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Viegas ÂA, Santos T, Nobre JNP, Santos JMD, Silva Lage VKD, Fernandes AC, Peixoto MFD, Morais RLDS, Sartorio A, Mendonça VA, Lacerda ACR. Association between biomarkers of redox status and cytokines with different patterns of habitual physical activity in eutrophic and overweight/obese preschoolers: multivariate analysis of a cross-sectional study. BMC Public Health 2023; 23:2353. [PMID: 38017390 PMCID: PMC10683275 DOI: 10.1186/s12889-023-17295-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 11/22/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Although it is well known that obesity is frequently associated with reduced levels of habitual physical activity (HPA), which contributes to determining severe oxidative stress and inflammatory state, this association is however unknown in preschoolers so far. This study aimed to investigate the association between biomarkers of redox status and cytokines with different patterns of HPA according to the adiposity of preschoolers. METHODS A cross-sectional study was conducted in 50 preschoolers (25 overweight/obese, OW/OB and 25 eutrophic, EU), matched for age, sex, economic level, and maternal education. Total antioxidant capacity (TAC), superoxide dismutase (SOD) and catalase (CAT) activities, substances reactive to thiobarbituric acid (TBARS), soluble tumor necrosis factor receptors (sTNFRs), and leptin levels were evaluated. HPA levels were evaluated by accelerometry (ActiGraph GT9X accelerometer). Correlation, multiple linear regression, and partial least squares regression analysis were used to determine the association between redox status biomarkers and cytokines with different patterns of HPA (HPA level, bouts of moderate to vigorous physical activity [MVPA], and multivariate pattern of HPA) in EU and OW/OB preschoolers. RESULTS OW/OB preschoolers had lower CAT activity, higher levels of TAC, TBARS, and cytokines, and similar levels of HPA to EU preschoolers. In EU preschoolers, SOD activity exhibited a stronger negative association with moderate intensity ranges of HPA (R2 = 0.18), and negative correlation with sTNFRs (r = -0.40 to -0.46). TBARS had a stronger positive association with ranges of light intensity in the multivariate pattern of HPA (R2 = 0.10). In OW/OB preschoolers, the HPA multivariate associative pattern was predominantly from vigorous intensity ranges. Thus, SOD activity had a positive association with the multivariate pattern of HPA (R2 = 0.38) and MVPA bouts (β [95% CI] = 0.457 [0.0026. 0.0576]). TAC had a negative association with the multivariate pattern of HPA (R2 = 0.38) and MVPA bouts (β [95% CI] = -0.718 [-0.0025. -0.0003]). Additionally, leptin levels were lower in OW/OB preschoolers engaged in vigorous physical activity (VPA) (8000-9999 counts/min) for longer periods of time. CONCLUSION The results of this study indicate that OW/OB preschoolers have higher levels of oxidative stress biomarkers and pro-inflammatory cytokines compared to EU preschoolers. Moreover, VPA may exert antioxidative and anti-inflammatory effects in OW/OB preschoolers.
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Affiliation(s)
- Ângela Alves Viegas
- Multicenter Postgraduate Program in Physiological Sciences (PPGMCF), Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Minas Gerais, Brazil
- Integrated Center for Research and Postgraduate Studies in Health (CIPq Saúde), Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Thiago Santos
- Postgraduate Program in Animal Biology (PPGBA), Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Juliana Nogueira Pontes Nobre
- Multicenter Postgraduate Program in Physiological Sciences (PPGMCF), Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Minas Gerais, Brazil
- Integrated Center for Research and Postgraduate Studies in Health (CIPq Saúde), Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Jousielle Márcia Dos Santos
- Multicenter Postgraduate Program in Physiological Sciences (PPGMCF), Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Minas Gerais, Brazil
- Integrated Center for Research and Postgraduate Studies in Health (CIPq Saúde), Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Vanessa Kelly da Silva Lage
- Multicenter Postgraduate Program in Physiological Sciences (PPGMCF), Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Minas Gerais, Brazil
- Integrated Center for Research and Postgraduate Studies in Health (CIPq Saúde), Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Amanda Cristina Fernandes
- Postgraduate Program in Rehabilitation and Functional Performance (PPGReab), Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Marco Fabrício Dias Peixoto
- Multicenter Postgraduate Program in Physiological Sciences (PPGMCF), Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Minas Gerais, Brazil
- Integrated Center for Research and Postgraduate Studies in Health (CIPq Saúde), Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Rosane Luzia De Souza Morais
- Postgraduate Program Health, Society and Environment (PPGSaSA), Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Alessandro Sartorio
- Division of Auxology and Metabolic Diseases & Experimental Laboratory for Auxo-endocrinological Research, Istituto Auxologico Italiano, IRCCS, Piancavallo-Verbania, Italy
| | - Vanessa Amaral Mendonça
- Multicenter Postgraduate Program in Physiological Sciences (PPGMCF), Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Minas Gerais, Brazil
- Integrated Center for Research and Postgraduate Studies in Health (CIPq Saúde), Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Minas Gerais, Brazil
- Postgraduate Program in Rehabilitation and Functional Performance (PPGReab), Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Minas Gerais, Brazil
| | - Ana Cristina Rodrigues Lacerda
- Multicenter Postgraduate Program in Physiological Sciences (PPGMCF), Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Minas Gerais, Brazil.
