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Barlabà A, Grella C, Tammaro M, Petrone D, Guarino S, Miraglia Del Giudice E, Marzuillo P, Di Sessa A. Kidney function evaluation in children and adolescents with obesity: a not-negligible need. Eur J Pediatr 2024:10.1007/s00431-024-05641-0. [PMID: 38871979 DOI: 10.1007/s00431-024-05641-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Revised: 05/03/2024] [Accepted: 06/02/2024] [Indexed: 06/15/2024]
Abstract
The role of obesity as risk factor for chronic kidney disease (CKD) has been well-recognized. As previously demonstrated in adults, emerging data highlighted the relevant impact of obesity on renal function since childhood. As a matter of fact, obesity also affects renal health through a complex pathogenic mechanism in which insulin resistance (IR) plays a pivotal role. Worthy of note, the vicious interplay among obesity, IR, and renal hemodynamics clinically translates into a plethora of kidney function impairments potentially leading to CKD development. Therefore, renal injury needs to be added to the well-known spectrum of cardiometabolic obesity comorbidities (e.g., type 2 diabetes, IR, metabolic syndrome, cardiovascular disease). CONCLUSION Taking this into account, a careful and timely monitoring of kidney function should not be neglected in the global assessment of children with obesity. We aimed to provide a comprehensive overview on the relevance of kidney evaluation in children with obesity by shedding lights on the intriguing relationship of obesity with renal health in this at-risk population. WHAT IS KNOWN • Obesity has been found to be a risk factor for chronic kidney disease. • Unlike adults, pediatric data supporting the association between obesity and renal function are still limited. WHAT IS NEW • As observed in adults, obesity might affect renal function since childhood. • Kidney function should be carefully evaluated in children with obesity.
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Affiliation(s)
- Annalisa Barlabà
- Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Carolina Grella
- Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Mariagrazia Tammaro
- Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Delfina Petrone
- Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Stefano Guarino
- Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Emanuele Miraglia Del Giudice
- Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Pierluigi Marzuillo
- Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Anna Di Sessa
- Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.
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Gunasekara TDKSC, De Silva PMCS, Chandana EPS, Jayasinghe S, Herath C, Siribaddana S, Jayasundara N. Body mass index and implications for pediatric kidney health: a cross-sectional study with urinary biomarkers. Pediatr Nephrol 2024; 39:167-175. [PMID: 37453961 DOI: 10.1007/s00467-023-06071-0] [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: 03/31/2023] [Revised: 06/20/2023] [Accepted: 06/20/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Extremes of unhealthy body weight, particularly obesity, are known to increase the risk of chronic kidney diseases. However, the current knowledge of kidney health outcomes associated with unhealthy body weight remains incomprehensive, especially in pediatrics. Therefore, the present study aimed to evaluate body mass index (BMI) and its potential associations with kidney health in a selected subset of school students in Sri Lanka. METHODS This cross-sectional study was conducted among students of both sexes in the range of 11-18 years of age (N = 1078) in education zones with no reported cases of chronic kidney disease of uncertain etiology. Based on sex- and age-specific BMI percentiles (LMS method), the participants were classified into five BMI groups (severely thin, thin, healthy, overweight, and obese) for measurement of urinary biomarkers of kidney injury: kidney injury molecule (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), and albumin creatinine ratio (ACR). RESULTS The median urinary levels of NGAL, ACR, and particularly KIM-1, which is a more sensitive indicator of kidney injury, showed no significant differences across the BMI strata. Importantly, moderate correlations of BMI with KIM-1 and NGAL were identified in severely thin girls. CONCLUSIONS According to the present study, these findings do not produce plausibly strong evidence to establish a potential association of BMI with altered kidney function in the studied pediatric communities. Particularly, a likelihood of abnormal kidney health outcomes associated with undernutrition is apparent in severely thin girls. However, in-depth studies are warranted to develop a comprehensive understanding of the associations of nutritional status with pediatric kidney health in Sri Lanka. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
- T D K S C Gunasekara
- Department of Zoology, Faculty of Science, University of Ruhuna, Matara, 81000, Sri Lanka
| | - P Mangala C S De Silva
- Department of Zoology, Faculty of Science, University of Ruhuna, Matara, 81000, Sri Lanka.
