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Andrade RDS, de Souza FIS, Aranda CS, Mallozi MC, Ferreira AC, Barreto TLN, Fonseca FLA, Sarni ROS, Solé D. Antioxidant defense of children and adolescents with atopic dermatitis: Association with disease severity. Allergol Immunopathol (Madr) 2024; 52:65-70. [PMID: 38186195 DOI: 10.15586/aei.v52i1.933] [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] [Received: 06/09/2023] [Accepted: 10/10/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND Atopic dermatitis (AD) is a relapsing, chronic cutaneous inflammatory disease with onset, in general, in early childhood. Chronic skin inflammation is associated with overproduction of reactive oxygen species (ROS) such as superoxide and hydrogen peroxide. Oxidative stress, an imbalance between the production of free radicals and antioxidant defense, results in tissue inflammation due to the upregulation of genes that encode inflammatory cytokines. This condition plays an important role in the pathogenesis of AD. OBJECTIVE To compare the antioxidant defense in children and adolescents with AD with that of healthy individuals and to verify the association of antioxidant defense with disease severity and nutritional status. METHODS Cross-sectional study that evaluated 48 children and adolescents with AD and 25 controls for nutritional assessment (body mass index z score [BMIZ] and height for age z score [HAZ]) and levels of vitamins A, C, E, and D, zinc (Zn), copper (Cu), antioxidant enzymes (superoxide dismutase [SOD], catalase [CAT], glutathione peroxidase [GPx]), high-sensitivity C-reactive protein (CRP) and interleukin 33 (IL-33). RESULTS There was no significant difference in the comparison between AD and control groups for serum levels of vitamins (A, D, C, and E), copper, and antioxidant enzymes. Serum zinc levels were higher in the AD group (β = 24.20; 95% CI 13.95-34.91; P < 0.001) even after adjusting the BMIZ, HAZ, gender, IL-33, and CRP. Children and adolescents with moderate or severe AD compared to mild AD (SCORAD - 36.7±17.4 vs 11.8 ± 3.9; P < 0.001) had lower values of the vitamin E/total lipid ratio (3.68 [0.29;12.63] vs 5.92 [3.27;17.37]; P = 0.013). CONCLUSION Children and adolescents with AD had higher concentrations OF elevated levels of zinc compared to controls, a fact not observed for other biomarkers of antioxidant defense. AD in moderate or severe forms presented lower concentrations of vitamin E, a potent antioxidant fat soluble.
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Affiliation(s)
- Roseani da Silva Andrade
- Department of Pediatrics. Division of Allergy, Clinical Immunology and Rheumatology. Universidade Federal de São Paulo (UNIFESP);
| | - Fabíola Isabel Suano de Souza
- Department of Pediatrics. Division of Allergy, Clinical Immunology and Rheumatology. Universidade Federal de São Paulo (UNIFESP)
| | - Carolina Sanchez Aranda
- Department of Pediatrics. Division of Allergy, Clinical Immunology and Rheumatology. Universidade Federal de São Paulo (UNIFESP)
| | - Marcia Carvalho Mallozi
- Department of Pediatrics. Division of Allergy, Clinical Immunology and Rheumatology. Universidade Federal de São Paulo (UNIFESP)
| | | | - Talita Lemos Neves Barreto
- Department of Pediatrics. Division of Allergy, Clinical Immunology and Rheumatology. Universidade Federal de São Paulo (UNIFESP)
| | | | - Roseli Oselka Saccardo Sarni
- Department of Pediatrics. Division of Allergy, Clinical Immunology and Rheumatology. Universidade Federal de São Paulo (UNIFESP)
| | - Dirceu Solé
- Department of Pediatrics. Division of Allergy, Clinical Immunology and Rheumatology. Universidade Federal de São Paulo (UNIFESP)
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Xi X, Wu D, Wu W, Zhou Y, Zhang Q, Wang Y, Wang H, Liu Q. The influence of the trajectory of obesity indicators on the age of pubertal onset and pubertal tempo in girls: A longitudinal study in Chongqing, China. Front Public Health 2023; 11:1025778. [PMID: 36844817 PMCID: PMC9944025 DOI: 10.3389/fpubh.2023.1025778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 01/11/2023] [Indexed: 02/11/2023] Open
Abstract
Objective This study aims to explore the influence of the trajectory of obesity indicators on the onset age of different pubertal development characteristics and pubertal tempo among girls. Methods Our longitudinal cohort study recruited 734 girls at baseline in May 2014 from a district of Chongqing and followed them at 6-month intervals. Data were available from baseline to the 14th follow-up with a full record of height, weight, waist circumference (WC), breast development, pubic hair, and armpit hair development, as well as the age of menarche. The Group-Based Trajectory Model (GBTM) was fitted for the optimum trajectory of the body mass index (BMI), WC, and waist-to-height ratio (WHtR) of girls before the pubertal onset and