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Dinpanah K, Kazemi T, Shetty S, Bizhaem SK, Fanoodi A, Riahi SM. The association of the apolipoprotein B/A1 ratio and the metabolic syndrome in children and adolescents: a systematic review and meta-analysis. J Diabetes Metab Disord 2024; 23:1-10. [PMID: 38932877 PMCID: PMC11196517 DOI: 10.1007/s40200-023-01235-z] [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: 01/28/2023] [Accepted: 05/03/2023] [Indexed: 06/28/2024]
Abstract
Objectives Metabolic syndrome (MetS) is a constellation of coexisting cardiovascular risk factors. This study aimed to assess the evidence for the association between the apolipoprotein B/A1 ratio, apolipoprotein B, and apolipoprotein A1, and the MetS in children and adolescents. Methods The English electronic databases including PubMed, Embase, Web of Science, and Scopus were searched up to February 28, 2022. To ascertain the validity of eligible studies, modified JBI scale was used. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were pooled using the random-effects model to evaluate the association between the apolipoprotein B/A1 ratio, apolipoprotein B, and apolipoprotein A1 and the MetS. Heterogeneity amongst the studies was determined by the use of the Galbraith diagram, Cochran's Q-test, and I2 test. Publication bias was assessed using Egger's and Begg's tests. Results From 7356 records, 5 studies were included in the meta-analysis, representing a total number of 232 participants with MetS and 1320 participants as control group. The results indicated that increased levels of apolipoprotein B/A1 ratio (SMD 1.26; 95% CI: 1.04, 1.47) and apolipoprotein B (SMD 0.75; 95% CI: 0.36, 1.14) and decreased levels of apolipoprotein A1 (SMD -0.53; 95% CI: -0.69, -0.37) are linked to the presence of MetS. The notable findings were, children and adolescents with MetS had elevated levels of the apolipoprotein B/A1 ratio, apolipoprotein B, and decreased levels of apolipoprotein A1. Conclusions Our results suggest the need to evaluate the levels of apolipoproteins for detecting the risk of MetS in children and adolescents. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-023-01235-z.
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Affiliation(s)
- Kayhan Dinpanah
- Student Research Committee, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Toba Kazemi
- Cardiovascular Diseases Research Center, Department of Cardiology, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Sameep Shetty
- Department of oral and maxillofacial surgery Manipal college of dental sciences Mangalore 575001, Manipal academy of higher education. A constituent unit of MAHE, Manipal, India
| | - Saeede Khosravi Bizhaem
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Ali Fanoodi
- Student Research Committee, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Seyed Mohammad Riahi
- Department of Community Medicine, School of Medicine, Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
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Tragomalou A, Paltoglou G, Manou M, Kostopoulos IV, Loukopoulou S, Binou M, Tsitsilonis OE, Bacopoulou F, Kassari P, Papadopoulou M, Mastorakos G, Charmandari E. Non-Traditional Cardiovascular Risk Factors in Adolescents with Obesity and Metabolic Syndrome May Predict Future Cardiovascular Disease. Nutrients 2023; 15:4342. [PMID: 37892418 PMCID: PMC10609627 DOI: 10.3390/nu15204342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/28/2023] [Accepted: 10/03/2023] [Indexed: 10/29/2023] Open
Abstract
Obesity in adolescence is associated with significant morbidity and predisposes adolescents to the development of cardiovascular disease (CVD). Although a number of traditional CVD risk factors have been identified in youth, limited data exist regarding non-traditional CVD risk factors. In 89 adolescents with metabolic syndrome (MetS), with 60 age-, gender-, and BMI-matched controls, we determined the non-traditional CVD risk factors (hs-CRP, TG/HDL ratio, ApoB/ApoA1 ratio, NAFLD) in order to investigate whether they may be used as biomarkers for predicting future CVD, and we evaluated their response to the implementation of a multidisciplinary, personalized, lifestyle intervention program for 1 year. We demonstrated that the TG/HDL ratio, IL-2, IL-6, IL-17A, and INF-γ were significantly increased in subjects with MetS than in controls, and may be used as biomarkers to predict future CVD. Subjects with MetS had an increased mean carotid intima-media thickness (cIMT) and prevalence of NAFLD than the controls, while the prevalence of NAFLD correlated strongly with cIMT and IL-6 concentrations. Most of the non-traditional cardiovascular risk factors improved following the implementation of a lifestyle intervention program. These findings indicate that adolescents with MetS may have a greater risk for developing atherosclerosis early in life, while early lifestyle intervention is crucial for preventing the arteriosclerotic process in youth.