| | - E P S Chandana
- Department of Biosystems Technology, Faculty of Technology, University of Ruhuna, Matara, 81000, Sri Lanka
| | - Sudheera Jayasinghe
- Department of Pharmacology, Faculty of Medicine, University of Ruhuna, Galle, 80000, Sri Lanka
| | - Chula Herath
- Department of Nephrology, Sri Jayewardenepura General Hospital, Colombo, 10100, Sri Lanka
| | - Sisira Siribaddana
- Department of Medicine, Faculty of Medical & Allied Sciences, Rajarata University, Saliyapura, 50008, Sri Lanka
| | - Nishad Jayasundara
- Nicholas School of the Environment, Duke University, Durham, NC, 27708, USA
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Fernandez HE, Foster BJ. Long-Term Care of the Pediatric Kidney Transplant Recipient. Clin J Am Soc Nephrol 2022; 17:296-304. [PMID: 33980614 PMCID: PMC8823932 DOI: 10.2215/cjn.16891020] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Pediatric kidney transplant recipients are distinguished from adult recipients by the need for many decades of graft function, the potential effect of CKD on neurodevelopment, and the changing immune environment of a developing human. The entire life of an individual who receives a transplant as a child is colored by their status as a transplant recipient. Not only must these young recipients negotiate all of the usual challenges of emerging adulthood (transition from school to work, romantic relationships, achieving independence from parents), but they must learn to manage a life-threatening medical condition independently. Regardless of the age at transplantation, graft failure rates are higher during adolescence and young adulthood than at any other age. All pediatric transplant recipients must pass through this high-risk period. Factors contributing to the high graft failure rates in this period include poor adherence to treatment, potentially exacerbated by the transfer of care from pediatric- to adult-oriented care providers, and perhaps an increased potency of the immune response. We describe the characteristics of pediatric kidney transplant recipients, particularly those factors that may influence their care throughout their lives. We also discuss the risks associated with the transition from pediatric- to adult-oriented care and provide some suggestions to optimize the transition to adult-oriented transplant care and long-term outcomes.
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Affiliation(s)
- Hilda E. Fernandez
- Department of Medicine, Columbia University Medical Center, New York, New York
| | - Bethany J. Foster
- Department of Pediatrics, McGill University, Montreal, Quebec, Canada,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada,Research Institute of the McGill University Health Centre, McGill University, Montreal, Quebec, Canada
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Grèze C, Pereira B, Boirie Y, Guy L, Millet C, Clerfond G, Garrouste C, Heng AE. Impact of obesity in kidney transplantation: a prospective cohort study from French registries between 2008 and 2014. Nephrol Dial Transplant 2021; 37:584-594. [PMID: 34610103 DOI: 10.1093/ndt/gfab277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The access of obese patients to kidney transplantation is limited despite several studies showing that obese transplant recipients had a better survival rate than those undergoing dialysis. The aim of this study was to compare patient and graft survival rates and post-renal transplant complications in obese patients and non-obese patients and to assess the effect of pre-transplant weight loss in obese patients on transplant outcomes. METHODS We carried out a prospective cohort study using two French registries REIN and CRISTAL on 7 270 kidney transplant patients between 2008 and 2014 in France. We compared obese patients with non-obese patients and obese patients who lost more than 10% of weight before the transplant (Obese WL and Obese nWL). RESULTS The mean BMI in our obese patients was 32 kg/m2. Graft survival was lower in obese patients than in non-obese patients (HR = 1.40, IC 95% [1.09; 1.78], P = 0.007) whereas patient survival was similar (HR = 0.94, IC 95% [0.73; 1.23], P = 0.66). Graft survival was significantly lower in Obese WL than in Obese nWL (HR = 2.17, CI 95% [1.02; 4.63], P = 0.045) whereas patient survival was similar in the two groups (HR = 0.79, IC 95% [0.35; 1.77], P = 0.56). CONCLUSION Grade I obesity does not seem to be a risk factor for excess mortality after kidney transplantation and should not be an obstacle to having access to a graft. Weight loss before a kidney transplant in this patients should not be essential for registration on waiting list.
