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Tanofsky-Kraff M, Schvey NA, Grilo CM. A developmental framework of binge-eating disorder based on pediatric loss of control eating. AMERICAN PSYCHOLOGIST 2020; 75:189-203. [PMID: 32052994 PMCID: PMC7027731 DOI: 10.1037/amp0000592] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Although binge-eating disorder may manifest in childhood, a significantly larger proportion of youth report episodes involving a loss of control while eating, the hallmark feature of binge eating that predicts excess weight gain and obesity. Adults with binge-eating disorder often report that symptoms emerged during childhood or adolescence, suggesting that a developmental perspective of binge eating may be warranted. Thus, loss of control eating may be a marker of prodromal binge-eating disorder among certain susceptible youth. The present article offers a broad developmental framework of binge-eating disorder and proposes areas of future research to determine which youths with loss of control eating are at risk for persistent and exacerbated behavior that may develop into binge-eating disorder and adult obesity. To this end, this article provides an overview of loss of control eating in childhood and adolescence, including its characterization, etiology, and clinical significance, with a particular focus on associations with metabolic risk, weight gain, and obesity. A conceptual model is proposed to further elucidate the mechanisms that may play a role in determining which youths with loss of control are at greatest risk for binge-eating disorder and obesity. Ways in which treatments for adult binge-eating disorder may inform approaches to reduce loss of control eating and prevent excess weight gain in youth are discussed. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences
| | - Natasha A Schvey
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences
| | - Carlos M Grilo
- Department of Psychiatry, Yale University School of Medicine
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Acar S, Paketçi A, Küme T, Tuhan H, Gürsoy Çalan Ö, Demir K, Böber E, Abacı A. Serum galectin-1 levels are positively correlated with body fat and negatively with fasting glucose in obese children. Peptides 2017; 95:51-56. [PMID: 28728946 DOI: 10.1016/j.peptides.2017.07.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 07/08/2017] [Accepted: 07/13/2017] [Indexed: 01/03/2023]
Abstract
Galectin-1, a recently identified peptide, is primarily released from the adipose tissue. Although galectin-1 was shown to have an anti-inflammatory effect, its specific function is not clearly understood. We aimed to evaluate the relationship of serum galectin-1 levels with clinical and laboratory parameters in childhood obesity. A total of 45 obese children (mean age: 12.1±3.1years) and 35 normal-weight children (mean age: 11.8±2.2years) were enrolled. Clinical [body mass index (BMI), waist circumference (WC), percentage of body fat and blood pressure] and biochemical [glucose, insulin, lipids, galectin-1, high-sensitive C-reactive protein (hsCRP) and leptin levels] parameters were assessed. Serum galectin-1, hsCRP and leptin levels were significantly higher in obese children than those in normal-weight children (12.4 vs 10.2ng/mL, p<0.001; 3.28 vs 0.63mg/L, p<0.001; 8.3 vs 1.2ng/mL, p<0.001, respectively). In obese children, galectin-1 levels correlated negatively with fasting glucose (r=-0.346, p=0.020) and positively with fat mass (r=0.326, p=0.026) and WC standard deviation score (SDS) (r=0.451, p=0.002). The multivariate regression analysis demonstrated that serum galectin-1 levels were significantly associated with fasting glucose and WC SDS. This study showed that obese children had significantly higher galectin-1 levels in proportion to fat mass in obese cases than those in healthy children, which may be interpreted as a compensatory increase in an attempt to improve glucose metabolism.
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Affiliation(s)
- Sezer Acar
- Division of Pediatric Endocrinology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Ahu Paketçi
- Division of Pediatric Endocrinology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Tuncay Küme
- Department of Biochemistry, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Hale Tuhan
- Division of Pediatric Endocrinology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Özlem Gürsoy Çalan
- Department of Biochemistry, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Korcan Demir
- Division of Pediatric Endocrinology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Ece Böber
- Division of Pediatric Endocrinology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Ayhan Abacı
- Division of Pediatric Endocrinology, Dokuz Eylul University School of Medicine, Izmir, Turkey.