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Affiliation(s)
- Athanasia Tragomalou
- Center for the Prevention and Management of Overweight and Obesity, Division of Clinical and Translational Research in Endocrinology, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece; (A.T.); (G.P.); (M.M.); (M.B.); (P.K.); (M.P.)
- Division of Endocrinology and Metabolism, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece
| | - George Paltoglou
- Center for the Prevention and Management of Overweight and Obesity, Division of Clinical and Translational Research in Endocrinology, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece; (A.T.); (G.P.); (M.M.); (M.B.); (P.K.); (M.P.)
- Division of Endocrinology and Metabolism, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece
| | - Maria Manou
- Center for the Prevention and Management of Overweight and Obesity, Division of Clinical and Translational Research in Endocrinology, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece; (A.T.); (G.P.); (M.M.); (M.B.); (P.K.); (M.P.)
| | - Ioannis V. Kostopoulos
- Flow Cytometry Unit, Section of Animal and Human Physiology, Department of Biology, National and Kapodistrian University of Athens, 15784 Athens, Greece; (I.V.K.); (O.E.T.)
| | - Sofia Loukopoulou
- Department of Pediatric Cardiology, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece;
| | - Maria Binou
- Center for the Prevention and Management of Overweight and Obesity, Division of Clinical and Translational Research in Endocrinology, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece; (A.T.); (G.P.); (M.M.); (M.B.); (P.K.); (M.P.)
| | - Ourania E. Tsitsilonis
- Flow Cytometry Unit, Section of Animal and Human Physiology, Department of Biology, National and Kapodistrian University of Athens, 15784 Athens, Greece; (I.V.K.); (O.E.T.)
| | - Flora Bacopoulou
- Center for Adolescent Medicine in Adolescent Health Care, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece;
| | - Penio Kassari
- Center for the Prevention and Management of Overweight and Obesity, Division of Clinical and Translational Research in Endocrinology, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece; (A.T.); (G.P.); (M.M.); (M.B.); (P.K.); (M.P.)
- Division of Endocrinology and Metabolism, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece
| | - Marina Papadopoulou
- Center for the Prevention and Management of Overweight and Obesity, Division of Clinical and Translational Research in Endocrinology, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece; (A.T.); (G.P.); (M.M.); (M.B.); (P.K.); (M.P.)
| | - George Mastorakos
- Division of Endocrinology, Diabetes Mellitus and Metabolism, Second Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens Medical School, ‘Aretaieion’ University Hospital, 11527 Athens, Greece;
| | - Evangelia Charmandari
- Center for the Prevention and Management of Overweight and Obesity, Division of Clinical and Translational Research in Endocrinology, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece; (A.T.); (G.P.); (M.M.); (M.B.); (P.K.); (M.P.)
- Division of Endocrinology and Metabolism, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece
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Antani M, Oza C, Khadilkar V, Gondhalekar K, Khadilkar A. Utility of apolipoprotein ratio in predicting metabolic risk and microvascular complications in Indian children and young adults with type 1 diabetes mellitus. J Pediatr Endocrinol Metab 2023:jpem-2022-0403. [PMID: 37141397 DOI: 10.1515/jpem-2022-0403] [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: 08/12/2022] [Accepted: 04/17/2023] [Indexed: 05/06/2023]
Abstract
OBJECTIVES To assess the relationship of apolipoproteins with glycemic control and insulin resistance (IR) in Indian children and youth with type-1 diabetes (T1D) and to assess its utility in predicting metabolic risk (MR) and microvascular complications in these subjects. METHODS This cross-sectional study included 152 participants aged 6-23 years with T1D. Demographic, anthropometric, clinical, biochemical and body composition data were obtained using standard protocols. IR was calculated using estimated glucose disposal rate (eGDR) and metabolic syndrome (MS) was diagnosed using the international diabetes federation consensus definition 2017. RESULTS Apolipoprotein ratio in subjects with T1D had negative and positive correlation with eGDR and HbA1c respectively. Positive correlation of Apolipoproten B and apolipoprotein ratio with urinary albumin creatinine ratio is noted. The ratio had area under curve of 0.766 and 0.737 to predict MR and microvascular complications respectively. The ratio cut-off of 0.536 yielded 77.1 % sensitivity and 61 % specificity to predict MR. On adding the apolipoprotein ratio as a predictor to the regression model developed to predict MR, the R2 and accuracy improved. CONCLUSIONS The apolipoprotein ratio had significant correlation with IR, microalbuminuria and glycaemic control. The ratio also predicts risk of development of microvascular complications and maybe used to predict MR in subjects with T1D.
