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Bandeira CP, Schaan BD, Cureau FV. Association of BMI and WC for insulin resistance and type 2 diabetes among Brazilian adolescents. J Pediatr (Rio J) 2024:S0021-7557(24)00098-6. [PMID: 39147370 DOI: 10.1016/j.jped.2024.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 07/10/2024] [Accepted: 07/11/2024] [Indexed: 08/17/2024] Open
Abstract
OBJECTIVE To investigate how body mass index (BMI) and waist circumference (WC) may be associated with insulin resistance and type 2 diabetes (T2DM) in Brazilian adolescents. METHODS Cross-sectional study using data from the Brazilian Study of Cardiovascular Risks in Adolescents (ERICA) including adolescents aged 12-17 years. The relationship between adiposity and T2DM was investigated using ordinal logistic regression models. To study the association between adiposity categories and the occurrence of insulin resistance, linear regression models were used. RESULTS The prevalence of T2DM for the same BMI category did not increase with the presence of high WC. Regarding insulin resistance, for the same BMI categories, having a high WC resulted in a higher prevalence of insulin resistance (HOMA-IR). The only groups significantly associated with prediabetes and T2DM were those with obesity by BMI with elevated WC (POR 1.68, 95 % CI 1.45; 1.94) and obesity with normal WC (POR 1.58, 95 % CI 1.01; 2.46). Similar findings were observed concerning insulin resistance, where the increased WC had its greatest effect when associated with obesity by BMI (β Coefficient 2.20, 95 % CI 1.89; 2.50). CONCLUSION The combination of BMI and WC is better for assessing adolescents at risk of developing T2DM.
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Affiliation(s)
- Cesar Pirajá Bandeira
- Faculty of Medical Sciences, Graduate Program in Health Sciences: Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Beatriz D Schaan
- Faculty of Medical Sciences, Graduate Program in Health Sciences: Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Endocrine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil; Graduate Program in Medical Science: Endocrinology, Universidade Federal do Rio Grande do Sul, Faculty of Medical Sciences, Porto Alegre, RS, Brazil
| | - Felipe Vogt Cureau
- Faculty of Medical Sciences, Graduate Program in Health Sciences: Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Graduate Program in Physical Education, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
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Masquio DCL, Campos RMDS, Netto BDM, de Carvalho-Ferreira JP, Bueno CR, Alouan S, Poletto GT, Ganen ADP, Tufik S, de Mello MT, Nardo N, Dâmaso AR. Interdisciplinary Therapy Improves the Mediators of Inflammation and Cardiovascular Risk in Adolescents with Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7114. [PMID: 38063544 PMCID: PMC10706419 DOI: 10.3390/ijerph20237114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 10/21/2023] [Accepted: 11/03/2023] [Indexed: 12/18/2023]
Abstract
Obesity is associated with inflammation and an increased risk of cardiovascular disease and premature mortality, as well as a range of other conditions. Obesity is a growing global problem, not only in adults, but also in children and adolescents. Therefore, the present study aimed to assess the effects of a one-year interdisciplinary intervention on the cardiometabolic and inflammatory profiles of adolescents with obesity. Twenty-two adolescents completed the intervention, which included clinical, nutritional, psychological and physical exercise counselling. Body composition, and metabolic, inflammatory, and cardiovascular risk biomarkers were analyzed before and after one year of intervention. Visceral and subcutaneous fat were determined ultrasonographically. The homeostasis model assessment of insulin resistance (HOMA-IR) and the quantitative insulin sensitivity check index (QUICKI) equation were used to estimate insulin resistance and insulin sensitivity, respectively. A reduction in body mass, adiposity, glucose, and insulin and an improved lipid profile were observed after the therapy. Hyperleptinemia was reduced from 77.3% to 36.4%. Plasminogen activator inhibitor-1 (PAI-1), intercellular adhesion molecule 1 (ICAM-1), leptin, the leptin/adiponectin ratio, and the adiponectin/leptin ratio were also significantly improved. Metabolic changes were associated with a reduction in visceral fat and waist circumference, and adiponectin and the leptin/adiponectin ratio were associated with HOMA-IR. The interdisciplinary therapy promoted improvements in hyperleptinemia and metabolic, inflammatory, and cardiovascular biomarkers.
