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Lee EB. What is the disease burden from childhood and adolescent obesity?: a narrative review. JOURNAL OF YEUNGNAM MEDICAL SCIENCE 2024; 41:150-157. [PMID: 38932702 PMCID: PMC11294796 DOI: 10.12701/jyms.2024.00360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 05/30/2024] [Accepted: 06/03/2024] [Indexed: 06/28/2024]
Abstract
The prevalence of childhood and adolescent obesity has increased and exacerbated during the coronavirus disease 2019 pandemic, both in Korea and globally. Childhood and adolescent obesity poses significant risks for premature morbidity and mortality. The development of serious comorbidities depends not only on the duration of obesity but also on the age of onset. Obesity in children and adolescents affects almost all organ systems, including the endocrine, cardiovascular, gastrointestinal, reproductive, nervous, and immune systems. Obesity in children and adolescents affects growth, cognitive function, and psychosocial interactions during development, in addition to aggravating known adult comorbidities such as type 2 diabetes mellitus, hypertension, dyslipidemia, nonalcoholic fatty liver disease, obstructive sleep apnea, and cancer. Childhood and adolescent obesity are highly associated with increased cardiometabolic risk factors and prevalence of metabolic syndrome. The risk of cardiovascular and metabolic diseases in later life can be considerably decreased by even a small weight loss before the onset of puberty. Childhood and adolescent obesity is a disease that requires treatment and is associated with many comorbidities and disease burdens. Therefore, early detection and therapeutic intervention are crucial.
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Affiliation(s)
- Eun Byoul Lee
- Department of Pediatrics, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
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Kostopoulou E. The Interplay Between COVID-19 and Pediatric Endocrine Disorders. What have we Learned After More than Three Years of the Pandemic? Horm Metab Res 2024; 56:181-192. [PMID: 37673081 DOI: 10.1055/a-2152-4590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
As an increased body of COVID-19 related research is now available, it becomes apparent that the effects of COVID-19 extend beyond that of the respiratory system. Among others, the endocrine system is particularly vulnerable to perturbation from the COVID-19 infection. The present scoping review summarizes the bidirectional relationship between COVID-19 and endocrine system in children and adolescents, by describing both the possible susceptibility of children and adolescents without endocrinopathies to endocrine disorders following COVID-19 infection, but also the potential susceptibility to COVID-19 infection and severe infection, or the aggravation of endocrine dysfunction in patients with pre-existing endocrine diseases. Data suggest increased obesity and diabetes rates, as well as increased severity and frequency of diabetic ketoacidosis following COVID-19 infection. Conversely, patients with diabetes and obesity may experience a more severe course of COVID-19 infection. However, in the majority of cases, children and adolescents with well-managed and regulated endocrine disorders do not appear to be at increased risk of infection or severe infection from COVID-19. Thus, adhering to the appropriate "sick day management rules", maintaining adequate supply of medications and supplies, keeping close contact with the therapeutic team and seeking medical help without delay when needed, are the main recommendations for a safe outcome. Additional lessons learnt during the pandemic include the risk for mental health diseases caused by children's disrupted routine due to COVID-19 related protective measures and the importance of adopting alternative communication options, such as telehealth visits, in order to ensure uninterrupted endocrine care.
