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Salton N, Kern S, Interator H, Lopez A, Moran-Lev H, Lebenthal Y, Brener A. Muscle-to-Fat Ratio for Predicting Metabolic Syndrome Components in Children with Overweight and Obesity. Child Obes 2022; 18:132-142. [PMID: 34550798 DOI: 10.1089/chi.2021.0157] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Background: Pediatric obesity has been linked to the components of metabolic syndrome (MetS: abdominal obesity, atherogenic dyslipidemia, elevated blood pressure, and insulin resistance). Data on the role of muscle mass in the development of MetS are sparse. We explored the interaction between the muscle-to-fat ratio (MFR) and MetS components in children with overweight or obesity. Methods: An observational study of 210 pediatric subjects (88 boys, mean age [±standard deviation (SD)] 11.9 ± 3.1 years, BMI z-score range 1.036-3.140) from January 2018 to January 2021. Body composition was measured by bioelectrical impedance analysis (Tanita MC-780 MA and GMON Professional Software), and MFR z-scores were calculated. Results: The 148 subjects (70%) who had MetS components were older (p = 0.008), had lower socioeconomic positions, higher triglyceride/high-density lipoprotein-cholesterol ratios, fat percentages (FATP), truncal FATPs (TRFATPs), and lower MFR z-scores (p < 0.001 for all parameters) than those without MetS components. The correlation between the MFR z-score and the BMI z-score was stronger in subjects with obesity than in subjects with overweight (r = -0.556 vs. r = -0.440, p < 0.001 for both). The risk for MetS components increased by 1.4 for every 3% increase in FATP or TRFATP [odds ratio (OR) = 1.4, confidence interval ([CI] 1.20, 1.64), p < 0.001]. The risk for MetS components was tripled for every 1 SD decrease in MFR z-scores [OR = 3.3, CI (1.74, 6.27), p < 0.001]. Conclusions: Given the strong predictive value of the MFR z-score in the development of early-onset MetS components, preventive strategies should apply interventions for improving the body composition parameters of both adiposity and muscle.
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Affiliation(s)
- Noga Salton
- The Pediatric Endocrinology and Diabetes Unit, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center Affiliated with Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Sharona Kern
- The Pediatric Endocrinology and Diabetes Unit, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center Affiliated with Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel.,Department of Pediatrics, NYU Langone Hospital Long Island, Long Island, NY, USA
| | - Hagar Interator
- The Pediatric Endocrinology and Diabetes Unit, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center Affiliated with Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel.,The Nutrition and Dietetics Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Adar Lopez
- The Pediatric Endocrinology and Diabetes Unit, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center Affiliated with Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel.,The Nutrition and Dietetics Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Hadar Moran-Lev
- Pediatric Gastroenterology Unit, Dana Dwek Children's Hospital, Tel Aviv Sourasky Medical Center Affiliated with Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yael Lebenthal
- The Pediatric Endocrinology and Diabetes Unit, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center Affiliated with Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Avivit Brener
- The Pediatric Endocrinology and Diabetes Unit, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center Affiliated with Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel
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Silva FACCD, Bragança MLBM, Bettiol H, Cardoso VC, Barbieri MA, Silva AAMD. Socioeconomic status and cardiovascular risk factors in young adults: a cross-sectional analysis of a Brazilian birth cohort. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2020; 23:e200001. [PMID: 32130390 DOI: 10.1590/1980-549720200001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 01/26/2019] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION In high-income countries, persons of high socioeconomic status (SES) have a lower cardiovascular risk. However, in middle and low-income countries, the results are controversial. OBJECTIVE To evaluate the association between family income and cardiovascular risk factors in young adults. METHODS A total of 2,063 individuals of a birth cohort initiated in 1978/79 in the city of Ribeirão Preto, Brazil, were evaluated at age of 23/25 years. Cardiovascular risk factors (hypertension, sedentary lifestyle, smoking, low high-density lipoprotein (HDL)-cholesterol, high low-density lipoprotein (LDL)-cholesterol, high fibrinogen, insulin resistance, diabetes, abdominal and total obesity, and metabolic syndrome) were evaluated according to family income. Income was assessed in multiples of the minimum wage. Simple Poisson regression models were used to estimate the prevalence ratios (PR) with robust estimation of the variance. RESULTS High-income women showed lower prevalences of low HDL-cholesterol (PR = 0.47), total obesity (PR = 0.22), abdominal obesity (PR = 0.28), high blood pressure (PR = 0.28), insulin resistance (PR = 0.57), sedentary lifestyle (PR = 0.47), metabolic syndrome (PR = 0.24), and high caloric intake (PR = 0.71) (p < 0.05). High-income men showed lower prevalences of low HDL-cholesterol (PR = 0.73) and sedentarism (PR = 0.81) (p < 0.05). These results may be explained by the fact that high-income women pay more attention to healthy habits and those with the lowest family income are least likely to access health services resources and treatments. CONCLUSION Women were in the final phase of the epidemiologic transition, whereas men were in the middle phase.
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Affiliation(s)
| | | | - Heloisa Bettiol
- Department of Puericulture and Pediatrics, Faculty of Medicine of Ribeirão Preto, Universidade de São Paulo - Ribeirão Preto (SP), Brazil
| | - Viviane Cunha Cardoso
- Department of Puericulture and Pediatrics, Faculty of Medicine of Ribeirão Preto, Universidade de São Paulo - Ribeirão Preto (SP), Brazil
| | - Marco Antonio Barbieri
- Department of Puericulture and Pediatrics, Faculty of Medicine of Ribeirão Preto, Universidade de São Paulo - Ribeirão Preto (SP), Brazil
| | - Antônio Augusto Moura da Silva
- Postgraduation Program of Collective Health, Department of Public Health, Universidade Federal do Maranhão - São Luís (MA), Brazil
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Demir AK, Şahin Ş, Kaya SU, Bütün İ, Çıtıl R, Önder Y, Taşlıyurt T, Demir O, Deveci K, Kutlutürk F. Prevalence of insulin resistance and identifying HOMA1-IR and HOMA2-IR indexes in the Middle Black Sea region of Turkey. Afr Health Sci 2020; 20:277-286. [PMID: 33402916 PMCID: PMC7750083 DOI: 10.4314/ahs.v20i1.33] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background Insulin resistance (IR) is one of the most important etiological risk factors in the development of diabetes. However, there is no clear data regarding the prevalence of IR in the country. Objective This study evaluates the prevalence of IR and identifies the optimal threshold values for the HOMA indexes in Turkey. Methods This cross-sectional, population-based survey includes 2013 participants aged 20–84 years. The values of the anthropometric measurements and laboratory analysis were recorded. The 90th percentile in the non-obese and non-diabetic population was accepted as cut-off values for IR. Results The optimal threshold values for IR were 2.46 in HOMA1-IR and 1.40 in HOMA2-IR. Using the HOMA2-IR method, the overall prevalence of IR was 33.2%. The IR prevalence was higher in women (35.6%) compared to men (30.1%) [p=0.008]. There was a higher IR prevalence in men living in urban areas (p=0.001), not in women. The multivariate logistic regression analysis showed that gender, serum glucose level, serum levels of triglycerides and high-density lipoprotein cholesterol, bodymass index and income status were associated with insulin resistance. Conclusion The cut-off values of HOMA1-IR and HOMA2-IR were determined in this study and we believe that these findings will be helpful to clinicians in the fight against health problems such as diabetes.
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Affiliation(s)
- Ayşe Kevser Demir
- Gaziosmanpaşa University Faculty of Medicine, Department of Internal Medicine
| | - Şafak Şahin
- Gaziosmanpaşa University Faculty of Medicine, Department of Internal Medicine
| | - Süheyla Uzun Kaya
- Gaziosmanpaşa University Faculty of Medicine, Department of Internal Medicine
| | | | | | | | - Türker Taşlıyurt
- Gaziosmanpaşa University Faculty of Medicine, Department of Internal Medicine
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Pathak U, Gupta NC, Suri JC. Risk of COPD due to indoor air pollution from biomass cooking fuel: a systematic review and meta-analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2020; 30:75-88. [PMID: 30754998 DOI: 10.1080/09603123.2019.1575951] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 01/25/2019] [Indexed: 06/09/2023]
Abstract
Chronic obstructive pulmonary disease (COPD) is one of the leading causes of mortality in developing nations. In this meta-analysis, we aimed to determine the association between indoor air pollution and risk of COPD. Database searches were conducted using indoor air pollution, biomass and COPD related terms to identify relevant articles. The eligible studies were case-control, retrospective cohort, cross-sectional studies and conducted in adults that assessed COPD using any diagnostic criteria. A total of 35 studies with 73,122 participants were included. The pooled analysis showed that exposure to indoor air pollution due to solid biomass fuels increased risk of COPD by 2.65 (95% confidence interval [CI] 2.13-3.31; n = 73,122) and chronic bronchitis by 2.89 (95% CI 2.18-3.82) times more compared to non-biomass fuels. The risk of COPD was higher in Africa region (odds ratio [OR] 3.19), Asia (OR 2.88), South America (OR 2.15), Europe (OR 2.30) and North America (OR 2.14). The results of our meta-analysis indicated that exposure to indoor air pollution due to biomass smoke is strongly associated with COPD.Abbreviations: CS: cross-sectional; CC: case-control; NR: not reported; ATS: American Thoracic Society; BMRC: British Medical Research Council; GOLD: Global Initiative for Obstructive Lung Disease; IAP: indoor air pollution; BMF: biomass fuel; CB: chronic bronchitis; OR: odds ratio; UCI; upper confidence interval; LCI: lower confidence interval; COPD: chronic obstructive pulmonary disease.
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Affiliation(s)
- Utkarsha Pathak
- University School of Environment Management, Guru Gobind Singh Indraprastha University, New Delhi, India
| | - Naresh Chandra Gupta
- University School of Environment Management, Guru Gobind Singh Indraprastha University, New Delhi, India
| | - Jagdish Chandra Suri
- Department of Pulmonary, Critical Care and Sleep Medicine, Safdarjang Hospital and VMMC College, Guru Gobind Singh Indraprastha University, New Delhi, India
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Schuler BR. Social work and toddler overweight risk: Identifying modifiable child and parent factors across the socioeconomic gradient. SOCIAL WORK IN HEALTH CARE 2019; 58:952-969. [PMID: 31671025 DOI: 10.1080/00981389.2019.1680478] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 09/19/2019] [Accepted: 10/10/2019] [Indexed: 06/10/2023]
Abstract
Objective: Childhood obesity is associated with long-term health consequences, yet little is known about the prevalence of child and parent risk factors of overweight across the socioeconomic gradient in early life. This exploratory study documents the prevalence of risk factors that contribute to overweight among toddlers within and across socioeconomic status (SES). Methods: Obesity risk factors were examined within and across SES quintiles in a nationally representative sample. Data were collected from 5,100 mothers and 2-year-old children. Weighted regression models assessed child and parent characteristics that predict toddler weight status in a national sample and samples stratified by SES quintiles. Results: Higher rates of overweight were observed in Q1 (29.2%) and reduced with each successive SES quintile (16.9%-Q5), suggesting a gradient effect. Results indicated factors unique within quintiles, distinct from the full national sample: Q1-motor development; Q2-motor and mental development, maternal BMI, breastfeeding, bottle feeding, introduction of solid foods; Q3-breastfeeding; and Q4-5-introduction of solid foods. Discussion: Findings further existing knowledge of toddler obesity by uncovering risks relevant for specific SES groups. Results yield implications for social workers to refine strategies for improving toddler health and preventing overweight/obesity.
