI: 10.1210/js.2017-00006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 04/04/2017] [Indexed: 12/20/2022] Open
Abstract
Context: F2-isoprostanes (F2-isoPs) are biomarkers for oxidative stress in humans and have been shown to be elevated in obesity, cardiovascular disease, and diabetes. Therefore, F2-isoPs are often implicated in oxidative stress contributing to insulin resistance, although this has not been rigorously examined. Objective: To determine whether urinary F2-isoPs are predictive of insulin sensitivity and other clinical metabolic parameters. Participants: Sedentary, weight-stable, nondiabetic adults equilibrated on a standard isocaloric diet. Main Outcome Measures: Insulin sensitivity via hyperinsulinemic-euglycemic clamp, urinary F2-isoPs by gas chromatography-mass spectrometry, and body composition by dual-energy x-ray absorptiometry. Results: No correlation was found between 15-F2t-IsoP nor its major metabolite, 2,3-dinor-5,6-dihydro-15-F2t-IsoP, with insulin sensitivity, even after adjusting for age, race, sex, BMI, and smoking status. 15-F2t-IsoP was also not associated with body fat. However, there was a strong negative correlation between 15-F2t-IsoP and lean body mass (LBM; r = −0.46, P = 0.0001), bone mineral content (BMC; r = −0.58, P < 0.0001), bone mineral density (BMD; r = −0.65, P < 0.0001), and skeletal muscle protein 4-hydroxynonenal (4-HNE; r = −0.54, P = 0.0239), another marker of oxidative stress. 15-F2t-IsoP was also positively associated with circulating triglycerides and total cholesterol, and increased as a function of age. Conclusions: Urinary 15-F2t-IsoP and its major metabolite are not associated with insulin sensitivity, suggesting the lipid peroxidation process that produces F2-isoPs does not reflect oxidative stress reactions operative in insulin resistance. However, urinary F2-isoPs were negatively correlated with LBM, BMC, BMD, and muscle 4-HNE. Because lean and bone mass decline as a function of biological aging, F2-isoPs may reflect the oxidative stress operative in the aging process.
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Affiliation(s)
- Elizabeth Ma
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama 35294
| | - Katherine H Ingram
- Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, Georgia 30144
| | - Ginger L Milne
- Department of Medicine, Vanderbilt University Medical Center, Vanderbilt University, Nashville, Tennessee 37232
| | - W Timothy Garvey
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama 35294.,Department of Medicine, The Birmingham Veterans Affairs Medical Center, Birmingham, Alabama 35233
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Sun DQ, Liu WY, Wu SJ, Zhu GQ, Braddock M, Zhang DC, Shi KQ, Song D, Zheng MH. Increased levels of low-density lipoprotein cholesterol within the normal range as a risk factor for nonalcoholic fatty liver disease. Oncotarget 2016; 7:5728-37. [PMID: 26735337 PMCID: PMC4868717 DOI: 10.18632/oncotarget.6799] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 12/04/2015] [Indexed: 02/06/2023] Open
Abstract
Objectives Dyslipidemia exists within the setting of NAFLD and the relationship of a normal level of low-density lipoprotein cholesterol (LDL-c) with NAFLD is largely unknown. This large population-based study aimed to investigate the association between LDL-c levels within the normal range and the incidence of NAFLD. Methods A total of 60527 subjects from 2 medical centers who had undergone liver ultrasonography were initially enrolled into this study. NAFLD was defined by ultrasonographic detection of steatosis in the absence of other liver disease. Subjects were divided into 4 groups (Q1 to Q4) by normal LDL-c quartiles : Q1: ≤ 2.00, Q2: 2.10-2.35, Q3: 2.36-2.68 and Q4: 2.69-3.12 mmol/L. The odds ratios (OR), hazard ratio (HR) and 95% confidence intervals (CIs) for NAFLD were calculated across each quartile of LDL-c, using the Q1 as reference. Results The prevalence rates of NAFLD in a cross-sectional population from Q1 to Q4 were 19.34%, 25.86%, 35.65% and 42.08%, respectively. The OR for NAFLD in the cross-sectional population were 1.31 (95% CI 1.14-1.54), 1.73 (95% CI 1.46-2.04), and 1.82 (95% CI 1.49-2.23), respectively, after adjusting for known confounding variables. The HR for NAFLD in the longitudinal population were 1.23 (95% CI 1.12-1.35), 1.57 (95% CI 1.44-1.72) and 2.02 (95% CI 1.86-2.21), compared with Q1. Subjects with higher LDL-c level within the normal range had an increased cumulative incidence rate of NAFLD. Conclusions Increased levels of LDL-c within the normal range may play a significant role in the prevalence and incidence of NAFLD, independent of other confounding factors.