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Affiliation(s)
- Misha Antani
- Hirabai Cowasji Jehangir Medical Research Institute, Pune, India
| | - Chirantap Oza
- Hirabai Cowasji Jehangir Medical Research Institute, Pune, India
| | - Vaman Khadilkar
- Hirabai Cowasji Jehangir Medical Research Institute, Pune, India
- Senior Paediatric Endocrinologist, Jehangir Hospital, Pune and Bombay Hospital, Pune, India
- Department of Health Sciences, Savitribai Phule Pune University, Pune, Maharashtra, India
| | | | - Anuradha Khadilkar
- Hirabai Cowasji Jehangir Medical Research Institute, Pune, India
- Department of Health Sciences, Savitribai Phule Pune University, Pune, Maharashtra, India
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Gómez-Pérez S, Ovando-Gómez V, Hernández-Contreras AC, Herón-Petri M, Díaz-López HO, García-Miranda R, Irecta-Nájera CA. Atherogenic indices in pediatric population in South-Southeast region of Mexico. J Trop Pediatr 2022; 68:6827489. [PMID: 36375036 DOI: 10.1093/tropej/fmac099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Atherosclerosis is a cardiovascular disease, highly predictable, and associated with different atherogenic indices (AI) in adults. However, such indexes in the pediatric population are far less explored. The objective of this study was to evaluate the AI and the cardiovascular factors in the pediatric population in the South-Southeast of México. METHODS A total of 481 children between 2 and 17 years old were recruited. Anthropometric evaluation, blood pressure (BP), lipid profile, apolipoprotein A-I (ApoA-I) and apolipoprotein B (ApoB) were measured, and AI were calculated. The population was grouped by age, binary logistic regression analysis was performed to analysis for associations of AI and cardiovascular risk factors. Sensibility and specificity of AI to detect metabolic alteration were evaluated for curve ROC. RESULTS The atherogenic risk presented a high prevalence in the pediatric population, such as LDL-c/ApoB (86.9%), AIP (78%) and AC (36.6%). Preschoolers showed a higher risk of ApoB/ApoA-I and ApoB/LDL-c, while adolescents have a high risk of AIP. CRI-I and AC were associated with elements of lipid profile and body mass index (BMI). ROC curves analysis shows that AIP is the best index evaluating metabolic syndrome (MS) (0.87) and dyslipidemia (0.91). CONCLUSION Such pediatric population showed a high risk of AI, mainly by LDL-c/ApoB and AIP. The BMI was the cardiovascular risk factors most frequently related to AI, AIP is the best index for detecting cases of MS and dyslipidemia. This is the first study carried out in the pediatric population from the South-Southeast of Mexico that evaluated the AI.
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Affiliation(s)
- Samuel Gómez-Pérez
- Health Department, El Colegio de la Frontera Sur, 86280 Villahermosa, Tabasco, Mexico
| | - Valeria Ovando-Gómez
- Health Department, El Colegio de la Frontera Sur, 86280 Villahermosa, Tabasco, Mexico
| | - Armando Camilo Hernández-Contreras
- Department of Pediatrics, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Comitán de Domínguez Chiapas 30090, Mexico
| | - Marcelo Herón-Petri
- Department of Cardiothoracic and Vascular Surgery, Örebro University Hospital, 70185 Örebro, Sweden
| | | | - Rosario García-Miranda
- Health Department, El Colegio de la Frontera Sur, 29290 San Cristóbal de las Casas, Mexico
- School of Languages-Campus San Cristóbal, Autonomous University of Chiapas, 29264 San Cristóbal de las Casas, Mexico
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Matricciani L, Dumuid D, Paquet C, Fraysse F, Wang Y, Baur LA, Juonala M, Ranganathan S, Lycett K, Kerr JA, Burgner D, Wake M, Olds T. Sleep and cardiometabolic health in children and adults: examining sleep as a component of the 24-h day. Sleep Med 2020; 78:63-74. [PMID: 33387878 DOI: 10.1016/j.sleep.2020.12.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 11/30/2020] [Accepted: 12/01/2020] [Indexed: 10/22/2022]
Abstract