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Affiliation(s)
- Brittany R Schuler
- School of Social Work, College of Public Health, Temple University, Philadelphia, Pennsylvania, USA
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Werneck AO, Silva DR, Collings PJ, Fernandes RA, Ronque ERV, Sardinha LB, Cyrino ES. Prenatal, biological and environmental factors associated with physical activity maintenance from childhood to adolescence. CIENCIA & SAUDE COLETIVA 2019; 24:1201-1210. [PMID: 30892539 DOI: 10.1590/1413-81232018243.11442017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 06/23/2017] [Indexed: 11/22/2022] Open
Abstract
Our aim was to identify prenatal, biological and environmental correlates of child to adolescence physical activity maintenance in 1,186 Brazilian youth (525 boys) aged between 10 and 16 years. Current and former physical activity levels were obtained cross-sectionally through questionnaires. As potential correlates, parent's activity levels, socioeconomic status and offspring's birth weight were self-reported by parents. Somatic maturation was estimated by the peak of height velocity. Logistic regression analyses revealed that, regardless of chronological age, males were more likely to be active in childhood (OR = 1.73 [CI 95% = 1.33 to 2.27]) and to maintain physical activity (adjusted by chronological age, sex, birth weight and mother's physical activity) (OR = 3.58 [CI 95% = 2.32 to 5.54]), as well as late maturing adolescents (OR = 2.52 [CI 95% = 1.02 to 6.22]). Adolescents whose mother was inactive (OR = 0.31 [CI 95% = 0.11 to 0.86]) also had a lower probability of maintaining physical activity. Thus, girls, adolescents born with low weight and those with inactive mother are less likely to maintain physical activity levels from childhood to adolescence.
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Affiliation(s)
- André Oliveira Werneck
- Grupo de Estudo e Pesquisa em Metabolismo, Nutrição e Exercício , Universidade Estadual de Londrina . Rodovia Celso Garcia Cid - Pr 445 Km 380, Campus Universitário. 86057-970 Londrina PR Brasil .
| | - Danilo Rodrigues Silva
- Grupo de Estudo e Pesquisa em Metabolismo, Nutrição e Exercício , Universidade Estadual de Londrina . Rodovia Celso Garcia Cid - Pr 445 Km 380, Campus Universitário. 86057-970 Londrina PR Brasil .
| | - Paul James Collings
- Bradford Institute for Health Research , Bradford Teaching Hospitals Foundation Trust . Bradford UK
| | - Rômulo Araújo Fernandes
- Departamento de Educação Física , Faculdade de Ciências e Tecnologia de Presidente Prudente , Universidade Estadual Paulista . Presidente Prudente SP Brasil
| | - Enio Ricardo Vaz Ronque
- Grupo de Estudo e Pesquisa em Metabolismo, Nutrição e Exercício , Universidade Estadual de Londrina . Rodovia Celso Garcia Cid - Pr 445 Km 380, Campus Universitário. 86057-970 Londrina PR Brasil .
| | | | - Edilson Serpeloni Cyrino
- Grupo de Estudo e Pesquisa em Metabolismo, Nutrição e Exercício , Universidade Estadual de Londrina . Rodovia Celso Garcia Cid - Pr 445 Km 380, Campus Universitário. 86057-970 Londrina PR Brasil .
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Skårner A, Gerdner A. Conceptual and theoretical framework of the MAP-NET: A social networks analysis tool. COGENT PSYCHOLOGY 2018. [DOI: 10.1080/23311908.2018.1488515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- Anette Skårner
- Department of Social Work, University of Gothenburg, Gothenburg, Sweden
| | - Arne Gerdner
- Department of Social Work, Jönköping University, School of Health and Welfare, Jönköping, Sweden
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Magdon-Ismail Z, Ledneva T, Sun M, Schwamm LH, Sherman B, Qian F, Bettger JP, Xian Y, Stein J. Factors associated with 1-year mortality after discharge for acute stroke: what matters? Top Stroke Rehabil 2018; 25:576-583. [PMID: 30281414 DOI: 10.1080/10749357.2018.1499303] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To evaluate factors associated with 1-year mortality after discharge for acute stroke. METHODS In this retrospective cohort study, we studied 305 patients with ischemic stroke or intracerebral hemorrhage discharged in 2010/2011. We linked Get With The Guidelines®-Stroke clinical data with New York State administrative data and used multivariate regression models to examine variables related to 1-year all-cause mortality poststroke. RESULTS The mean age was 68.6 ± 14.8 years and 51.1% were women. A total of 146 (47.9%) were discharged directly home, 96 (31.5%) to inpatient rehabilitation facilities (IRFs), and 63 (20.7%) to skilled nursing facilities (SNFs). Overall, 24 (7.9%) patients died within 1-year post-discharge. Older age (adjusted odds ratio [OR] 1.05, 95% confidence interval [CI] 1.00-1.10), higher National Institutes of Health Stroke Scale (NIHSS) on admission (OR 1.10, 95% CI 1.03-1.17), and discharge destination (IRF vs. home, OR 0.10, 95% CI 0.01-0.94; and SNF vs. home, OR 2.22, 95% CI 0.71-6.95) were factors associated with 1-year all-cause mortality. When ambulation status at discharge was added to the model, ambulation with assistance and non-ambulation were significantly associated with mortality (ambulatory with assistance vs. ambulatory, OR 9.42, 95% CI 1.87-47.61; nonambulatory vs. ambulatory, OR 12.65, 95% CI 1.89-84.89). CONCLUSIONS While age and NIHSS on admission are important predictors of long-term outcomes, factors at discharge - ambulation status at discharge and discharge destination - are associated with 1-year mortality post-discharge for acute stroke and therefore could represent therapeutic targets to improve long-term survival in future studies.
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Affiliation(s)
- Zainab Magdon-Ismail
- a American Heart Association/American Stroke Association, Founders Affiliate , Albany , NY.,b School of Public Health , University at Albany, State University of New York , Rensselaer , NY
| | | | - Mingzeng Sun
- c The New York State Department of Health , Albany , NY
| | - Lee H Schwamm
- d Department of Neurology , Massachusetts General Hospital , Boston , MA.,e Harvard Medical School , Boston , MA
| | - Barry Sherman
- b School of Public Health , University at Albany, State University of New York , Rensselaer , NY
| | - Feng Qian
- b School of Public Health , University at Albany, State University of New York , Rensselaer , NY
| | | | - Ying Xian
- f Duke Clinical Research Institute , Durham , NC
| | - Joel Stein
- g Department of Rehabilitation and Regenerative Medicine , Columbia University College of Physicians and Surgeons , New York , NY.,h Department of Rehabilitation Medicine , Weill Cornell Medical College , New York , NY.,i New York-Presbyterian Hospital , New York , NY
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Tarp J, Jespersen E, Møller NC, Klakk H, Wessner B, Wedderkopp N, Bugge A. Long-term follow-up on biological risk factors, adiposity, and cardiorespiratory fitness development in a physical education intervention: a natural experiment (CHAMPS-study DK). BMC Public Health 2018; 18:605. [PMID: 29739385 PMCID: PMC5941623 DOI: 10.1186/s12889-018-5524-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 04/27/2018] [Indexed: 12/18/2022] Open
Abstract
Background Schools are a key setting for large-scale primordial non-communicable disease prevention in young people, but little data on sustainability of impacts on cardiometabolic risk markers is available. Methods Six and a half year follow-up of a natural experiment. In 2008, six public schools in the municipality of Svendborg (Denmark) augmented their curricular physical education (intervention) and four matched schools served as controls. At long term follow up in 2015 n = 312 participants aged 5–11 years had complete data (33% of children providing necessary baseline data). The intervention, that consisted of a trebling of weekly physical education lessons and courses provided to physical education teachers, was provided at intervention schools up until 6th grade. Participants attended 6th to 10th grade at follow-up. Differences in the homeostasis model assessment of insulin resistance, blood pressure, triglycerides, cholesterol ratios, cardiorespiratory fitness, waist-circumference, and a composite score of these, between participants attending intervention and control schools were analysed by mixed linear regression models. Differences in physical activity at follow-up was analysed cross-sectionally (no baseline available) in n = 495. Results Compared to controls, children at intervention schools had a non-significant − 0.07 (− 0.32 to 0.18) standard deviations lower composite risk score 6.5 years after project initiation. Likewise, no statistically significant differences between intervention and control schools were found for any of the other outcomes (p-values ≥ 0.41). However, six of seven outcomes were in a direction favouring intervention schools. No statistically significant differences between intervention and control schools were observed for physical activity outcomes (p-values ≥ 0.13). Conclusions An augmented physical activity program including 270 min of weekly physical education provided for three to seven years did not materialize in statistically significant differences in established risk markers in children from intervention compared to control schools. As the intervention was discontinued after 6th grade, the post-intervention effect of augmented physical education throughout adolescence is unknown. School-based physical activity programs may benefit from incorporating instruments for behaviour translation to leisure time in their intervention models to increase the probability of achieving public health relevance. Trial registration ClinicalTrials.gov Identifier: NCT03510494. Electronic supplementary material The online version of this article (10.1186/s12889-018-5524-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jakob Tarp
- Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.
| | - Eva Jespersen
- Department of Rehabilitation, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Niels Christian Møller
- Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Heidi Klakk
- Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.,University College Lillebælt, Odense, Denmark
| | - Barbara Wessner
- Centre for Sport Science and University Sports, Department of Sports and Exercise Physiology, University of Vienna, Vienna, Austria
| | - Niels Wedderkopp
- Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.,Sports Medicine Clinic, The Orthopedic Department, Hospital of Lillebaelt Middelfart, Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Anna Bugge
- Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
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Chen SY, Hwang JS, Sung FC, Lin CY, Hsieh CJ, Chen PC, Su TC. Mono-2-ethylhexyl phthalate associated with insulin resistance and lower testosterone levels in a young population. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2017; 225:112-117. [PMID: 28359975 DOI: 10.1016/j.envpol.2017.03.037] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 03/16/2017] [Accepted: 03/16/2017] [Indexed: 05/21/2023]
Abstract
Phthalates are commonly used as plasticizers and are reported to associate with testicular dysfunction or insulin resistance in different studies, but the concurrent relationship between phthalate exposure, testosterone levels, and insulin resistance in the young population is not well understood. We recruited 786 subjects aged 12-30 years from a population-based sample of Taiwanese adolescents and young adults from 2006 to 2008. Generalized additive models were used to evaluate glucose homeostasis and testicular function in relation to seven urinary phthalate metabolites among adolescents (aged 12-20) and young adults (aged 20-30) in Taiwan. We observed a trend toward a decrease in male testosterone and an increase in urinary mono-2-ethylhexyl phthalate (MEHP) levels across four quartiles of homeostasis model assessment of insulin resistance (HOMA-IR). After adjusting for potential covariates, generalized additive models further showed that log-transformed insulin and HOMA-IR were raised by 0.055 [95% confidence interval (CI), 0.027-0.082] and 0.056 (95% CI, 0.027-0.084), respectively, with a one-unit increase in log-transformed MEHP in young adults. In male adults (aged 22-30), the log-testosterone levels were reduced by 0.018 (95% CI, 0.001-0.036), with a one-unit of increase in log-transformed MEHP. Such relationships were not observed in adolescents. In conclusion, this study demonstrated age-related associations of urinary MEHP metabolites with impaired metabolic homeostasis of glucose that were only observed in young adults. In addition, MEHP exposure was concurrently associated with lower testosterone levels in young, male adults.