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Affiliation(s)
- Deborah Cristina Landi Masquio
- Programa de Pós-Graduação em Nutrição, Departamento de Fisiologia, Universidade Federal de São Paulo (UNIFESP), Campus São Paulo, São Paulo 04023-061, SP, Brazil;
- Programa de Mestrado Profissional em Nutrição: do Nascimento à Adolescência, Curso de Nutrição, Centro Universitário São Camilo (CUSC), São Paulo 05025-010, SP, Brazil;
- Grupo de Estudos da Obesidade (GEO), Universidade Federal de São Paulo (UNIFESP), São Paulo 04023-061, SP, Brazil; (S.A.); (G.T.P.)
| | - Raquel Munhoz da Silveira Campos
- Programa de Pós-Graduação Interdisciplinar em Ciências da Saúde, Departamento de Biociências, Universidade Federal de São Paulo (UNIFESP), Campus Baixada Santista, Santos 11010-150, SP, Brazil;
| | - Bárbara Dal Molin Netto
- Programa de Pós-Graduação em Alimentação e Nutrição, Departamento de Nutrição, Universidade Federal do Paraná (UFPR), Curitiba 80210-170, PR, Brazil;
| | - Joana Pereira de Carvalho-Ferreira
- Laboratório Multidisciplinar em Alimentos e Saúde, Faculdade de Ciências Aplicadas, Universidade Estadual de Campinas (UNICAMP), Limeira 13484-350, SP, Brazil;
| | - Carlos Roberto Bueno
- Escola de Educação Física e Esporte de Ribeirão Preto (EEFERP), Universidade de São Paulo (USP), Ribeirão Preto 14040-900, SP, Brazil;
| | - Stella Alouan
- Grupo de Estudos da Obesidade (GEO), Universidade Federal de São Paulo (UNIFESP), São Paulo 04023-061, SP, Brazil; (S.A.); (G.T.P.)
| | - Gabriela Tronca Poletto
- Grupo de Estudos da Obesidade (GEO), Universidade Federal de São Paulo (UNIFESP), São Paulo 04023-061, SP, Brazil; (S.A.); (G.T.P.)
| | - Aline de Piano Ganen
- Programa de Mestrado Profissional em Nutrição: do Nascimento à Adolescência, Curso de Nutrição, Centro Universitário São Camilo (CUSC), São Paulo 05025-010, SP, Brazil;
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo 04724-000, SP, Brazil;
| | - Marco Túlio de Mello
- Escola de Educação Física, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte 31310-250, MG, Brazil;
| | - Nelson Nardo
- Departamento de Educação Física, Universidade Estadual de Maringá (UEM), Maringá 87020-900, PR, Brazil;
| | - Ana R. Dâmaso
- Programa de Pós-Graduação em Nutrição, Departamento de Fisiologia, Universidade Federal de São Paulo (UNIFESP), Campus São Paulo, São Paulo 04023-061, SP, Brazil;
- Grupo de Estudos da Obesidade (GEO), Universidade Federal de São Paulo (UNIFESP), São Paulo 04023-061, SP, Brazil; (S.A.); (G.T.P.)
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3
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Niba LL, Navti LK, Musa AJ. Relationship between measures of adiposity and hypertension amongst secondary school adolescents in an urban setting in Cameroon. Pan Afr Med J 2023; 46:57. [PMID: 38223873 PMCID: PMC10787134 DOI: 10.11604/pamj.2023.46.57.41547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 10/06/2023] [Indexed: 01/16/2024] Open
Abstract
Introduction measures of obesity such as body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR) have been shown to be associated with high blood pressure (BP) in children and adolescents. The purpose of this study was to determine the proportion of secondary school adolescents with elevated BP and high BP in relation to some measures of adiposity (BMI, WC, WHtR) and to examine the association between BP and adiposity indices amongst the children. Methods the study was an institutional-based cross-sectional study involving 534 adolescents (mean age 15.1 ± 2.3 years) attending 4 secondary schools (2 public and 2 private) in the Bamenda municipality of the North West Region of Cameroon. Anthropometric and BP measurements were carried out following standard procedures. Diagnosis of hypertension in the children was done by obtaining three elevated systolic or diastolic BP readings (BP ≥ 95th percentile for the child's age, sex and height). Linear regression was used to determine the relationship between BP and some measures of adiposity (BMI, WC, WHtR) amongst the children. Results the prevalence of elevated BP and hypertension amongst the study participants was 33.3% and 33.3% in the BMI-obese children, 25.9% and 25.2% in the WC overweight/obese children and 29.4% and 41.2% in the "high risk" (WHtR ≥ 0.5) children respectively. Body mass index-obese, WC overweight/obese and "high risk" (WHtR ≥ 0.5) children had a significantly (p <0.05) higher mean SBP and DBP compared to their healthy weight counterparts. Linear regression indicated a significant association (p <0.001) between WC (β=0.75; 95% CI = 0.57, 0.92), BMI (β=0.88; 95% CI = 0.49, 1.25) and WHtR (β= 67.08; 95% CI = 45.64, 88.51) with systolic BP for the unadjusted analysis. After adjusting for age, gender and school type, only WC (β= 0.66; 95% CI = (0.43, 0.89) showed a positive significant (p <0.001) relationship with systolic BP. Conclusion this study has demonstrated that WC is positively associated with high BP in children and adolescents. Thus, WC can be used in predicting children and adolescents with a high risk of developing high BP in our setting.