- Integrated Center for Research and Postgraduate Studies in Health (CIPq Saúde), Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Minas Gerais, Brazil.
- Postgraduate Program in Rehabilitation and Functional Performance (PPGReab), Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Minas Gerais, Brazil.
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Type 2 Diabetes and Alzheimer's Disease: The Emerging Role of Cellular Lipotoxicity. Biomolecules 2023; 13:biom13010183. [PMID: 36671568 PMCID: PMC9855893 DOI: 10.3390/biom13010183] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/06/2023] [Accepted: 01/13/2023] [Indexed: 01/18/2023] Open
Abstract
Type 2 diabetes (T2D) and Alzheimer's diseases (AD) represent major health issues that have reached alarming levels in the last decades. Although growing evidence demonstrates that AD is a significant comorbidity of T2D, and there is a ~1.4-2-fold increase in the risk of developing AD among T2D patients, the involvement of possible common triggers in the pathogenesis of these two diseases remains largely unknown. Of note, recent mechanistic insights suggest that lipotoxicity could represent the missing ring in the pathogenetic mechanisms linking T2D to AD. Indeed, obesity, which represents the main cause of lipotoxicity, has been recognized as a major risk factor for both pathological conditions. Lipotoxicity can lead to inflammation, insulin resistance, oxidative stress, ceramide and amyloid accumulation, endoplasmic reticulum stress, ferroptosis, and autophagy, which are shared biological events in the pathogenesis of T2D and AD. In the current review, we try to provide a critical and comprehensive view of the common molecular pathways activated by lipotoxicity in T2D and AD, attempting to summarize how these mechanisms can drive future research and open the way to new therapeutic perspectives.
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3
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Wang X, Lan H, Sun T, Cong P, Xue C, Xu J. Serum metabolomics analysis reveals amelioration effects of sea cucumber ether phospholipids on oxidative stress and inflammation in high-fat diet-fed mice. Food Funct 2022; 13:10134-10146. [PMID: 36106708 DOI: 10.1039/d2fo00918h] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Emerging evidence suggests that sea cucumber ether phospholipids (ether-PLs) can modulate high-fat diet (HFD)-induced metabolic disorders. However, whether this modulation is associated with metabolic pathways related to oxidative stress and inflammation remains unclear. This study aimed to investigate the antioxidative and anti-inflammatory effects on HFD-fed mice and the associated metabolism pathways in response to administration with sea cucumber ether-PLs using integrated biochemistry and a metabolomics approach. Biochemistry analysis and histological examinations showed that sea cucumber ether-PLs significantly decreased body weight gain and fat deposition in tissues. PE-P was superior to PC-O in alleviating reactive oxygen species (ROS), malondialdehyde (MDA) and inflammatory responses (IL-6, TNF-α and MCP-1) in the HFD-induced mouse model. Serum metabolomics analysis revealed that it upregulated four metabolites and downregulated twenty-four metabolites compared to those in HFD mice after ether-PL administration. Pathway analysis indicated that sea cucumber ether-PLs alleviate the HFD-induced inflammation and oxidative stress by three main metabolic pathways, namely fatty acid metabolism, branched-chain amino acid (BCAA) metabolism, and trichloroacetic acid (TCA) metabolism. Taken together, sea cucumber ether-PLs showed great potential to become a natural functional food against oxidative stress and inflammation caused by HFD.