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Affiliation(s)
- Szu-Ying Chen
- Division of Surgical Intensive Care, Department of Critical Care Medicine, E-Da Hospital, I-Shou University, Kaohsiung 824, Taiwan; Department of Nursing, Fooyin University, Kaohsiung 831, Taiwan
| | - Jing-Shiang Hwang
- Institute of Statistical Science, Academia Sinica, Taipei 11529, Taiwan
| | - Fung-Chang Sung
- Institute of Environmental Health, College of Public Health, China Medical University, Taichung 404, Taiwan
| | - Chien-Yu Lin
- Department of Internal Medicine, En Chu Kong Hospital, New Taipei City 237, Taiwan; School of Medicine, Fu Jen Catholic University, New Taipei City 242, Taiwan
| | - Chia-Jung Hsieh
- Department of Public Health, Tzu Chi University, Hualian County 970, Taiwan; Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei 10002, Taiwan
| | - Pau-Chung Chen
- Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei 10002, Taiwan; Department of Public Health, College of Public Health, National Taiwan University, Taipei 10002, Taiwan; Department of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei 10002, Taiwan
| | - Ta-Chen Su
- Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei 10002, Taiwan; Department of Internal Medicine and Cardiovascular Center, National Taiwan University Hospital, Taipei 10002, Taiwan.
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Prevalence of metabolic syndrome in children aged 5-9 years from southwest colombia: a cross-sectional study. World J Pediatr 2016; 12:477-483. [PMID: 26830308 DOI: 10.1007/s12519-016-0008-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Accepted: 12/24/2014] [Indexed: 02/06/2023]
Abstract
BACKGROUND Exploration of cardiometabolic alterations in the pre-adolescent stage is necessary to characterize possible patterns for matabolic syndrome (MetS) in the earliest stages of the life. However, defining specific cutoff points for metabolic and vascular markers represents a complex task in pre-adolescent populations. This study aimed to estimate the prevalence of MetS and its components in children aged 5-9 years old by using the MetS definition for adolescents with the lowest cut-off points, and evaluate its relationship with overweight and socio-demographic determinants. METHODS A total of 494 children were evaluated. Multivariate models with filtered variables in preliminary univarite analyses were built to find predictive factors of MetS and its components. RESULTS The prevalence of MetS was 8.7% in the studied children. Multivariate models showed that age, overweight and low socioeconomic stratum were associated with MetS; low high-density lipoprotein cholesterol was not significantly associated with any variable; high triglycerides were positively associated with age, overweight and inversely associated with kilocalories/day; female gender was the only variable significantly associated with high fasting glucose (inverse association); and age, gender and overweight were significant factors for increased waist circumference. In the case of high blood pressure, no variable was classified to the multivariate analysis. CONCLUSION This study showed disturbing figures regarding cardiometabolic risk in the children based on comparisons with studies in adolescents. Further studies are needed to confirm the utility of the de Ferranti Mets definition in children.
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12
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Examining the socioeconomic effects on third molar maturation in a Portuguese sample of children, adolescents and young adults. Int J Legal Med 2016; 131:235-242. [DOI: 10.1007/s00414-016-1476-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 10/11/2016] [Indexed: 10/20/2022]
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13
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Socio-economic differences in cardiometabolic risk markers are mediated by diet and body fatness in 8- to 11-year-old Danish children: a cross-sectional study. Public Health Nutr 2016; 19:2229-39. [PMID: 26926594 DOI: 10.1017/s1368980015003766] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To explore whether socio-economic differences exist in cardiometabolic risk markers in children and whether lifestyle-related factors potentially mediate these differences. DESIGN Cross-sectional study including measurements of fasting blood lipids, glucose, homeostasis model assessment of insulin resistance (HOMA-IR), blood pressure and heart rate. Potential mediators examined were fat mass index (FMI); intakes of fruit, vegetables, dietary fibre and added sugar; whole-blood n-3 long-chain PUFA (LCPUFA) as a biomarker of fish intake; and physical activity and sedentary time. SETTING Nine primary schools in Denmark. SUBJECTS Children aged 8-11 years (n 715). RESULTS Children of parents with the shortest compared with longest education had higher TAG by 0·12 (95 % CI 0·04, 0·21) mmol/l and HOMA-IR by 0·36 (0·10, 0·62), whereas children of parents with a vocational education had higher total cholesterol by 0·14 (0·02, 0·27) mmol/l and LDL cholesterol by 0·14 (0·03, 0·25) mmol/l compared with children of parents with the longest education; all P<0·05. FMI explained 25 % of the difference in TAG, 64 % of the difference in HOMA-IR and 21-29 % of the differences in cholesterols. FMI and whole-blood n-3 LCPUFA combined explained 42 % of the difference in TAG, whereas FMI, whole-blood n-3 LCPUFA and dietary fibre explained 89 % of the difference in HOMA-IR. CONCLUSIONS Socio-economic differences were present in blood lipids and insulin resistance among 8- to 11-year-olds and were mediated by body fatness, whole-blood n-3 LCPUFA and dietary fibre. These lifestyle factors may be targets in public initiatives to reduce socio-economic differences. Confirmation in longitudinal studies and trials is warranted.
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14
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Campos-Matos I, Russo G, Perelman J. Connecting the dots on health inequalities--a systematic review on the social determinants of health in Portugal. Int J Equity Health 2016; 15:26. [PMID: 26879973 PMCID: PMC4754837 DOI: 10.1186/s12939-016-0314-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 02/01/2016] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION Health inequalities are recognised as a public health issue worldwide, but only a few countries have developed national strategies to monitor and reduce them. Despite its considerable health inequalities, Portugal seems to lack a systematic strategy to tackle them, possibly due to the absence of organised evidence on the issue. We performed a systematic review that aimed to describe the available evidence on social inequalities in health in Portugal, in order to contribute towards a comprehensive and focused strategy to tackle them. METHODS We followed the PRISMA guidelines and searched Scopus, Web of Science and PubMed for studies that looked at the association between a measure of socioeconomic status and a health outcome in the Portuguese resident population since the year 2000. We excluded health behaviours and healthcare use from our search. We performed a qualitative description of the results. RESULTS Seventy-one publications were selected, all reporting observational analyses, most of them using cross-sectional data. These publications showed strong evidence for health inequalities related to education and gender, chiefly for obesity, self-rated health and mental health. CONCLUSIONS Analysis of the eligible publications showed that current research does not seem to have consistently covered the link between health and key Portuguese social problems. A strategy focusing on the monitoring of most prevalent diseases, most determining socioeconomic factors and vulnerable populations would be crucial to guide academic research in a country in which health inequalities are so ubiquitous and deeply rooted. REGISTRATION This systematic review is not registered.
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Affiliation(s)
- Inês Campos-Matos
- Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Lisbon, Portugal.
- Centro de Investigação em Saúde Pública, Lisbon, Portugal.
| | - Giuliano Russo
- Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Lisbon, Portugal
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, NOVA University of Lisbon, Lisbon, Portugal
| | - Julian Perelman
- Centro de Investigação em Saúde Pública, Lisbon, Portugal
- Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
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15
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Sherar LB, Griffin TP, Ekelund U, Cooper AR, Esliger DW, van Sluijs EMF, Bo Andersen L, Cardon G, Davey R, Froberg K, Hallal PC, Janz KF, Kordas K, Kriemler S, Pate RR, Puder JJ, Sardinha LB, Timperio AF, Page AS. Association between maternal education and objectively measured physical activity and sedentary time in adolescents. J Epidemiol Community Health 2016; 70:541-8. [PMID: 26802168 PMCID: PMC4893139 DOI: 10.1136/jech-2015-205763] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 12/14/2015] [Indexed: 11/24/2022]
Abstract
Background Investigating socioeconomic variation in physical activity (PA) and sedentary time is important as it may represent a pathway by which socioeconomic position (SEP) leads to ill health. Findings on the association between children's SEP and objectively assessed PA and/or sedentary time are mixed, and few studies have included international samples. Objective Examine the associations between maternal education and adolescent's objectively assessed PA and sedentary time. Methods This is an observational study of 12 770 adolescents (10–18 years) pooled from 10 studies from Europe, Australia, Brazil and the USA. Original PA data were collected between 1997 and 2009. The associations between maternal education and accelerometer variables were examined using robust multivariable regression, adjusted for a priori confounders (ie, body mass index, monitor wear time, season, age and sex) and regression coefficients combined across studies using random effects meta-analyses. Analyses were conducted in March 2014. Results Adolescents of university educated mothers spent more time sedentary (9.5 min/day, p=0.005) and less time in light activity (10 min/day, p<0.001) compared with adolescents of high school educated mothers. Pooled analysis across two studies from Brazil and Portugal (analysed separately because of the different coding of maternal education) showed that children of higher educated mothers (tertiary vs primary/secondary) spent less time in moderate to vigorous PA (MVPA) (6.6 min/day, p=0.001) and in light PA (39.2 min/day: p<0.001), and more time sedentary (45.9 min/day, p<0.001). Conclusions Across a number of international samples, adolescents of mothers with lower education may not be at a disadvantage in terms of overall objectively measured PA.