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Affiliation(s)
- Clarisse Grèze
- Service de Néphrologie, Dialyse et Transplantation, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Bruno Pereira
- Unité de Biostatistiques (DRCI), CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Yves Boirie
- Service de Nutrition clinique, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Laurent Guy
- Service d'Urologie, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Clémentine Millet
- Service d'Urologie, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Guillaume Clerfond
- Service de Cardiologie, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Cyril Garrouste
- Service de Néphrologie, Dialyse et Transplantation, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Anne-Elisabeth Heng
- Service de Néphrologie, Dialyse et Transplantation, CHU de Clermont-Ferrand, Clermont-Ferrand, France
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Santos JLF, Valério VP, Fernandes RN, Duarte L, Assumpção AC, Guerreiro J, Sickler AL, Lemos ÁAR, Goulart Filho JG, Cesar LAM, Pinto IM, Magalhães C, Hussid MF, Camacho C, Avezum A, Sangaleti CT, Consolim-Colombo FM. Waist Circumference Percentiles and Cut-Off Values for Obesity in a Large Sample of Students from 6 To 10 Years Old Of The São Paulo State, Brazil. Arq Bras Cardiol 2020; 114:530-537. [PMID: 32267326 PMCID: PMC7792724 DOI: 10.36660/abc.20190043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 06/18/2019] [Indexed: 02/06/2023] Open
Abstract
Fundamento A prevalência da obesidade vem aumentando sistematicamente na população, inclusive nas crianças e adolescentes, ao redor do mundo. Objetivos Descrever curvas percentílicas de referência para a circunferência abdominal (CA) nas crianças brasileiras e fornecer pontos de corte da CA para identificar crianças com risco de obesidade. Métodos Um estudo multicêntrico, prospectivo, tranversal foi realizado em crianças com idades entre 6 e 10 anos, matriculadas no ensino fundamental de escolas públicas e particulares de 13 cidades do estado de São Paulo. A estatura, o peso e a CA foram medidos em duplicata em 22.000 crianças (11.199 meninos). Para estabelecer o melhor ponto de corte da CA para o diagnóstico da obesidade, foram calculadas curvas ROC com crianças classificadas como com peso normal e obesas, de acordo com as curvas do IMC, estratificadas por gênero e idade, e o índice Youden foi utilizado como a eficácia potencial máxima desse biomarcador. Valores de p < 0,05 foram considerados estatisticamente significativos. Resultados Os valores da CA aumentaram com a idade, tanto nos meninos quanto nas meninas. A prevalência de obesidade em cada grupo variou de 17% (6 anos de idade) a 21,6 % (9 anos de idade), dentre os meninos, e de 14,1% (7 anos de idade) a 17,3 % (9 anos de idade), dentre as meninas. As análises ROC mostraram o percentil 75 como ponto de corte para o risco de obesidade, e o diagnóstico de obesidade está classificado no percentil 85 ou acima. Conclusão Curvas de referência da CA específicas para idade e sexo em crianças brasileiras e pontos de corte para o risco de obesidade podem ser usados em triagem nacional e estudos intervencionais para reduzir a carga da obesidade no Brasil. (Arq Bras Cardiol. 2020; 114(3):530-537)
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Affiliation(s)
| | | | | | - Ligia Duarte
- Sociedade de Cardiologia do Estado de São Paulo, São Paulo, SP - Brasil
| | | | - Jayme Guerreiro
- Sociedade de Cardiologia do Estado de São Paulo, São Paulo, SP - Brasil
| | - Antonio L Sickler
- Sociedade de Cardiologia do Estado de São Paulo, São Paulo, SP - Brasil
| | - Álvaro A R Lemos
- Sociedade de Cardiologia do Estado de São Paulo, São Paulo, SP - Brasil
| | | | | | | | | | | | | | - Alvaro Avezum
- Sociedade de Cardiologia do Estado de São Paulo, São Paulo, SP - Brasil
| | - Carine T Sangaleti
- Universidade Estadual do Centro-Oeste - Enfermagem, Guarapuava, PR - Brasil