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Affiliation(s)
- Eirini Kostopoulou
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, University of Patras School of Medicine, Patras, Greece
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Thorén A, Filipsson T, Englund E, Sandström O, Janson A, Silfverdal SA. Significant effects of childhood obesity treatment with a web-based component in a randomised controlled study (Web-COP). Acta Paediatr 2024; 113:276-285. [PMID: 37837210 DOI: 10.1111/apa.17000] [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: 05/16/2022] [Revised: 09/29/2023] [Accepted: 10/04/2023] [Indexed: 10/15/2023]
Abstract
AIM We evaluated the effect on body mass index standard deviation score (BMI-SDS) of a combined treatment (Web-COP) for children with obesity, including a web-based component targeting their parents. METHODS This randomised controlled trial recruited children 5-12 years of age with obesity (International Obesity Task Force BMI [IOTF-BMI] ≥30 kg/m2 ) from school health care and outpatient paediatric clinics in in Northern Sweden from 1 June 2019 to 21 June 2020. The children were randomised to Web-COP, an intervention with group sessions and a 12-week web-based component, or standard care. The primary outcome was the change in IOTF BMI-SDS after 6 months. RESULTS In total, 75 children (33 girls), mean age 9.5 years, were randomised, and 65/75 (87%) children and their parents completed the study, 35/39 (90%) in the Web-COP intervention and 30/36 (83%) in the standard care group. BMI-SDS at 6 months was changed from 3.08 to 2.81 in the intervention group compared to an increase from 3.07 to 3.16 in the standard care group, representing a significant difference between groups (p < 0.001). In the intervention group, 14/30 (47%) reduced their BMI-SDS ≥0.25, compared to none in the standard care group. CONCLUSION The parent-focused intervention significantly improved BMI-SDS in children with obesity as compared to children in standard care.
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Affiliation(s)
- Annelie Thorén
- Department of Clinical Sciences, Paediatrics, Umeå University, Umeå, Sweden
- Department of Paediatrics, Sollefteå hospital, Sollefteå, Sweden
| | - Tobias Filipsson
- Department of Paediatrics, Örnsköldsvik hospital, Örnsköldsvik, Sweden
| | - Erling Englund
- Department of Research and Development, Västernorrland County Council, Sundsvall, Sweden
| | - Olof Sandström
- Department of Clinical Sciences, Paediatrics, Umeå University, Umeå, Sweden
| | - Annika Janson
- National Childhood Obesity Centre, Karolinska University Hospital, Stockholm, Sweden
- Department of Women's and Children's Health, Division of Paediatric Endocrinology, Karolinska Institutet, Stockholm, Sweden
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Ali Ibrahim AI, Mendoza B, Stanford FC, Malhotra S. Real-World Experience of the Efficacy and Safety of Phentermine Use in Adolescents: A Case Series. Child Obes 2023; 19:535-540. [PMID: 36576420 DOI: 10.1089/chi.2022.0147] [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: 12/29/2022]
Abstract
Background: Pharmacotherapy has emerged as a practical option for weight management in pediatrics. This study aims to assess the effectiveness and safety of phentermine use in pediatric patients with obesity. Methods: We performed a retrospective single-center analysis of patients younger than or equal to 18 years of age, over 10 years, who underwent phentermine treatment and recommended lifestyle changes. We evaluated efficacy by the change in the percent of the 95th percentile for BMI (%BMIp95). We deemed a 5% decrease in %BMIp95 as a favorable outcome. Results: We identified 30 pediatric patients who were treated with phentermine. The cohort was primarily female, 63% white, with a mean (standard deviation) baseline age of 15.63 (1.97) years. The average duration of treatment was 10 months, with a period ranging from 2 weeks to 2 years. The average %BMIp95 at the start of treatment was 137%, and that at the time of analysis was 122%, with a mean reduction of 15%. Five patients, 17%, experienced side effects that resolved after dose reduction or discontinuing phentermine. Conclusions: Phentermine monotherapy is an effective and safe means for weight loss in pediatric patients when combined with lifestyle interventions. Twenty-one of 30 (70%) patients achieved at least a 5% decrease in %BMIp95 within a mean duration of treatment of 10 months. We noted no severe adverse events.