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Affiliation(s)
- Lauren B Sherar
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK NIHR Leicester - Loughborough Diet, Lifestyle, and Physical Activity Biomedical Research Unit, Leicester, UK
| | - Tom P Griffin
- Centre for Exercise, Nutrition and Health Sciences/School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Ulf Ekelund
- Norwegian School for Sport Science, Oslo, Norway MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Ashley R Cooper
- Centre for Exercise, Nutrition and Health Sciences/School for Policy Studies, University of Bristol, Bristol, UK
| | - Dale W Esliger
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK NIHR Leicester - Loughborough Diet, Lifestyle, and Physical Activity Biomedical Research Unit, Leicester, UK
| | - Esther M F van Sluijs
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK Centre of Diet and Activity Research, Unicersity of Cambridge, Cambridge, UK
| | - Lars Bo Andersen
- Norwegian School for Sport Science, Oslo, Norway Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Greet Cardon
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - Rachel Davey
- Centre for Research & Action in Public Health, University of Canberra, Canberra, Australia
| | - Karsten Froberg
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | | | - Kathleen F Janz
- Department of Health and Human Physiology, Department of Epidemiology, University of Iowa, Iowa City, Iowa, USA
| | - Katarzyna Kordas
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Zürich, Switzerland
| | - Russell R Pate
- Department of Exercise Science at the University of South Carolina, South Carolina, USA
| | - Jardena J Puder
- Service of Endocrinology, Diabetes and Metabolism, University Hospital, CHUV, Lausanne, Switzerland
| | - Luis B Sardinha
- Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - Anna F Timperio
- School of Exercise and Nutrition Sciences/Centre for Physical Activity and Nutrition Research, Deakin University, Melbourne, Victoria, Australia
| | - Angie S Page
- Centre for Exercise, Nutrition and Health Sciences/School for Policy Studies, University of Bristol, Bristol, UK
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Silva D, Werneck AO, Collings P, Tomeleri CM, Fernandes RA, Ronque E, Venturini D, Barbosa DS, Coelho-E-Silva MJ, Sardinha LB, Cyrino ES. Cardiorespiratory fitness is related to metabolic risk independent of physical activity in boys but not girls from Southern Brazil. Am J Hum Biol 2016; 28:534-8. [PMID: 26762308 DOI: 10.1002/ajhb.22826] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 07/22/2015] [Accepted: 12/09/2015] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE Our aim was to determine the relationship between cardiorespiratory fitness (CRF) and metabolic risk in adolescents from Southern Brazil. METHODS We performed a school-based cross-sectional study in 1,037 adolescents (436 boys) aged 10-16 years from Londrina, PR, Brazil. CRF was determined by 20-m shuttle run test. A continuous metabolic risk score was obtained from the mean of fasting glucose, triglycerides, high density lipoprotein, blood pressure, and waist circumference z-scores. Age, physical activity (Baecke questionnaire), body mass index (BMI; weight/stature(2) ), and somatic maturity (Mirwald method) were included as covariates in multiple linear regression analyses. RESULTS CRF was related to metabolic risk in boys (β = -0.02, P < 0.01) and girls (β = -0.01, P = 0.02) after adjusting for chronological age, BMI, and somatic maturity. However, when adjusted for physical activity, CRF failed to explain metabolic risk in girls (β = -0.01, P = 0.24). CONCLUSION We conclude that CRF is independently and inversely related to metabolic risk in boys, but physical activity either mediates or confounds the association between CRF and metabolic risk in girls. Am. J. Hum. Biol. 28:534-538, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Danilo Silva
- Study and Research Group in Metabolism, Nutrition, and Exercise (GEPEMENE) State University of Londrina (UEL), Londrina, Brazil
| | - André O Werneck
- Study and Research Group in Metabolism, Nutrition, and Exercise (GEPEMENE) State University of Londrina (UEL), Londrina, Brazil
| | - Paul Collings
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- Bradford Institute for Health Research, Bradford NHS Foundation Trust, Bradford, UK
| | - Crisieli M Tomeleri
- Study and Research Group in Metabolism, Nutrition, and Exercise (GEPEMENE) State University of Londrina (UEL), Londrina, Brazil
| | - RôMulo A Fernandes
- Scientific Research Group Related to Physical Activity (GICRAF), Laboratory of InVestigation in Exercise (LIVE), Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente, Brazil
| | - Enio Ronque
- Study and Research Group in Metabolism, Nutrition, and Exercise (GEPEMENE) State University of Londrina (UEL), Londrina, Brazil
| | - Danielle Venturini
- Department of Pathology, Clinical and Toxicological Analysis, Center of Health Sciences, University Hospital, State University of Londrina (UEL), Londrina, Brazil
| | - Décio S Barbosa
- Department of Pathology, Clinical and Toxicological Analysis, Center of Health Sciences, University Hospital, State University of Londrina (UEL), Londrina, Brazil
| | | | - Luís B Sardinha
- Exercise and Health Laboratory, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - Edilson S Cyrino
- Study and Research Group in Metabolism, Nutrition, and Exercise (GEPEMENE) State University of Londrina (UEL), Londrina, Brazil
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Buitrago-Lopez A, van den Hooven EH, Rueda-Clausen CF, Serrano N, Ruiz AJ, Pereira MA, Mueller NT. Socioeconomic status is positively associated with measures of adiposity and insulin resistance, but inversely associated with dyslipidaemia in Colombian children. J Epidemiol Community Health 2015; 69:580-7. [PMID: 25691273 DOI: 10.1136/jech-2014-204992] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 01/13/2015] [Indexed: 12/16/2022]
Abstract
BACKGROUND Low socioeconomic status (SES) has been associated with higher risk of cardiometabolic diseases in developed societies, but investigation of SES and cardiometabolic risk in children in less economically developed populations is sparse. We aimed to examine associations among SES and cardiometabolic risk factors in Colombian children. METHODS We used data from a population-based study of 1282 children aged 6-10 years from Bucaramanga, Colombia. SES was classified according to household wealth, living conditions and access to public utilities. Anthropometric and biochemical parameters were measured at a clinic visit. Cardiometabolic risk factors were analysed continuously using linear regression and as binary outcomes-according to established paediatric cut points-using logistic regression to calculate OR and 95% CIs. RESULTS Mean age of the children was 8.4 (SD 1.4) and 51.1% of the sample were boys. Odds of overweight/obesity, abdominal obesity and insulin resistance were greater among higher SES. Compared with the lowest SES stratum, children in the highest SES had higher odds of overweight/obesity (OR=3.25, 95% CI 1.89 to 5.57), abdominal obesity (OR=2.74, 95% CI 1.41 to 5.31) and insulin resistance (OR=2.60, 95% CI 1.81 to 3.71). In contrast, children in the highest SES had lower odds of hypertriglyceridaemia (triglycerides ≥90th centile; OR=0.28, 95% CI 0.14 to 0.54) and low (≤10th centile) high-density lipoprotein (HDL) cholesterol (OR=0.35, 95% CI 0.15 to 0.78). CONCLUSIONS In Colombian children, SES is directly associated with obesity and insulin resistance, but inversely associated with dyslipidaemia (hypertriglyceridaemia and low HDL cholesterol). Our findings highlight the need to analyse cardiometabolic risk factors separately in children and to carefully consider a population's level of economic development when studying their social determinants of cardiometabolic disease.
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Affiliation(s)
- Adriana Buitrago-Lopez
- Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Edith H van den Hooven
- Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Christian F Rueda-Clausen
- Department of Medicine, University of Alberta, Li Ka Shing Centre for Heath Research Innovation, University of Alberta, Edmonton, Alberta, Canada
| | - Norma Serrano
- Division of Research, Fundacion Cardiovascular de Colombia, Floridablanca, Santander, Colombia
| | - Alvaro J Ruiz
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogota DC, Colombia
| | - Mark A Pereira
- Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Noel T Mueller
- Department of Epidemiology, Mailman School of Public Health, Columbia University Medical Center, New York, New York, USA Institute of Human Nutrition and Department of Medicine, College of Physicians and Surgeons, Columbia University Medical Center, New York, New York, USA
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18
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Andersen LB, Lauersen JB, Brønd JC, Anderssen SA, Sardinha LB, Steene-Johannessen J, McMurray RG, Barros MVG, Kriemler S, Møller NC, Bugge A, Kristensen PL, Ried-Larsen M, Grøntved A, Ekelund U. A new approach to define and diagnose cardiometabolic disorder in children. J Diabetes Res 2015; 2015:539835. [PMID: 25945355 PMCID: PMC4402570 DOI: 10.1155/2015/539835] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 03/17/2015] [Indexed: 02/06/2023] Open
Abstract
The aim of the study was to test the performance of a new definition of metabolic syndrome (MetS), which better describes metabolic dysfunction in children. Methods. 15,794 youths aged 6-18 years participated. Mean z-score for CVD risk factors was calculated. Sensitivity analyses were performed to evaluate which parameters best described the metabolic dysfunction by analysing the score against independent variables not included in the score. Results. More youth had clustering of CVD risk factors (>6.2%) compared to the number selected by existing MetS definitions (International Diabetes Federation (IDF) < 1%). Waist circumference and BMI were interchangeable, but using insulin resistance homeostasis model assessment (HOMA) instead of fasting glucose increased the score. The continuous MetS score was increased when cardiorespiratory fitness (CRF) and leptin were included. A mean z-score of 0.40-0.85 indicated borderline and above 0.85 indicated clustering of risk factors. A noninvasive risk score based on adiposity and CRF showed sensitivity and specificity of 0.85 and an area under the curve of 0.92 against IDF definition of MetS. Conclusions. Diagnosis for MetS in youth can be improved by using continuous variables for risk factors and by including CRF and leptin.
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Affiliation(s)
- Lars Bo Andersen
- Center of Research in Childhood Health, Department of Sport Sciences and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
- Department of Sports Medicine, Norwegian School of Sport Sciences, Sognsveien 220, 0806 Oslo, Norway
- *Lars Bo Andersen:
| | - Jeppe Bo Lauersen
- Department of Sports Medicine, Norwegian School of Sport Sciences, Sognsveien 220, 0806 Oslo, Norway
| | - Jan Christian Brønd
- Center of Research in Childhood Health, Department of Sport Sciences and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Sigmund Alfred Anderssen
- Department of Sports Medicine, Norwegian School of Sport Sciences, Sognsveien 220, 0806 Oslo, Norway
| | - Luis B. Sardinha
- Exercise and Health Laboratory, CIPER, Fac Motricidade Humana, Universidade de Lisboa, Estrada Dacosth, Cruz-Quebrada, 1499 Lisbon, Portugal
| | | | - Robert G. McMurray
- Department of Exercise and Sport Science, University of North Carolina, 025 Fetzer Gym, CB No. 8700, Chapel Hill, NC 27599-8700, USA
| | - Mauro V. G. Barros
- School of Physical Education, University of Pernambuco, Campus Universitario HUOC-ESEF, Arnobio Marques 310, Santo Amaro, 50.100-130 Recife, PE, Brazil
| | - Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Hirschengraben 84, 8001 Zürich, Switzerland
| | - Niels Christian Møller
- Center of Research in Childhood Health, Department of Sport Sciences and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Anna Bugge
- Center of Research in Childhood Health, Department of Sport Sciences and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Peter Lund Kristensen
- Center of Research in Childhood Health, Department of Sport Sciences and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Mathias Ried-Larsen
- Center of Research in Childhood Health, Department of Sport Sciences and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
- The Centre of Inflammation and Metabolism and Trygfondens Center for Aktiv Sundhed, Department of Infectious Diseases and CMRC, Rigshospitalet, Faculty of Health Sciences, University of Copenhagen, Tagensvej 20, 2100 Copenhagen, Denmark
| | - Anders Grøntved
- Center of Research in Childhood Health, Department of Sport Sciences and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Ulf Ekelund
- Department of Sports Medicine, Norwegian School of Sport Sciences, Sognsveien 220, 0806 Oslo, Norway
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, University of Cambridge, Hills Road, Cambridge CB2 0QQ, UK
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Slopen N, Goodman E, Koenen KC, Kubzansky LD. Socioeconomic and other social stressors and biomarkers of cardiometabolic risk in youth: a systematic review of less studied risk factors. PLoS One 2013; 8:e64418. [PMID: 23691213 PMCID: PMC3656855 DOI: 10.1371/journal.pone.0064418] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Accepted: 04/13/2013] [Indexed: 12/29/2022] Open
Abstract
Background Socioeconomic disadvantage and other social stressors in childhood have been linked with cardiometabolic diseases in adulthood; however the mechanisms underlying these observed associations and the timing of their emergence are unclear. The aim of this review was to evaluate research that examined relationships between socioeconomic disadvantage and other social stressors in relation to less-studied cardiometabolic risk factors among youth, including carbohydrate metabolism-related factors, lipids, and central adiposity. Methods We searched PubMed and ISI Web of Science to identify relevant publications between 2001 and 2013.Studies were selected based on 4 criteria: (1) the study examined an association between at least one social or economic stressor and one relevant outcome prior to age 21; (2) the sample originated from a high-income country; (3) the sample was not selected based on a health condition; and (4) a central aim was to evaluate the effect of the social or economic stressor on at least one relevant outcome. Abstracts were screened and relevant publications were obtained and evaluated for inclusion criteria. We abstracted data from selected articles, summarized them by exposures and outcomes, and assigned an evidence grade. Results Our search identified 37 publications from 31 studies. Socioeconomic disadvantage was consistently associated with greater central adiposity. Research to date does not provide clear evidence of an association between childhood stressors and lipids or carbohydrate metabolism-related factors. Conclusions This review demonstrates a paucity of research on the relationship of socioeconomic disadvantage and other social stressors to lipid and carbohydrate metabolism-related factors in youth. Accordingly, it is not possible to form strong conclusions, particularly with regard to stressors other than socioeconomic disadvantage. Findings are used to inform priorities for future research. An improved understanding of these pathways is critical for identifying novel prevention targets and intervention opportunities to protect the long-term health of children and adolescents.