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Affiliation(s)
- Dan-Qin Sun
- Department of Nephrology, Affiliated Wuxi Second Hospital, Nanjing Medical University, Wuxi 214002, China
| | - Wen-Yue Liu
- Department of Endocrinology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Sheng-Jie Wu
- Department of Cardiovascular Medicine, the Heart Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Gui-Qi Zhu
- Department of Infection and Liver Diseases, Liver Research Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.,School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou 325000, China
| | - Martin Braddock
- Global Medicines Development, AstraZeneca R&D, Alderley Park, United Kingdom
| | - Dong-Chu Zhang
- Wenzhou Medical Center, Wenzhou People's Hospital, Wenzhou 325000, China
| | - Ke-Qing Shi
- Department of Infection and Liver Diseases, Liver Research Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.,Institute of Hepatology, Wenzhou Medical University, Wenzhou 325000, China
| | - Dan Song
- Department of Nephrology, Affiliated Wuxi Second Hospital, Nanjing Medical University, Wuxi 214002, China
| | - Ming-Hua Zheng
- Department of Infection and Liver Diseases, Liver Research Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.,Institute of Hepatology, Wenzhou Medical University, Wenzhou 325000, China
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Sun DQ, Wu SJ, Liu WY, Wang LR, Chen YR, Zhang DC, Braddock M, Shi KQ, Song D, Zheng MH. Association of low-density lipoprotein cholesterol within the normal range and NAFLD in the non-obese Chinese population: a cross-sectional and longitudinal study. BMJ Open 2016; 6:e013781. [PMID: 27927668 PMCID: PMC5168665 DOI: 10.1136/bmjopen-2016-013781] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES The relationship between normal low-density lipoprotein cholesterol (LDL-c) levels and non-alcoholic fatty liver disease (NAFLD) in non-obese individuals remains unclear. We aimed to investigate the precise prevalence and incidence of NAFLD within the normal LDL-c range in non-obese individuals. DESIGN Cross-sectional and longitudinal study. SETTING Wenzhou Medical Center of Wenzhou People's Hospital from 2010 to 2014. PARTICIPANTS 183 903 non-obese individuals were enrolled from a cross-sectional population, and a total of 16 173 initially NAFLD-free non-obese individuals were included who completed a 5-year follow-up examination in the longitudinal population. RESULTS In our study, NAFLD was defined by ultrasonographic detection of steatosis in the absence of other liver disease. The cross-sectional study showed that at baseline, the prevalence of NAFLD was 13.9% in non-obese individuals with normal LDL-c levels. The prospective study demonstrated that NAFLD-free participants developed NAFLD during the 5-year follow-up period, with a cumulative incidence of 14.4%. In addition, the ORs for NAFLD in the cross-sectional population were 1.11 (95% CI 1.04 to 1.18), 1.37 (95% CI 1.27 to 1.47) and 1.56 (95% CI 1.43 to 1.69), respectively, after adjusting for known confounding variables. The HRs for NAFLD in the longitudinal population were 1.15 (95% CI 0.98 to 1.36), 1.32 (95% CI 1.10 to 1.58) and 1.82 (95% CI 1.47 to 2.52), compared with Q1. Individuals with higher LDL-c level within the normal range had an increased cumulative incidence rate of NAFLD in non-obese individuals. CONCLUSIONS NAFLD is prevalent in the non-obese Chinese population. Furthermore, this is the first study to demonstrate that increased normal LDL-c levels are independently associated with an elevated risk of NAFLD in non-obese individuals.
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Affiliation(s)
- Dan-Qin Sun
- Department of Nephrology, Affiliated Wuxi Second Hospital, Nanjing Medical University, Wuxi, China
| | - Sheng-Jie Wu
- Department of Cardiovascular Medicine, The Heart Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Wen-Yue Liu
- Department of Endocrinology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Li-Ren Wang
- Department of Hepatology, Liver Research Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Yi-Ran Chen
- Department of Hepatology, Liver Research Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Dong-Chu Zhang
- Wenzhou Medical Center, Wenzhou People's Hospital, Wenzhou, China
| | - Martin Braddock
- Global Medicines Development, AstraZeneca R&D, Alderley Park, UK
| | - Ke-Qing Shi
- Department of Hepatology, Liver Research Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Institute of Hepatology, Wenzhou Medical University, Wenzhou, China
| | - Dan Song
- Department of Nephrology, Affiliated Wuxi Second Hospital, Nanjing Medical University, Wuxi, China
| | - Ming-Hua Zheng
- Department of Hepatology, Liver Research Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Institute of Hepatology, Wenzhou Medical University, Wenzhou, China
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Ulloa-Martínez M, Burguete-García AI, Murugesan S, Hoyo-Vadillo C, Cruz-Lopez M, García-Mena J. Expression of candidate genes associated with obesity in peripheral white blood cells of Mexican children. Arch Med Sci 2016; 12:968-976. [PMID: 27695486 PMCID: PMC5016575 DOI: 10.5114/aoms.2016.58126] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 02/04/2015] [Indexed: 01/16/2023] Open
Abstract
INTRODUCTION Obesity is a chronic, complex, and multifactorial disease, characterized by excess body fat. Diverse studies of the human genome have led to the identification of susceptibility genes that contribute to obesity. However, relatively few studies have addressed specifically the association between the level of expression of these genes and obesity. MATERIAL AND METHODS We studied 160 healthy and obese unrelated Mexican children aged 6 to 14 years. We measured the transcriptional expression of 20 genes associated with obesity, in addition to the biochemical parameters, in peripheral white blood cells. The detection of mRNA levels was performed using the OpenArray Real-Time PCR System (Applied Biosystems). RESULTS Obese children exhibited higher values of fasting glucose (p = 0.034), fasting insulin (p = 0.004), low-density lipoprotein (p = 0.006), triglycerides (p < 0.001), systolic blood pressure and diastolic blood pressure (p < 0.001), and lower values of high-density lipoprotein (p < 0.001) compared to lean children. Analysis of transcriptional expression data showed a difference for ADRB1 (p = 0.0297), ADIPOR1 (p = 0.0317), GHRL (p = 0.0060) and FTO (p = 0.0348) genes. CONCLUSIONS Our results suggest that changes in the expression level of the studied genes are involved in biological processes implicated in the development of childhood obesity. Our study contributes new perspectives for a better understanding of biological processes involved in obesity. The protocol was approved by the National Committee and Ethical Committee Board from the Mexican Social Security Institute (IMSS) (IMSS FIS/IMSS/PRIO/10/011).