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Affiliation(s)
- Xincen Wang
- College of Food Science and Engineering, Ocean University of China, No. 5, Yushan Road, Qingdao, Shandong Province 266003, China.
| | - Haohui Lan
- College of Food Science and Engineering, Ocean University of China, No. 5, Yushan Road, Qingdao, Shandong Province 266003, China.
| | - Tong Sun
- College of Food Science and Engineering, Ocean University of China, No. 5, Yushan Road, Qingdao, Shandong Province 266003, China.
| | - Peixu Cong
- College of Food Science and Engineering, Ocean University of China, No. 5, Yushan Road, Qingdao, Shandong Province 266003, China.
| | - Changhu Xue
- College of Food Science and Engineering, Ocean University of China, No. 5, Yushan Road, Qingdao, Shandong Province 266003, China. .,Laboratory of Marine Drugs and Biological Products, Pilot National Laboratory for Marine Science and Technology (Qingdao), No. 1, Wenhai Road, Qingdao, Shandong Province, 266237, China
| | - Jie Xu
- College of Food Science and Engineering, Ocean University of China, No. 5, Yushan Road, Qingdao, Shandong Province 266003, China.
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Estébanez B, Huang CJ, Rivera-Viloria M, González-Gallego J, Cuevas MJ. Exercise Outcomes in Childhood Obesity-Related Inflammation and Oxidative Status. Front Nutr 2022; 9:886291. [PMID: 35859754 PMCID: PMC9289530 DOI: 10.3389/fnut.2022.886291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 06/08/2022] [Indexed: 12/14/2022] Open
Abstract
Childhood obesity is identified as one of the major public health issues to increase the risk for cardiometabolic diseases and related complications in adulthood. The literature has supported inflammation and oxidative stress as the primary underlying mechanisms involved in the pathogenesis of obesity-related diseases. Epidemiological evidence consistently shows the benefits of physical activity in the improvement of obesity-mediated inflammation and oxidative stress status. In this narrative mini-review, the available scientific evidence on the potential effects of exercise in alleviating these susceptibilities in childhood obesity will be assessed.
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Affiliation(s)
- Brisamar Estébanez
- Institute of Biomedicine (IBIOMED), University of León, León, Spain
- *Correspondence: Brisamar Estébanez,
| | - Chun-Jung Huang
- Exercise Biochemistry Laboratory, Department of Exercise Science and Health Promotion, Florida Atlantic University, Boca Raton, FL, United States
| | | | - Javier González-Gallego
- Institute of Biomedicine (IBIOMED), University of León, León, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - María J. Cuevas
- Institute of Biomedicine (IBIOMED), University of León, León, Spain
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5
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Fuentes-Venado CE, Terán-Pérez G, Espinosa-Hernández VM, Martínez-Herrera E, Segura-Uribe JJ, Mercadillo RE, Pinto-Almazán R, Guerra-Araiza C. Nutritional Status Influences Oxidative Stress and Insulin Resistance in Preschool Children. Metab Syndr Relat Disord 2021; 19:513-523. [PMID: 34314624 DOI: 10.1089/met.2021.0021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background: Child malnutrition represents a major public health problem with physiological, psychological, and social short- and long-term implications. Objective: To compare the influence of nutritional status on oxidative stress (OS) markers in children aged 3-6 years. Methods: Children were categorized into four groups: underweight, normal weight, overweight, and obesity. Glucose (Glu), cholesterol (Chol), high-density lipoproteins, insulin, triacylglycerols (TG), triacylglycerols/glucose (TyG) index, and the homeostasis model assessment of insulin resistance (HOMA-IR) were analyzed. In addition, OS [malondialdehyde (MDA) and 3-nitrotyrosine (3-NT)] and antioxidant defense markers [superoxide dismutase (SOD), catalase (CAT), and the ratio of reduced/oxidized glutathione (GSH/GSSG)] were quantified. Results: Children with obesity showed significantly higher levels of MDA and 3-NT, and increased SOD activity compared with normal weight children. Glu, Chol, TG levels, TyG indexes, HOMA-IR, MDA, 3-NT, and SOD positively correlated with body mass index (BMI) and Centers for Disease Control and Prevention percentiles (CDC PC). However, CAT concentration and the GSH/GSSG ratio correlated negatively with BMI and CDC PC. In children with underweight, we found a positive correlation of TG levels and TyG indexes with BMI, whereas both markers positively correlated with BMI and CDC PC in children with overweight. MDA negatively correlated with BMI in children with underweight, while a positive association was observed in children with overweight. Finally, SOD, CAT, and GSH/GSSG negatively correlated with both BMI and CDC PC in children with overweight. Conclusions: Malnutrition, especially obesity, is associated with metabolic and OS disturbances in preschool children. It is urgent to design strategies to prevent malnutrition in this age group since this stage of development is crucial to potentially avoid future co-morbidities.
