Serum cholesterol levels in school-aged Japanese children: the Hisayama study

Favorable Impacts of Growth Hormone (GH) Replacement Therapy on Atherogenic Risks in Japanese Children with GH Deficiency

Growth hormone (GH) affects body composition and atherogenic risk factors. Severe hyperlipidemia may develop in GH-deficient adults as a consequence of continuous GH deficiency. We investigated changes in lipid profiles in 158 Japanese children (103 boys and 55 girls) with GH deficiency who had been enrolled in the Pfizer International Growth Database Japan during 3 yr of GH replacement therapy to evaluate whether GH treatment has beneficial effects on atherogenic risk factors. Total cholesterol (TC), high-density lipoprotein cholesterol (HDLC), low-density lipoprotein cholesterol (LDLC) and atherogenic index were evaluated before treatment and then once a year during treatment. The mean baseline TC was within the normal range in both boys and girls. Seventeen (16.5%) of the 103 boys and 18 (32.7%) of the 55 girls, however, had a TC level over 200 mg/dl before treatment. The mean TC level showed a significant decrease in girls. In a separate analysis, patients of both sexes with a TC level > 200 mg/dl showed significantly decreased TC. LDLC decreased significantly only in girls, while HDLC showed no change in either sex. The atherogenic index decreased significantly in girls. GH replacement therapy in children with GH deficiency had beneficial effects on lipid metabolism and atherogenic risk in both sexes. Early GH treatment would produce lipid metabolism benefits in these patients.

The signal transducer and activator of transcription 5B gene polymorphism contributes to the cholesterol metabolism in Japanese children with growth hormone deficiency

BACKGROUND AND AIMS

GH plays a significant role in the lipid metabolism. In this study, we focused on the JAK2 - signal transducer and activator of the transcription 5 (STAT5) pathway, which transmit the signals from the GH receptor, and selected the STAT5A/B gene as a candidate for the regulation of lipid metabolism in GH deficiency (GHD).

DESIGN AND PARTICIPANTS

The study population comprised 83 children with idiopathic GHD. The serum total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and the non-HDL cholesterol (non-HDL-C) levels were monitored before and at 3, 6, 9 and 12 months after starting GH treatment. The height, weight, body mass index, and serum insulin-like growth factor-I (IGF-I) level were also measured before and 12 months after starting the GH treatment. For the genetic analysis of the STAT5A/B gene, five tag SNPs were selected using the tag SNP picker programme on the homepage of the HapMap project. The evaluation of promoter activity of the -44816A/G SNP in the STAT5B gene was performed by a luciferase assay in vitro.

RESULTS

The TC and non-HDL-C levels were gradually decreased during the GH treatment. Five tag SNPs (rs4029774, rs6503691, rs9900213, rs16967637 and rs2272087) were picked up for the STAT5A/B gene, and the genetic study demonstrated that the paediatric GHD patients who were heterozygotes or homozygotes of minor alleles of the analysed SNPs in the same block of the STAT5B gene showed significantly higher serum TC or non-HDL-C levels both before and after GH treatment for 12 months. Most of the SNPs also demonstrated significant differences among genotypes in the decreases in serum TC or non-HDL-C levels during the 12 months of GH treatment. A luciferase assay showed that the -44816A/G SNP (rs4029774) in the STAT5B gene functionally affected the expression level in vitro.

CONCLUSION

These results indicate that STAT5B may therefore play a role in regulating the cholesterol metabolism in children with GHD.

Obesity and cholesterol in Japanese, French, and U.S. children

The number of children at risk for overweight/obesity has increased dramatically in the last decade worldwide. This study compares measures of obesity (body mass index [BMI] and body fat percentage) and total cholesterol in 4,013 fourth-grade students from three countries, France, Japan, and the United States. Data were analyzed using t test, chi-square, and analysis of variance to determine differences between groups and by multiple linear regression. All variables differed significantly by group. BMI was highest in U.S. children. Body fat percentage was also highest in U.S. children and lowest in French children. Total cholesterol was highest in French children and lowest in U.S. White children. There were modest but significant associations between BMI and cholesterol in all groups except French children; associations varied by gender. Results indicate there was great variation in measures of obesity and cholesterol by country. The association between obesity and cholesterol may vary by culture, ethnicity, and gender.

Atherosclerotic risk factors in adolescents

METHODS

We studied 200 school going children age ranging 12-18 yr with regard to their nutritional intake, family history, anthropometric measurements, blood pressure and lipid profile.

RESULTS

It was observed that adolescents received less energy from carbohydrates and more from fats in comparison to the recommended standard. Sodium intake was found to be very high whereas fibre intake was low. The prevalence of hypertension was 1.5% and hypercholesterolemia 50%. The high prevalence of hypercholesterolemia was related mainly to dietary habits of these children. Thus our study shows that for the prevention of adult atherosclerotic cardiovascular disease in Indian population measures are urgently needed towards behavioral and life style modification including change in dietary habits.