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Duan Y, Wang X, Zhang J, Ye P, Cao R, Yang X, Bai Y, Wu H. Body mass index is an independent predictive factor for kidney function evaluated by glomerular filtration rate in a community-dwelling population. Eat Weight Disord 2019; 24:731-738. [PMID: 28871501 DOI: 10.1007/s40519-017-0434-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 04/10/2017] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The effects of overweight and obesity on kidney function have since been identified and become a subject of increased study and concern. But the association between body mass index (BMI) and estimated glomerular filtration rate (eGFR) is not well characterized. The aim of this study was to determine the relationship between BMI and eGFR. METHODS To better understand the relationship between BMI and kidney function, we investigated the association between BMI and eGFR using both the baseline BMI level and the follow-up eGFR level and investigated the relationship between the change in BMI and the change in eGFR in 1447 patients from a 4.8-year prospective study in Beijing, People's Republic of China. RESULTS In multiple linear regression analysis, age, antihypertensive treatment, and BMI were negatively associated with the follow-up eGFR levels in all participants (R = -0.622, -0.926, and -0.266, respectively; P < 0.05), or in the elderly (R = -0.883, -1.035, and -0.630, respectively; P < 0.05); sex was found to be associated with the follow-up eGFR levels independently not only in all participants (R = 6.783; P < 0.001), but also in the elderly (R = 3.518; P < 0.05). In addition, the change in eGFR levels was positively related to age, the change in LDL-C, the change in TC, and the change in SBP, but negatively related to the change in BMI and the change in HDL-C (all P < 0.05). CONCLUSIONS The present study clearly indicated that BMI is an independent predictive factor for kidney function evaluated by the eGFR level during a median 4.8 years of follow-up in Chinese population. LEVEL OF EVIDENCE Level III, prospective cohort study.
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Affiliation(s)
- Yuanyuan Duan
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Xiaona Wang
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Jiao Zhang
- Department of Cardiology, Chinese People's Armed Police Forces General Hospital, Beijing, China
| | - Ping Ye
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China.
| | - Ruihua Cao
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Xu Yang
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Yongyi Bai
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Hongmei Wu
- Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China
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Xiang MQ, Liao JW, Huang JH, Deng HL, Wang D, Xu Z, Hu M. Effect of a Combined Exercise and Dietary Intervention on Self-Control in Obese Adolescents. Front Psychol 2019; 10:1385. [PMID: 31316417 PMCID: PMC6610291 DOI: 10.3389/fpsyg.2019.01385] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 05/28/2019] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The aim of this study was to determine whether a combined exercise and dietary intervention improved cognitive and physical self-control and whether pre-to-post interventional changes in self-control were mediated by changes in body mass index (BMI) and maximal grip strength (MGS), in a sample of obese adolescents. METHODS Forty-four obese adolescents were randomly assigned to a combined exercise and dietary program or to a waitlist control group; the data from 36 participants (n = 18 for each group) were analyzed. The combined exercise and dietary program was performed over 6 weeks and was supervised by qualified trainers in a closed boot camp. The exercise consisted primarily of typical aerobic training, sports, outdoor training, yoga, and resistance training. Participants were placed on moderate dietary restriction according to individual target body weight (30 kcal/kg × target weight). The primary outcomes of this study were metrics based on cognitive and physical self-control, assessed by the Stroop task and a handgrip task, respectively. Secondary outcomes included BMI and MGS. RESULTS The combined exercise and dietary intervention significantly improved both cognitive and physical self-control. Similar positive effects were also found for reduced BMI and enhanced MGS. Correlation analyses showed that the reduced BMI and enhanced MGS were significantly closely associated with improved cognitive and physical self-control. The mediation analyses revealed that the pre-to-post intervention changes in BMI and MGS significantly mediated physical self-control, but did not mediate cognitive self-control. CONCLUSION Our combined exercise and dietary intervention is an effective approach to improve multiple aspects of self-control, reduce BMI, and strengthen MGS among obese adolescents. These findings also suggest that reduced BMI and enhanced MGS mediate specific aspects of self-control.