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Shank LM, Tanofsky-Kraff M, Kelly NR, Schvey NA, Marwitz SE, Mehari RD, Brady SM, Demidowich AP, Broadney MM, Galescu OA, Pickworth CK, Yanovski SZ, Yanovski JA. Pediatric Loss of Control Eating and High-Sensitivity C-Reactive Protein Concentrations. Child Obes 2017; 13:1-8. [PMID: 27732055 PMCID: PMC5278829 DOI: 10.1089/chi.2016.0199] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Loss of control (LOC) eating in youth is associated with excess body weight and adiposity. After adjusting for fat mass, youth with LOC eating have higher blood pressure and higher low-density lipoprotein cholesterol compared to youth without LOC eating. Increased inflammation may account for this relationship, although few data have examined this hypothesis. Therefore, this study explored the association between LOC eating and high-sensitivity C-reactive protein (hsCRP), a marker of inflammation. METHODS We investigated hsCRP concentrations in relation to LOC eating in a convenience sample of 194 youth (age 14.3 ± 2.1 years; 63.9% female; BMI-z 1.64 ± 1.06). The presence of LOC eating in the past month was assessed by the Eating Disorder Examination interview. Serum hsCRP was measured by enzyme-linked immunosorbent assay. Adiposity was measured by air displacement plethysmography or dual-energy x-ray absorptiometry. We compared hsCRP in those with and without LOC eating in analyses accounting for sex, adiposity, height, depressive symptoms, and eating psychopathology. RESULTS Youth with LOC eating had significantly greater hsCRP than youth without LOC eating (p = 0.02), after accounting for all covariates. The number of LOC eating episodes in the past month was positively associated with hsCRP (p = 0.01). The relationship between LOC eating and hsCRP was not mediated by depressive symptoms or eating psychopathology (ps > 0.05). CONCLUSIONS Youth with disinhibited eating may manifest increased chronic inflammation. Those with LOC eating may be an important subgroup at risk for adverse health outcomes associated with both chronic inflammation and obesity. Future research should examine whether hsCRP concentrations mediate the relationship between LOC eating and its association with cardiometabolic risk.
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Affiliation(s)
- Lisa M. Shank
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD.,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, Bethesda, MD
| | - Marian Tanofsky-Kraff
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD.,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, Bethesda, MD
| | - Nichole R. Kelly
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD.,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, Bethesda, MD
| | - Natasha A. Schvey
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD.,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, Bethesda, MD
| | - Shannon E. Marwitz
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD
| | - Rim D. Mehari
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD
| | - Sheila M. Brady
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD
| | - Andrew P. Demidowich
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD
| | - Miranda M. Broadney
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD
| | - Ovidiu A. Galescu
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD
| | - Courtney K. Pickworth
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD
| | - Susan Z. Yanovski
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD.,Office of Obesity Research, Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH), DHHS, Bethesda, MD
| | - Jack A. Yanovski
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD
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Kosecik M, Dervisoglu P, Koroglu M, Isguven P, Elmas B, Demiray T, Altindis M. Usefulness of soluble urokinase plasminogen activator receptor (suPAR) as an inflammatory biomarker in obese children. Int J Cardiol 2016; 228:158-161. [PMID: 27865178 DOI: 10.1016/j.ijcard.2016.11.201] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 11/06/2016] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Soluble urokinase plasminogen activator receptor (suPAR) has emerged as a relatively new biomarker that reflects increased inflammatory status and been associated with cardiovascular risk. We wanted to investigate the predictive value and usefulness of suPAR as an inflammatory biomarker in obese children. METHODS AND RESULTS Of the total 136 participants, 76 (36 male, 40 female) were in obese group and 60 (24 male, 36 female) were in control group. The median age was 12.05 (6.16-17.30) years old for obese group, and 12.83 (8.00-16.75) years old for control group. Obese children had statistically significantly higher heart rate, systolic and diastolic blood pressure, EAT and LV mass than control group (p<0.01). The median suPAR level in obese group was not statistically different than in control group (0.54 vs. 0.59, p=0.26). The median hsCRP level in obese group was found statistically significantly higher than in control group (1.97 vs. 0.41, p<0.01). A significant positive correlation between hsCRP and BMI in the obese participants was found (r=0.45, p<0.01), but not a relationship between suPAR and BMI (r=-0.21, p>0.05). CONCLUSION Our research did not demonstrate the usefulness of suPAR as an inflammatory biomarker and a predictive value for future atherosclerosis in obese children. Further studies with larger sample size are required to determine whether suPAR is useful as an inflammatory biomarker in childhood obesity.