STUDY OBJECTIVES Sleep, physical activity and sedentary time are all known to play a role in cardiometabolic health. Compositional data analysis (CoDA) enables us to examine associations between 24-h use of time and health outcomes. METHODS Data were collected in the Child Health CheckPoint study, a one-off national population-cohort study conducted between February 2015 and March 2016. Wrist-worn actigraphy monitors (GENEActiv Original, Cambs, UK) were used to measure activity behaviours (sleep, physical activity and sedentary time) and sleep characteristics (sleep variability, midsleep, efficiency). CoDA was applied to determine the association between 24-h use of time and cardiometabolic risk markers (blood pressure; body mass index; apolipoprotein B/A1; glycoprotein acetyls; and composite metabolic syndrome score). Substitution modelling (one-for-remaining and one-for-one) examined the associations of reallocating sleep time with other activity behaviours. RESULTS Data were available for 1073 Australian children aged 11-12 years (50% male) and 1337 adults (13% male). Strong association was found between 24-h use of time and all cardiometabolic health outcomes. Longer sleep was associated with more favourable cardiovascular health. Sleep characteristics other than duration (efficiency, timing, variability) were weakly and inconsistently associated with outcomes. Reallocating time from sleep to moderate-vigorous physical activity (MVPA) had favourable associations with cardiometabolic health, but reallocating from sleep to sedentary time was associated with less favourable cardiometabolic health. CONCLUSION The 24-h activity composition is strongly associated with cardiometabolic health in children and adults. Days with more sleep and MVPA are associated with improved cardiometabolic health.
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Affiliation(s)
- Lisa Matricciani
- Allied Health and Human Performance, Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, Australia.
| | - Dorothea Dumuid
- Allied Health and Human Performance, Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, Australia
| | - Catherine Paquet
- Australian Centre for Precision Health, University of South Australia, Adelaide, SA, Australia; Faculté des Sciences de l'Administration, Université Laval, Québec, QC, Canada
| | - François Fraysse
- Allied Health and Human Performance, Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, Australia
| | - Yichao Wang
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia; Murdoch Children's Research Institute, Parkville, VIC, Australia
| | | | - Markus Juonala
- Department of Medicine, University of Turku, Turku, Finland; Division of Medicine, Turku University Hospital, Turku, Finland
| | - Sarath Ranganathan
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia; Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Kate Lycett
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia; Murdoch Children's Research Institute, Parkville, VIC, Australia; The Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, Victoria, Australia
| | - Jessica A Kerr
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia; Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - David Burgner
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia; Murdoch Children's Research Institute, Parkville, VIC, Australia; Department of Paediatrics, Monash University, Clayton, Victoria, Australia
| | - Melissa Wake
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia; The University of Auckland, Grafton, Auckland, New Zealand; Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Tim Olds
- Allied Health and Human Performance, Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, Australia
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Abstract
PURPOSE OF REVIEW Cardiovascular (CV) disease is a major cause of mortality in type 2 diabetes mellitus (T2D). Dyslipidemia is prevalent in children with T2D and is a known risk factor for CVD. In this review, we critically examine the epidemiology, pathophysiology, and recommendations for dyslipidemia management in pediatric T2D. RECENT FINDINGS Dyslipidemia is multifactorial and related to poor glycemic control, insulin resistance, inflammation, and genetic susceptibility. Current guidelines recommend lipid screening after achieving glycemic control and annually thereafter. The desired lipid goals are low-density lipoprotein cholesterol (LDL-C) < 100 mg/dL, high-density lipoprotein cholesterol (HDL-C) > 35 mg/dL, and triglycerides (TG) < 150 mg/dL. If LDL-C remains > 130 mg/dL after 6 months, statins are recommended with a treatment goal of < 100 mg/dL. If fasting TG are > 400 mg/dL or non-fasting TG are > 1000 mg/dL, fibrates are recommended. Although abnormal levels of atherogenic TG-rich lipoproteins, apolipoprotein B, and non-HDL-C are commonly present in pediatric T2D, their measurement is not currently considered in risk assessment or management.
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Affiliation(s)
- Bhuvana Sunil
- Department of Pediatrics, Division of Endocrinology and Diabetes, University of Alabama at Birmingham, CPPII M30, 1601 4th Ave S, Birmingham, AL, 35233, USA
| | - Ambika P Ashraf
- Department of Pediatrics, Division of Endocrinology and Diabetes, University of Alabama at Birmingham, CPPII M30, 1601 4th Ave S, Birmingham, AL, 35233, USA.