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Affiliation(s)
- Awab I Ali Ibrahim
- Pediatric Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Fatima Cody Stanford
- Pediatric Endocrinology, MGH Weight Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Neuroendocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Nutrition Obesity Research Center at Harvard, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Sonali Malhotra
- Pediatric Endocrinology, MGH Weight Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Rhythm Pharmaceuticals, Boston, MA, USA
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Szczyrska J, Brzeziński M, Szlagatys-Sidorkiewicz A. Long-term effects of 12-month integrated weight-loss programme for children with excess body weight- who benefits most? Front Endocrinol (Lausanne) 2023; 14:1221343. [PMID: 38027174 PMCID: PMC10656687 DOI: 10.3389/fendo.2023.1221343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 10/09/2023] [Indexed: 12/01/2023] Open
Abstract
The aim of the study was to assess long-term effects of the 12-month integrated weight-loss programme in children with excess body weight. We also attempted to identify the determinants of intervention effectiveness. Two groups were included in the analysis: 241 children with excess body weight who participated in the full 12-month intervention (full participation group) and 891 children with excess body weight who did not participate in the intervention (no participation group). Changes in BMI SDS, SBP SDS, DBP SDS and post-exercise HR with a follow-up period of 4 years between this groups were compared. In the full participation group, the reduction in mean BMI SDS was greater, we also observed significantly higher decrease in DBP SDS. Subgroup analysis by age category and sex showed a significant difference in the change in mean BMI SDS (from baseline to follow-up) in the subgroup of younger children and in the subgroup of younger girls. In the subgroup of younger girls significantly higher decrease in DBP SDS and SBP was also observed. Younger children, who participated in the intervention at age 6, particularly girls, benefited the most.
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Affiliation(s)
- Joanna Szczyrska
- Department of Pediatrics, Gastroenterology, Allergology and Pediatric Nutrition, Medical University of Gdansk, Gdansk, Poland
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Sequi-Dominguez I, Mavridis D, Cavero-Redondo I, Saz-Lara A, Martinez-Vizcaino V, Núñez de Arenas-Arroyo S. Comparative effectiveness of different types of exercise in reducing arterial stiffness in children and adolescents: a systematic review and network meta-analysis. Br J Sports Med 2023:bjsports-2022-106285. [PMID: 36963807 DOI: 10.1136/bjsports-2022-106285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2023] [Indexed: 03/26/2023]
Abstract
OBJECTIVE Arterial stiffness is an early and detectable marker of vascular changes leading to atherosclerotic cardiovascular disease (ACVD). Our objective was to compare the effectiveness of different types of exercise in reducing arterial stiffness in children and adolescents. DESIGN A systematic review and network meta-analysis (NMA) was conducted including experimental studies reporting the effects of exercise interventions on pulse wave velocity (PWV) in children and adolescents. DATA SOURCES Cochrane Central Register of Controlled Trials, EMBASE (via Scopus), PubMed (via Medline) and Web of Science from database inception to 25 March 2022. ELIGIBILITY CRITERIA Experimental studies reporting the effects of exercise interventions on PWV in children and adolescents. RESULTS Fourteen studies were included in the NMA, all of them were randomised controlled trials except one quasi-experimental study, with an overall risk of bias of some concern. Regarding PWV reduction, all exercise modalities were more effective than control, with standardised mean difference ranging from -1.93 (95% CI: -2.84 to -1.02) and -1.11 (95% CI: -2.01 to -0.21) for aerobic exercise and high intensity interval training (HIIT), respectively, to -0.59 (95% CI: -1.39 to 0.22) for combined exercise. Only sensorimotor training was not superior to the control group 0.11 (95% CI: -1.10 to 1.32). CONCLUSION Our results support that exercise interventions, especially aerobic exercise or HIIT, can improve arterial stiffness at early ages. The potential to address ACVD early and mitigate long-term consequences via exercise interventions in children and adolescents with higher arterial stiffness requires further investigation. PROSPERO REGISTRATION NUMBER CRD42022322536.