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Affiliation(s)
- Marcela Ulloa-Martínez
- Departamento de Genética y Biología Molecular, Centro de Investigación y de Estudios Avanzados del IPN, México, México
| | - Ana I. Burguete-García
- Dirección de Infecciones Crónicas y Cáncer, CISEI, Instituto Nacional de Salud Pública, México, México
| | - Selvasankar Murugesan
- Departamento de Genética y Biología Molecular, Centro de Investigación y de Estudios Avanzados del IPN, México, México
- Departamento de Farmacología, Centro de Investigación y de Estudios Avanzados del IPN, México, México
| | - Carlos Hoyo-Vadillo
- Departamento de Farmacología, Centro de Investigación y de Estudios Avanzados del IPN, México, México
| | - Miguel Cruz-Lopez
- Unidad Unidad de Investigación Médica en Bioquímica, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México, México
| | - Jaime García-Mena
- Departamento de Genética y Biología Molecular, Centro de Investigación y de Estudios Avanzados del IPN, México, México
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Dasari PS, Gandomani BS, Teague AM, Pitale A, Otto M, Short KR. Glycemic Variability Is Associated with Markers of Vascular Stress in Adolescents. J Pediatr 2016; 172:47-55.e2. [PMID: 26922105 DOI: 10.1016/j.jpeds.2016.01.065] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 12/28/2015] [Accepted: 01/27/2016] [Indexed: 01/01/2023]
Abstract
OBJECTIVES We used continuous glucose monitoring to test the hypothesis that mean amplitude of glycemic excursions (MAGE) is associated with circulating markers of oxidative and vascular stress in adolescents with habitually low physical activity classified as healthy weight, healthy obese, or obese with type 2 diabetes mellitus (T2DM). STUDY DESIGN A group of 13- to 21-year-olds (healthy weight = 12, healthy obese = 10, T2DM = 12) wore a continuous glucose monitor and step activity monitor for 5 days. RESULTS Physical activity was similar among groups (6551 ± 401 steps/d), but aerobic fitness (peak rate of oxygen consumption) was lower (P < .05) in T2DM (15.6 ± 1.8 mL/kg/min) than either healthy weight (26.2 ± 2.2) or healthy obese (24.4 ± 2.5). MAGE (mg/dL) was higher (P < .01) in T2DM (82 ± 10) vs healthy obese (33 ± 3) and healthy weight (30 ± 3). Average glucose followed a similar pattern as MAGE. Oxidized low density lipoprotein was higher (P < .05) in T2DM (70.3 ± 5.0 U/L) and healthy obese (58.1 ± 3.8) than healthy weight (48.4 ± 2) and positively correlated with MAGE (r = 0.77). Other stress markers that were both elevated in T2DM and correlated with MAGE included E-selectin (r = 0.50), intercellular adhesion molecule 1 (r = 0.35), and C-reactive protein (r = 0.52); soluble receptor for advanced glycosylation end product was lower in T2DM and inversely correlated with MAGE (r = -0.38). CONCLUSIONS MAGE is highest in obese youth with T2DM. The associations between MAGE and oxidative stress markers support the proposed contribution of glycemic variability to risk for future cardiovascular disease.
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Affiliation(s)
- Paul S Dasari
- Department of Pediatrics, Section of Diabetes and Endocrinology, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Benjamin S Gandomani
- College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - April M Teague
- Department of Pediatrics, Section of Diabetes and Endocrinology, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | | | | | - Kevin R Short
- Department of Pediatrics, Section of Diabetes and Endocrinology, University of Oklahoma Health Sciences Center, Oklahoma City, OK.
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38
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Caminiti C, Armeno M, Mazza CS. Waist-to-height ratio as a marker of low-grade inflammation in obese children and adolescents. J Pediatr Endocrinol Metab 2016; 29:543-51. [PMID: 26887032 DOI: 10.1515/jpem-2014-0526] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 12/07/2015] [Indexed: 01/01/2023]
Abstract
BACKGROUND The epidemic of childhood obesity is associated with early atherosclerosis. Several reports have related this event to low-grade inflammation described in obesity. CRP and IL6 are markers that correlate with adiposity. The waist-to-height ratio (WtHR) is an anthropometric marker associated with insulin resistance and inflammation. The objective of this study was to assess the correlation between WtHR, metabolic complications and pro-inflammatory factors in obese children and adolescents. METHODS Weight, height, waist circumference, glycemia, insulin, CRP, TNF-α and IL-6 were measured in the baseline sample in 280 patients 6-19 years of age with overweight or obesity (OW/OB) and 112 normal-weight controls. Logistic regression was performed using WtHR as an independent variable. p>0.05 STATA11. RESULTS Mean WtHR was 0.6±0.06 in OW/OB and 0.43±0.02 in controls (p<0.01). WtHR was increased in 93% of the OW/OB vs. 2% of the controls. In the OW/OB inflammatory markers were significantly increased (p<0.01) compared to the controls (CRP 2.2 vs. 0.8; Il-6 2.9 vs. 2.1; and TNF-α 6.2 vs. 5.5). In the WtHR>0.5, insulin resistence and inflammatory markers were significantly increased (p<0.01) compared to the WtHR<0.5 (HOMA 3.4 vs. 1.4; CRP 2.3 vs. 0.6; Il-6 2.9 vs. 2.1; and TNF-α 6.4 vs. 5.55). In logistic regression, a significant independent association was found between WtHR with CRP (OR1.47), IL6 (OR1.60) and TNF-α (OR1.79). CONCLUSIONS Obese children and adolescents have high inflammatory markers that may increase cardiovascular risk. WtHR is associated with low-grade inflammation and may be considered a relevant anthropometric marker in the clinical practice.