menarche. The ANOVA and multiple linear regression model were conducted to analyze the influence of the trajectory of obesity indicators on the onset age of different pubertal development characteristics and pubertal tempo in girls. Results Compared with the healthy (gradual BMI increase) group before pubertal onset, the overweight (persistent BMI increase) group has an earlier onset age of breast development (B: -0.331, 95%CI: -0.515, -0.147) and pubic hair development (B: -0.341, 95%CI: -0.546, -0.136). The B2-B5 development time was shorter in girls in the overweight (persistent BMI increase) group (B: -0.568, 95%CI: -0.831, -0.305) and the obese (rapid BMI increase) group (B: -0.328, 95%CI: -0.524, -0.132). The age of menarche was earlier, and the B2-B5 development time was shorter in girls in the overweight (persistent BMI increase) group than in girls in the healthy (gradual BMI increase) group before menarche (B: -0.276, 95%CI: -0.406, -0.146; B: -0.263, 95%CI: -0.403, -0.123). Girls with high WC (rapid WC increase) before menarche had an earlier age of menarche than normal WC (gradual WC increase) (B: -0.154, 95%CI: -0.301, -0.006), and the B2-B5 development time was shorter in girls in the overweight (gradual WHtR increase) group than in girls in the healthy (persistent WHtR increase) (B: -0.278, 95%CI: -0.529, -0.027) group. Conclusion Among girls, overweight and obesity (BMI scale) before pubertal onset can not only influence pubertal onset age but also accelerate B2-B5 pubertal tempo. Overweight (BMI scale) and high WC before menarche also have an impact on the age of menarche. Overweight (WHtR scale) before menarche is significantly associated with B2-B5 pubertal tempo.
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Affiliation(s)
- Xuan Xi
- School of Public Health, Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
| | - Di Wu
- School of Public Health, Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China,College of Medical Informatics, Chongqing Medical University, Chongqing, China
| | - Wenyi Wu
- School of Public Health, Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
| | - Yuanke Zhou
- School of Public Health, Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
| | - Qin Zhang
- School of Public Health, Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
| | - Yujie Wang
- School of Public Health, Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
| | - Hong Wang
- School of Public Health, Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
| | - Qin Liu
- School of Public Health, Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China,*Correspondence: Qin Liu ✉
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Aristizabal JC, Barona-Acevedo J, Estrada-Restrepo A. Correlation of body mass index and waist to height ratio with cardiovascular risk factors in Colombian preschool and school children. Colomb Med (Cali) 2023; 54:e2014113. [PMID: 37424739 PMCID: PMC10324468 DOI: 10.25100/cm.v54i1.4113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 02/23/2023] [Accepted: 03/29/2023] [Indexed: 07/11/2023] Open
Abstract
Objective To analyze the agreement between body mass index (BMI) and waist-to-height Ratio (WHtR) to identify preschool and school children with cardiovascular risk factors (CRFs). Methods Three-hundred-twenty-one kids were divided into preschool (3-5 years) and school children (6-10 years). BMI was used to classify children as overweight or obese. Abdominal obesity was defined with a WHtR ≥0.50. Fasting blood lipids, glucose and insulin were measured, and the homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. The presence of CRFs and multiple non-waist circumference (non-WC) metabolic syndrome factors (MetS-Factors) [high HOMA-IR, high triglycerides and low high-density lipoprotein cholesterol (HDL-C)] were analyzed. Results One-hundred-twelve preschool and 209 school children were evaluated. WHtR ≥0.50 classified abdominal obesity in more than half of the preschool children, exceeding those classified with overweight+obesity by BMI (59.5% vs. 9.8%; p<0.001). There was no agreement between WHtR and BMI to identify preschool kids with CRFs and multiple non-WC MetS-Factors (kappa: 0.0 to 0.23, p>0.05). There were similar proportions of school children classified with abdominal obesity by the WHtR and overweight+obesity by the BMI (18.7% vs. 24.9%; p>0.05). There was substantial agreement between WHtR and BMI to identify school children with high total cholesterol values, low-density lipoprotein cholesterol (LDL-C), triglycerides, non-HDL-C, insulin, HOMA-IR, low HDL-C values, and the presence of multiple non-WC MetS-Factors (kappa: 0.616 to 0.857, p<0.001). Conclusion In preschool children WHtR ≥0.5 disagree with BMI results, but in school kids, it has good agreement with the BMI to classify the children´s nutritional status and to identify those with CRFs.