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Affiliation(s)
- Irene Sequi-Dominguez
- Health and Social Research Center, Universidad de Castilla - La Mancha - Campus de Cuenca, Cuenca, Spain
- Facultad de Enfermería de Albacete, Universidad de Castilla-La Mancha - Campus de Albacete, Albacete, Spain
| | - Dimitris Mavridis
- Department of Primary Education, University of Ioannina, Ioannina, Greece
- Faculty of Medicine, Université Paris Descartes BU, Paris, France
| | - Iván Cavero-Redondo
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Temuco, Chile
| | - Alicia Saz-Lara
- Health and Social Research Center, Universidad de Castilla - La Mancha - Campus de Cuenca, Cuenca, Spain
| | - Vicente Martinez-Vizcaino
- Health and Social Research Center, Universidad de Castilla - La Mancha - Campus de Cuenca, Cuenca, Spain
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Calcaterra V, Rossi V, Mari A, Casini F, Bergamaschi F, Zuccotti GV, Fabiano V. Medical treatment of weight loss in children and adolescents with obesity. Pharmacol Res 2022; 185:106471. [PMID: 36174963 DOI: 10.1016/j.phrs.2022.106471] [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: 07/19/2022] [Revised: 09/16/2022] [Accepted: 09/23/2022] [Indexed: 12/01/2022]
Abstract
Obesity remains one of the biggest health problems both in adults and children. Lifestyle modification, including diet and exercise, continues to be the mainstay of obesity prevention and treatment. Unfortunately, lifestyle modifications are often unsuccessful. Pharmacological treatment of obesity in pediatric patients can be applied in selected cases, and not before evidence of failure of the multidisciplinary lifestyle intervention. In this narrative review, we revised the most up-to-date evidence on medical treatment of weight loss in children and adolescents with obesity, including FDA- or EMA-approved and -experimented, not approved, drugs for pediatric population. Multidisciplinary treatment of childhood obesity, regulation of appetite control, energy balance and body weight were also discussed, in order to clarify the indications and mechanism action of drugs. Despite a substantial number of medications used for the treatment of obesity in adults, a limited number of drugs are approved by the drug regulatory agencies for pediatric population. Further research is needed to evaluate the efficacy and safety of novel pharmacological approaches for treatment of pediatric obesity in order to optimize weight management for children and adolescents and limit the development obesity-related comorbidities.
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Affiliation(s)
- Valeria Calcaterra
- Department of Pediatrics, Vittore Buzzi Children's Hospital, 20154 Milan, Italy; Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy
| | - Virginia Rossi
- Department of Pediatrics, Vittore Buzzi Children's Hospital, 20154 Milan, Italy
| | - Alessandra Mari
- Department of Pediatrics, Vittore Buzzi Children's Hospital, 20154 Milan, Italy
| | - Francesca Casini
- Department of Pediatrics, Vittore Buzzi Children's Hospital, 20154 Milan, Italy
| | | | - Gian Vincenzo Zuccotti
- Department of Pediatrics, Vittore Buzzi Children's Hospital, 20154 Milan, Italy; Department of Biomedical and Clinical Sciences, Università di Milano, 20122 Milan, Italy
| | - Valentina Fabiano
- Department of Pediatrics, Vittore Buzzi Children's Hospital, 20154 Milan, Italy; Department of Biomedical and Clinical Sciences, Università di Milano, 20122 Milan, Italy.
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Abstract
PURPOSE OF REVIEW Approximately 370 million children and adolescents worldwide showed overweight or obesity in 2016. The risk of developing severe comorbidities depends on the age of onset and the duration of obesity. This review discusses available methodologies to detect excess body fat in children as well as the early life factors that predict excess body fat and its development. RECENT FINDINGS Factors, such as parental nutritional status, maternal weight gain during pregnancy, maternal malnutrition, maternal smoking during pregnancy, low and high birth weight, rapid weight gain, and short infant sleep duration have been independently and positively associated with neonatal, infant, and children adiposity. Early detection of excess body fat in children through the use of various tools is the first step in preventing nutrition-related diseases in adulthood. SUMMARY The early detection of excess body fat and the implementation of efficient interventions to normalize the weight of children and adolescents at obesity risk are essential to prevent diseases in adult life.