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Affiliation(s)
- Natalie Slopen
- Center on the Developing Child, Harvard University, Cambridge, Massachusetts, United States of America.
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Yaghoubi A, Safaie N, Azarfarin R, Alizadehasl A, Golzari SEJ. Evaluation of cardiovascular diseases and their risk factors in hospitalized patients in East azerbaijan province, northwest iran: a review of 18323 cases. J Tehran Heart Cent 2013; 8:101-5. [PMID: 23967032 PMCID: PMC3740106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2011] [Accepted: 10/10/2012] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Coronary artery disease (CAD) is accountable for more than 30% of deaths worldwide and is, thus, deemed the most important factor in terms of disease burden around the globe. This study aimed to evaluate CAD and its risk factors in hospitalized patients in the East Azerbaijan Province, northwest Iran, from 2006 to 2007. METHODS Data on 18.323 patients hospitalized due to cardiovascular diseases were collected to evaluate the diseases and their risk factors in 15 hospitals in the East Azerbaijan Province, northwest Iran. We assessed the main diagnosis of cardiovascular disease on admission in each hospital. Also, types of interventional and surgical procedures were assessed and all these variables were compared between men and women. RESULTS The study population consisted of 56.6% male and 43.4% female patients. The median and range between quartile 1 and 3 (Q1-Q3) ages of the males and females were 59 (49-70) and 62 (51-71) years, respectively. Ischemic heart diseases were diagnosed in 68.4%, electrophysiological disorders in 6.5%, and valvular heart diseases in 4.5% of the patients. The frequencies of the studied risk factors were as follows: cigarette smoking (47.5%); hypertension (66.95%); diabetes mellitus (35.9%); and history of cerebrovascular accident (16.4%) and renal disease (13.4%). Medical therapy was performed in 79.23%, surgery in 6.28%, and cardiovascular interventional therapy in 13.99% of the patients. The in-hospital mortality rate was 1.57% (1.42% in the males and 1.76% in the females; p value = 0.009). CONCLUSION The most frequent known risk factors in the hospitalized patients were smoking, alcohol consumption, and diabetes. In the northwest of Iran, age at hospitalization due to cardiovascular diseases is slightly lower than that in the Western populations; however, sex distribution, diagnoses, and treatment modalities are not significantly different from those reported in Western countries.
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Affiliation(s)
- Alireza Yaghoubi
- Cardiovascular Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Naser Safaie
- Cardiovascular Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran.,Corresponding Author: Naser Safaie, Cardiovascular Research Center, Tabriz University of Medical Sciences, Daneshghah Street, Tabriz, Iran. 5166615573. Tel: +98 411 3373950. Fax: +98 411 3373950. E-mail:
| | - Rasoul Azarfarin
- Cardiovascular Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Azin Alizadehasl
- Cardiovascular Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Samad EJ Golzari
- Physical Medicine and Rehabilitation Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran.,Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
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van den Berg G, van Eijsden M, Vrijkotte TGM, Gemke RJBJ. Socioeconomic inequalities in lipid and glucose metabolism in early childhood in a population-based cohort: the ABCD-Study. BMC Public Health 2012; 12:591. [PMID: 22852830 PMCID: PMC3490773 DOI: 10.1186/1471-2458-12-591] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Accepted: 07/18/2012] [Indexed: 11/25/2022] Open
Abstract
Background Socioeconomic inequalities in cardiovascular disease are pervasive, yet much remains to be understood about how they originate. The objective of this study was to explore the relations of socioeconomic status to lipid and glucose metabolism as indicators of cardiovascular health in 5–6 year olds. Additionally to explore the explanatory role of maternal factors, birth outcome, and child factors. Methods In 1308 5–6 year old ethnic Dutch children from the ABCD cohort study, lipids (cholesterol, LDL, HDL, triglycerides), glucose and C-peptide were measured after an overnight-fast. Results There were no differences in cholesterol, HDL, LDL, and triglycerides between socioeconomic groups, as indicated by maternal education and income adequacy. However, children of low educated mothers had on average a higher glucose (β = 0.15; 95% confidence interval (CI) 0.03 – 0.27), logC-peptide (β = 0.07; 95% CI 0.04 – 0.09), and calculated insulin resistance (HOMA-IR) (β = 0.15; 95% CI 0.08 – 0.22) compared to children of high educated mothers. Only childhood BMI partly explained these differences (models controlled for age, height, and sex). Conclusions The socioeconomic gradient in cardiovascular risk factors seems to emerge in early childhood. In absence of underlying mechanisms these empirical findings are relevant for public health care and further explanatory research.
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Affiliation(s)
- Gerrit van den Berg
- Department of Pediatrics, VU University Medical Center, Amsterdam, The Netherlands.
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Tamayo T, Jacobs DR, Strassburger K, Giani G, Seeman TE, Matthews K, Roseman JM, Rathmann W. Race- and sex-specific associations of parental education with insulin resistance in middle-aged participants: the CARDIA study. Eur J Epidemiol 2012; 27:349-55. [PMID: 22565544 DOI: 10.1007/s10654-012-9691-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2012] [Accepted: 04/18/2012] [Indexed: 11/26/2022]
Abstract
Low childhood socioeconomic status (SES) has been linked with insulin resistance (HOMA-IR) in adulthood. Our aim was to examine if maternal and paternal education, as indicators of childhood SES, equally contributed to increased HOMA-IR in later life. Of 5,115 adults from the Coronary Artery Disease Risk Development in Young Adults (CARDIA) Study aged 18-30 years in 1985-1986, data on 1,370 females and 1,060 males with baseline and 20 year follow-up data were used to estimate associations of maternal and paternal education with HOMA-IR, adjusting for personal education, BMI, lipids, blood pressure, and lifestyle factors. Parental education was determined as high with ≥ 12 years of schooling and classified as both high, only mother high, only father high, both low education. Distinct combinations of maternal and paternal education were associated with HOMA-IR across race and sex groups. Lowest year 20 HOMA-IR in European American (EA) females occurred when both parents were better educated, but was highest when only the father had better education. HOMA-IR was lowest in African American (AA) participants when the mother was better educated but the father had less education, but was highest when both parents were better educated. Parental education was unrelated to HOMA-IR in EA males. Associations of parental education with HOMA-IR are seen in AA females, AA males, and EA females but not in EA males. The distinct combinations of parental education and their associations with HOMA-IR especially in AA participants need to be addressed in further research on health disparities.
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Affiliation(s)
- Teresa Tamayo
- Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University, Auf'm Hennekamp 65, 40225 Düsseldorf, Germany.
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Thomas C, Nightingale CM, Donin AS, Rudnicka AR, Owen CG, Sattar N, Cook DG, Whincup PH. Socio-economic position and type 2 diabetes risk factors: patterns in UK children of South Asian, black African-Caribbean and white European origin. PLoS One 2012; 7:e32619. [PMID: 22412897 PMCID: PMC3296720 DOI: 10.1371/journal.pone.0032619] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Accepted: 02/02/2012] [Indexed: 11/19/2022] Open
Abstract
Background Socio-economic position (SEP) and ethnicity influence type 2 diabetes mellitus (T2DM) risk in adults. However, the influence of SEP on emerging T2DM risks in different ethnic groups and the contribution of SEP to ethnic differences in T2DM risk in young people have been little studied. We examined the relationships between SEP and T2DM risk factors in UK children of South Asian, black African-Caribbean and white European origin, using the official UK National Statistics Socio-economic Classification (NS-SEC) and assessed the extent to which NS-SEC explained ethnic differences in T2DM risk factors. Methods and Findings Cross-sectional school-based study of 4,804 UK children aged 9–10 years, including anthropometry and fasting blood analytes (response rates 70%, 68% and 58% for schools, individuals and blood measurements). Assessment of SEP was based on parental occupation defined using NS-SEC and ethnicity on parental self-report. Associations between NS-SEC and adiposity, insulin resistance (IR) and triglyceride differed between ethnic groups. In white Europeans, lower NS-SEC status was related to higher ponderal index (PI), fat mass index, IR and triglyceride (increases per NS-SEC decrement [95%CI] were 1.71% [0.75, 2.68], 4.32% [1.24, 7.48], 5.69% [2.01, 9.51] and 3.17% [0.96, 5.42], respectively). In black African-Caribbeans, lower NS-SEC was associated with lower PI (−1.12%; [−2.01, −0.21]), IR and triglyceride, while in South Asians there were no consistent associations between NS-SEC and T2DM risk factors. Adjustment for NS-SEC did not appear to explain ethnic differences in T2DM risk factors, which were particularly marked in high NS-SEC groups. Conclusions SEP is associated with T2DM risk factors in children but patterns of association differ by ethnic groups. Consequently, ethnic differences (which tend to be largest in affluent socio-economic groups) are not explained by NS-SEC. This suggests that strategies aimed at reducing social inequalities in T2DM risk are unlikely to reduce emerging ethnic differences in T2DM risk.
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Affiliation(s)
- Claudia Thomas
- Population Health Research Centre, Division of Population Health Sciences and Education, St Georges, University of London, London, United Kingdom.