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Affiliation(s)
- Mustafa Kosecik
- Department of Pediatric Cardiology, School of Medicine, Sakarya University, Sakarya, Turkey.
| | - Pinar Dervisoglu
- Department of Pediatric Cardiology, School of Medicine, Sakarya University, Sakarya, Turkey
| | - Mehmet Koroglu
- Department of Medical Microbiology, School of Medicine, Sakarya University, Sakarya, Turkey
| | - Pinar Isguven
- Department of Pediatric Endocrinology, School of Medicine, Sakarya University, Sakarya, Turkey
| | - Bahri Elmas
- Department of Pediatrics, School of Medicine, Sakarya University, Sakarya, Turkey
| | - Tayfur Demiray
- Department of Medical Microbiology, School of Medicine, Sakarya University, Sakarya, Turkey
| | - Mustafa Altindis
- Department of Medical Microbiology, School of Medicine, Sakarya University, Sakarya, Turkey
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Eren E, Abuhandan M, Solmaz A, Taşkın A. Serum paraoxonase/arylesterase activity and oxidative stress status in children with metabolic syndrome. J Clin Res Pediatr Endocrinol 2014; 6:163-8. [PMID: 25241610 PMCID: PMC4293645 DOI: 10.4274/jcrpe.1454] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE This study aimed to measure paraoxonase/arylesterase activities and to evaluate the total oxidant and antioxidant capacities in obese children and in children with metabolic syndrome (MetS). METHODS A total of 151 children of comparable ages (13.23±1.96 years, 13.45±1.85 years and 13.95±1.31 years) were enrolled in the study. Forty of these were children with MetS, 55 were obese and 56 were healthy controls. Diagnosis of the MetS was made according to International Diabetes Federation criteria. Paraoxonase/arylesterase activities were evaluated by using paraoxon and phenylacetate substrates. Total oxidant status (TOS) and total antioxidant status (TAS) were measured and oxidative stress index (OSI) was estimated by calculation. RESULTS High levels of paraoxonase were detected in the obese group, whereas high levels of arylesterase were detected in both MetS and obese groups. Higher values for TOS, TAS and OSI were found in the MetS group (p<0.05). CONCLUSION Higher values of mean TOS and OSI in the MetS group than those in the control groups indicate that these parameters may be indicators of future risks such as atherosclerosis in patients with MetS.