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Marín-Echeverri C, Aristizábal JC, Gallego-Lopera N, Santa-Ramírez HA, Hoyos-Gómez M, Ruiz-Pineda AM, Arias AA, Barona-Acevedo J. Cardiometabolic risk factors in preschool children with abdominal obesity from Medellín, Colombia. J Pediatr Endocrinol Metab 2018; 31:1179-1189. [PMID: 30367807 DOI: 10.1515/jpem-2018-0140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 09/20/2018] [Indexed: 11/15/2022]
Abstract
Background Abdominal obesity (AO) is linked to inflammation and insulin resistance (IR). However, there is limited information on whether preschoolers with AO present these risk factors. We evaluated the association between AO and cardiovascular risk factors in preschoolers. Methods We enrolled 232 children (2-5 years), of whom 50% had AO. Serum total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-c), high-density lipoprotein-cholesterol (HDL-c), triglycerides (TG), apolipoprotein B (Apo-B) and apolipoprotein A-1 (Apo-A1), glucose, insulin, high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-alpha (TNF-α), interleukin (IL)-6, IL-1β, monocyte chemoattractant protein (MCP-1/CCL2), leptin, adiponectin, vascular cell adhesion molecule (VCAM-1/CD106) and intercellular adhesion molecule (ICAM-1/CD54) were measured. The homeostatic model assessment of IR (HOMA-IR) was calculated. We analyzed these variables according to the presence of AO and other metabolic syndrome (MetS) components. Results A total of 75.8% of children with AO had one or more risk factors for MetS. Children with AO had significantly higher body mass indexes (BMIs), insulin, HOMA-IR, TG, very low-density lipoprotein-cholesterol (VLDL-c) and TC/HDL-c ratio and lower HDL-c, compared to children without AO; but there were no differences in inflammatory markers. After adjusting for BMI, sex and age, the differences between groups were not significant for any variable. Waist circumference (WC) was correlated with insulin (r=0.547; p<0.001), TG (r=0.207; p=0.001), ICAM-1 (r=0.213; p=0.039), hs-CRP (r=0.189; p=0.015) and glucose (r=0.187; p=0.004). After adjusting for BMI, age and sex, AO plus one MetS component contributed to individual variation in glucose, insulin, HOMA-IR and TG. Conclusions AO in preschool children is associated with greater IR and atherogenic lipid profiles, although these findings seem to be more related to general obesity than just central obesity. In addition, our data suggest that IR may precede the elevation of systemic cytokines in obese children, unlike findings in adults. More studies in pediatric populations are needed to elucidate these associations.
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Affiliation(s)
| | - Juan C Aristizábal
- Grupo de Investigación de Fisiología y Bioquímica (PHYSIS), Escuela de Nutrición y Dietética, Universidad de Antioquia UdeA, Medellín, Colombia
| | - Natalia Gallego-Lopera
- Grupo Biociencias, Facultad de Ciencias de la Salud, Institución Universitaria Colegio Mayor de Antioquia-IUCMA, Grupo Biología de Sistemas, Facultad de Medicina, Universidad Pontificia Bolivariana-UPB, Medellín, Colombia
| | | | - Marcela Hoyos-Gómez
- Unidad de Seguridad Alimentaria, Secretaría de Inclusión Social y Familia, Alcaldía de Medellín, Medellín, Colombia
| | - Adriana Marcela Ruiz-Pineda
- Unidad de Seguridad Alimentaria, Secretaría de Inclusión Social y Familia, Alcaldía de Medellín, Medellín, Colombia.,Escuela de Nutrición y Dietética, Universidad de Antioquia UdeA, Medellín, Colombia
| | - Andrés A Arias
- Grupo de Inmunodeficiencias Primarias, Universidad de Antioquia UdeA, Medellín, Colombia
| | - Jacqueline Barona-Acevedo
- Línea de alternativas terapéuticas y alimentarias, Grupo de Ofidismo, Escuela de Microbiología, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia
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VRABLÍK M, DOBIÁŠOVÁ M, ZLATOHLÁVEK L, URBANOVÁ Z, ČEŠKA R. Biomarkers of Cardiometabolic Risk in Obese/Overweight Children: Effect of Lifestyle Intervention. Physiol Res 2014; 63:743-52. [DOI: 10.33549/physiolres.932895] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Obesity is a strong cardiometabolic (CM) risk factor in children. We tested potential CM risk in obese/overweight children and the effect of an intensive lifestyle intervention using newer CM markers: atherogenic index of plasma AIP [Log(TG/HDL-C)], apoB/apoAI ratio and a marker of insulin resistance HOMA-IR. The participants (194 girls, 115 boys, average age 13) were enrolled in an intensive, one-month, inpatient weight reduction program. The program consisted of individualised dietary changes and the exercise program comprised aerobic and resistance training. Anthropometrical and biochemical parameters in plasma and CM risk biomarkers – (AIP, apoB/apoAI ratio and HOMA-IR) were examined before and after the intervention. AIP and HOMA-IR significantly correlated with BMI while apoB/apoAI ratio did not. Only AIP and HOMA-IR showed systematic increases according to the level of obesity by BMI quartiles. Lifestyle intervention significantly improved anthropometrical and biochemical values and the biomarkers too. The response of lipid parameters to the intervention was considerably higher in boys than in girls. The children were stratified into three risk categories according to AIP, where 13.8 % of boys and 5.3 % of girls fell into high risk category. The monitored biomarkers may complement each other in the prognosis of CM risk. AIP was strongly related to obesity and to lipid and glycid metabolism, while the relationship of the apoB/apoAI ratio to obesity and glycid metabolism was not significant. The obese children benefited from the intensive lifestyle intervention which improved the anthropometrical and biochemical parameters and CM risk biomarkers.