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Matijasevich A, Victora CG, Lawlor DA, Golding J, Menezes AMB, Araújo CL, Barros AJD, Santos IS, Barros FC, Smith GD. Association of socioeconomic position with maternal pregnancy and infant health outcomes in birth cohort studies from Brazil and the UK. J Epidemiol Community Health 2012; 66:127-35. [PMID: 20628081 PMCID: PMC3245894 DOI: 10.1136/jech.2010.108605] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2010] [Indexed: 11/10/2022]
Abstract
BACKGROUND Socioeconomic inequalities in health outcomes are dynamic and vary over time. Differences between countries can provide useful insights into the causes of health inequalities. The study aims to compare the associations between two measures of socioeconomic position (SEP)-maternal education and family income-and maternal and infant health outcomes between ALSPAC and Pelotas cohorts. METHODS Birth cohort studies were started in Avon, UK, in 1991 (ALSPAC) and in the city of Pelotas, Brazil, in 1982, 1993 and 2004. Maternal outcomes included smoking during pregnancy, caesarean section and delivery not attended by a doctor. Infant outcomes were preterm birth, intra-uterine growth restriction (IUGR) and breast feeding for <3 months. The relative index of inequality was used for each measure of SEP so that results were comparable between cohorts. RESULTS An inverse association (higher prevalence among the poorest and less educated) was observed for almost all outcomes, with the exception of caesarean sections where a positive association was found. Stronger income-related inequalities for smoking and education-related inequalities for breast feeding were found in the ALSPAC study. However, greater inequalities in caesarean section and education-related inequalities in preterm birth were observed in the Pelotas cohorts. CONCLUSIONS Mothers and infants have more adverse health outcomes if they are from poorer and less well-educated socioeconomic backgrounds in both Brazil and the UK. However, our findings demonstrate the dynamic nature of the association between SEP and health outcomes. Examining differential socioeconomic patterning of maternal and infant health outcomes might help understanding of mechanisms underlying such inequalities.
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Affiliation(s)
- A Matijasevich
- Rua Marechal Deodoro, 1160-3rd floor, CEP 96020-220, Pelotas, RS, Brazil.
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Khader Y, Batieha A, Jaddou H, El-Khateeb M, Ajlouni K. Metabolic Syndrome and Its Individual Components among Jordanian Children and Adolescents. INTERNATIONAL JOURNAL OF PEDIATRIC ENDOCRINOLOGY 2010; 2010:316170. [PMID: 21197084 PMCID: PMC3004400 DOI: 10.1155/2010/316170] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2010] [Revised: 10/14/2010] [Accepted: 11/09/2010] [Indexed: 02/06/2023]
Abstract
This study aimed to determine the prevalence of metabolic syndrome (MeS) and its individual components in Jordanian children and adolescents aged 7-18 years and determine the factors that are associated with clustering of metabolic abnormalities. MeS was defined using the International Diabetes Federation (IDF) definition. The prevalence of MeS was estimated from 512 subjects who had complete information on all MeS components. The prevalence of MeS according to IDF criteria was 1.4% in subjects aged between 10 and 15.9 years and 3.6% in subjects aged between 16 and 18 years. When categorized according to body mass index (BMI), the prevalence of the MeS was 15.1% in obese subjects, compared to 0.3% in subjects with normal BMI, and 3.0% in overweight subjects. In conclusion, our results indicate that although the prevalence of MeS is low in Jordanian children and adolescents, a large proportion of them had one or two metabolic abnormalities.
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Affiliation(s)
- Yousef Khader
- Department of Community Medicine, Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science & Technology, Irbid 22110, Jordan
| | - Anwar Batieha
- Department of Community Medicine, Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science & Technology, Irbid 22110, Jordan
| | - Hashim Jaddou
- Department of Community Medicine, Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science & Technology, Irbid 22110, Jordan
| | - Mohammed El-Khateeb
- National Center for Diabetes, Endocrinology and Genetics, P.O. Box 13165, Amman 11942, Jordan
| | - Kamel Ajlouni
- National Center for Diabetes, Endocrinology and Genetics, P.O. Box 13165, Amman 11942, Jordan
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Goodman E, Must A, Daniels SR, Dolan LM. Hostility and adiposity mediate disparities in insulin resistance among adolescents and young adults. J Pediatr 2010; 157:572-7, 577.e1. [PMID: 20542297 PMCID: PMC3166621 DOI: 10.1016/j.jpeds.2010.04.048] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2009] [Revised: 03/12/2010] [Accepted: 04/26/2010] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study explores whether the relationship between lower socioeconomic status and insulin resistance in adolescents is mediated by both physiological and psychological factors associated with increased cardiometabolic risk. STUDY DESIGN School-based longitudinal cohort study of 1222 healthy, non-Hispanic black and white teens. Parent education (PE), youth-specific Cook-Medley hostility scale, waist circumference, height, weight, pubertal status, and fasting plasma insulin (FPI) were measured and FPI reassessed 1 year later. Regression analyses utilizing bootstrapping (n=2000) were used to estimate the direct and indirect effects of PE on FPI and assess the role of hostility and adiposity while adjusting for covariates. RESULTS Lower PE predicted higher FPI (B=-1.52, P=.003), as did hostility (B=.19, P=.002) and adiposity (waist circumference B=.44, P<.001, BMI B=.98, P<.001). The effect of PE on FPI was mediated by both hostility and adiposity. When adiposity and hostility were accounted for, the effect of PE on FPI decreased by 32% (B=-1.04, P=.04); the total indirect estimate was -.485 (95% CI, -.652, -.041). Hostility accounted for 36% of the meditational effect. CONCLUSIONS Lower PE influences insulin resistance through adiposity and hostility. Thus, interventions to reduce health disparities associated with insulin resistance should consider both physiological and psychological approaches.
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Affiliation(s)
- Elizabeth Goodman
- Floating Hospital for Children at Tufts Medical Center, Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA 02114, USA.
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Tamayo T, Christian H, Rathmann W. Impact of early psychosocial factors (childhood socioeconomic factors and adversities) on future risk of type 2 diabetes, metabolic disturbances and obesity: a systematic review. BMC Public Health 2010; 10:525. [PMID: 20809937 PMCID: PMC2940917 DOI: 10.1186/1471-2458-10-525] [Citation(s) in RCA: 149] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2009] [Accepted: 09/01/2010] [Indexed: 12/10/2023] Open
Abstract
Background Psychological factors and socioeconomic status (SES) have a notable impact on health disparities, including type 2 diabetes risk. However, the link between childhood psychosocial factors, such as childhood adversities or parental SES, and metabolic disturbances is less well established. In addition, the lifetime perspective including adult socioeconomic factors remains of further interest. We carried out a systematic review with the main question if there is evidence in population- or community-based studies that childhood adversities (like neglect, traumata and deprivation) have considerable impact on type 2 diabetes incidence and other metabolic disturbances. Also, parental SES was included in the search as risk factor for both, diabetes and adverse childhood experiences. Finally, we assumed that obesity might be a mediator for the association of childhood adversities with diabetes incidence. Therefore, we carried out a second review on obesity, applying a similar search strategy. Methods Two systematic reviews were carried out. Longitudinal, population- or community-based studies were included if they contained data on psychosocial factors in childhood and either diabetes incidence or obesity risk. Results We included ten studies comprising a total of 200,381 individuals. Eight out of ten studies indicated that low parental status was associated with type 2 diabetes incidence or the development of metabolic abnormalities. Adjustment for adult SES and obesity tended to attenuate the childhood SES-attributable risk but the association remained. For obesity, eleven studies were included with a total sample size of 70,420 participants. Four out of eleven studies observed an independent association of low childhood SES on the risk for overweight and obesity later in life. Conclusions Taken together, there is evidence that childhood SES is associated with type 2 diabetes and obesity in later life. The database on the role of psychological factors such as traumata and childhood adversities for the future risk of type 2 diabetes or obesity is too small to draw conclusions. Thus, more population-based longitudinal studies and international standards to assess psychosocial factors are needed to clarify the mechanisms leading to the observed health disparities.
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Affiliation(s)
- Teresa Tamayo
- Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany.
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Rahu K, Rahu M, Pullmann H, Allik J. Effect of birth weight, maternal education and prenatal smoking on offspring intelligence at school age. Early Hum Dev 2010; 86:493-7. [PMID: 20634008 DOI: 10.1016/j.earlhumdev.2010.06.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2009] [Revised: 06/19/2010] [Accepted: 06/21/2010] [Indexed: 11/17/2022]
Abstract
To examine the combined effect of birth weight, mothers' education and prenatal smoking on psychometrically measured intelligence at school age 1,822 children born in 1992-1999 and attending the first six grades from 45 schools representing all of the fifteen Estonian counties with information on birth weight, gestational age and mother's age, marital status, education, parity and smoking in pregnancy, and intelligence tests were studied. The scores of Raven's Standard Progressive Matrices were related to the birth weight: in the normal range of birth weight (>or=2500 g) every 500 g increase in birth weight was accompanied by around 0.7-point increase in IQ scores. A strong association between birth weight and IQ remained even if gestational age and mother's age, marital status, education, place of residence, parity and smoking during pregnancy have been taken into account. Maternal prenatal smoking was accompanied by a 3.3-point deficit in children's intellectual abilities. Marriage and mother's education had an independent positive correlation with offspring intelligence. We concluded that the statistical effect of birth weight, maternal education and smoking in pregnancy on offspring's IQ scores was remarkable and remained even if other factors have been taken into account.
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Affiliation(s)
- Kaja Rahu
- National Institute for Health Development, The Estonian Centre of Behavioural and Health Sciences, Estonia
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Howe LD, Galobardes B, Sattar N, Hingorani AD, Deanfield J, Ness AR, Davey-Smith G, Lawlor DA. Are there socioeconomic inequalities in cardiovascular risk factors in childhood, and are they mediated by adiposity? Findings from a prospective cohort study. Int J Obes (Lond) 2010; 34:1149-59. [PMID: 20231844 PMCID: PMC4052430 DOI: 10.1038/ijo.2010.52] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2009] [Revised: 01/21/2010] [Accepted: 01/31/2010] [Indexed: 11/24/2022]
Abstract
BACKGROUND Socioeconomic gradients in adiposity were not present during childhood for previous generations, but have emerged in contemporary children. It is unknown whether this translates to socioeconomic gradients in associated cardiovascular risk factors in children, with consequent implications for inequalities in coronary heart disease (CHD) and diabetes when these children reach adulthood. METHODS Using data from 7772 participants aged 10-years from the Avon Longitudinal Study of Parents and Children, we examined the association between maternal education and a large number of cardiovascular risk factors (cholesterol, triglycerides, high-density lipoprotein, apolipoprotein, adiponectin, leptin, C-reactive protein (CRP), interleukin-6 (IL-6) and systolic and diastolic blood pressure), and examined whether inequalities were mediated by adiposity, measured by dual energy X-ray absorptiometry (DXA)-assessed total fat mass. RESULTS There were socioeconomic differences in a number of the cardiovascular risk factors (apolipoprotein B, systolic and diastolic blood pressure, CRP, leptin and IL-6). Inequalities were greater in girls than boys. Inequalities in CRP and leptin were completely mediated by adiposity. Inequalities in other cardiovascular risk factors were partially mediated by adiposity. CONCLUSION This study showed important socioeconomic inequalities in adiposity and associated cardiovascular risk factors in a contemporary UK population of 10-year-old children. Differences between contemporary children and previous generations in the socioeconomic patterning of cardiovascular risk factors suggest future adults may have greater inequalities in diabetes and CHD than current adults. These findings highlight the importance of interventions aimed at preventing obesity in childhood, particularly among those of lower socioeconomic position.