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Affiliation(s)
- Diana Paola Córdoba-Rodríguez
- Departamento de Nutrición y Bioquímica, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá DC, Colombia
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2)Universidad de Zaragoza, Zaragoza, Spain
| | - Gerardo Rodriguez
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2)Universidad de Zaragoza, Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
- Red de Salud Materno Infantil y del Desarrollo (SAMID), Instituto de Salud Carlos III, Madrid, Spain
- Área de Pediatría, Universidad de Zaragoza, Zaragoza, Spain
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2)Universidad de Zaragoza, Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III Madrid, Madrid, Spain
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Prevention and Treatment of Cardiometabolic Diseases in Children with Overweight and Obesity: The Future of Healthcare. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9020176. [PMID: 35204897 PMCID: PMC8869912 DOI: 10.3390/children9020176] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 01/24/2022] [Indexed: 12/29/2022]
Abstract
In this Special Issue we will consider the impact of obesity on health in order to review the latest findings on the risk factors associated with cardiometabolic diseases in children with overweight and obesity as well as to explore the pathogenic mechanisms and potential therapeutic targets. The role of weight-management strategies, including exercise, dietary changes and nutritional education, in preventing obesity-related complications will be considered. The improvement of many obesity-associated complications following bariatric surgery will also be reported. The timely implementation of preventive strategies in pediatric patients with overweight and obesity may ameliorate the future burden of weight-related diseases and the future of healthcare.
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Vogel M, Geserick M, Gausche R, Beger C, Poulain T, Meigen C, Körner A, Keller E, Kiess W, Pfäffle R. Age- and weight group-specific weight gain patterns in children and adolescents during the 15 years before and during the COVID-19 pandemic. Int J Obes (Lond) 2022; 46:144-152. [PMID: 34556774 PMCID: PMC8458556 DOI: 10.1038/s41366-021-00968-2] [Citation(s) in RCA: 65] [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: 02/18/2021] [Revised: 09/02/2021] [Accepted: 09/10/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES There is a concern that measures aiming to limit a further spread of COVID-19, e.g., school closures and social distancing, cause an aggravation of the childhood obesity epidemic. Therefore, we compared BMI trends during the 15 years before and during the COVID-19 pandemic. SUBJECTS/METHODS To assess the change in weight dynamics during the first months of COVID-19, we compared the trends of 3-month change in BMI-SDS (ΔBMI-SDS) and the proportions of children showing a high positive (HPC) or high negative (HNC) weight change between 2005 and 2019 and the respective changes from 2019 (pre-pandemic) to 2020 (after the onset of anti-pandemic measures) in more than 150,000 children (9689 during the pandemic period). The period of 3 months corresponds approximately to the first lockdown period in Germany. RESULTS During the COVID-19 pandemic, we found a substantial weight gain across all weight and age groups, reflected by an increase in the 3-month change in BMI-SDS (β = 0.05, p < 0.001), an increase in the proportion of children showing HPC (OR = 1.4, p < 0.001), and a decrease in the proportion of children showing HNC (OR = 0.7, p < 0.001). Besides, we found the same trends since 2005 on a low but stable level with a yearly increase of ΔBMI-SDS by β = 0.001 (p < 0.001), the odds of HPC increased by ORhigh_pos = 1.01 (p < 0.001), and the odds of HNC decreased by ORhigh_neg = 0.99 (p < 0.001). These rather small effects accumulated to β = 0.02, ORhigh_pos = 1.14, and ORhigh_pos = 0.85 over the whole period 2005-2019. Alarmingly, both the long-term and the short-term effects were most pronounced in the obese subgroup. CONCLUSIONS There are positive dynamics in different measures of weight change, indicating a positive trend in weight gain patterns, especially within the group of children with obesity. These dynamics are likely to be escalated by COVID-19-related measures. Thus, they may lead to a significant further aggravation of the childhood obesity pandemic.
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Affiliation(s)
- Mandy Vogel
- Leipzig University Hospital for Children and Adolescents, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany.