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Moss A, Sievert K, Siegfried W, Siegfried A, Brandt S, Koenig W, Wabitsch M. Sonographically Assessed Intra-Abdominal Fat And Cardiometabolic Risk Factors in Adolescents with Extreme Obesity. Obes Facts 2016; 9:121-37. [PMID: 27058884 PMCID: PMC5644824 DOI: 10.1159/000443690] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 07/12/2015] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE The metabolic and cardiovascular risk of obesity is predominantly defined through the amount of intra-abdominal fat (IAF). Regarding this risk and the benefits of weight reduction gender-specific differences have been described. The aim of this study was to examine the gender-specific relationship between IAF assessed via ultrasound and the cardiometabolic risk profile in extremely obese adolescents before and after weight loss. METHODS In 107 consecutively admitted adolescents (n = 59 girls, mean age 15.4 ± 2.6 years boys and 15.1 ± 2.1 years girls, mean BMI z-score 3.2 ± 0.6 boys and 3.5 ± 0.6 girls) anthropometric and fasting laboratory chemical parameters were measured before and after an in-patient long-term therapy (mean durance 5.6 ± 2.3 months). IAF was determined by measuring the intra-abdominal depth (IAD) via ultrasound. RESULTS IAD was higher in boys as compared to girls (58.0 ± 22.4 mm vs. 51.3 ± 16.0 mm). IAD values were positively associated with BMI-z scores, waist circumferences, HOMA-IR and serum levels of x03B3;GT, hs-CRP and IL-6 in both genders. In boys, but not in girls, IAD was significantly correlated with systolic and diastolic blood pressure, serum levels of triglycerides, ALT as well as adiponectin and HDL-cholesterol. After a marked mean weight loss of -27.1 ± 16.2 kg (-20.1 ± 7.9%) in boys and of -20.5 ± 11.5 kg (-17.3 ± 7.1%) in girls, IAD decreased by -20.7 ± 16.2 mm (--32.4 ± 16.9%) in boys and by -18.4 ± 12,7 mm (-34.3 ± 18.4%) in girls, resulting in more pronounced ameliorations of cardiovascular risk factors in boys than in girls. CONCLUSIONS The present study indicates that IAF assessed by ultrasound is a good indicator for the cardiometabolic risk factor profile in extremely obese adolescents. Associations between IAF and risk factors are more pronounced in boys than in girls.
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Affiliation(s)
- Anja Moss
- Division of Paediatric Endocrinology and Diabetes, Department of Paediatrics and Adolescent Medicine, Ulm University, Ulm, Germany
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40
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Ryder JR, O’Connell M, Bosch TA, Chow L, Rudser KD, Dengel DR, Fox CK, Steinberger J, Kelly AS. Impaired cardiac autonomic nervous system function is associated with pediatric hypertension independent of adiposity. Pediatr Res 2016; 79:49-54. [PMID: 26389821 PMCID: PMC4724304 DOI: 10.1038/pr.2015.188] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 07/21/2015] [Indexed: 12/19/2022]
Abstract
BACKGROUND We examined whether sympathetic nervous system activity influences hypertension status and systolic blood pressure (SBP) independent of adiposity in youth ranging from normal-weight to severe obesity. METHODS We examined the association of heart rate variability (HRV) with hypertension status and SBP among youth (6-18 y old; n = 188; 103 female). Seated SBP was measured using an automated cuff. Prehypertension (SBP percentile ≥ 90th to <95th) and hypertension (SBP percentile ≥ 95th) were defined by age-, sex-, and height-norms. Autonomic nervous system activity was measured using HRV via SphygmoCor MM3 system and analyzed for time- and frequency-domains. Total body fat was measured via dual-energy X-ray absorptiometry. RESULTS Logistic regression models demonstrated lower values in each time-domain HRV measure and larger low-frequency (LF):high-frequency (HF) ratio to be significantly associated with higher odds of being prehypertensive/hypertensive (11-47% higher odds) independent of total body fat (P < 0.05). In linear regression analysis, lower time-domain, but not frequency-domain, HRV measures were significantly associated with higher SBP independent of total body fat (P < 0.05). CONCLUSION These data suggest that impaired cardiac autonomic nervous system function, at rest, is associated with higher odds of being prehypertensive/hypertensive and higher SBP which may be independent of adiposity in youth.
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Affiliation(s)
- Justin R. Ryder
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN,Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, MN
| | - Michael O’Connell
- Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis, MN
| | - Tyler A. Bosch
- Department of Medicine, University of Minnesota Medical School, Minneapolis, MN
| | - Lisa Chow
- Department of Medicine, University of Minnesota Medical School, Minneapolis, MN
| | - Kyle D. Rudser
- Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis, MN
| | - Donald R. Dengel
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN,School of Kinesiology, University of Minnesota, Minneapolis, MN
| | - Claudia K. Fox
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN
| | - Julia Steinberger
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN
| | - Aaron S. Kelly
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN,Department of Medicine, University of Minnesota Medical School, Minneapolis, MN
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van der Heijden RA, Bijzet J, Meijers WC, Yakala GK, Kleemann R, Nguyen TQ, de Boer RA, Schalkwijk CG, Hazenberg BPC, Tietge UJF, Heeringa P. Obesity-induced chronic inflammation in high fat diet challenged C57BL/6J mice is associated with acceleration of age-dependent renal amyloidosis. Sci Rep 2015; 5:16474. [PMID: 26563579 PMCID: PMC4643235 DOI: 10.1038/srep16474] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 10/13/2015] [Indexed: 01/13/2023] Open
Abstract
Obesity-induced inflammation presumably accelerates the development of chronic kidney diseases. However, little is known about the sequence of these inflammatory events and their contribution to renal pathology. We investigated the effects of obesity on the evolution of age-dependent renal complications in mice in conjunction with the development of renal and systemic low-grade inflammation (LGI). C57BL/6J mice susceptible to develop age-dependent sclerotic pathologies with amyloid features in the kidney, were fed low (10% lard) or high-fat diets (45% lard) for 24, 40 and 52 weeks. HFD-feeding induced overt adiposity, altered lipid and insulin homeostasis, increased systemic LGI and adipokine release. HFD-feeding also caused renal upregulation of pro-inflammatory genes, infiltrating macrophages, collagen I protein, increased urinary albumin and NGAL levels. HFD-feeding severely aggravated age-dependent structural changes in the kidney. Remarkably, enhanced amyloid deposition rather than sclerosis was observed. The degree of amyloidosis correlated significantly with body weight. Amyloid deposits stained positive for serum amyloid A (SAA) whose plasma levels were chronically elevated in HFD mice. Our data indicate obesity-induced chronic inflammation as a risk factor for the acceleration of age-dependent renal amyloidosis and functional impairment in mice, and suggest that obesity-enhanced chronic secretion of SAA may be the driving factor behind this process.