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Affiliation(s)
- L D Howe
- Department of Social Medicine, University of Bristol, Bristol BS8 2BN, UK.
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Bréchat N, Besnier M, Vogel T, Berthel M, Castiel D, Labalette C, Lonsdorfer J, Mathieu-Grenouilleau MC, Rymer R, Bréchat PH. Personnes âgées, précarité, handicap social et durée de séjour : étude pilote au groupe hospitalier Lariboisière–Fernand Widal de Paris. Presse Med 2010; 39:e86-96. [PMID: 20153135 DOI: 10.1016/j.lpm.2009.06.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2008] [Revised: 02/12/2009] [Accepted: 06/12/2009] [Indexed: 11/26/2022] Open
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Khader Y, Batieha A, Jaddou H, El-Khateeb M, Ajlouni K. Metabolic Syndrome and Its Individual Components among Jordanian Children and Adolescents. INTERNATIONAL JOURNAL OF PEDIATRIC ENDOCRINOLOGY 2010. [DOI: 10.1186/1687-9856-2010-316170] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Nilsson A, Andersen LB, Ommundsen Y, Froberg K, Sardinha LB, Piehl-Aulin K, Ekelund U. Correlates of objectively assessed physical activity and sedentary time in children: a cross-sectional study (The European Youth Heart Study). BMC Public Health 2009; 9:322. [PMID: 19735565 PMCID: PMC2745386 DOI: 10.1186/1471-2458-9-322] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2009] [Accepted: 09/07/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Identifying leisure time activities performed before and after school that influence time in physical activity (PA) and/or time spent sedentary can provide useful information when designing interventions aimed to promote an active lifestyle in young people. The purpose of this study was to examine associations between mode of transportation to school, outdoor play after school, participation in exercise in clubs, and TV viewing with objectively assessed PA and sedentary behaviour in children. METHODS A total of 1327 nine- and 15-year-old children from three European countries (Norway, Estonia, Portugal) participated as part of the European Youth Heart Study. PA was measured during two weekdays and two weekend days using the MTI accelerometer, and average percent of time in moderate-to-vigorous PA (MVPA) and time spent sedentary were derived. Potential correlates were assessed by self-report. Independent associations between self-reported correlates with percent time in MVPA and percent time sedentary were analysed by general linear models, adjusted by age, gender, country, measurement period, monitored days and parental socio-economic status. RESULTS In 9-year-olds, playing outdoors after school was associated with higher percent time in MVPA (P < 0.01), while participation in sport clubs was associated with higher percent time in MVPA (P < 0.01) in 15-year-olds. No associations with percent time sedentary were observed in either age group. CONCLUSION Frequency of outdoor play after school is a significant correlate for daily time in MVPA in 9-year-olds, while this correlate is attenuated in favour of participation in sport and exercise in clubs in 15-year-olds. Targeting walking to school or reduced TV viewing time in order to increase time in daily MVPA in children is unlikely to be sufficient. Correlates related to time spent sedentary need further examination.
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Affiliation(s)
- Andreas Nilsson
- School of Health and Medical Sciences, Orebro University, Orebro, Sweden.
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Cardoso HF, Padez C. Changes in height, weight, BMI and in the prevalence of obesity among 9- to 11-year-old affluent Portuguese schoolboys, between 1960 and 2000. Ann Hum Biol 2009; 35:624-38. [DOI: 10.1080/03014460802464200] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Hugo F.V. Cardoso
- Departamento de Antropologia & Centro de Investigação em Antropologia e Saúde, Universidade de Coimbra, Portugal
- Departamento de Higiene e Epidemiologia, Faculdade de Medicina, Universidade do Porto, Portugal
| | - Cristina Padez
- Departamento de Antropologia & Centro de Investigação em Antropologia e Saúde, Universidade de Coimbra, Portugal
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Obesity in Irish youth: epidemiology and implications. Ir J Med Sci 2009; 178:249-55. [DOI: 10.1007/s11845-009-0360-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2009] [Accepted: 05/02/2009] [Indexed: 01/15/2023]
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Haysom L, Williams R, Hodson E, Lopez-Vargas P, Roy LP, Lyle D, Craig JC. Risk of CKD in Australian Indigenous and Nonindigenous Children: A Population-Based Cohort Study. Am J Kidney Dis 2009; 53:229-37. [DOI: 10.1053/j.ajkd.2008.08.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2008] [Accepted: 08/01/2008] [Indexed: 11/11/2022]
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Haysom L, Williams RE, Hodson EM, Lopez-Vargas P, Roy LP, Lyle DM, Craig JC. Cardiovascular risk factors in Australian indigenous and non-indigenous children: a population-based study. J Paediatr Child Health 2009; 45:20-7. [PMID: 19208061 DOI: 10.1111/j.1440-1754.2008.01426.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM Indigenous people have a two- to tenfold increased risk of premature death from cardiovascular disease. We aimed to determine whether some key risk factors for cardiovascular disease occur more commonly in Aboriginal than non-Aboriginal Australian children. METHODS Children were enrolled from primary schools throughout New South Wales, the state with the highest number of Aboriginal people. Associations between ethnicity, gender, birthweight, socio-demographic status and hypertension, obesity, baseline and persistent albuminuria were determined. RESULTS A total of 2266 children (55% Aboriginal) were enrolled. Mean age was 8.9 years (+/-3.8 years). Obesity (body mass index >or=2 standard deviations) was detected in 7.1%, systolic hypertension (blood pressure >90th percentile) in 7.2%, diastolic hypertension in 5.9%, baseline albuminuria (albumin : creatinine >or=3.4 mg/mmol) in 7.3% and persistent albuminuria in 1.5% with no differences between Aboriginal and non-Aboriginal children. Hypertension was less common with increasing social disadvantage (trend P < 0.02). Increasing body mass index standard deviation was strongly associated with systolic and diastolic hypertension (both P < 0.0001). CONCLUSIONS Many risk factors for cardiovascular disease are already common in young children but not more prevalent in Aboriginal than in non-Aboriginal children. In all children, overweight and obesity have the strongest association with hypertension, but social disadvantage appears protective for hypertension. Our findings suggest that risk for cardiovascular health disparities seen in indigenous adults manifests beyond childhood and that a window of opportunity exists to prevent some of these outcomes.
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Affiliation(s)
- Leigh Haysom
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead NSW, Australia.
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Albright A. Biological and social exposures in youth set the stage for premature chronic diseases. ACTA ACUST UNITED AC 2008; 108:1843-5. [PMID: 18954573 DOI: 10.1016/j.jada.2008.09.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2008] [Accepted: 09/09/2008] [Indexed: 10/21/2022]
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Cooper R, Lucke J, Lawlor DA, Mishra G, Chang JH, Ebrahim S, Kuh D, Dobson A. Socioeconomic position and hysterectomy: a cross-cohort comparison of women in Australia and Great Britain. J Epidemiol Community Health 2008; 62:1057-63. [PMID: 18413433 PMCID: PMC2582341 DOI: 10.1136/jech.2007.071001] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To examine the associations between indicators of socioeconomic position (SEP) and hysterectomy in two Australian and two British cohorts. STUDY POPULATION Women participating in the Australian Longitudinal Study on Women's Health (ALSWH), born 1921-1926 and 1946-1951, and two cohorts of British women, the British Women's Heart and Health Study and the MRC National Survey of Health and Development, born at similar times (1920 to 1939 and 1946, respectively) and surveyed at similar ages to the ALSWH cohorts. METHODS Relative indices of inequality were derived for own and head of household occupational class, educational level attained and age at leaving school. Logistic regression was used to test the associations between these indicators of SEP and self-reported hysterectomy and/or oophorectomy. RESULTS Inverse associations between indicators of SEP and hysterectomy were found in both the Australian and British cohorts of women born in 1946 or later. There was also evidence of an inverse association between education and hysterectomy in the older Australian cohort. However, the associations in this older cohort were weaker than those found in the mid-aged Australian cohort. In the older British cohort, born in the 1920s and 1930s, little evidence of association between SEP in adulthood and hysterectomy was found. CONCLUSIONS These results suggest that inverse associations between indicators of SEP and hysterectomy are stronger in younger than in older cohorts in both Australia and Great Britain. They provide further evidence of the dynamic nature of the association between indicators of SEP and hysterectomy.
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Affiliation(s)
- R Cooper
- MRC National Survey of Health and Development, Department of Epidemiology and PublicHealth, University College London, London, UK.
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Manios Y, Moschonis G, Kourlaba G, Bouloubasi Z, Grammatikaki E, Spyridaki A, Hatzis C, Kafatos A, Fragiadakis GA. Prevalence and independent predictors of insulin resistance in children from Crete, Greece: the Children Study. Diabet Med 2008; 25:65-72. [PMID: 18028438 DOI: 10.1111/j.1464-5491.2007.02318.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND It has been proposed that insulin resistance (IR) is associated with the development of Type 2 diabetes mellitus and cardiovascular disease. The aim of this study is to determine the prevalence of IR in Greek schoolchildren and to investigate factors associated with IR. METHODS Between October 2005 and March 2006, 522 children were recruited from Crete. Physical activity and dietary habits, anthropometric and biochemical characteristics, as well as medical history of pupils' parents were recorded. IR was estimated using the homeostasis model assessment (HOMA-IR), fasting glucose-to-insulin ratio (FGIR) and quantitative insulin sensitivity check index (QUICKI). Multiple linear regression was used to determine independent predictors for IR. RESULTS Fasting insulin levels and HOMA-IR scores were higher in obese children and girls compared with their normal-weight peers (P < 0.001). Moreover, the former had lower values in FGIR and QUICKI indices compared with the latter, indicating that obese children and girls are more insulin resistant compared with their counterparts (P < 0.001). The prevalence of IR was 9.2% (2.9% in normal-weight, 10.5% in overweight and 31.0% in obese children), using as a threshold HOMA-IR > 2.10 97.5th percentile of normal-weight participants). Multiple linear regression revealed that central adiposity, female gender and intake of simple carbohydrates is associated positively with HOMA-IR values, even after controlling for many other factors. CONCLUSION These findings demonstrate that girls and obese children, particularly those with central adiposity, are at high risk of developing IR. Therefore, these groups should be targets of Type 2 diabetes mellitus and cardiovascular disease preventive interventions.
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Affiliation(s)
- Y Manios
- Department of Dietetics-Nutrition, Harokopio University, Athens, Greece.
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Batty GD, Alves JG, Correia J, Lawlor DA. Examining life-course influences on chronic disease: the importance of birth cohort studies from low- and middle- income countries. An overview. Braz J Med Biol Res 2007; 40:1277-86. [PMID: 17876486 DOI: 10.1590/s0100-879x2007000900015] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2007] [Accepted: 08/21/2007] [Indexed: 11/22/2022] Open
Abstract
The objectives of this overview are to describe the past and potential contributions of birth cohorts to understanding chronic disease aetiology; advance a justification for the maintenance of birth cohorts from low- and middle-income countries (LMIC); provide an audit of birth cohorts from LMIC; and, finally, offer possible future directions for this sphere of research. While the contribution of birth cohorts from affluent societies to understanding disease aetiology has been considerable, we describe several reasons to anticipate why the results from such studies might not be directly applied to LMIC. More than any other developing country, Brazil has a tradition of establishing, maintaining and exploiting birth cohort studies. The clear need for a broader geographical representation may be precipitated by a greater collaboration worldwide in the sharing of ideas, fieldwork experience, and cross-country cohort data comparisons in order to carry out the best science in the most efficient manner. This requires the involvement of a central overseeing body--such as the World Health Organization--that has the respect of all countries and the capacity to develop strategic plans for 'global' life-course epidemiology while addressing such issues as data-sharing. For rapid progress to be made, however, there must be minimal bureaucratic entanglements.