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Affiliation(s)
- Claudia Erika Fuentes-Venado
- Doctorado en Ciencias Biológicas y de la Salud-Universidad Autónoma Metropolitana, Mexico City, Mexico.,Servicio de Medicina Física y Rehabilitación, Hospital General de Zona No. 197, Texcoco, Mexico.,Unidad de Investigación Médica en Farmacología, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Guadalupe Terán-Pérez
- Clínica de Trastornos del Sueño, Universidad Autónoma Metropolitana-Iztapalapa, Mexico City, Mexico
| | - Victor Manuel Espinosa-Hernández
- Maestría en Ciencias de la Salud, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City, Mexico.,Unidad de Investigación, Hospital Regional de Alta Especialidad de Ixtapaluca, Ixtapaluca, Mexico
| | - Erick Martínez-Herrera
- Unidad de Investigación, Hospital Regional de Alta Especialidad de Ixtapaluca, Ixtapaluca, Mexico.,Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City, Mexico
| | - Julia J Segura-Uribe
- Subdirección de Gestión de la Investigación, Hospital Infantil de México Federico Gómez, Secretaría de Salud, Mexico City, Mexico
| | - Roberto E Mercadillo
- Consejo Nacional de Ciencia y Tecnología, Mexico City, Mexico.,Departamento de Biología de la Reproducción, Universidad Autónoma Metropolitana-Iztapalapa, Mexico City, Mexico
| | - Rodolfo Pinto-Almazán
- Unidad de Investigación, Hospital Regional de Alta Especialidad de Ixtapaluca, Ixtapaluca, Mexico.,Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City, Mexico
| | - Christian Guerra-Araiza
- Servicio de Medicina Física y Rehabilitación, Hospital General de Zona No. 197, Texcoco, Mexico
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6
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Hirao H, Dery KJ, Kageyama S, Nakamura K, Kupiec-Weglinski JW. Heme Oxygenase-1 in liver transplant ischemia-reperfusion injury: From bench-to-bedside. Free Radic Biol Med 2020; 157:75-82. [PMID: 32084514 PMCID: PMC7434658 DOI: 10.1016/j.freeradbiomed.2020.02.012] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 01/02/2020] [Accepted: 02/17/2020] [Indexed: 12/16/2022]
Abstract
Hepatic ischemia-reperfusion injury (IRI), a major risk factor for early allograft dysfunction (EAD) and acute or chronic graft rejection, contributes to donor organ shortage for life-saving orthotopic liver transplantation (OLT). The graft injury caused by local ischemia (warm and/or cold) leads to parenchymal cell death and release of danger-associated molecular patterns (DAMPs), followed by reperfusion-triggered production of reactive oxygen species (ROS), activation of inflammatory cells, hepatocellular damage and ultimate organ failure. Heme oxygenase 1 (HO-1), a heat shock protein-32 induced under IR-stress, is an essential component of the cytoprotective mechanism in stressed livers. HO-1 regulates anti-inflammatory responses and may be crucial in the pathogenesis of chronic diseases, such as arteriosclerosis, hypertension, diabetes and steatosis. An emerging area of study is macrophage-derived HO-1 and its pivotal intrahepatic homeostatic function played in IRI-OLT. Indeed, ectopic hepatic HO-1 overexpression activates intracellular SIRT1/autophagy axis to serve as a key cellular self-defense mechanism in both mouse and human OLT recipients. Recent translational studies in rodents and human liver transplant patients provide novel insights into HO-1 mediated cytoprotection against sterile hepatic inflammation. In this review, we summarize the current bench-to-bedside knowledge on HO-1 molecular signaling and discuss their future therapeutic potential to mitigate IRI in OLT.
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Affiliation(s)
- Hirofumi Hirao
- Dumont-UCLA Transplantation Center, Department of Surgery, Division of Liver and Pancreas Transplantation, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90095, USA
| | - Kenneth J Dery
- Dumont-UCLA Transplantation Center, Department of Surgery, Division of Liver and Pancreas Transplantation, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90095, USA
| | - Shoichi Kageyama
- Dumont-UCLA Transplantation Center, Department of Surgery, Division of Liver and Pancreas Transplantation, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90095, USA
| | - Kojiro Nakamura
- Dumont-UCLA Transplantation Center, Department of Surgery, Division of Liver and Pancreas Transplantation, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90095, USA; Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Department of Surgery, Nishi-Kobe Medical Center, 5-7-1 Koji-dai, Nishi-ku, Kobe, Hyogo, 651-2273, Japan
| | - Jerzy W Kupiec-Weglinski
- Dumont-UCLA Transplantation Center, Department of Surgery, Division of Liver and Pancreas Transplantation, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90095, USA.