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Affiliation(s)
- Erdal Eren
- Uludağ University, Faculty of Medicine, Department of Pediatric Endocrinology, Bursa, Turkey. E-ma-il:
| | - Mahmut Abuhandan
- Harran University, Faculty of Medicine, Department of Pediatrics, Şanlıurfa, Turkey
| | - Abdullah Solmaz
- Harran University, Faculty of Medicine, Department of Pediatrics, Şanlıurfa, Turkey
| | - Abdullah Taşkın
- Harran University, Faculty of Medicine, Department of Biochemistry, Şanlıurfa, Turkey
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Dalla Pozza R. Kardiovaskuläre Risikofaktoren im Kindes- und Jugendalter. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2013; 56:487-91. [DOI: 10.1007/s00103-012-1633-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Kitsios K, Papadopoulou M, Kosta K, Kadoglou N, Papagianni M, Tsiroukidou K. High-sensitivity C-reactive protein levels and metabolic disorders in obese and overweight children and adolescents. J Clin Res Pediatr Endocrinol 2013; 5:44-9. [PMID: 23367494 PMCID: PMC3628392 DOI: 10.4274/jcrpe.789] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To compare high-sensitivity C-reactive protein (hsCRP) levels in obese and overweight children and adolescents to normal-weight individuals as well as to compare hsCRP levels in overweight children/adolescents with and without additional metabolic disorders such as metabolic syndrome (MS), non-alcoholic fatty liver disease (NAFLD), and prediabetes. METHODS 54 consecutive obese children and adolescents with a body mass index (BMI) ≥ 95th centile and 50 overweight children and adolescents with BMI values between 85th and 95th centiles were screened for MS, prediabetes and NAFLD. Serum hsCRP levels were measured in all the participants and in 40 age-matched normal-weight individuals (controls). RESULTS HsCRP levels were significantly increased in obese and overweight subjects as compared to the control group, (0.61 ± 1.08 vs. 0.05 ± 0.18 mg/dL,p<0.001 and 0.33 ± 0.25 vs. 0.05 ± 0.18 mg/dL, p<0.001, respectively). HsCRP levels were similar between obese and overweight subjects (p=0.109). Obese and overweight children with NAFLD had significantly higher levels of hsCRP compared to their counterparts without NAFLD (0.78 ± 1.4 vs. 0.34 ± 0.31 mg/dL, p=0.016). The levels of hsCRP were comparable in the obese and overweight children/adolescents with and without MS and with or without prediabetes(0.95 ± 1.66 vs. 0.35 ± 0.27 mg/dL, p = 0.096 and 0.43 ± 0.34 vs. 0.53 ± 1.0mg/dL, p=0.589, respectively). CONCLUSIONS HsCRP is significantly elevated in children and adolescents with excess weight as compared to normal-weight individuals. In addition,children and adolescents with excessive weight and NAFLD show increased levels of hsCRP compared to their counterparts with normal liver.
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Affiliation(s)
- Konstantinos Kitsios
- G Gennimatas General Hospital, Department of Internal Medicine, Thessaloniki, Greece.
| | - Maria Papadopoulou
- Aristotle University of Thessaloniki, Hippokration General Hospital, Third Department of Pediatrics, Thessaloniki, Greece
| | - Konstantina Kosta
- Aristotle University of Thessaloniki, Hippokration General Hospital, Third Department of Pediatrics, Thessaloniki, Greece
| | - Nikolaos Kadoglou
- Foundation of Biomedical Research, Academy of Athens, Athens, Greece
| | - Maria Papagianni
- Aristotle University of Thessaloniki, Hippokration General Hospital, Third Department of Pediatrics, Thessaloniki, Greece
| | - Kiriaki Tsiroukidou
- Aristotle University of Thessaloniki, Hippokration General Hospital, Third Department of Pediatrics, Thessaloniki, Greece
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Abstract
Mounting evidence indicates that inflammation may play a significant role in the development of depression. Patients with depression exhibit increased inflammatory markers, and administration of cytokines and other inflammatory stimuli can induce depressive symptoms. Mechanisms by which cytokines access the brain and influence neurotransmitter systems relevant to depression have also been described, as have preliminary findings indicating that antagonizing inflammatory pathways may improve depressive symptoms. One primary source of inflammation in depression appears to be adiposity. Adipose tissue is a rich source of inflammatory factors including adipokines, chemokines, and cytokines, and a bidirectional relationship between adiposity and depression has been revealed. Adiposity is associated with the development of depression, and depression is associated with adiposity, reflecting a potentional vicious cycle between these two conditions which appears to center around inflammation. Treatments targeting this vicious cycle may be especially relevant for the treatment and prevention of depression as well as its multiple comorbid disorders such as cardiovascular disease, diabetes, and cancer, all of which have also been associated with both depression and inflammation.
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Affiliation(s)
- Richard C Shelton
- Department of Psychiatry, Vanderbilt University School of Medicine, Nashville, Tennessee 37212, USA.