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Affiliation(s)
- G D Batty
- MRC Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK.
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Abstract
Early life conditions, such as socioeconomic status (SES) and health, have the potential to set in motion multiple and reinforcing pathways that shape both the prevalence and onset of diabetes among older adults. Using data from the Health and Retirement Study (1998-2002) for persons age 51 years and older, we investigated the core mediating mechanisms linking early life conditions with diabetes prevalence in 1998 and onset over a 4-year follow-up period, focusing on adult achievement processes and obesity as key mechanisms. We found that father's education is negatively associated with diabetes prevalence for older men and women. However, no markers of early life SES are directly associated with older men's and women's onset of diabetes, and the negative effects of adult SES on diabetes onset pertain only to women. Early life health affects the onset of diabetes among women--but not the prevalence--and no evidence of this association was found for men. We found no evidence that obesity is an important mechanism connecting either early life or adult SES with diabetes development in men or women. We speculate that early life SES may accelerate the development of diabetes at younger ages, and that the pathways linking life course SES, early life health, and diabetes are partly gender-specific and biological in nature.
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Affiliation(s)
- Latrica E Best
- Department of Sociology and Population Research Institute, The Pennsylvania State University, 211 Oswald Tower, University Park, PA 16802, USA.
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Veena SR, Geetha S, Leary SD, Saperia J, Fisher DJ, Kumaran K, Coakley P, Stein CE, Fall CHD. Relationships of maternal and paternal birthweights to features of the metabolic syndrome in adult offspring: an inter-generational study in South India. Diabetologia 2007; 50:43-54. [PMID: 17143606 PMCID: PMC2493388 DOI: 10.1007/s00125-006-0516-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2006] [Accepted: 10/06/2006] [Indexed: 02/06/2023]
Abstract
AIMS/HYPOTHESIS The association between lower birthweight and metabolic syndrome may result from fetal undernutrition (fetal programming hypothesis) and/or genes causing both low birthweight and insulin resistance (fetal insulin hypothesis). We studied associations between the birthweight of parents and metabolic syndrome in the offspring. METHODS We identified men and women (aged 35-68 years), who had been born in Holdsworth Memorial Hospital, Mysore, India. We also identified the offspring (20-46 years) of these men and women. In total, 283 offspring of 193 mothers and 223 offspring of 144 fathers were studied. Investigations included anthropometry, oral glucose tolerance, plasma insulin and lipid concentrations and blood pressure. The metabolic syndrome was defined using WHO criteria. RESULTS Among the offspring, lower birthweight was associated with an increased risk of glucose intolerance (impaired glucose tolerance, impaired fasting glucose or type 2 diabetes) and higher cholesterol and triacylglycerol concentrations (p < 0.05 for all adjusted for sex and age). Most outcomes in the offspring, including most individual components of the metabolic syndrome, were unrelated to parental birthweight. However, both maternal and paternal birthweight were inversely related to offspring metabolic syndrome (odds ratio [OR] 0.36 [95% CI: 0.13-1.01] per kg, p = 0.053 for mother-offspring pairs; OR 0.26 [0.07-0.93], p = 0.04 for father-offspring pairs, adjusted for offspring age, sex, BMI and socioeconomic status). Maternal birthweight was inversely related to offspring systolic blood pressure (beta = -2.5 mmHg [-5.00 to 0.03] per kg maternal birthweight; p = 0.052). CONCLUSIONS/INTERPRETATION Factors in both parents may influence the risk of metabolic syndrome in their offspring. There are several possible explanations, but the findings are consistent with the fetal insulin (genetic) hypothesis.
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Affiliation(s)
- S R Veena
- Holdsworth Memorial Hospital, Mysore, Karnataka, India.
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Goodman E, Daniels SR, Dolan LM. Socioeconomic disparities in insulin resistance: results from the Princeton School District Study. Psychosom Med 2007; 69:61-7. [PMID: 17167128 DOI: 10.1097/01.psy.0000249732.96753.8f] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The objectives of this study were to determine whether lower socioeconomic status (SES) is associated with changes in insulin resistance in adolescents over a 3-year period and explore moderators of this effect. METHODS A total of 1167 healthy non-Hispanic black and white participants in the Princeton School District Study, a longitudinal study of fifth to 12th graders in a suburban Midwestern public school district were included in this study. Inclusion criteria were a) physical examination and fasting morning blood draw at baseline and 3 years later, b) younger than 20 years old at follow up, and c) information available on SES provided by a parent. The influence of SES on insulin resistance and change in insulin resistance over time was examined using general linear models adjusting for multiple covariates. Models also assessed if race or baseline weight status changed the SES-insulin resistance relationship and explored the role of perceived stress. RESULTS Blacks and lower SES youth had higher body mass index z score and increased insulin resistance (p < .001). In multivariable models, lower parent education, but not household income, was associated with higher baseline insulin resistance (F = 7.84, p < .001) and worsening insulin resistance over time (F = 18.86, p < .001). Parent education's effect on change in insulin resistance was more pronounced for obese youth compared with nonobese (F interaction = 10.12, p < .001) even with adjustment for multiple covariates. Perceived stress did not alter these relationships. CONCLUSIONS Lower parent education appears to be related to increased insulin resistance both cross-sectionally and over time in black and white adolescents. Worsening insulin resistance is especially problematic for obese adolescents from families with low parent education.
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Affiliation(s)
- Elizabeth Goodman
- Department of Pediatrics, Tufts-New England Medical Center and Tufts University School of Medicine, Boston, MA 02111, USA.
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Lucove JC, Kaufman JS, James SA. Association between adult and childhood socioeconomic status and prevalence of the metabolic syndrome in African Americans: the Pitt County Study. Am J Public Health 2006; 97:234-6. [PMID: 17194854 PMCID: PMC1781392 DOI: 10.2105/ajph.2006.087429] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
We evaluated the association between socioeconomic status (SES) during childhood and adulthood and prevalence of the metabolic syndrome in African Americans. Higher adult educational status and adult skilled occupation were protective against the metabolic syndrome, but no associations were found between the metabolic syndrome and other SES variables. Differences by gender were observed. Improving access to education among African Americans could reduce risk for the metabolic syndrome, but more research is needed in minority populations.
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Affiliation(s)
- Jaime C Lucove
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC 27599, USA
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Møller NC, Wedderkopp N, Kristensen PL, Andersen LB, Froberg K. Secular trends in cardiorespiratory fitness and body mass index in Danish children: The European Youth Heart Study. Scand J Med Sci Sports 2006; 17:331-9. [PMID: 16903897 DOI: 10.1111/j.1600-0838.2006.00583.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To examine the secular trends in cardiorespiratory fitness (CF) and body fatness in Danish children. Trends were analyzed overall and across socioeconomic status (SES). METHODS Two cross-sectional studies conducted on 589 and 458 third-grade Danish children in 1997-1998 and 2003-2004, respectively. CF was determined by a maximal cycle-ergometer test. The lowest sex-specific quartile of CF in the study from 1997 to 1998 was used as a cut-point for low CF. Body mass index (BMI) cut-points were used to describe overweight, and SES was divided into two groups according to parents' occupation. RESULTS This study showed a secular decline in CF in girls overall. Increased CF, BMI, and prevalence of overweight were observed in boys with high SES, in boys with low SES, and in girls with low SES, respectively. However, after additional Bonferroni's correction, none of the statistical analyses performed across socioeconomic gradients reached significant P-values. CONCLUSION CF declined in girls overall. Although not statistically significant after additional Bonferroni's correction, results in general showed less favorable trends in low SES children. Thus, trying to describe secular trends in CF and body fatness overall without any regard to SES might disguise social-caused differences. However, further studies are needed in order to verify this hypothesis.
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Affiliation(s)
- N C Møller
- Institute of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
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Grjibovski AM, Bergman P, Hagströmer M, Hurtig-Wennlöf A, Meusel D, Ortega FB, Patterson E, Poortvliet E, Rizzo N, Ruiz JR, Wärnberg J, Sjöström M. A dropout analysis of the second phase of the Swedish part of the European Youth Heart Study. J Public Health (Oxf) 2006. [DOI: 10.1007/s10389-006-0057-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Kristensen PL, Wedderkopp N, Møller NC, Andersen LB, Bai CN, Froberg K. Tracking and prevalence of cardiovascular disease risk factors across socio-economic classes: a longitudinal substudy of the European Youth Heart Study. BMC Public Health 2006; 6:20. [PMID: 16441892 PMCID: PMC1403767 DOI: 10.1186/1471-2458-6-20] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2005] [Accepted: 01/27/2006] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The highest prevalence of several cardiovascular disease risk factors including obesity, smoking and low physical activity level is observed in adults of low socioeconomic status. This study investigates whether tracking of body mass index and physical fitness from childhood to adolescence differs between groups of socioeconomic status. Furthermore the study investigates whether social class differences in the prevalence of overweight and low physical fitness exist or develop within the age range from childhood to adolescence. METHODS In all, 384 school children were followed for a period of six years (from third to ninth grade). Physical fitness was determined by a progressive maximal cycle ergometer test and the classification of overweight was based on body mass index cut-points proposed by the International Obesity Task Force. Socioeconomic status was defined according to The International Standard Classification of Occupation scheme. RESULTS Moderate and moderately high tracking was observed for physical fitness and body mass index, respectively. No significant difference in tracking was observed between groups of socioeconomic status. A significant social gradient was observed in both the prevalence of overweight and low physical fitness in the 14-16-year-old adolescents, whereas at the age of 8-10 years, only the prevalence of low physical fitness showed a significant inverse relation to socioeconomic status. The odds of both developing and maintaining risk during the measurement period were estimated as bigger in the group of low socioeconomic status than in the group of high socioeconomic status, although differences were significant only with respect to the odds of developing overweight. CONCLUSION The results indicate that the fundamental possibilities of predicting overweight and low physical fitness at an early point in time are the same for different groups of socio-economic status. Furthermore, the observed development of social inequalities in the absolute prevalence of overweight and low physical fitness underline the need for broad preventive efforts targeting children of low socioeconomic status in early childhood.
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Affiliation(s)
- Peter L Kristensen
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | | | - Niels C Møller
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Lars B Andersen
- Department of Sports Medicine, Norwegian School of Sport Sciences, Postboks 4014 Ullevål Stadion, 0806 Oslo, Norway
| | - Charlotte N Bai
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Karsten Froberg
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
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Affiliation(s)
- Denny Vågerö
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, SE-106 91 Stockholm, Sweden.
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