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Affiliation(s)
- Roel A van der Heijden
- Department of Pathology &Medical Biology, Medical Biology Section, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Top Institute Food and Nutrition, Wageningen, The Netherlands
| | - Johan Bijzet
- Department of Rheumatology and Clinical Immunology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Wouter C Meijers
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Gopala K Yakala
- Translational Laboratory in Genetic Medicine (TLGM), Agency for Science, Technology and Research (A*STAR) and Department of Medicine, National University of Singapore, Singapore
| | - Robert Kleemann
- Department of Metabolic Health Research, The Netherlands Organization for Applied Scientific Research (TNO), Leiden, The Netherlands.,Top Institute Food and Nutrition, Wageningen, The Netherlands
| | - Tri Q Nguyen
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Rudolf A de Boer
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Casper G Schalkwijk
- Experimental Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands.,Top Institute Food and Nutrition, Wageningen, The Netherlands
| | - Bouke P C Hazenberg
- Department of Rheumatology and Clinical Immunology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Uwe J F Tietge
- Department of Pediatrics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Peter Heeringa
- Department of Pathology &Medical Biology, Medical Biology Section, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Top Institute Food and Nutrition, Wageningen, The Netherlands
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Changes in inflammation, oxidative stress and adipokines following bariatric surgery among adolescents with severe obesity. Int J Obes (Lond) 2015; 40:275-80. [PMID: 26315843 DOI: 10.1038/ijo.2015.174] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 07/14/2015] [Accepted: 08/03/2015] [Indexed: 01/15/2023]
Abstract
BACKGROUND/OBJECTIVES Inflammation, oxidative stress and dysregulation of adipokines are thought to be pathophysiological mechanisms linking obesity to the development of insulin resistance and atherosclerosis. In adults, bariatric surgery reduces inflammation and oxidative stress, and beneficially changes the levels of several adipokines, but little is known about the postsurgical changes among adolescents. SUBJECTS/METHODS In two separate longitudinal cohorts we evaluated change from baseline of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), monocyte chemo-attractant protein-1 (MCP-1), oxidized low-density lipoprotein cholesterol (oxLDL), adiponectin, leptin and resistin up to 12 months following elective laparoscopic Roux-en-Y gastric bypass (RYGB) or vertical sleeve gastrectomy (VSG) surgery in adolescents with severe obesity. RESULTS In cohort 1, which consisted of 39 adolescents (mean age 16.5±1.6 years; 29 females) undergoing either RYGB or VSG, IL-6 (baseline: 2.3±3.4 pg ml(-1) vs 12 months: 0.8±0.6 pg ml(-1), P<0.01), leptin (baseline: 178±224 ng ml(-1) vs 12 months: 41.4±31.9 ng ml(-1), P<0.001) and oxLDL (baseline: 41.6±11.6 U l(-1) vs 12 months: 35.5±11.1 U l(-1), P=0.001) significantly decreased and adiponectin significantly increased (baseline: 5.4±2.4 μg ml(-1) vs 12 months: 13.5±8.9 μg ml(-1), P<0.001). In cohort 2, which consisted of 13 adolescents (mean age 16.5±1.6 years; 10 females) undergoing RYGB, results were similar: IL-6 (baseline: 1.7±0.9 pg ml(-1) vs 12 months: 0.4±0.9 pg ml(-1), P<0.05) and leptin (baseline: 92.9±31.3 ng ml(-1) vs 12 months: 37.3±33.4 ng ml(-1), P<0.001) significantly decreased and adiponectin significantly increased (baseline: 6.1±2.9 μg ml(-1) vs 12 months: 15.4±8.0 μg ml(-1), P<0.001). When the cohorts were combined to evaluate changes at 12 months, oxLDL also significantly decreased (baseline: 39.8±16.7 U l(-1) vs 12 months: 32.7±11.9 U l(-1), P=0.03). CONCLUSIONS Bariatric surgery produced robust improvements in markers of inflammation, oxidative stress and several adipokines among adolescents with severe obesity, suggesting potential reductions in risk for type 2 diabetes and cardiovascular disease.
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Hitchcock E, Patankar JV, Tyson C, Hrynchak M, Hayden MR, Gibson WT. A novel microdeletion affecting the CETP gene raises HDL-associated cholesterol levels. Clin Genet 2015; 89:495-500. [PMID: 26126777 DOI: 10.1111/cge.12633] [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: 03/14/2015] [Revised: 06/27/2015] [Accepted: 06/29/2015] [Indexed: 11/30/2022]
Abstract
We describe a novel, inherited 16q13 microdeletion that removes cholesteryl ester transfer protein (CETP) and several nearby genes. The proband was originally referred for severe childhood-onset obesity and moderate developmental delay, but his fasting lipid profile revealed relatively high levels of high density lipoprotein cholesterol (HDL-C) and relatively low levels of low density lipoprotein cholesterol (LDL-C) for age, despite his obesity. Testing of first-degree relatives identified two other microdeletion carriers. Functional assays in affected individuals showed decreased CETP mRNA expression and enzymatic activity. This microdeletion may or may not be pathogenic for obesity and developmental delay, but based on the lipid profile, the functional studies, and the phenotype of other patients with loss-of-function mutations of CETP, we believe this microdeletion to be antipathogenic for cardiovascular disease.