- Center for Pediatric Research, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany.
| | - Mandy Geserick
- Leipzig University Hospital for Children and Adolescents, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany
- Center for Pediatric Research, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany
| | - Ruth Gausche
- Leipzig University Hospital for Children and Adolescents, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany
- Center for Pediatric Research, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany
| | - Christoph Beger
- Leipzig University Hospital for Children and Adolescents, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany
- Center for Pediatric Research, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany
| | - Tanja Poulain
- Leipzig University Hospital for Children and Adolescents, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany
- Center for Pediatric Research, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany
| | - Christof Meigen
- Leipzig University Hospital for Children and Adolescents, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany
- Center for Pediatric Research, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany
| | - Antje Körner
- Leipzig University Hospital for Children and Adolescents, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany
- Center for Pediatric Research, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany
| | - Eberhard Keller
- Leipzig University Hospital for Children and Adolescents, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany
- Center for Pediatric Research, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany
| | - Wieland Kiess
- Leipzig University Hospital for Children and Adolescents, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany
- Center for Pediatric Research, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany
| | - Roland Pfäffle
- Leipzig University Hospital for Children and Adolescents, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany
- Center for Pediatric Research, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany
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Hashim A, Sedky M, Masood W, Shehata I, Kaye A. Pediatric obesity and anesthetic challenges of metabolic surgery. Saudi J Anaesth 2022; 16:444-451. [DOI: 10.4103/sja.sja_469_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/20/2022] [Accepted: 08/27/2022] [Indexed: 11/04/2022] Open
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Power GM, Tyrrell J, Frayling TM, Davey Smith G, Richardson TG. Mendelian Randomization Analyses Suggest Childhood Body Size Indirectly Influences End Points From Across the Cardiovascular Disease Spectrum Through Adult Body Size. J Am Heart Assoc 2021; 10:e021503. [PMID: 34465205 PMCID: PMC8649247 DOI: 10.1161/jaha.121.021503] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 05/26/2021] [Indexed: 12/04/2022]
Abstract
Background Obesity is associated with long-term health consequences including cardiovascular disease. Separating the independent effects of childhood and adulthood obesity on cardiovascular disease risk is challenging as children with obesity typically remain overweight throughout the lifecourse. Methods and Results This study used 2-sample univariable and multivariable Mendelian randomization to estimate the effect of childhood body size both independently and after accounting for adult body size on 12 endpoints across the cardiovascular disease disease spectrum. Univariable analyses identified strong evidence of a total effect between genetically predicted childhood body size and increased risk of atherosclerosis, atrial fibrillation, coronary artery disease, heart failure, hypertension, myocardial infarction, peripheral artery disease, and varicose veins. However, evidence of a direct effect was weak after accounting for adult body size using multivariable Mendelian randomization, suggesting that childhood body size indirectly increases risk of these 8 disease outcomes via the pathway involving adult body size. Conclusions These findings suggest that the effect of genetically predicted childhood body size on the cardiovascular disease outcomes analyzed in this study are a result of larger body size persisting into adulthood. Further research is necessary to ascertain the critical timepoints where, if ever, the detrimental impact of obesity initiated in early life begins to become immutable.
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Affiliation(s)
- Grace M. Power
- MRC Integrative Epidemiology UnitPopulation Health SciencesBristol Medical SchoolUniversity of BristolUnited Kingdom
| | - Jessica Tyrrell
- Genetics of Complex TraitsUniversity of Exeter Medical SchoolUniversity of ExeterUnited Kingdom
| | - Timothy M. Frayling
- Genetics of Complex TraitsUniversity of Exeter Medical SchoolUniversity of ExeterUnited Kingdom
| | - George Davey Smith
- MRC Integrative Epidemiology UnitPopulation Health SciencesBristol Medical SchoolUniversity of BristolUnited Kingdom
| | - Tom G. Richardson
- MRC Integrative Epidemiology UnitPopulation Health SciencesBristol Medical SchoolUniversity of BristolUnited Kingdom