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Affiliation(s)
| | - M. DOBIÁŠOVÁ
- Institute of Physiology Academy of Sciences of the Czech Republic, Prague, Czech Republic
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Beyond the Standard Lipid Profile: What is Known about Apolipoproteins, Lp(a), and Lipoprotein Particle Distributions in Children. CURRENT CARDIOVASCULAR RISK REPORTS 2014. [DOI: 10.1007/s12170-014-0381-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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10
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McDonald EL, Bailie RS, Morris PS. Participatory systems approach to health improvement in Australian Aboriginal children. Health Promot Int 2014; 32:62-72. [DOI: 10.1093/heapro/dau003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Tamang HK, Timilsina U, Singh KP, Shrestha S, Raman RK, Panta P, Karna P, Khadka L, Dahal C. Apo B/Apo A-I Ratio is Statistically A Better Predictor of Cardiovascular Disease (CVD) than Conventional Lipid Profile: A Study from Kathmandu Valley, Nepal. J Clin Diagn Res 2014; 8:34-6. [PMID: 24701475 DOI: 10.7860/jcdr/2014/7588.4000] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2013] [Accepted: 11/25/2013] [Indexed: 11/24/2022]
Abstract
BACKGROUND Apo B and Apo A-I, are structural and functional components of lipoprotein particles that serve as transporters of cholesterol. The apo B/apo A-I ratio reflects the cholesterol transport and has been shown to be strongly related to risk of Myocardial infarction, stroke and other Cardiovascular manifestations. MATERIALS AND METHODS Forty five participants with Cardiovascular Disease (CVD) and forty four healthy participants were included from different locations of Kathmandu valley, Nepal. Fasting blood samples were collected from ante-cubital vein and serum samples were used for lipid parameters, apo B and apo A-I levels measurement. RESULTS Statistically significant differences were found for apo B/apo A-I ratio, HDL-c and apo B between the groups. The other lipid parameters and lipid ratios such as total cholesterol, triglyceride, low density lipoprotein, TC/HDL-c, TG/HDL-c and LDL-c/HDL-c were not found to be significant. CONCLUSION Apo B/apo A-I ratio seems to have better predictive value than that of classical lipid parameters in cardiovascular risk assessment.