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Affiliation(s)
- Loveline Lum Niba
- Department of Public Health, The University of Bamenda, Bambili, North West Region, Cameroon
- Nutrition and Health Research Group (NHRG), Bamenda, Cameroon
| | - Lifoter Kenneth Navti
- Nutrition and Health Research Group (NHRG), Bamenda, Cameroon
- Department of Biochemistry, The University of Bamenda, Bambili, North West Region, Cameroon
| | - Ahmadou Jingi Musa
- Department of Clinical Sciences, The University of Bamenda, Bambili, North West Region, Cameroon
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Ejheisheh MA, Batran A, Ayed A, Correa-Rodríguez M, Fernández-Aparicio Á, Gómez-Urquiza JL, Schmidt-RioValle J. Correlation between anthropometric measurements and blood pressure in a population of Palestinian adults. Sci Prog 2022; 105:368504221102782. [PMID: 35635260 PMCID: PMC10450307 DOI: 10.1177/00368504221102782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Obesity can be a major problem due to its potential to cause a number of health issues, including high blood pressure and diabetes. Many reports have come out of Palestine on overweight and obesity and their direct link to non-communicable diseases, although there is only limited evidence available on the connection between obesity and hypertension in Palestinian adults. We aimed to look at the associations between anthropometric and body composition variables and blood pressure in a large population of Palestinian adults (1337 subjects) and determine which anthropometric indices most strongly correlate with high blood pressure. Anthropometric measurements including height, waist circumference (WC), hip circumference (HC), body mass index (BMI), and total body fat (TBF) were assessed. A body composition analyzer was used to measure body weight, fat mass and fat-free mass. Systolic (SBP) and diastolic (DBP) blood pressure were measured using a Dinamap vital signs monitor. In both males and females, all the anthropometric measurements showed significant strong positive correlations with mean SBP and mean DBP (p < 0.01). SBP correlated the most strongly with waist circumference in all subjects (r = 0.444 in females, r = 0.422 in males), while DBP correlated the most strongly with WC in males (r = 0.386), but with TBF in females (r = 0.256). By controlling fat percentage, WC, HC, and BMI, which are affected by extra weight and lack of exercise, blood pressure levels can be regulated.
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Affiliation(s)
- Moath Abu Ejheisheh
- Faculty of Allied Medical Sciences, Department of Nursing, Palestine Ahliya University, Jenin, Palestine
| | - Ahmad Batran
- Faculty of Allied Medical Sciences, Department of Nursing, Palestine Ahliya University, Jenin, Palestine
| | - Ahmad Ayed
- Faculty of nursing, Arab American University, Jenin, Palestine
| | - María Correa-Rodríguez
- Department of Nursing, Faculty of Health Sciences, University of Granada (UGR), Avenida de la Ilustración s/n, 18100-Armilla (Granada), Granada, Spain
- CTS-436 Aspectos psicosociales y Transculturales de la Salud y la Enfermedad, Granada, Spain
| | - Ángel Fernández-Aparicio
- Department of Nursing, Faculty of Health Sciences, University of Granada (UGR), Avenida de la Ilustración s/n, 18100-Armilla (Granada), Granada, Spain
- CTS-436 Aspectos psicosociales y Transculturales de la Salud y la Enfermedad, Granada, Spain
| | - José Luis Gómez-Urquiza
- Department of Nursing, Faculty of Health Sciences, University of Granada (UGR), Avenida de la Ilustración s/n, 18100-Armilla (Granada), Granada, Spain
| | - Jacqueline Schmidt-RioValle
- Department of Nursing, Faculty of Health Sciences, University of Granada (UGR), Avenida de la Ilustración s/n, 18100-Armilla (Granada), Granada, Spain
- CTS-436 Aspectos psicosociales y Transculturales de la Salud y la Enfermedad, Granada, Spain
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Otiashvili L. Metabolic Syndromes in Overweight/Obese School-Age Children. Glob Pediatr Health 2022; 9:2333794X221122716. [PMID: 36091355 PMCID: PMC9459452 DOI: 10.1177/2333794x221122716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 08/07/2022] [Indexed: 12/04/2022] Open
Abstract
The research aimed at studying the phenomenological structure of metabolic
syndromes in overweight and obese school-age children. The cohort of 210
students participated in the cross-sectional study. Among them 84 children (40%)
were overweight/obese and 126 students (60%)—with normal weight. The incidence
of abdominal obesity and arterial hypertension were studied and lipid profile
was assessed in obese children. The results of research revealed the early
manifestation of abdominal obesity (14.3%-16.7%), arterial hypertension (the
elevation of systolic pressure—27.4%, the increase in diastolic pressure—10.7%)
and hypercholesterolemia (9.5%) in the population of overweight/obese school age
children, which allows to take prompt corrective actions on metabolic syndrome
and reduce the risk of its formation.