- Department of GeneticsNovo Nordisk Research Centre OxfordUnited Kingdom
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Karere GM, Cox LA, Bishop AC, South AM, Shaltout HA, Mercado-Deane MG, Cuda S. Sex Differences in MicroRNA Expression and Cardiometabolic Risk Factors in Hispanic Adolescents with Obesity. J Pediatr 2021; 235:138-143.e5. [PMID: 33831442 PMCID: PMC8926296 DOI: 10.1016/j.jpeds.2021.03.070] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 03/25/2021] [Accepted: 03/30/2021] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To evaluate sex differences in microRNA (miRNA) expression, anthropometric measures, and cardiometabolic risk factors in Hispanic adolescents with obesity. STUDY DESIGN Cross-sectional study of 68 (60% male) Hispanic adolescents with obesity, aged 13-17 years, recruited from a pediatric weight management clinic. We used small RNA sequencing to identify differentially expressed circulating miRNAs. We used ingenuity pathway analysis and David bioinformatic resource tools to identify target genes for these miRNAs and enriched pathways. We used standard procedures to measure anthropometric and cardiometabolic factors. RESULTS We identified 5 miRNAs (miR-24-3p, miR-361-3p, miR-3605-5p, miR-486-5p, and miR-199b-3p) that differed between females and males. miRNA targets-enriched pathways included phosphatidylinositol 3-kinase-protein, 5' AMP-activated protein kinase, insulin resistance, sphingolipid, transforming growth factor-β, adipocyte lipolysis regulation, and oxytocin signaling pathways. In addition, there were sex differences in blood pressure, skeletal muscle mass, lean body mass, and percent body fat. CONCLUSIONS We have identified sex differences in miRNA expression in Hispanic adolescents relevant to cardiometabolic health. Future studies should focus on sex-specific mechanistic roles of miRNAs on gene pathways associated with obesity pathophysiology to support development of precision cardiometabolic interventions.
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Affiliation(s)
- Genesio M. Karere
- Department of Internal Medicine, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina,Corresponding author Department of Internal Medicine, Center for Precision Medicine, Wake Forest Baptist, Medical Center, Winston-Salem, NC 27157., Telephone: (336) 713-7561, Fax: (336) 713-7566,
| | - Laura A. Cox
- Department of Internal Medicine, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina
| | - Andrew C. Bishop
- Department of Internal Medicine, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina
| | - Andrew M. South
- Department of Pediatrics, Brenner Children’s Hospital, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina,Division of Public Health Sciences, Department of Epidemiology and Prevention, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina
| | - Hossam A. Shaltout
- Department of Obstetrics and Gynecology, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina
| | - Maria-Gisela Mercado-Deane
- Department of Radiology, Baylor College of Medicine, Children’s Hospital of San Antonio, San Antonio, Texas
| | - Suzanne Cuda
- Department of Pediatrics, Baylor College of Medicine, Children’s Hospital of San Antonio, San Antonio, Texas
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14
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Livne-Margolin M, Tokatly Latzer I, Pinhas-Hamiel O, Harari G, Achiron A. Bodyweight Measures and Lifestyle Habits in Individuals with Multiple Sclerosis and Moderate to Severe Disability. J Clin Med 2021; 10:2083. [PMID: 34066209 PMCID: PMC8151674 DOI: 10.3390/jcm10102083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/08/2021] [Accepted: 05/08/2021] [Indexed: 02/05/2023] Open
Abstract
Multiple sclerosis (MS) is a chronic disease marked by progressive disability and decreased mobility over time. We studied whether individuals with MS of higher disability levels will be more overweight/obese as a result of their immobility and/or recurrent steroid treatments. In a prospective study, 130 individuals with MS and significant disability were classified according to the Expanded Disability Status Scale (EDSS) score as belonging to four groups: EDSS 3.0-4.0 (n = 31, 24%), EDSS 4.5-5.5 (n = 24, 18%), EDSS = 6.0 (n = 44, 34%) and EDSS ≥ 6.5 (n = 31, 24%). Medical history, body mass index (BMI), waist circumference and the level of engagement in physical activity were obtained. The mean ± standard error age was 55.8 ± 0.5 years, disease duration 18.2 ± 1.0 years and EDSS score 5.5 ± 0.1. Disease duration, the number of steroid courses per disease duration, weight, BMI and physical activity did not differ according to the four disability groups. The mean waist circumference increased significantly with increased severity of EDSS, p = 0.03. Increased disability in individuals with MS was not correlated with disease duration, lifestyle habits or overweight/obesity. However, increased disability was associated with central obesity.
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Affiliation(s)
- Moran Livne-Margolin
- Sackler School of Medicine, Tel-Aviv University, Ramat Aviv 69978, Israel; (M.L.-M.); (O.P.-H.); (A.A.)