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Affiliation(s)
- Ming-Qiang Xiang
- Department of Sports and Health, Guangzhou Sport University, Guangzhou, China
| | - Jing-Wen Liao
- Guangdong Provincial Key Laboratory of Sports and Health Promotion, Guangzhou Sport University, Guangzhou, China
| | - Jun-Hao Huang
- Guangdong Provincial Key Laboratory of Sports and Health Promotion, Guangzhou Sport University, Guangzhou, China
| | - Hai-Lin Deng
- Guangdong Provincial Key Laboratory of Sports and Health Promotion, Guangzhou Sport University, Guangzhou, China
| | - Dan Wang
- Guangdong Provincial Key Laboratory of Sports and Health Promotion, Guangzhou Sport University, Guangzhou, China
| | - Zebo Xu
- Department of Sports and Health, Guangzhou Sport University, Guangzhou, China
| | - Min Hu
- Department of Sports and Health, Guangzhou Sport University, Guangzhou, China
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Abstract
OBJECTIVE Based on a nationally representative adolescent sample, we examined the association of depression on the prevalence of overweight or obesity and whether this association was moderated by gender. METHODS There were 1081 adolescents from the China Family Panel Studies that participated in our study. Depression in adolescents was assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). Ordered logistic regression model was used to quantify its association with overweight or obesity. Analyses were performed for the total group, and separately for males and females. RESULTS The prevalence of depression in Chinese adolescents was 23.22%. Depression (CES-D ≥16) was significantly associated with overweight or obesity (OR=1.47, 95% CI: 1.14 to 1.91, p=0.004) after adjustment for personal, household and regional confounders. Among four subdimensions of depression, depressed affect and lack of positive affect were significantly associated with increases in the odds of overweight or obesity. In females, only lack of positive affect was significantly associated with overweight or obesity, whereas the estimated associations of all other measures of depression on overweight or obesity were positive in males. CONCLUSIONS These findings provide evidence that depression is associated with overweight or obesity among adolescents in China, especially among males.
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Affiliation(s)
- Zhongyi Zhao
- School of Public Health, China Medical University, Shenyang, China
| | - Ning Ding
- School of Public Health, China Medical University, Shenyang, China
| | - Shenzhi Song
- School of Public Health, China Medical University, Shenyang, China
| | - Yang Liu
- School of Public Health, China Medical University, Shenyang, China
| | - Deliang Wen
- School of Public Health, China Medical University, Shenyang, China
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Zhen S, Ma Y, Zhao Z, Yang X, Wen D. Dietary pattern is associated with obesity in Chinese children and adolescents: data from China Health and Nutrition Survey (CHNS). Nutr J 2018; 17:68. [PMID: 29996840 PMCID: PMC6042200 DOI: 10.1186/s12937-018-0372-8] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Accepted: 06/26/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Associations of dietary patterns in Chinese adolescents and children with later obesity have not previously been investigated. The purpose of the present study was to evaluate the associations between dietary patterns and the risk of obesity in Chinese adolescents and children by using a longitudinal design. METHODS Data from the China Health and Nutrition Survey (CHNS), a nationally representative survey, were used for our analysis. 489 participants 6-14 years of age were followed from 2006 to 2011. Factor analysis was used to identify the dietary patterns in Chinese adolescents and children. Ordered logistic regression models were used to examine the association between dietary patterns and later obesity. RESULTS Two dietary patterns were revealed by factor analysis, the traditional Chinese dietary pattern (with high intake of rice, vegetables, poultry, pork and fish and the modern dietary pattern (with high intake of wheat, processed meat and fast food). Children in the highest quartile and the second-highest quartile of the traditional Chinese dietary pattern was inversely associated with later obesity compared with children in the lowest quartile over 5 years (OR = 0.19, 95%CI: 0.09, 0.40 for Q4; OR = 0.47, 95%CI: 0.33, 0.67 for Q3); Children in the highest quartile of the modern dietary pattern was positively associated with later obesity compared with children in the lowest quartile over 5 years (OR = 2.02, 95%CI: 1.17, 3.48). CONCLUSIONS Dietary patterns in Chinese adolescents and children are associated with later obesity. These findings further confirm the importance of children's dietary patterns in later obesity and lay groundwork for dietary culture-specific interventions targeted at reducing rates of obesity in children and adolescents.