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Affiliation(s)
- Lia Otiashvili
- Ivane Javakhishvili Tbilisi State University, Tbilisi, Georgia
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6
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Gentry AE, Robins J, Makowski M, Kliewer W. Differential DNA Methylation and Cardiometabolic Risk in African American Mother-Adolescent Dyads. Biol Res Nurs 2022; 24:75-84. [PMID: 34719281 PMCID: PMC9248288 DOI: 10.1177/10998004211039017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Cardiovascular disease disproportionately affects African Americans as the leading cause of morbidity and mortality. Among African Americans, compared to other racial groups, cardiovascular disease onset occurs at an earlier age due to a higher prevalence of cardiometabolic risk factors, particularly obesity, hypertension and type 2 diabetes. Emerging evidence suggests that heritable epigenetic processes are related to increased cardiovascular disease risk, but this is largely unexplored in adolescents or across generations. MATERIALS AND METHODS In a cross-sectional descriptive pilot study in low-income African American mother-adolescent dyads, we examined associations between DNA methylation and the cardiometabolic indicators of body mass index, waist circumference, and insulin resistance. RESULTS Four adjacent cytosine and guanine nucleotides (CpG) sites were significantly differentially methylated and associated with C-reactive protein (CRP), 62 with waist circumference, and none to insulin resistance in models for both mothers and adolescents. CONCLUSION Further study of the relations among psychological and environmental stressors, indicators of cardiovascular disease, risk, and epigenetic factors will improve understanding of cardiovascular disease risk so that preventive measures can be instituted earlier and more effectively. To our knowledge this work is the first to examine DNA methylation and cardiometabolic risk outcomes in mother-adolescent dyads.
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Affiliation(s)
- Amanda Elswick Gentry
- Department of Psychiatry, Virginia
Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University,
Richmond, VA, USA,Amanda Elswick Gentry, PhD, Department of
Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia
Commonwealth University, 800 East Leigh Street, Suite 100, Room 130-B, Richmond,
VA 23219, USA.
| | - Jo Robins
- School of Nursing, Virginia
Commonwealth University, Richmond, VA, USA
| | | | - Wendy Kliewer
- Department of Psychology, College of
Humanities and Sciences, Virginia Commonwealth University, Richmond, VA, USA
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Domingo-Bolio V, Medina-Vera I, Shamah-Levy T, Moreno-Macías L, Avila-Nava A. Evaluation of Cardiovascular Risk by Waist-to-Height Ratio in School-Age Children. Metab Syndr Relat Disord 2021; 19:531-536. [PMID: 34520256 DOI: 10.1089/met.2021.0048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Childhood overweight and obesity are among the major public health problems worldwide. In Mexico, it has been reported in 2018 that 35.6% of children between 5 and 11 years old were overweight or obese. Central obesity is associated with the development of different complications, such as cardiovascular diseases (CVDs). An important tool used to evaluate obesity is the waist-to-height ratio (WHtR), and values higher than 0.5 suggest the existence of cardiovascular risk (CVR). The aim of this study was to evaluate CVR by the WHtR in school-age children from Yucatan, Mexico. Methods: This study included a sample of school-age children between the ages of 10 and 13 years from public schools in Yucatan, Mexico. Anthropometric parameters such as body weight, height, body mass index z-score (zBMI), waist circumference, WHtR, and CVR were evaluated. Results: A total of 2559 children with a median age of 12.1 ± 0.57 years old were evaluated. The classification by height z score showed that 26.8% were of short height, 73.1% were of normal height, and 0.1% were of tall height. The prevalence of body weight excess determined by zBMI was 48%. The prevalence of normal weight was 44%, and the prevalence of body weight deficiencies was 8%. The CVR determined by WHtR was 47.5%. In the population with obesity, 63.3% had an increased risk of CVDs and 30.7% had a very high risk. Moreover, it was observed that 13.2% of the population with normal weight had an increased risk of CVDs. Conclusion: One out of two child 10 to 13 years of age is overweight or obese as defined with zBMI in Mexico. According to WHtR, almost half of this population is at increased CVR, while near two-third of child with obesity are at high or very high CVR.
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Affiliation(s)
- Vanessa Domingo-Bolio
- Dirección de Nutrición de los Servicios de Salud de Yucatán, Mérida, Yucatán, México.,Escuela de Salud, Universidad Modelo, Mérida, Yucatán, México
| | - Isabel Medina-Vera
- Departamento de Metodología de la Investigación, Instituto Nacional de Pediatría, CDMX, México
| | - Teresa Shamah-Levy
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Lidia Moreno-Macías
- Facultad de Medicina, Universidad Autónoma de Yucatán, Merida, Yucatán, México
| | - Azalia Avila-Nava
- Hospital Regional de Alta Especialidad de la Península de Yucatán, Mérida, Yucatán, México
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8
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Association Between Abdominal Waist Circumference and Blood Pressure In Brazilian Adolescents With Normal Body Mass Index: Waist circumference and blood pressure in Adolescents. Glob Heart 2020; 15:27. [PMID: 32489800 PMCID: PMC7218763 DOI: 10.5334/gh.779] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Obesity is the most common chronic disease in adolescents. In adults, waist circumference (WC) is associated with the presence of cardiovascular risk factors and is also a better predictor of cardiovascular (CV) risk than body mass index (BMI). The association between WC and CV risk factors in adolescents has been poorly explored so far, mainly in those within the normal BMI range.