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Metabolic syndrome, adipokines and ghrelin in overweight and obese schoolchildren: results of a 1-year lifestyle intervention programme. Eur J Pediatr 2011; 170:483-92. [PMID: 20957391 DOI: 10.1007/s00431-010-1316-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2010] [Accepted: 09/20/2010] [Indexed: 10/18/2022]
Abstract
The aim of this study was to evaluate the effect of a lifestyle intervention programme (nutrition and exercise counselling) on metabolic syndrome (MS) components, adipokines (leptin, adiponectin) and ghrelin levels in overweight children. A total of 61 overweight children aged 7-9 years (≥ 85th body mass index (BMI) percentile; 27 boys/34 girls) were randomly assigned and completed a 1-year individual (IT) or group-based treatment (GT). Anthropometric and biochemical parameters were assessed at baseline, at 6 months and at 1 year. Twenty-two normal weight children (<85th BMI percentile; 7-9 years old; 13 boys/nine girls) were also evaluated at baseline. Insulin resistance (IR) was determined by the homeostasis model assessment of IR (HOMA-IR). Overweight children presented significantly higher blood pressure, triglycerides, apolipoprotein B, insulin, HOMA-IR, leptin, C-reactive protein and homocysteine levels, while apolipoprotein A-I was significantly lower. At baseline, MS was present in ten overweight children, of which only five maintained it at 1 year. Leptin and ghrelin levels were associated with IR and MS components. MS was predicted by apolipoprotein A-I, insulin and pre-puberty. The lifestyle intervention led to a significant improvement in standard deviation score of BMI, waist circumference/height ratio and lipid profile. Changes in insulin, HOMA-IR, leptin and adiponectin were not significant. Ghrelin behaved differently between IT and GT. The GT intervention seems to be more successful, with a decrease in BMI Z-score and an improvement of metabolic parameters. In conclusion, overweight children have multiple risk factors associated with MS. A lifestyle intervention programme seems to be an effective mean for reducing obesity and MS components and improving adipokines concentrations.
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High-sensitivity C-reactive protein and mean platelet volume in paediatric hypertension. Pediatr Nephrol 2010; 25:1519-27. [PMID: 20414684 DOI: 10.1007/s00467-010-1513-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2009] [Revised: 02/09/2010] [Accepted: 03/13/2010] [Indexed: 10/19/2022]
Abstract
The purpose of the study was to investigate serum uric acid (SUA), high-sensitivity C-reactive protein (hs-CRP) and mean platelet volume (MPV) in pre-hypertensive (PH) and hypertensive (HT) children and adolescents. The study group consisted of 80 patients aged 10-19 years subdivided into PH and HT groups according to mean daytime or night-time systolic or diastolic blood pressure (BP) levels (> 90th percentile, but < 95th percentile and > or = 95th percentile, respectively). The control group (C) contained 25 normotensive subjects. Serum hs-CRP level was determined by a nephelometric method (Behring); platelets (PLTs) were counted, and MPV was assessed by a Coulter Analyzer MAXM. SUA was measured with an Hitachi instrument. The median SUA and hs-CRP levels in PH and HT subjects were significantly higher than those of the controls (P < 0.01) and were higher in the HT group than in the PH group (P < 0.05). An increase in SUA above 5.5 mg/dl was associated with an increase in hs-CRP [odds ratio (OR) 4.8; confidence interval (CI) 1.3-17.4; P < 0.01]. MPV values in the PH group did not differ from those of the controls (P > 0.05), but it was significantly higher in HT patients (P < 0.01). Serum hs-CRP and MPV concentrations were positively correlated with all BP measurements except night-time diastolic blood pressure (DBP). We demonstrated that, in HT children and adolescents, increased SUA with a parallel increase in hs-CRP and PLTs with MPV is observed. Although large, multicentre, prospective studies are needed to confirm this observation, hyperuricaemia seems to be associated with an increase in hs-CRP in PH and HT patients.