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Affiliation(s)
- E Hitchcock
- Child and Family Research Institute, Vancouver, Canada.,Department of Medical Genetics, University of British Columbia, Vancouver, Canada
| | - J V Patankar
- Department of Medical Genetics, University of British Columbia, Vancouver, Canada.,Centre for Molecular Medicine and Therapeutics, Vancouver, Canada
| | - C Tyson
- Cytogenetic Laboratory, Royal Columbian Hospital, New Westminster, Canada
| | - M Hrynchak
- Cytogenetic Laboratory, Royal Columbian Hospital, New Westminster, Canada
| | - M R Hayden
- Department of Medical Genetics, University of British Columbia, Vancouver, Canada.,Centre for Molecular Medicine and Therapeutics, Vancouver, Canada
| | - W T Gibson
- Child and Family Research Institute, Vancouver, Canada.,Department of Medical Genetics, University of British Columbia, Vancouver, Canada
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Shah AS, Dolan LM, Khoury PR, Gao Z, Kimball TR, Urbina EM. Severe Obesity in Adolescents and Young Adults Is Associated With Subclinical Cardiac and Vascular Changes. J Clin Endocrinol Metab 2015; 100:2751-7. [PMID: 25974736 PMCID: PMC4490306 DOI: 10.1210/jc.2014-4562] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
CONTEXT Severe obesity is the fastest growing subgroup of obesity in youth. OBJECTIVE We sought to explore the association between severe obesity and subclinical measures of cardiac and vascular structure and function in adolescents and young adults. DESIGN, SETTING, AND PARTICIPANTS This was a cross-sectional comparison of 265 adolescents and young adults with severe obesity (defined as body mass index [BMI] ≥120% of the 95th percentile) to 182 adolescents and young adults with obesity (defined as BMI ≥100-119th of the 95th percentile) at tertiary medical center. MAIN OUTCOMES Noninvasive measures of cardiac and vascular structure and function were assessed. RESULTS Participants were a mean age of 17.9 years, 62% were non-Caucasian, and 68% were female. Systolic blood pressure, fasting insulin, C-reactive protein, IL-6, and frequency of type 2 diabetes were higher in participants with severe obesity (all P < .05). Arterial thickness and stiffness, cardiac structure, and diastolic function were also significantly worse in youth with severe obesity as measured by higher left ventricular mass index, worse diastolic function, higher carotid intima media thickness, and pulse wave velocity and lower brachial distensibility (all P < .05). Regression modeling showed that severe obesity (compared with obesity) was independently associated with each of the above outcomes after adjustment for age, race, sex, blood pressure, lipids, and inflammatory markers (P < .05). CONCLUSIONS Adolescents and young adults with severe obesity have a more adverse cardiovascular risk profile and worse cardiac and vascular structure and function. More importantly, severe obesity is independently associated with these subclinical cardiac and vascular changes.
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Affiliation(s)
- Amy S Shah
- Cincinnati Children's Hospital Medical Center, The University of Cincinnati, Cincinnati, Ohio 45229
| | - Lawrence M Dolan
- Cincinnati Children's Hospital Medical Center, The University of Cincinnati, Cincinnati, Ohio 45229
| | - Philip R Khoury
- Cincinnati Children's Hospital Medical Center, The University of Cincinnati, Cincinnati, Ohio 45229
| | - Zhiqan Gao
- Cincinnati Children's Hospital Medical Center, The University of Cincinnati, Cincinnati, Ohio 45229
| | - Thomas R Kimball
- Cincinnati Children's Hospital Medical Center, The University of Cincinnati, Cincinnati, Ohio 45229
| | - Elaine M Urbina
- Cincinnati Children's Hospital Medical Center, The University of Cincinnati, Cincinnati, Ohio 45229
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Marin MT, Dasari PS, Tryggestad JB, Aston CE, Teague AM, Short KR. Oxidized HDL and LDL in adolescents with type 2 diabetes compared to normal weight and obese peers. J Diabetes Complications 2015; 29:679-85. [PMID: 25881918 PMCID: PMC9549762 DOI: 10.1016/j.jdiacomp.2015.03.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 02/16/2015] [Accepted: 03/05/2015] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Obesity and type 2 diabetes mellitus (T2DM) are associated with oxidative stress. Oxidative damage of high-density lipoprotein (oxHDL) leads to a dysfunctional molecule, potentially a mediator and/or marker of cardiometabolic disease. We tested the hypothesis that circulating concentration of oxHDL is higher in obese (Ob) or T2DM adolescents compared to normal-weight (NW) peers. METHODS In 37 NW, 38 Ob, and 42 T2DM adolescents, ages 11-18 y, fasting concentrations of HDL and LDL cholesterol, oxHDL, oxidized low-density lipoprotein (oxLDL), and myeloperoxidase (MPO) were measured. RESULTS Compared to the NW group, oxHDL in the Ob group was not different, but was 65% higher (p < 0.01) in the T2DM group. Within the T2DM group oxHDL was higher in boys than in girls, but this sex difference was not evident in NW or Ob groups. OxLDL was 23% higher in Ob (p = 0.02), and 56% higher in T2DM (p < 0.01) versus NW and did not differ between boys and girls. MPO was not different between NW and Ob but was 88% (p < 0.02) higher in T2DM compared to NW. Contrary to our hypothesis MPO and insulin resistance (HOMA-IR) were not correlated with oxHDL. OxHDL was positively associated with oxLDL and lean body mass while oxLDL was positively associated with apolipoprotein B, triglycerides, HOMA-IR and trunk fat. CONCLUSIONS The higher concentrations of oxHDL and oxLDL, along with higher MPO in children with T2DM reflect higher oxidative stress compared with obesity alone and potentially increased cardiovascular disease risk in youth with T2DM.
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Affiliation(s)
- Monica T Marin
- Pediatrics, Section of Diabetes/Endocrinology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Paul S Dasari
- Pediatrics, Section of Diabetes/Endocrinology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Jeanie B Tryggestad
- Pediatrics, Section of Diabetes/Endocrinology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Christopher E Aston
- Pediatrics, Biomedical and Behavioral Methodology Core, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - April M Teague
- Pediatrics, Section of Diabetes/Endocrinology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Kevin R Short
- Pediatrics, Section of Diabetes/Endocrinology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
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Zhang QQ, Lu LG. Nonalcoholic Fatty Liver Disease: Dyslipidemia, Risk for Cardiovascular Complications, and Treatment Strategy. J Clin Transl Hepatol 2015; 3:78-84. [PMID: 26357637 PMCID: PMC4542078 DOI: 10.14218/jcth.2014.00037] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 12/15/2014] [Accepted: 12/22/2014] [Indexed: 12/11/2022] Open
Abstract
Studies have shown that nonalcoholic fatty liver disease (NAFLD) is strongly associated with several metabolic disorders and diseases, such as obesity, type 2 diabetes mellitus, and dyslipidemia. In NAFLD, dyslipidemia is manifested as increased serum triglyceride and low-density lipoprotein cholesterol levels and decreased high-density lipoprotein cholesterol levels, all of which are key risk factors for cardiovascular disease (CVD). CVD is a leading cause of mortality in NAFLD patients. Thus, implementation of an aggressive therapeutic strategy for dyslipidemia with hypolipidemic agents may mitigate the risk for CVD among NAFLD patients. Here, we provide a current review of literature regarding NAFLD, with particular emphasis on dyslipidemia and available treatment options.