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Bitew ZW, Alemu A, Ayele EG, Tenaw Z, Alebel A, Worku T. Metabolic syndrome among children and adolescents in low and middle income countries: a systematic review and meta-analysis. Diabetol Metab Syndr 2020; 12:93. [PMID: 33117455 PMCID: PMC7590497 DOI: 10.1186/s13098-020-00601-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 10/19/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is a clustering of cardiovascular risk factors, which is rising in the low and middle income countries (LMICs). There are various studies with inconsistent findings that are inconclusive for policy makers and program planners. Thus, this systematic review and meta-analysis aimed at estimating the pooled prevalence of MetS and its components in LMICs. METHODS Electronic searches were conducted in international databases including PubMed, Web of Science, EMBASE (Elsevier), Scopus, CINAHL (EBSCOhost), Science direct (Elsevier), Food Science and Technology Abstracts (FSTA), Global Health and Medline, and other sources (World Cat, Google Scholar, and Google). The pooled estimates were computed in the random effect model. The pooled prevalence was computed using the three diagnostic methods (IDF, ATP III and de Ferranti). Publication bias was verified using funnel plot and Egger's regression test. Subgroup and sensitivity analysis were performed to identify the possible sources of heterogeneity among the included studies. RESULT In this study, 142,142 children and adolescents from 76 eligible articles were included to compute the pooled prevalence of MetS and its components in LMCIs. MeTs among overweight and obese population was computed from 20 articles with the pooled prevalence of 24.09%, 36.5%, and 56.32% in IDF, ATP III and de Ferranti criteria, respectively. Similarly, a total of 56 articles were eligible to compute the pooled prevalence of MetS in the general population of children and adolescents. Hence, Mets was found in 3.98% (IDF), 6.71% (ATP III) and 8.91% (de Ferranti) of study subjects. Regarding the components of MetS, abdominal obesity was the major component in overweight and obese population and low HDL-C was the most common component in the general population. This study also revealed that males were highly affected by MetS than females. CONCLUSION This study illustrates that MetS among children and adolescents is an emerging public health challenge in LMICs, where the prevalence of obesity is on the move. Preventive strategies such as community and school based intervention need to be designed. Promoting physical activities and healthy eating behaviors could avert this problem.
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Affiliation(s)
| | | | | | - Zelalem Tenaw
- College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Anmut Alebel
- College of Health Science, Debremarkose University, Debre Markos, Ethiopia
- Australian Centre for Public and Population Health Research, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW Australia
| | - Teshager Worku
- College of Health and Medical Sciences, School of Nursing and Midwifery, Haramaya University, Harar, Ethiopia
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Fazeli M, Mohammad-Zadeh M, Darroudi S, Meshkat Z, Moslem A, Ghazizadeh H, Kargozar S, Ferns G, Bahrami-Taghanaki H, Ghayour-Mobarhan M. New anthropometric indices in the definition of metabolic syndrome in pediatrics. Diabetes Metab Syndr 2019; 13:1779-1784. [PMID: 31235094 DOI: 10.1016/j.dsx.2019.03.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 03/14/2019] [Indexed: 02/02/2023]
Abstract
Pediatrics metabolic syndrome (MetS) may be associated with the risk of development of chronic diseases in adulthood; however, the definition of pediatric MetS is unclear, and may vary with ethnicity. The primary goal of this study was to determine the best anthropometric predictors for pediatric MetS. For this purpose, 988 high school girls were recruited. Anthropometric indices and biochemical parameters were measured using standard procedures. The adapted MetS for pediatrics, including the IDF, NCEP, and two modified-NCEPs (Cook's and DeFerranti's) were used to establish a diagnosis of MetS. Statistical analysis was performed using SPSS and MedCalc softwares. Except for body frame size (r), the values for anthropometric indices were significantly lower in an individual without MetS. Waist to height (WHtR), BMI and hip circumference (HiC) showed the strongest association with the different MetS definitions. For the IDF definition, the highest sensitivity and specificity were observed for HiC (100.0, 85.2) and WHtR (100.0, 84.7); while for the NCEP definition, the r index showed the highest sensitivity (85.0); but low specificity made it inapplicable. For the Cook's definition of MetS, wrist circumference (WrC), HiC, WHtR, BMI and SR had similar sensitivity values with WC (92.9%), and HiC (85.3%) have the highest specificity. WHtR (86.05, 80.5), SR (86.05, 82.7) and HiC (76.7, 87.0) sensitivity and specificity were the best indexes for DeFerranti's criteria. Based on this date, we concluded that HiC and WHtR might be helpful as auxiliary indexes for pediatric MetS definition; however, further studies are required in both genders.