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7
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Iron Metabolism in Obesity and Metabolic Syndrome. Int J Mol Sci 2020; 21:ijms21155529. [PMID: 32752277 PMCID: PMC7432525 DOI: 10.3390/ijms21155529] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 07/27/2020] [Accepted: 07/29/2020] [Indexed: 12/12/2022] Open
Abstract
Obesity is an excessive adipose tissue accumulation that may have detrimental effects on health. Particularly, childhood obesity has become one of the main public health problems in the 21st century, since its prevalence has widely increased in recent years. Childhood obesity is intimately related to the development of several comorbidities such as nonalcoholic fatty liver disease, dyslipidemia, type 2 diabetes mellitus, non-congenital cardiovascular disease, chronic inflammation and anemia, among others. Within this tangled interplay between these comorbidities and associated pathological conditions, obesity has been closely linked to important perturbations in iron metabolism. Iron is the second most abundant metal on Earth, but its bioavailability is hampered by its ability to form highly insoluble oxides, with iron deficiency being the most common nutritional disorder. Although every living organism requires iron, it may also cause toxic oxygen damage by generating oxygen free radicals through the Fenton reaction. Thus, iron homeostasis and metabolism must be tightly regulated in humans at every level (i.e., absorption, storage, transport, recycling). Dysregulation of any step involved in iron metabolism may lead to iron deficiencies and, eventually, to the anemic state related to obesity. In this review article, we summarize the existent evidence on the role of the most recently described components of iron metabolism and their alterations in obesity.
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8
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Ross PA, Klein MJ, Nguyen T, Leung D, Khemani RG, Newth CJL, Bhalla AK. Body Habitus and Risk of Mortality in Pediatric Sepsis and Septic Shock: A Retrospective Cohort Study. J Pediatr 2019; 210:178-183.e2. [PMID: 31036411 DOI: 10.1016/j.jpeds.2019.03.027] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 03/18/2019] [Accepted: 03/18/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To investigate the association between body habitus and mortality in critically ill children with sepsis or septic shock. STUDY DESIGN This was a retrospective cohort study of prospectively collected data of children admitted to US pediatric intensive care units (PICUs) with a primary or secondary diagnosis of sepsis or septic shock. We separated body habitus into underweight, normal weight, overweight, and obese. Outcomes were mortality (primary), treatment with invasive mechanical ventilation (secondary), and time to PICU discharge for survivors (secondary). Multivariable analyses using mixed-effects logistic regression and shared frailty models clustered by unit and adjusted for confounding variables were used to assess the association between body habitus and outcomes. RESULTS There were 7038 children with sepsis or septic shock. Mortality was 10.1% (n = 714) and 52.9% (n = 3720) required invasive mechanical ventilation. Body habitus was not associated with mortality after controlling for hospital level effects and confounding variables. Children who were overweight and obese had greater odds of invasive mechanical ventilation (overweight OR 1.23 [95% CI 1.05-1.45], P = .011 and obese OR 1.57 [95% CI 1.37-1.80], P < .001) compared with children of normal weight. In survivors treated with invasive mechanical ventilation, children who were obese had a longer time to PICU discharge than children of normal weight (obese hazard ratio for discharge 0.84 [95% CI, 0.77-0.92], P < .0001). CONCLUSIONS There was no association between body habitus and mortality in critically ill children with sepsis. Children who were overweight and obese were more likely to receive invasive mechanical ventilation and mechanically ventilated survivors who were obsese had a longer time to PICU discharge.