- Gastroenterology Department, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
| | - Itay Tokatly Latzer
- Sackler School of Medicine, Tel-Aviv University, Ramat Aviv 69978, Israel; (M.L.-M.); (O.P.-H.); (A.A.)
- Pediatric Neurology Institute, Dana-Dwek Children’s Hospital, Tel Aviv Medical Center, Tel Aviv 60198, Israel
| | - Orit Pinhas-Hamiel
- Sackler School of Medicine, Tel-Aviv University, Ramat Aviv 69978, Israel; (M.L.-M.); (O.P.-H.); (A.A.)
- Pediatric Endocrinology and Diabetes Unit, Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel-Hashomer, Ramat Gan 52621, Israel
| | - Gil Harari
- School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa 3498838, Israel;
| | - Anat Achiron
- Sackler School of Medicine, Tel-Aviv University, Ramat Aviv 69978, Israel; (M.L.-M.); (O.P.-H.); (A.A.)
- Multiple Sclerosis Center, Sheba Medical Center, Tel-Hashomer, Ramat Gan 52621, Israel
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15
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Gordon-Larsen P, French JE, Moustaid-Moussa N, Voruganti VS, Mayer-Davis EJ, Bizon CA, Cheng Z, Stewart DA, Easterbrook JW, Shaikh SR. Synergizing Mouse and Human Studies to Understand the Heterogeneity of Obesity. Adv Nutr 2021; 12:2023-2034. [PMID: 33885739 PMCID: PMC8483969 DOI: 10.1093/advances/nmab040] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/17/2021] [Accepted: 03/13/2021] [Indexed: 12/12/2022] Open
Abstract
Obesity is routinely considered as a single disease state, which drives a "one-size-fits-all" approach to treatment. We recently convened the first annual University of North Carolina Interdisciplinary Nutrition Sciences Symposium to discuss the heterogeneity of obesity and the need for translational science to advance understanding of this heterogeneity. The symposium aimed to advance scientific rigor in translational studies from animal to human models with the goal of identifying underlying mechanisms and treatments. In this review, we discuss fundamental gaps in knowledge of the heterogeneity of obesity ranging from cellular to population perspectives. We also advocate approaches to overcoming limitations in the field. Examples include the use of contemporary mouse genetic reference population models such as the Collaborative Cross and Diversity Outbred mice that effectively model human genetic diversity and the use of translational models that integrate -omics and computational approaches from pre-clinical to clinical models of obesity. Finally, we suggest best scientific practices to ensure strong rigor that will allow investigators to delineate the sources of heterogeneity in the population with obesity. Collectively, we propose that it is critical to think of obesity as a heterogeneous disease with complex mechanisms and etiologies, requiring unique prevention and treatment strategies tailored to the individual.
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Affiliation(s)
| | - John E French
- Department of Nutrition, Gillings School of Global Public Health and School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA,Nutrition Research Institute, University of North Carolina at Chapel Hill, Kannapolis, NC, USA
| | - Naima Moustaid-Moussa
- Obesity Research Institute and Department of Nutritional Sciences, Texas Tech University, Lubbock, TX, USA
| | - Venkata S Voruganti
- Department of Nutrition, Gillings School of Global Public Health and School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA,Nutrition Research Institute, University of North Carolina at Chapel Hill, Kannapolis, NC, USA
| | - Elizabeth J Mayer-Davis
- Department of Nutrition, Gillings School of Global Public Health and School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Christopher A Bizon
- Renaissance Computing Institute, University of North Carolina at Chapel Hill, NC, USA
| | - Zhiyong Cheng
- Food Science and Human Nutrition Department, University of Florida, Gainesville, FL, USA
| | - Delisha A Stewart
- Department of Nutrition, Gillings School of Global Public Health and School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA,Nutrition Research Institute, University of North Carolina at Chapel Hill, Kannapolis, NC, USA
| | - John W Easterbrook
- Department of Nutrition, Gillings School of Global Public Health and School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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