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Affiliation(s)
- Mostafa Fazeli
- Molecular Medicine Group, Department of Modern Sciences and Technologies, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Mohammad-Zadeh
- Department of Physiology & Pharmacology, Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Susan Darroudi
- Molecular Medicine Group, Department of Modern Sciences and Technologies, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Meshkat
- Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Moslem
- Department of Anesthesiology, Faculty of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Hamideh Ghazizadeh
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saeid Kargozar
- Tissue Engineering Research Group (TERG), Department of Anatomy and Cell Biology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon Ferns
- Division of Medical Education, Brighton & Sussex Medical School, Falmer, Brighton, Sussex, BN1 9PH, UK
| | | | - Majid Ghayour-Mobarhan
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
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11
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Association of anthropometric indices with continuous metabolic syndrome in children and adolescents: the CASPIAN-V study. Eat Weight Disord 2018; 23:597-604. [PMID: 29094277 DOI: 10.1007/s40519-017-0455-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 10/19/2017] [Indexed: 01/03/2023] Open
Abstract
PURPOSE This study aims to examine the association of anthropometric indices with continuous metabolic syndrome (cMetS) among Iranian children and adolescents. METHODS This multicentric study was conducted on 14138 students aged 7-18 years, who participated in a national surveillance program. Fasting blood sample was obtained from a subsample of 3843 randomly selected students. Physical examination including the measurement of anthropometric indices and blood pressure was conducted; fasting blood glucose and lipid profile were measured; and cMetS score was computed. Standardized residuals (z-scores) were calculated for MetS components. A higher cMetS score indicates a less favorable metabolic profile. Linear regression models were applied to determine the association between cMetS and anthropometric indices. RESULTS The study participants consisted of 3843 children and adolescents (52.3% boys) with mean (SD) age of 12.45 ± 3.04 years. All anthropometric indices had positive correlation with standardized scores of mean arterial pressure, waist circumference and cMetS (P < 0.05). Standardized scores of triglycerides were positively correlated with weight and body mass index (P < 0.05). In multivariate model, general and abdominal obesity, as well as high circumferences of neck, wrist, and hip circumferences increased the standardized cMetS risk score to 1.8, 1.9, 1.6, 1.5 and 1.5, respectively (P < 0.05 for all variables). CONCLUSION The results demonstrated that higher anthropometric indices are associated with higher cMetS risk score in children and adolescents. This information could be valuable for screening and prevention of MetS at population level. LEVEL OF EVIDENCE V, cross-sectional descriptive study (National surveillance study).
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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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Heshmat R, Qorbani M, Shahr Babaki AE, Djalalinia S, Ataei-Jafari A, Motlagh ME, Ardalan G, Arefirad T, Rezaei F, Asayesh H, Kelishadi R. Joint Association of Screen Time and Physical Activity with Cardiometabolic Risk Factors in a National Sample of Iranian Adolescents: The CASPIANIII Study. PLoS One 2016; 11:e0154502. [PMID: 27167372 PMCID: PMC4864273 DOI: 10.1371/journal.pone.0154502] [Citation(s) in RCA: 21] [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: 01/05/2015] [Accepted: 04/14/2016] [Indexed: 02/06/2023] Open
Abstract
Metabolic syndrome (MetS) and its contributing factors are considered important health problems in the pediatric age group. This study was designed to assess the joint association of ST and PA with cardiometabolic risk factors among Iranian adolescents. A representative sample of 5625 (50.2% boys) school students with a mean age of 14.73 (SD: 2.41) were selected through multistage random cluster sampling method from urban and rural areas of 27 provinces in Iran. ST and PA were assessed by self-administered validated questionnaires. Anthropometric measures (height, weight and waist circumference (WC)) and MetS components (abdominal obesity, elevated blood pressure (BP), low high-density lipoprotein cholesterol (HDL-C), elevated triglycerides (TG) and high fasting blood sugar (FBG)) were measured according to standardized protocols. MetS was defined according to the Adult Treatment Panel III criteria modified for the pediatric age group. Moreover, elevated total cholesterol (TC), elevated low-density lipoprotein cholesterol (LDL-C), and generalized obesity were considered as other cardiometabolic risk factors. Students with high ST levels had significantly higher body mass index z-score (BMI z-score), WC, TG, LDL-C, and BP as well as lower HDL-C level; whereas those with high PA levels had significantly higher HDL-C levels as well as lower BMI z-score, TC, and BP. Adolescents with low PA/ high ST levels had significantly higher BMI, WC, LDL-C levels, as well as higher SBP and DBP compared to their other counterparts. In Multivariate model, joint effect of low PA/ high ST (compared to the high PA/low ST group) increased the odds of overweight, abdominal obesity and low HDL-C and decreased the odds of elevated TC. The findings of this study showed that joint association of high ST and low PA have direct association with abdominal obesity, overweight and low HDL-C and indirect association with elevated TC.