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Affiliation(s)
- Hem Kumar Tamang
- Lecturer, Department of Biochemistry, Kantipur Dental College Teaching Hospital , Dhapasi, Basundhara, Kathamandu, Nepal
| | - Uddhav Timilsina
- Phd Scholar, Department of Life Sciences and Biotechnology, South Asian University , New Delhi, India
| | - Khelanand Prasad Singh
- Lecturer, Department of Biochemistry, Institute of Medicine (TUTH) , Maharajgunj, Kathmandu, Nepal
| | - Sanjit Shrestha
- Medical Laboratory Technologist, Department of Pathology, Kathmandu Model Hospital , Exhibition Road, Kathmandu, Nepal
| | - Ramendra Kumar Raman
- Lecturer, Department of Anatomy, Kantipur Dental college Teaching Hospital , Dhapasi, Basundhara, Kathmandu, Nepal
| | - Pujan Panta
- Faculty, Department of Medical Laboratory Technology, Nobel College , Sinamangal, Kathmandu, Nepal
| | - Preeti Karna
- Faculty, Department of Medical Laboratory Technology, Nobel College , Sinamangal, Kathmandu, Nepal
| | - Laxmi Khadka
- Faculty, Department of Medical Laboratory Technology, Nobel College , Sinamangal, Kathmandu, Nepal
| | - Chandika Dahal
- Faculty, Department of Medical Laboratory Technology, Nobel College , Sinamangal, Kathmandu, Nepal
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Rodríguez-Moran M, Aradillas-García C, Guerrero-Romero F. The ApoB/A-I Ratio and Metabolic Syndrome in Prepubertal Children. Metab Syndr Relat Disord 2013; 11:115-20. [DOI: 10.1089/met.2012.0124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Non-traditional markers of metabolic risk in prepubertal children with different levels of cardiorespiratory fitness. Public Health Nutr 2012; 15:1827-34. [PMID: 22244458 DOI: 10.1017/s1368980011003533] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To assess classical and non-classical metabolic risk biomarkers in prepubertal children with different levels of cardiorespiratory fitness (CRF). DESIGN CRF was assessed by the 20 m shuttle run test. To estimate physical activity, participants were observed while engaged in an after-school programme. Additionally, a short test based on a validated questionnaire was used to obtain information about physical activity practice and sedentary habits. Anthropometric parameters, blood pressure, and classical and non-traditional metabolic risk biomarkers--plasma lipid profile, glucose and insulin, homeostasis model assessment-insulin resistance index (HOMA-IR), plasma uric acid, transaminases and C-reactive protein (CRP)--were measured. SETTING The study was conducted in local elementary schools in Córdoba, Spain. SUBJECTS One hundred and forty-one healthy children (eighty-eight boys, fifty-three girls) aged 7-12 years, in Tanner stage I, were recruited. They were divided into two groups after they performed the 20 m shuttle run test: equal or higher cardiovascular fitness (EHCF) group and low cardiovascular fitness (LCF) group. RESULTS The LCF group displayed significantly higher TAG (P = 0.004) and lower HDL cholesterol levels (P = 0.001), as well as significantly lower values for the non-traditional lipid marker apo-A1 (P = 0.001) compared with the EHCF group. The LCF children displayed higher plasma glucose (P = 0.003) and insulin levels, higher HOMA-IR scores (P < 0.001) and higher plasma uric acid and CRP levels (P < 0.05). After adjustment for BMI, age and sex, no statistically significant differences were found between groups for the biomarkers analysed. CONCLUSIONS The study provides new information to understand the role not only of weight status but also of the level of CRF on the metabolic health profile of prepubertal children.
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Galata Z, Moschonis G, Makridakis M, Dimitraki P, Nicolaides NC, Manios Y, Bartzeliotou A, Chrousos GP, Charmandari E. Plasma proteomic analysis in obese and overweight prepubertal children. Eur J Clin Invest 2011; 41:1275-83. [PMID: 21569026 DOI: 10.1111/j.1365-2362.2011.02536.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Childhood obesity represents one of the most challenging health problems of our century and is associated with significant morbidity and mortality in adult life. Proteomics is a large-scale analysis of proteins, which provides, information on protein expression levels, post-translational modifications, subcellular localization and interactions. OBJECTIVE To investigate whether obesity in childhood is associated with alterations in plasma protein expression profiles. METHODS Plasma samples from 10 obese [age: 10·75 ± 0·16 year; body mass index (BMI): 27·50 ± 0·69 kg m(-2) ], 10 overweight (age: 10·54 ± 0·1 year; BMI: 21·88 ± 0·28 kg m(-2) ) and 10 normal-weight (age: 10·89 ± 0·19 year; BMI: 18·34 ± 0·42kg m(-2) ) prepubertal boys were subjected to protein fractionation and analysed by two-dimensional electrophoresis, followed by protein identification using matrix-assisted laser desorption time-of-flight mass spectrometry. Fasting plasma glucose and serum insulin, lipid and apolipopoprotein concentrations were determined in all subjects. RESULTS The expression of apolipoprotein (Apo) A-I (ApoA-I) was significantly lower in obese and overweight children compared with children of normal BMI (P < 0·05). The expression of ApoE was significantly lower in overweight compared with normal-weight children (P < 0·05), while that of ApoA-IV was significantly higher in obese children compared with their normal counterparts (P < 0·01). Serum ApoA-I concentrations were significantly lower in obese (147 ± 4·27mg dL(-1) ) and overweight (145·5 ± 9·65mg dL(-1) ) than in normal-weight (157 ± 8·77mg dL(-1) ; P = 0·036) children. CONCLUSIONS Obese and overweight prepubertal children demonstrated prominent alterations in the expression of plasma apolipoproteins compared with their normal counterparts. Low ApoA-I plasma expression levels and serum concentrations in obesity might be present in childhood before any significant alterations in total or high-density lipoprotein-cholesterol concentrations are documented. We recommend that serum ApoA-I concentrations are determined in all overweight and obese children.