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Affiliation(s)
- Shihan Zhen
- China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province China
| | - Yanan Ma
- China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province China
| | - Zhongyi Zhao
- China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province China
| | - Xuelian Yang
- China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province China
| | - Deliang Wen
- China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province China
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Influence of the 6-month physical activity programs on renal function in obese boys. Pediatr Res 2018; 83:1011-1015. [PMID: 29638229 DOI: 10.1038/pr.2018.15] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 01/11/2018] [Indexed: 01/10/2023]
Abstract
BackgroundWe intended to evaluate the effects of physical activity (PA) programs on renal function in obese boys.MethodsThirty-nine boys participated in one of the following three groups: soccer (SG, n=13), traditional PA (AG, n=13), and sedentary control (CG, n=13). SG and AG were involved in 6-month PA programs, involving three sessions/week for 60-90 min. Anthropometric measurements, body composition, creatinine and cystatin C plasmatic levels, and estimated glomerular filtration rate (eGFR) were evaluated.ResultsAt baseline (n=39), age and lean mass index (LMI) were positively correlated with creatinine levels. After 6 months, both intervention groups decreased the BMI z-score and waist circumference, while the CG increased the body fat percentage (BFP). LMI increased in all the groups. SG presented a small increment in plasma creatinine and a decrease in the eGFR values, using the Schwartz formula. Concerning the cystatin C levels and eGFR values using Filler (cystatin C-based) or Combined Zappitelli (creatinine/cystatin C-based) formulas, no significant changes were observed in any group.ConclusionThe combined Zappitelli formula showed no significant impact of PA on eGFR in obese boys. Although plasma creatinine is significantly influenced by lean body mass, cystatin C is likely to be a more accurate marker of renal function in this population.
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Lucke-Wold B, Shawley S, Ingels JS, Stewart J, Misra R. A Critical Examination of the Use of Trained Health Coaches to Decrease the Metabolic Syndrome for Participants of a Community-Based Diabetes Prevention and Management Program. JOURNAL OF HEALTHCARE COMMUNICATIONS 2016; 1. [PMID: 27857997 PMCID: PMC5110146 DOI: 10.4172/2472-1654.100038] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The epidemic of obesity and diabetes in the United States poses major challenge to the prevention and management of chronic diseases. Furthermore, when this is viewed in other components of the metabolic syndrome (i.e., the burden of high cholesterol and hypertension), the prevalence of the metabolic syndrome continues to rise in the USA continued challenge is how to deal with this epidemic from a medical and public health standpoint. Community Based Participatory Research (CBPR) is a unique approach and offers a novel perspective for answering this challenge. A critical set of goals for CBPR is to address health disparities and social inequalities while getting community members engaged in all aspects of the research process. Utilizing the West Virginia Diabetes Prevention and Management Program and trained Health Coaches as a model, we discuss topics of consideration related to CBPR, involving trained health coaches, optimizing early adoption of healthy lifestyle behaviors, and enhancing participation. Through careful project planning and design, questions regarding disparities increasing susceptibility and preventive efforts within the community can be addressed successfully. These topics are part of a broader integration of theories such as participatory research, community engagement, and outcomes measurement. The understanding of the pathophysiology and epidemiology of the metabolic syndrome can help frame an appropriate strategy for establishing long-term community-wide changes that promote health. In order to continue to improve investigations for preventing the metabolic syndrome, it will be necessary to have aggressive efforts at the individual and population level for developing culturally sensitive programs that start early and are sustainable in practical environments such as the workplace. In this comprehensive review, we will discuss practical considerations related to project design, implementation, and how to measure effectiveness in regards to reducing the burden of the metabolic syndrome.