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Affiliation(s)
| | - Lun-Gen Lu
- Correspondence to: Lun-Gen Lu, Department of Gastroenterology, Shanghai First People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200080, China. Tel: +86-21-63240090, Fax: +86-21-63241377. E-mail:
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Nascimento H, Alves AI, Coimbra S, Catarino C, Gomes D, Bronze-da-Rocha E, Costa E, Rocha-Pereira P, Aires L, Mota J, Ferreira Mansilha H, Rêgo C, Santos-Silva A, Belo L. Bilirubin is independently associated with oxidized LDL levels in young obese patients. Diabetol Metab Syndr 2015; 7:4. [PMID: 25972929 PMCID: PMC4429330 DOI: 10.1186/1758-5996-7-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 01/14/2015] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Bilirubin can prevent lipid oxidation in vitro, but the association in vivo with oxidized low-density lipoprotein (Ox-LDL) levels has been poorly explored. Our aim is to the association of Ox-LDL with total bilirubin (TB) levels and with variables related with metabolic syndrome and inflammation, in young obese individuals. FINDINGS 125 obese patients (13.4 years; 53.6% females) were studied. TB, lipid profile including Ox-LDL, markers of glucose metabolism, and levels of C-reactive protein (CRP) and adiponectin were determined. Anthropometric data was also collected. In all patients, Ox-LDL correlated positively with BMI, total cholesterol, LDLc, triglycerides (TG), CRP, glucose, insulin and HOMAIR; while inversely with TB and HDLc/Total cholesterol ratio (P < 0.05 for all). In multiple linear regression analysis, LDLc, TG, HDLc and TB levels were significantly associated with Ox-LDL (standardized Beta: 0.656, 0.293, -0.283, -0.164, respectively; P < 0.01 for all). After removing TG and HDLc from the analysis, HOMAIR was included in the regression model. In this new model, LDLc remained the best predictor of Ox-LDL levels (β = 0.665, P < 0.001), followed by TB (β = -0.202, P = 0.002) and HOMAIR (β = 0.163, P = 0.010). CONCLUSIONS Lower bilirubin levels may contribute to increased LDL oxidation in obese children and adolescents, predisposing to increased cardiovascular risk.
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Affiliation(s)
- Henrique Nascimento
- />Instituto de Biologia Molecular e Celular (Institute for Molecular and Cell Biology), Universidade do Porto, Porto, Portugal
- />Instituto de Investigaçãoe Inovação em Saúde (Institute for Research and Innovation in Health), Universidade do Porto, Porto, Portugal
- />Biological Science Department, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Ana Inês Alves
- />Instituto de Biologia Molecular e Celular (Institute for Molecular and Cell Biology), Universidade do Porto, Porto, Portugal
- />Instituto de Investigaçãoe Inovação em Saúde (Institute for Research and Innovation in Health), Universidade do Porto, Porto, Portugal
| | - Susana Coimbra
- />Instituto de Biologia Molecular e Celular (Institute for Molecular and Cell Biology), Universidade do Porto, Porto, Portugal
- />Instituto de Investigaçãoe Inovação em Saúde (Institute for Research and Innovation in Health), Universidade do Porto, Porto, Portugal
- />CESPU, Institute for Research and Advanced Training in Health Sciences and Technologies, Gandra, Portugal
| | - Cristina Catarino
- />Instituto de Biologia Molecular e Celular (Institute for Molecular and Cell Biology), Universidade do Porto, Porto, Portugal
- />Instituto de Investigaçãoe Inovação em Saúde (Institute for Research and Innovation in Health), Universidade do Porto, Porto, Portugal
- />Biological Science Department, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Diana Gomes
- />Instituto de Investigaçãoe Inovação em Saúde (Institute for Research and Innovation in Health), Universidade do Porto, Porto, Portugal
| | - Elsa Bronze-da-Rocha
- />Instituto de Biologia Molecular e Celular (Institute for Molecular and Cell Biology), Universidade do Porto, Porto, Portugal
- />Instituto de Investigaçãoe Inovação em Saúde (Institute for Research and Innovation in Health), Universidade do Porto, Porto, Portugal
- />Biological Science Department, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Elísio Costa
- />Instituto de Biologia Molecular e Celular (Institute for Molecular and Cell Biology), Universidade do Porto, Porto, Portugal
- />Instituto de Investigaçãoe Inovação em Saúde (Institute for Research and Innovation in Health), Universidade do Porto, Porto, Portugal
- />Biological Science Department, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | | | - Luísa Aires
- />Research Centre in Physical Activity, Health and Leisure – CIAFEL, Faculty of Sport, University of Porto, Porto, Portugal
- />High Education Institute from Maia (ISMAI), S. Pedro Avioso, Portugal
| | - Jorge Mota
- />Research Centre in Physical Activity, Health and Leisure – CIAFEL, Faculty of Sport, University of Porto, Porto, Portugal
| | - Helena Ferreira Mansilha
- />Childhood and Adolescence Department/Pediatric Service of Porto Hospital Centre, Porto, Portugal
| | - Carla Rêgo
- />Children and Adolescent Centre, CUF Hospital. CINTESIS. Faculty of Medicine, University of Porto, Porto, Portugal
| | - Alice Santos-Silva
- />Instituto de Biologia Molecular e Celular (Institute for Molecular and Cell Biology), Universidade do Porto, Porto, Portugal
- />Instituto de Investigaçãoe Inovação em Saúde (Institute for Research and Innovation in Health), Universidade do Porto, Porto, Portugal
- />Biological Science Department, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Luís Belo
- />Instituto de Biologia Molecular e Celular (Institute for Molecular and Cell Biology), Universidade do Porto, Porto, Portugal
- />Instituto de Investigaçãoe Inovação em Saúde (Institute for Research and Innovation in Health), Universidade do Porto, Porto, Portugal