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Affiliation(s)
- Zoi Galata
- Division of Endocrinology and Metabolism, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
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Lee YH, Choi SH, Lee KW, Kim DJ. Apolipoprotein B/A1 ratio is associated with free androgen index and visceral adiposity and may be an indicator of metabolic syndrome in male children and adolescents. Clin Endocrinol (Oxf) 2011; 74:579-86. [PMID: 21138461 DOI: 10.1111/j.1365-2265.2010.03953.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE A high apolipoprotein B/apolipoprotein A1 (apoB/A1) ratio is strongly associated with cardiometabolic diseases. However, few studies have examined this ratio in children and adolescents. The aim of our study was to determine significant factors related to the apoB/A1 ratio and examine its association with paediatric metabolic syndrome. PATIENTS AND METHODS Sixty-seven male children and adolescents were recruited. We measured anthropometric parameters, fat areas by abdominal computed tomography, fasting glucose, insulin, lipid profiles, apoB, apoA1, adiponectin, free androgen index (FAI) and oestradiol. RESULTS Thirty per cent of participants (n = 20) were identified as having paediatric metabolic syndrome. The apoB/A1 ratio was significantly correlated with BMI z-score, waist circumference, waist-to-hip ratio (WHR), waist-to-height ratio, abdominal fat areas, total cholesterol, triglycerides, LDL-cholesterol, HDL-cholesterol, adiponectin and leptin. In addition to lipid profiles, WHR was identified as a significant independent variable correlated with the apoB/A1 ratio. Obese boys with a high FAI (>75th percentile) had significantly lower adiponectin and higher apoB/A1 ratios than those with a low FAI. The apoB/A1 ratio was higher in subjects with high visceral fat (>50th percentile) and a high FAI when compared with subjects with low visceral fat and a low FAI. The prevalence of paediatric metabolic syndrome was significantly associated with increasing tertiles of the apoB/A1 ratio (highest tertile; odds ratio = 18·8 [95% confidence interval = 1·8-198·8], P < 0·05). CONCLUSION ApoB/A1 ratio was significantly higher in viscerally obese male children and adolescents with high levels of FAI and was associated with increased frequency of paediatric metabolic syndrome.
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Affiliation(s)
- Yong-ho Lee
- Department of Internal Medicine, Graduate School, Yonsei University College of Medicine, Seoul, Korea
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Vijayaraghavan K. Treatment of dyslipidemia in patients with type 2 diabetes. Lipids Health Dis 2010; 9:144. [PMID: 21172030 PMCID: PMC3022752 DOI: 10.1186/1476-511x-9-144] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2010] [Accepted: 12/20/2010] [Indexed: 12/18/2022] Open
Abstract
Type 2 diabetes is associated with significant cardiovascular morbidity and mortality. Although low-density lipoprotein cholesterol levels may be normal in patients with type 2 diabetes, insulin resistance drives a number of changes in lipid metabolism and lipoprotein composition that render low-density lipoprotein cholesterol and other lipoproteins more pathogenic than species found in patients without type 2 diabetes. Dyslipidemia, which affects almost 50% of patients with type 2 diabetes, is a cardiovascular risk factor characterized by elevated triglyceride levels, low high-density lipoprotein cholesterol levels, and a preponderance of small, dense, low-density lipoprotein particles. Early, aggressive pharmacological management is advocated to reduce low-density lipoprotein cholesterol levels, regardless of baseline levels. A number of lipid-lowering agents, including statins, fibrates, niacin, and bile acid sequestrants, are available to target normalization of the entire lipid profile. Despite use of combination and high-dose lipid-lowering agents, many patients with type 2 diabetes do not achieve lipid targets. This review outlines the characteristics and prevalence of dyslipidemia in patients with type 2 diabetes and discusses strategies that may reduce the risk of cardiovascular disease in this population.
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