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Affiliation(s)
| | | | | | | | - Ranjita Misra
- West Virginia University, Morgantown, West Virginia, USA
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Dougan MM, Field AE, Rich-Edwards JW, Hankinson SE, Glynn RJ, Willett WC, Michels KB. Is grand-parental smoking associated with adolescent obesity? A three-generational study. Int J Obes (Lond) 2015; 40:531-7. [PMID: 26388349 PMCID: PMC4800484 DOI: 10.1038/ijo.2015.186] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2015] [Revised: 07/12/2015] [Accepted: 08/23/2015] [Indexed: 12/18/2022]
Abstract
BACKGROUND/OBJECTIVES Data from previous studies consistently suggest that maternal smoking is positively associated with obesity later in life. Whether this association persists across generations is unknown. We examined whether grand-parental smoking was positively associated with overweight status in adolescence. SUBJECT/METHODS Participants were grandmother-mother-child triads in the Nurses' Health Study II (NHS II), the Nurses Mothers' Cohort Study and the Growing up Today Study (GUTS). Grandmothers provided information on their and their partner's smoking during pregnancy with the child's mother. Information on child's weight and height at ages 12 (N=3094) and 17 (N=3433) was obtained from annual or biennial GUTS questionnaires. We used logistic regression to estimate the odds ratios (ORs) of being overweight or obese, relative to normal weight. RESULTS Grand-maternal smoking during pregnancy was not associated with overweight status in adolescence. After adjusting for covariates, the OR of being overweight or obese relative to normal weight at age 12 years in girls whose grandmothers smoked 15+ cigarettes daily during pregnancy was 1.21 (95% confidence interval (CI) 0.74-1.98; P(trend)=0.31) and 1.07 (0.65-1.77; P(trend)=0.41) in boys. Grand-paternal smoking during pregnancy was associated with being overweight or obese at age 12 in girls only, but not at age 17 for either sex: the OR for being overweight or obese at age 12 was 1.38 (95% CI 1.01-1.89; P(trend)=0.03) in girls and 1.31 (95% CI 0.97-1.76; P(trend)=0.07) in boys. Among children of non-smoking mothers, the OR for granddaughter obesity for grand-paternal smoking was attenuated and no longer significant (OR 1.28 (95% CI 0.87-1.89; P(trend)=0.18)). CONCLUSIONS Our findings suggest that the association between maternal smoking and offspring obesity may not persist beyond the first generation. However, grand-paternal smoking may affect the overweight status of the granddaughter, likely through the association between grand-paternal smoking and maternal smoking.