- />Biological Science Department, Faculty of Pharmacy, University of Porto, Porto, Portugal
- />Departamento de Ciências Biológicas, Faculdade de Farmácia da Universidade do Porto, Rua de Jorge Viterbo Ferreira, 228, Porto, 4050-313 Portugal
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48
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Trpkovic A, Resanovic I, Stanimirovic J, Radak D, Mousa SA, Cenic-Milosevic D, Jevremovic D, Isenovic ER. Oxidized low-density lipoprotein as a biomarker of cardiovascular diseases. Crit Rev Clin Lab Sci 2014; 52:70-85. [DOI: 10.3109/10408363.2014.992063] [Citation(s) in RCA: 196] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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49
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Severe obesity prevalence in 8- to 9-year-old Italian children: a large population-based study. Eur J Clin Nutr 2014; 69:603-8. [DOI: 10.1038/ejcn.2014.188] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Revised: 06/27/2014] [Accepted: 07/14/2014] [Indexed: 11/08/2022]
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50
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González-Chavarría I, Cerro RP, Parra NP, Sandoval FA, Zuñiga FA, Omazábal VA, Lamperti LI, Jiménez SP, Fernandez EA, Gutiérrez NA, Rodriguez FS, Onate SA, Sánchez O, Vera JC, Toledo JR. Lectin-like oxidized LDL receptor-1 is an enhancer of tumor angiogenesis in human prostate cancer cells. PLoS One 2014; 9:e106219. [PMID: 25170920 PMCID: PMC4149537 DOI: 10.1371/journal.pone.0106219] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Accepted: 07/29/2014] [Indexed: 11/22/2022] Open
Abstract
Altered expression and function of lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1) has been associated with several diseases such as endothelial dysfunction, atherosclerosis and obesity. In these pathologies, oxLDL/LOX-1 activates signaling pathways that promote cell proliferation, cell motility and angiogenesis. Recent studies have indicated that olr1 mRNA is over-expressed in stage III and IV of human prostatic adenocarcinomas. However, the function of LOX-1 in prostate cancer angiogenesis remains to be determined. Our aim was to analyze the contribution of oxLDL and LOX-1 to tumor angiogenesis using C4-2 prostate cancer cells. We analyzed the expression of pro-angiogenic molecules and angiogenesis on prostate cancer tumor xenografts, using prostate cancer cell models with overexpression or knockdown of LOX-1 receptor. Our results demonstrate that the activation of LOX-1 using oxLDL increases cell proliferation, and the expression of the pro-angiogenic molecules VEGF, MMP-2, and MMP-9 in a dose-dependent manner. Noticeably, these effects were prevented in the C4-2 prostate cancer model when LOX-1 expression was knocked down. The angiogenic effect of LOX-1 activated with oxLDL was further demonstrated using the aortic ring assay and the xenograft model of tumor growth on chorioallantoic membrane of chicken embryos. Consequently, we propose that LOX-1 activation by oxLDL is an important event that enhances tumor angiogenesis in human prostate cancer cells.
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Affiliation(s)
- Iván González-Chavarría
- Biotechnology and Biopharmaceuticals Laboratory, Department of Pathophysiology, School of Biological Sciences, Universidad de Concepción, Concepción, Chile
| | - Rita P. Cerro
- Biotechnology and Biopharmaceuticals Laboratory, Department of Pathophysiology, School of Biological Sciences, Universidad de Concepción, Concepción, Chile
| | - Natalie P. Parra
- Biotechnology and Biopharmaceuticals Laboratory, Department of Pathophysiology, School of Biological Sciences, Universidad de Concepción, Concepción, Chile
| | - Felipe A. Sandoval
- Biotechnology and Biopharmaceuticals Laboratory, Department of Pathophysiology, School of Biological Sciences, Universidad de Concepción, Concepción, Chile
| | - Felipe A. Zuñiga
- Department of Clinical Biochemistry and Immunology, School of Pharmacy, Universidad de Concepción, Concepción, Chile
| | - Valeska A. Omazábal
- Department of Basic Sciences, Faculty of Medicine, Universidad Católica de la Santísima Concepción, Concepción, Chile
| | - Liliana I. Lamperti
- Department of Clinical Biochemistry and Immunology, School of Pharmacy, Universidad de Concepción, Concepción, Chile
| | - Silvana P. Jiménez
- Biotechnology and Biopharmaceuticals Laboratory, Department of Pathophysiology, School of Biological Sciences, Universidad de Concepción, Concepción, Chile
| | - Edelmira A. Fernandez
- Biotechnology and Biopharmaceuticals Laboratory, Department of Pathophysiology, School of Biological Sciences, Universidad de Concepción, Concepción, Chile
| | - Nicolas A. Gutiérrez
- Biotechnology and Biopharmaceuticals Laboratory, Department of Pathophysiology, School of Biological Sciences, Universidad de Concepción, Concepción, Chile
| | - Federico S. Rodriguez
- Biotechnology and Biopharmaceuticals Laboratory, Department of Pathophysiology, School of Biological Sciences, Universidad de Concepción, Concepción, Chile
| | - Sergio A. Onate
- Translational Research Unit, School of Medicine, Universidad de Concepción, Concepción, Chile
| | - Oliberto Sánchez
- Department of Pharmacology, School of Biological Sciences, Universidad de Concepción, Concepción, Chile
| | - Juan C. Vera
- Biotechnology and Biopharmaceuticals Laboratory, Department of Pathophysiology, School of Biological Sciences, Universidad de Concepción, Concepción, Chile
| | - Jorge R. Toledo
- Biotechnology and Biopharmaceuticals Laboratory, Department of Pathophysiology, School of Biological Sciences, Universidad de Concepción, Concepción, Chile
- * E-mail:
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