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Affiliation(s)
- Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Department of Community Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- * E-mail: (MQ); (RK)
| | - Amir Eslami Shahr Babaki
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Djalalinia
- Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Development of Research & Technology Center, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | - Asal Ataei-Jafari
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | | | - Gelayol Ardalan
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Tahereh Arefirad
- Department of Exercise Physiology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Fatemeh Rezaei
- Department of Social Medicine, Medical School, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Hamid Asayesh
- Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran
| | - Roya Kelishadi
- Pediatrics Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
- * E-mail: (MQ); (RK)
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Nkeh-Chungag BN, Mxhosa TH, Mgoduka PN. Association of waist and hip circumferences with the presence of hypertension and pre-hypertension in young South African adults. Afr Health Sci 2015; 15:908-16. [PMID: 26957981 PMCID: PMC4765434 DOI: 10.4314/ahs.v15i3.27] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Obesity is one of the most important risk factors for cardiovascular diseases (CVDs) including hypertension (HT) which is itself a risk factor for CVDs. Recent studies suggest that waist circumference (WC) may be more sensitive than Body Mass Index (BMI) in determining individual risk scores for CVDs. OBJECTIVES The current study aimed at investigating the influence of various anthropometric variables on blood pressure status in a group of students from Walter Sisulu University. METHODS Informed consent was obtained from 216 male and female students from Walter Sisulu University with a mean age of 22.1±0.2 years. Anthropometric measurements were performed for each participant. Blood pressure was measured in triplicates after 10 minutes of rest and the average computed. RESULTS Just over 46% of the subjects were diagnosed with hypertension (HT) and pre-HT. The gender specific prevalence of HT/pre-HT was higher in the male (76.7%) compared to the female (30.5%) group. Waist circumference (WC) and total body fat (TBF) correlated significantly with blood pressure and HT/pre-HT in females but not males. ROC analysis showed that with the exception of waist-to-hip (WHR), all other anthropometric measurements and ratios studied can be used to discriminate blood pressure in young adult females not males. CONCLUSION Increased WC and HC were associated with HT and pre-HT in young adult females in the Walter Sisulu University.
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Affiliation(s)
- Benedicta N Nkeh-Chungag
- Zoology Department, Faculty of Science Engineering & Technology, Walter Sisulu University, PBX1, Mthatha 5117, South Africa
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Martino F, Puddu PE, Pannarale G, Colantoni C, Zanoni C, Martino E, Barillà F. Metabolic syndrome among children and adolescents from Southern Italy: contribution from the Calabrian Sierras Community Study (CSCS). Int J Cardiol 2014; 177:455-60. [PMID: 25443246 DOI: 10.1016/j.ijcard.2014.09.020] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 08/23/2014] [Accepted: 09/16/2014] [Indexed: 02/06/2023]
Abstract
Among 1657 children and adolescents aged 6 to 14 years (787, 47% girls and 870, 53% boys) from primary and secondary schools in a 14-town Southern Italian community, HDL cholesterol (54 ± 15 mg/dl), triglycerides (61 ± 29 mg/dl), blood glucose (78 ± 10 mg/dl), systolic (101 ± 11 mm Hg) and diastolic (62 ± 10 mm Hg) blood pressures, waist circumference (WC) (66 ± 10 cm) and WC/height (0.46 ± 0.006) and triglycerides/HDL cholesterol (1.31 ± 0.99) ratios were measured. The distributions were similar in both genders. Age did not affect triglycerides/HDL cholesterol ratio, whereas there was a slightly positive correlation (p<0.00001) between WC/height and triglycerides/HDL cholesterol ratios. We present individual gender and age specific percentile distributions (as Supplementary materials). Using percentile cut-offs (≤ 10th for HDL cholesterol and ≥ 90th for the other components), there were 183 (11%) children or adolescents with low HDL cholesterol, 162 (9.77%) with high triglycerides, 178 (10.74%) with high blood glucose, 178 (10.74%) with high WC, 244 (20.76%) with high systolic or diastolic BP and 126 (7.6%) with high systolic and diastolic BP. Abnormally high BP was seen in 470 (28.36%) children or adolescents. Using abnormal percentile values of 3 of 5 of its components, metabolic syndrome (MS) was diagnosed in 70 (4.2%) subjects, similarly in both genders. To assess out-of-limit distributions of all 5 individual MS components in children and adolescents gender- and age-distributions derived from local epidemiological data should be used: these distributions are presented and they might now be used both for comparative and applicative purposes at least in Southern Europe.