Serum lipid levels and factors affecting atherogenic index in Japanese children

An evaluation was made of the serum lipid levels and factors relating to atherogenicity in schoolchildren in Akita, Japan, in order to determine actual conditions and promote awareness of health. The subjects were 2878 boys and 2729 girls aged 9, 12 and 15 years, who lived in cities, towns and villages in the Akita prefecture. Physical and lifestyle data including serum lipids were collected from the subjects in their schools under the direction of the prefectural board of education. Total cholesterol levels were found to be nearly equal to those currently representative for Japanese children, ethnically situated between blacks and whites in the United States of America. Atherogenic indices (AIs) were lower than those in all other countries owing to the elevated high-density lipoprotein (HDL) cholesterol levels observed in this study. According to data obtained from the questionnaires that were part of the study, regularly taking breakfast and exercising in sports clubs seems connected to maintaining lower atherogenicity in childhood.

The relationship between physical activity and cholesterol levels in children and adolescents

OBJECTIVES: to describe total cholesterol (TC) plasma levels according to age and sex; to determine the contribution of sex, age, body mass index and physical activity (PA) to TC variation; to determine the odds ratio for high total cholesterol (HTC) plasma levels of the subjects in the first PA quartile (lower PA) in comparison to the fourth PA quartile. METHODS: the sample comprised 799 white children and adolescents, 353 males and 446 females. Body height and body weight were determined by standard anthropometric methods. Subject's capillary blood samples were taken from the earlobe after at least 12 hours fasting in order to obtain values of plasmatic TC. To calculate physical activity index (PAI) a PA questionnaire was used. RESULTS: the logistic regression of HTC for males and females showed that girls in the lower quartile of PAI, are 3.0 times (p <0.05; 95%CI: 1.3-6.8) as likely to belong at HTC group in relation to girls in the fourth PAI quartile. No significant influence was found in boys. CONCLUSIONS: the results of the present study suggested that the higher TC values could be found even in early ages.

Negative relationships between growth in height and levels of cholesterol in puberty: a 3-year follow-up study

BACKGROUND

Previously, there were only a few reports on the negative relationship between pubertal growth in height and levels of serum lipid in boys. Detailed information on both genders is needed.

METHODS

We investigated the relationship between pubertal growth in height and serum lipid. Subjects were 1442 boys and 1350 girls followed up from age 10-11 years (the fifth grade level of elementary school) to age 13-14 years (the second year of junior high school). Anthropometric variables and serum lipids were measured by the same protocol at both ages.

RESULTS

From cross-sectional analysis, at both ages negative relationships between total cholesterol levels and height were found in both genders. On longitudinal analysis, height at age 10-11 years was one of the factors predicting the level of total cholesterol at age 13-14 years. In addition, negative relationships between increase in height and change in serum lipids (total cholesterol and high density lipoprotein cholesterol) over the 3-year period were obtained in both genders. Thus, pubertal children who experience a large increase in height tended to show a decrease in serum lipids, and children who experience a small increase in height tended to show an increase in serum lipids.

CONCLUSION

In both genders, total cholesterol level in pubertal children is negatively associated with height. Height velocity is inversely associated with dynamic changes in serum lipids during puberty.

New criteria of normal serum lipid levels in Japanese children: the nationwide study

AIM

To make new criteria of serum lipid levels in current Japanese children using the large nationwide data provided from Japan Association of Health Service for the analysis.

METHODS

The subjects were schoolchildren who received screening and care programs for lifestyle related diseases since 1993-1999. Serum total cholesterol (TC), high-density lipoprotein cholesterol (HDLC) and triglyceride (TG) levels were measured, and low-density lipoprotein cholesterol (LDLC) levels were calculated. Serum lipid levels were analyzed by age and sex. For each serum lipid, we extracted age- and sex-specific group which the mean value was not statistically different from that in 1999 by Student's t-test analysis.

RESULTS

The level below the 75th percentile was defined to be acceptable, from the 75th to 95th to be borderline and over the 95th to be high in TC/LDLC. The level below the fifth percentile in HDLC was defined to be low and the level over the 95th percentile in TG to be high. Therefore, TC level was categorized as follows: acceptable < 190 mg/dL; borderline 190-219 mg/dL; and high > 220 mg/dL. The LDLC level was also categorized into: acceptable < 110 mg/dL; borderline 110-139 mg/dL; and high > 140 mg/dL. The cut-off value in TG was determined to be 140 mg/dL and in HDLC was 40 mg/dL.

CONCLUSIONS

This new criteria should prove valuable in health strategies for rational prevention and intervention in children. It should be emphasized to provide some intervention for Japanese children immediately.