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11
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Shelton RC, Miller AH. Eating ourselves to death (and despair): the contribution of adiposity and inflammation to depression. Prog Neurobiol 2010; 91:275-99. [PMID: 20417247 PMCID: PMC2929810 DOI: 10.1016/j.pneurobio.2010.04.004] [Citation(s) in RCA: 154] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2010] [Revised: 04/07/2010] [Accepted: 04/16/2010] [Indexed: 01/18/2023]
Abstract
Obesity and related metabolic conditions are of epidemic proportions in most of the world, affecting both adults and children. The accumulation of lipids in the body in the form of white adipose tissue in the abdomen is now known to activate innate immune mechanisms. Lipid accumulation causes adipocytes to directly secrete the cytokines interleukin (IL) 6 and tumor necrosis factor alpha (TNFalpha), but also monocyte chemoattractant protein 1 (MCP-1), which results in the accumulation of leukocytes in fat tissue. This sets up a chronic inflammatory state which is known to mediate the association between obesity and conditions such as cardiovascular disease, type 2 diabetes, and cancer. There is also a substantial literature linking inflammation with risk for depression. This includes the observations that: (1) people with inflammatory diseases such as multiple sclerosis, cardiovascular disease, and psoriasis have elevated rates of depression; (2) many people administered inflammatory cytokines such as interferon alpha develop depression that is indistinguishable from depression in non-medically ill populations; (3) a significant proportion of depressed persons show upregulation of inflammatory factors such as IL-6, C-reactive protein, and TNFalpha; (4) inflammatory cytokines can interact with virtually every pathophysiologic domain relevant to depression, including neurotransmitter metabolism, neuroendocrine function, and synaptic plasticity. While many factors may contribute to the association between inflammatory mediators and depression, we hypothesize that increased adiposity may be one causal pathway. Mediational analysis suggests a bi-directional association between adiposity and depression, with inflammation possibly playing an intermediary role.
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Affiliation(s)
- Richard C Shelton
- Vanderbilt University, 1500 21st Avenue South, Suite 2200, Nashville, TN 37212, USA.
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12
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Kelishadi R. Inflammation-induced atherosclerosis as a target for prevention of cardiovascular diseases from early life. Open Cardiovasc Med J 2010; 4:24-9. [PMID: 21804638 PMCID: PMC2840608 DOI: 10.2174/1874192401004020024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2009] [Revised: 11/16/2009] [Accepted: 12/05/2009] [Indexed: 12/29/2022] Open
Abstract
Atherogenesis starts from the fetal life, and its natural course consists of interrelations between traditional risk factors and inflammatory, immune, and endothelial biomarkers. Even the early-stages of atherosclerotic lesions, i.e. fatty streaks present the features of chronic inflammation. Markers of inflammation are associated with insulin resistance and major atherosclerosis risk factors. Several studies have confirmed a relationship between surrogate markers of future cardiovascular disease with childhood obesity, notably abdominal obesity, as well as with the degree of obesity. Moreover, functional and structural changes are documented in arteries of children with a familial predisposition to atherosclerotic diseases; these changes are associated with clusters of inflammatory factors and markers of oxidation. In addition to the development of atheromatous plaques, inflammation also plays an essential role in the destabilization of artery plaques, and in turn in the occurrence of acute thrombo-embolic disorders. Markers of inflammation can provide predictive clinical information about outcomes of patients with acute coronary syndromes, independent of the extent of myocardial damage. Moreover, serum levels of the inflammatory markers might add prognostic information provided by traditional risk factors. Platelets have an important role in vascular inflammation and atherosclerosis and in the formation of mural thrombi. As lifestyle modification trials have been successful in decreasing endothelial dysfunction and the level of markers of inflammation among children and adolescents, it is suggested that in addition to expanding pharmacological therapies considered for secondary prevention of atherosclerotic diseases aiming to control the inflammatory process, the importance of primordial/primary prevention of atherosclerosis should be underscored.
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Affiliation(s)
- Roya Kelishadi
- Pediatric Preventive Cardiology Department, Isfahan Cardiovascular Research Centre, Isfahan University of Medical Sciences, Isfahan, Iran
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