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Affiliation(s)
- Francesco Martino
- Department of Pediatrics and Child Neuropsychiatry, Sapienza University of Rome, Rome, Italy.
| | - Paolo Emilio Puddu
- Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences, Sapienza University of Rome, Rome, Italy.
| | - Giuseppe Pannarale
- Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences, Sapienza University of Rome, Rome, Italy.
| | - Chiara Colantoni
- Department of Pediatrics and Child Neuropsychiatry, Sapienza University of Rome, Rome, Italy.
| | - Cristina Zanoni
- Department of Pediatrics and Child Neuropsychiatry, Sapienza University of Rome, Rome, Italy.
| | - Eliana Martino
- Department of Pediatrics and Child Neuropsychiatry, Sapienza University of Rome, Rome, Italy.
| | - Francesco Barillà
- Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences, Sapienza University of Rome, Rome, Italy.
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Saragusty J, Shavit-Meyrav A, Yamaguchi N, Nadler R, Bdolah-Abram T, Gibeon L, Hildebrandt TB, Shamir MH. Comparative skull analysis suggests species-specific captivity-related malformation in lions (Panthera leo). PLoS One 2014; 9:e94527. [PMID: 24718586 PMCID: PMC3981823 DOI: 10.1371/journal.pone.0094527] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Accepted: 03/18/2014] [Indexed: 11/24/2022] Open
Abstract
Lion (Panthera leo) populations have dramatically decreased worldwide with a surviving population estimated at 32,000 across the African savannah. Lions have been kept in captivity for centuries and, although they reproduce well, high rates of stillbirths as well as morbidity and mortality of neonate and young lions are reported. Many of these cases are associated with bone malformations, including foramen magnum (FM) stenosis and thickened tentorium cerebelli. The precise causes of these malformations and whether they are unique to captive lions remain unclear. To test whether captivity is associated with FM stenosis, we evaluated 575 lion skulls of wild (N = 512) and captive (N = 63) origin. Tiger skulls (N = 276; 56 captive, 220 wild) were measured for comparison. While no differences were found between males and females or between subadults and adults in FM height (FMH), FMH of captive lions (17.36±3.20 mm) was significantly smaller and with greater variability when compared to that in wild lions (19.77±2.11 mm). There was no difference between wild (18.47±1.26 mm) and captive (18.56±1.64 mm) tigers in FMH. Birth origin (wild vs. captive) as a factor for FMH remained significant in lions even after controlling for age and sex. Whereas only 20/473 wild lions (4.2%) had FMH equal to or smaller than the 5th percentile of the wild population (16.60 mm), this was evident in 40.4% (23/57) of captive lion skulls. Similar comparison for tigers found no differences between the captive and wild populations. Lions with FMH equal to or smaller than the 5th percentile had wider skulls with smaller cranial volume. Cranial volume remained smaller in both male and female captive lions when controlled for skull size. These findings suggest species- and captivity-related predisposition for the pathology in lions.
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Affiliation(s)
- Joseph Saragusty
- Department of Reproduction Management, Leibniz Institute for Zoo and Wildlife Research, Berlin, Germany
- * E-mail:
| | - Anat Shavit-Meyrav
- Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Nobuyuki Yamaguchi
- Wildlife Conservation Research Unit, Department of Zoology, University of Oxford, Tubney, Abingdon, United Kingdom
| | - Rona Nadler
- Zoological Center Tel Aviv-Ramat Gan, Ramat Gan, Israel
| | - Tali Bdolah-Abram
- Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Laura Gibeon
- NYC Veterinary Specialists, New York, New York, United States of America
| | - Thomas B. Hildebrandt
- Department of Reproduction Management, Leibniz Institute for Zoo and Wildlife Research, Berlin, Germany
| | - Merav H. Shamir
- Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
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Kelishadi R, Poursafa P. A review on the genetic, environmental, and lifestyle aspects of the early-life origins of cardiovascular disease. Curr Probl Pediatr Adolesc Health Care 2014; 44:54-72. [PMID: 24607261 DOI: 10.1016/j.cppeds.2013.12.005] [Citation(s) in RCA: 103] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Accepted: 12/04/2013] [Indexed: 12/29/2022]
Abstract
This article is a comprehensive review on developmental origins of health and disease regarding various factors related to the origins of cardiovascular diseases from early life. It presents a summary of the impacts of various factors such as epigenetics; gene-environment interaction; ethnic predisposition to cardiovascular diseases and their underlying risk factors; prenatal factors; fetal programming; maternal weight status and weight gain during pregnancy; type of feeding during infancy; growth pattern during childhood; obesity; stunting; socioeconomic status; dietary and physical activity habits; active, secondhand, and thirdhand smoking, as well as environmental factors including air pollution and global climate change on the development and progress of cardiovascular diseases and their risk factors. The importance of early identification of predisposing factors for cardiovascular diseases for primordial and primary prevention of cardiovascular diseases from early life is highlighted.
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Affiliation(s)
- Roya Kelishadi
- Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran; Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parinaz Poursafa
- Environment Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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