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Affiliation(s)
- Patrick A Ross
- Department of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA.
| | - Margaret J Klein
- Department of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, CA
| | - Tuan Nguyen
- Department of Pediatrics, Miller Children's and Women's Hospital of Long Beach, Long Beach, CA
| | - Dennis Leung
- Department of Pediatrics, University of North Carolina Healthcare Children's Hospital, Chapel Hill, NC
| | - Robinder G Khemani
- Department of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Christopher J L Newth
- Department of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Anoopindar K Bhalla
- Department of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA
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Chawla A, Ray S, Matettore A, Peters MJ. Arterial carboxyhaemoglobin levels in children admitted to PICU: A retrospective observational study. PLoS One 2019; 14:e0209452. [PMID: 30845230 PMCID: PMC6405068 DOI: 10.1371/journal.pone.0209452] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 02/21/2019] [Indexed: 01/07/2023] Open
Abstract
While carbon monoxide (CO) is considered toxic, low levels of endogenously produced CO are protective against cellular injury induced by oxidative stress. Carboxyhaemoglobin (COHb) levels have been associated with outcomes in critically ill adults. We aimed to describe the distribution of carboxyhaemoglobin in critically ill children and the relationship of these levels with clinical outcomes. This retrospective observational study was conducted at a large tertiary paediatric intensive care unit (PICU). We included all children admitted to the PICU over a two-year period who underwent arterial blood gas analysis. We measured the following: (i) Population and age-related differences in COHb distribution; (ii) Change in COHb over the first week of admission using a multi-level linear regression analysis; (iii) Uni- and multivariable relationships between COHb and length of ventilation and PICU survival. Arterial COHb levels were available for 559/2029 admissions. The median COHb level was 1.20% (IQR 1.00-1.60%). Younger children had significantly higher COHb levels (p-value <2 x 10-16). Maximum Carboxyhaemoglobin was associated with survival 1.67 (95% CI: 1.01-2.57; p-value = 0.02) and length of ventilation (OR 5.20, 95% CI: 3.07-7.30; p-value = 1.8 x 10-6) following multi-variable analysis. First measured and minimum COHb values were weakly associated with length of ventilation, but not survival. In conclusion, children have increased COHb levels in critical illness, which are greater in younger children. Higher COHb levels are associated with longer length of ventilation and death in PICU. This may reflect increased oxidative stress in these children.
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Affiliation(s)
- Ankur Chawla
- Respiratory, Critical Care and Anaesthesia Section, UCL GOSH Institute of Child Health, London, United Kingdom
| | - Samiran Ray
- Respiratory, Critical Care and Anaesthesia Section, UCL GOSH Institute of Child Health, London, United Kingdom
- Paediatric and Neonatal Intensive Care Unit, Great Ormond Street Hospital NHS Trust, London, United Kingdom
- * E-mail:
| | - Adela Matettore
- Paediatric and Neonatal Intensive Care Unit, Great Ormond Street Hospital NHS Trust, London, United Kingdom
| | - Mark J Peters
- Respiratory, Critical Care and Anaesthesia Section, UCL GOSH Institute of Child Health, London, United Kingdom
- Paediatric and Neonatal Intensive Care Unit, Great Ormond Street Hospital NHS Trust, London, United Kingdom
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Kaartokallio T, Utge S, Klemetti MM, Paananen J, Pulkki K, Romppanen J, Tikkanen I, Heinonen S, Kajantie E, Kere J, Kivinen K, Pouta A, Lakkisto P, Laivuori H. Fetal Microsatellite in the Heme Oxygenase 1 Promoter Is Associated With Severe and Early-Onset Preeclampsia. Hypertension 2018; 71:95-102. [DOI: 10.1161/hypertensionaha.117.10425] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 10/16/2017] [Accepted: 11/03/2017] [Indexed: 01/10/2023]
Abstract
Preeclampsia is a vascular pregnancy disorder that often involves impaired placental development. HO-1 (heme oxygenase 1, encoded by
HMOX1
) is a stress response enzyme crucial for endothelial and placental function. Long version of the guanine–thymine (GT
n
) microsatellite in the
HMOX1
promoter decreases HO-1 expression, and the long maternal repeat is associated with late-onset preeclampsia. Our aim was to study whether the length of fetal repeat is associated with mother’s preeclampsia, whether the length of fetal and maternal repeats affect HO-1 levels in placenta and maternal serum, and whether HO-1 levels are altered in preeclampsia. We genotyped the repeat in the cord blood of 609 preeclamptic and 745 nonpreeclamptic neonates. HO-1 levels were measured in 36 placental samples, and in the first (222 cases/243 controls) and third (176 cases/53 controls) pregnancy trimester serum samples using enzyme-linked immunosorbent assay. The long fetal GT
n
repeat was associated with preeclampsia and its severe and early-onset subtypes. Interaction analysis suggested the maternal and fetal effects to be independent. Placental or serum HO-1 levels were not altered in preeclamptics, possibly reflecting heterogeneity of preeclampsia. Carriers of the long fetal and maternal repeats had lower placental and serum HO-1 levels, respectively, providing functional evidence for the association. We conclude that the long fetal GT
n
repeat may increase mother’s risk for especially severe and early-onset preeclampsia. The fetal and maternal risk alleles likely predispose to different disease subtypes.