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Affiliation(s)
- M M Dougan
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - A E Field
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Division of Adolescent Medicine, Department of Medicine, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - J W Rich-Edwards
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - S E Hankinson
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Division of Biostatistics and Epidemiology, University of Massachusetts School of Public Health and Health Sciences, Amherst, MA, USA
| | - R J Glynn
- Center for Cardiovascular Disease Prevention, Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - W C Willett
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - K B Michels
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Obstetrics and Gynecology Epidemiology Center, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Cao X, Zhou J, Yuan H, Wu L, Chen Z. Chronic kidney disease among overweight and obesity with and without metabolic syndrome in an urban Chinese cohort. BMC Nephrol 2015; 16:85. [PMID: 26084279 PMCID: PMC4471928 DOI: 10.1186/s12882-015-0083-8] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 06/04/2015] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND It is widely accepted that metabolic syndrome is associated with an increased risk of chronic kidney disease (CKD). To investigate whether coexisting metabolic syndrome is a necessary condition for CKD in overweight and obese. METHODS A cohort study of 6852 Chinese individuals from August 2007 to December 2012. Examinations included a questionnaire, physical measurements, and blood sampling. Hazard ratios for incident CKD were estimated according to combinations of BMI category and absence or presence of metabolic syndrome. RESULTS For CKD, multivariable adjusted hazard ratios vs. normal weight individuals without metabolic syndrome were 1.31 (95% CI, 0.89-1.92) in overweight and 2.39 (95% CI, 1.27-4.52) in obese without metabolic syndrome and 1.54 (95% CI, 1.18-3.95) in normal weight, 2.06 (95% CI, 1.27-3.36) in overweight, and 2.77 (95% CI, 1.42-4.31) in obese with metabolic syndrome. There were no interactions between BMI and absence or presence of metabolic syndrome on risk of CKD when BMI was categorized (normal weight, overweight, obese) (P = 0.17). Among individuals both with and without metabolic syndrome there were increasing cumulative incidences of CKD from normal weight through overweight to obese individuals (log-rank trend P = 0.04 to P < 0.001). Although the multivariable adjusted hazard ratio for CKD in individuals with vs. without metabolic syndrome was 1.82 (95% CI, 1.20-2.78) within overweight and obese individuals (log-rank P = 0.005), only 26.1% of the increased risk observed for BMI is explained by metabolic syndrome. CONCLUSIONS These findings suggest overweight and obesity are risk factors for CKD regardless of the presence or absence of metabolic syndrome.
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Affiliation(s)
- Xia Cao
- Department of Health Management, the Third Xiangya Hospital, Central South University, Tongzipo Road 138, 410013, Changsha, Hunan Province, China.
| | - Jiansong Zhou
- Mental Health Institute, the Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
| | - Hong Yuan
- Department of Clinical Pharmacology Center, the Third Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
| | - Liuxin Wu
- Institute of Aviation Medicine, Beijing, China.
| | - Zhiheng Chen
- Department of Health Management, the Third Xiangya Hospital, Central South University, Tongzipo Road 138, 410013, Changsha, Hunan Province, China.
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Exantus J, Desrosiers F, Ternier A, Métayer A, Abel G, Buteau JH. The need for dialysis in Haiti: dream or reality? Blood Purif 2015; 39:145-50. [PMID: 25672966 DOI: 10.1159/000368979] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
According to the World Health Organization reports, nowadays burden of chronic kidney diseases (CKD) is well documented. The high prevalence of noncommunicable diseases (NCD) such as hypertension, diabetes, and obesity, which are the main causes of CKD, is a big concern in the world health scenario. These NCD can progress slowly to end-stage renal disease (ESRD) and the low-middle income countries (LMIC) like Haiti are not left unscathed by this worldwide scourge. Several well-known public health issues prevalent in Haiti such as acute diarrheal infections, malaria, tuberculosis, cholera, and acquired immunodeficiency syndrome (AIDS), can also impair the function of the kidney. Dialysis, a form of renal replacement therapy (RRT), represents a life-saving therapy for all patients affected with impaired kidney. In Haiti, few patients have access to health insurance or disability financial support. Considering that seventy-two percent (72%) of Haitians live with less than USD 2 per day, survival with CKD can be quite stressful for them. Data on the weight of the dialysis and its management are scarce. Addressing the need for dialysis in Haiti is an important component in decision-making and planning processes in the health sector. This paper is intended to bring forth discussion on the use of this type of renal replacement therapy in Haiti: the past, the present, and the challenges it presents. We will also make some recommendations in order to manage this serious problem.
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Affiliation(s)
- Judith Exantus
- Pediatrics Unit, State University Hospital, Port-au-Prince, Haïti
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