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Affiliation(s)
- Tea Kaartokallio
- From Medical and Clinical Genetics, Helsinki University Hospital (T.K., S.U., M.M.K., H.L.), Obstetrics and Gynaecology, Helsinki University Hospital (M.M.K., S.H.), Abdominal Center, Nephrology, Helsinki University Hospital (I.T.), Clinical Chemistry and Hematology, Helsinki University Hospital (P.L.), Children’s Hospital, Helsinki University Central Hospital (E.K.), Molecular Neurology Research Program (J.K.), and Institute for Molecular Medicine Finland, HiLIFE Unit (H.L.), University of Helsinki
| | - Siddheshwar Utge
- From Medical and Clinical Genetics, Helsinki University Hospital (T.K., S.U., M.M.K., H.L.), Obstetrics and Gynaecology, Helsinki University Hospital (M.M.K., S.H.), Abdominal Center, Nephrology, Helsinki University Hospital (I.T.), Clinical Chemistry and Hematology, Helsinki University Hospital (P.L.), Children’s Hospital, Helsinki University Central Hospital (E.K.), Molecular Neurology Research Program (J.K.), and Institute for Molecular Medicine Finland, HiLIFE Unit (H.L.), University of Helsinki
| | - Miira M. Klemetti
- From Medical and Clinical Genetics, Helsinki University Hospital (T.K., S.U., M.M.K., H.L.), Obstetrics and Gynaecology, Helsinki University Hospital (M.M.K., S.H.), Abdominal Center, Nephrology, Helsinki University Hospital (I.T.), Clinical Chemistry and Hematology, Helsinki University Hospital (P.L.), Children’s Hospital, Helsinki University Central Hospital (E.K.), Molecular Neurology Research Program (J.K.), and Institute for Molecular Medicine Finland, HiLIFE Unit (H.L.), University of Helsinki
| | - Jussi Paananen
- From Medical and Clinical Genetics, Helsinki University Hospital (T.K., S.U., M.M.K., H.L.), Obstetrics and Gynaecology, Helsinki University Hospital (M.M.K., S.H.), Abdominal Center, Nephrology, Helsinki University Hospital (I.T.), Clinical Chemistry and Hematology, Helsinki University Hospital (P.L.), Children’s Hospital, Helsinki University Central Hospital (E.K.), Molecular Neurology Research Program (J.K.), and Institute for Molecular Medicine Finland, HiLIFE Unit (H.L.), University of Helsinki
| | - Kari Pulkki
- From Medical and Clinical Genetics, Helsinki University Hospital (T.K., S.U., M.M.K., H.L.), Obstetrics and Gynaecology, Helsinki University Hospital (M.M.K., S.H.), Abdominal Center, Nephrology, Helsinki University Hospital (I.T.), Clinical Chemistry and Hematology, Helsinki University Hospital (P.L.), Children’s Hospital, Helsinki University Central Hospital (E.K.), Molecular Neurology Research Program (J.K.), and Institute for Molecular Medicine Finland, HiLIFE Unit (H.L.), University of Helsinki
| | - Jarkko Romppanen
- From Medical and Clinical Genetics, Helsinki University Hospital (T.K., S.U., M.M.K., H.L.), Obstetrics and Gynaecology, Helsinki University Hospital (M.M.K., S.H.), Abdominal Center, Nephrology, Helsinki University Hospital (I.T.), Clinical Chemistry and Hematology, Helsinki University Hospital (P.L.), Children’s Hospital, Helsinki University Central Hospital (E.K.), Molecular Neurology Research Program (J.K.), and Institute for Molecular Medicine Finland, HiLIFE Unit (H.L.), University of Helsinki
| | - Ilkka Tikkanen
- From Medical and Clinical Genetics, Helsinki University Hospital (T.K., S.U., M.M.K., H.L.), Obstetrics and Gynaecology, Helsinki University Hospital (M.M.K., S.H.), Abdominal Center, Nephrology, Helsinki University Hospital (I.T.), Clinical Chemistry and Hematology, Helsinki University Hospital (P.L.), Children’s Hospital, Helsinki University Central Hospital (E.K.), Molecular Neurology Research Program (J.K.), and Institute for Molecular Medicine Finland, HiLIFE Unit (H.L.), University of Helsinki
| | - Seppo Heinonen
- From Medical and Clinical Genetics, Helsinki University Hospital (T.K., S.U., M.M.K., H.L.), Obstetrics and Gynaecology, Helsinki University Hospital (M.M.K., S.H.), Abdominal Center, Nephrology, Helsinki University Hospital (I.T.), Clinical Chemistry and Hematology, Helsinki University Hospital (P.L.), Children’s Hospital, Helsinki University Central Hospital (E.K.), Molecular Neurology Research Program (J.K.), and Institute for Molecular Medicine Finland, HiLIFE Unit (H.L.), University of Helsinki
| | - Eero Kajantie
- From Medical and Clinical Genetics, Helsinki University Hospital (T.K., S.U., M.M.K., H.L.), Obstetrics and Gynaecology, Helsinki University Hospital (M.M.K., S.H.), Abdominal Center, Nephrology, Helsinki University Hospital (I.T.), Clinical Chemistry and Hematology, Helsinki University Hospital (P.L.), Children’s Hospital, Helsinki University Central Hospital (E.K.), Molecular Neurology Research Program (J.K.), and Institute for Molecular Medicine Finland, HiLIFE Unit (H.L.), University of Helsinki
| | - Juha Kere
- From Medical and Clinical Genetics, Helsinki University Hospital (T.K., S.U., M.M.K., H.L.), Obstetrics and Gynaecology, Helsinki University Hospital (M.M.K., S.H.), Abdominal Center, Nephrology, Helsinki University Hospital (I.T.), Clinical Chemistry and Hematology, Helsinki University Hospital (P.L.), Children’s Hospital, Helsinki University Central Hospital (E.K.), Molecular Neurology Research Program (J.K.), and Institute for Molecular Medicine Finland, HiLIFE Unit (H.L.), University of Helsinki
| | - Katja Kivinen
- From Medical and Clinical Genetics, Helsinki University Hospital (T.K., S.U., M.M.K., H.L.), Obstetrics and Gynaecology, Helsinki University Hospital (M.M.K., S.H.), Abdominal Center, Nephrology, Helsinki University Hospital (I.T.), Clinical Chemistry and Hematology, Helsinki University Hospital (P.L.), Children’s Hospital, Helsinki University Central Hospital (E.K.), Molecular Neurology Research Program (J.K.), and Institute for Molecular Medicine Finland, HiLIFE Unit (H.L.), University of Helsinki
| | - Anneli Pouta
- From Medical and Clinical Genetics, Helsinki University Hospital (T.K., S.U., M.M.K., H.L.), Obstetrics and Gynaecology, Helsinki University Hospital (M.M.K., S.H.), Abdominal Center, Nephrology, Helsinki University Hospital (I.T.), Clinical Chemistry and Hematology, Helsinki University Hospital (P.L.), Children’s Hospital, Helsinki University Central Hospital (E.K.), Molecular Neurology Research Program (J.K.), and Institute for Molecular Medicine Finland, HiLIFE Unit (H.L.), University of Helsinki
| | - Päivi Lakkisto
- From Medical and Clinical Genetics, Helsinki University Hospital (T.K., S.U., M.M.K., H.L.), Obstetrics and Gynaecology, Helsinki University Hospital (M.M.K., S.H.), Abdominal Center, Nephrology, Helsinki University Hospital (I.T.), Clinical Chemistry and Hematology, Helsinki University Hospital (P.L.), Children’s Hospital, Helsinki University Central Hospital (E.K.), Molecular Neurology Research Program (J.K.), and Institute for Molecular Medicine Finland, HiLIFE Unit (H.L.), University of Helsinki
| | - Hannele Laivuori
- From Medical and Clinical Genetics, Helsinki University Hospital (T.K., S.U., M.M.K., H.L.), Obstetrics and Gynaecology, Helsinki University Hospital (M.M.K., S.H.), Abdominal Center, Nephrology, Helsinki University Hospital (I.T.), Clinical Chemistry and Hematology, Helsinki University Hospital (P.L.), Children’s Hospital, Helsinki University Central Hospital (E.K.), Molecular Neurology Research Program (J.K.), and Institute for Molecular Medicine Finland, HiLIFE Unit (H.L.), University of Helsinki
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