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Affiliation(s)
- Juan Carlos Aristizabal
- Physiology and Biochemistry Research Group-PHYSIS, Universidad de Antioquia, Medellín, Colombia
- School of Nutrition and Dietetics, Universidad de Antioquia, Medellín, Colombia
| | - Jacqueline Barona-Acevedo
- Food and therapeutic alternatives area, Ophidism Program, School of Microbiology, Universidad de Antioquia, Medellín, Colombia
| | - Alejandro Estrada-Restrepo
- School of Nutrition and Dietetics, Universidad de Antioquia, Medellín, Colombia
- Demography and Health Research Group, Universidad de Antioquia, Medellín, Colombia
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Banhara FL, Trindade IEK, Trindade-Suedam IK, Fernandes MDBL, Trindade SHK. Respiratory sleep disorders, nasal obstruction and enuresis in children with non-syndromic Pierre Robin sequence. Braz J Otorhinolaryngol 2022; 88 Suppl 1:S133-S141. [PMID: 34092522 PMCID: PMC9734268 DOI: 10.1016/j.bjorl.2021.05.002] [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] [Received: 11/12/2020] [Revised: 04/01/2021] [Accepted: 05/03/2021] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Obstructive sleep apnea is highly prevalent in non-syndromic Pierre Robin sequence patients. Studies have found a probable relationship between obstructive sleep apnea and nasal obstruction and between obstructive sleep apnea and enuresis. Assessment of the relationship between these variables in non-syndromic Pierre Robin sequence patients is scarce. OBJECTIVE The present study aims to evaluate the relationship between symptoms of obstructive sleep apnea, nasal obstruction and enuresis, determining the prevalence of symptoms suggestive of these conditions, in schoolchildren with non-syndromic Pierre Robin sequence, and describe the prevalence of excessive daytime sleepiness habitual snoring and voiding dysfunction symptoms associated with enuresis. METHODS This was a prospective analytical cross-sectional study developed at a reference center. Anthropometric measurements and a structured clinical interview were carried out in a sample of 48 patients. The instruments "sleep disorders scale in children" "nasal congestion index questionnaire" (CQ-5), and the "voiding dysfunction symptom score questionnaire" were used. Statistical analysis was performed for p < 0.05. RESULTS Positive "sleep disorders scale in children" scores for obstructive sleep apnea and CQ-5 for nasal obstruction were observed in 38.78% and 16.33%, respectively. Enuresis was reported in 16.33% of children, being characterized as primary in 71.43% and polysymptomatic in 55.55%; according to the "voiding dysfunction symptom score questionnaire". There was a significant relationship between nasal obstruction and obstructive sleep apnea symptoms (p < 0.05), but no significance was found between obstructive sleep apnea symptoms and enuresis, and between nasal obstruction and enuresis. The prevalence of excessive daytime sleepiness was 12.24% and of habitual snoring, 48.98%. A family history of enuresis, younger age in years and a positive "voiding dysfunction symptom score questionnaire" score were associated with a higher prevalence of enuresis (p < 0.05). CONCLUSION Children with non-syndromic Pierre Robin sequence are at high risk for obstructive sleep apnea symptoms and habitual snoring, with a correlation being observed between nasal obstruction and obstructive sleep apnea symptoms. In addition, the study showed that non-syndromic Pierre Robin sequence, obstructive sleep apnea and nasal obstruction symptoms were not risk factors for enuresis in these patients.
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Affiliation(s)
- Fábio Luiz Banhara
- Universidade de São Paulo (USP), Hospital de Reabilitação de Anomalias Craniofaciais (HRAC), Unidade de Estudos do Sono do Laboratório de Fisiologia, Bauru, SP, Brazil.
| | - Inge Elly Kiemle Trindade
- Universidade de São Paulo (USP), Hospital de Reabilitação de Anomalias Craniofaciais (HRAC), Unidade de Estudos do Sono do Laboratório de Fisiologia, Bauru, SP, Brazil; Universidade de São Paulo (USP), Faculdade de Odontologia de Bauru, Bauru, SP, Brazil
| | - Ivy Kiemle Trindade-Suedam
- Universidade de São Paulo (USP), Hospital de Reabilitação de Anomalias Craniofaciais (HRAC), Unidade de Estudos do Sono do Laboratório de Fisiologia, Bauru, SP, Brazil; Universidade de São Paulo (USP), Faculdade de Odontologia de Bauru, Bauru, SP, Brazil
| | - Marilyse de Bragança Lopes Fernandes
- Universidade de São Paulo (USP), Hospital de Reabilitação de Anomalias Craniofaciais (HRAC), Unidade de Estudos do Sono do Laboratório de Fisiologia, Bauru, SP, Brazil
| | - Sergio Henrique Kiemle Trindade
- Universidade de São Paulo (USP), Hospital de Reabilitação de Anomalias Craniofaciais (HRAC), Unidade de Estudos do Sono do Laboratório de Fisiologia, Bauru, SP, Brazil; Universidade de São Paulo (USP), Faculdade de Odontologia de Bauru, Bauru, SP, Brazil; Universidade de São Paulo (USP), Hospital de Reabilitação de Anomalias Craniofaciais (HRAC), Seção de Otorrinolaringologia, Bauru, SP, Brazil; Universidade Nove de Julho, Curso de Medicina, Bauru, SP, Brazil
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Ware ME, Kadan-Lottick NS, Devidas M, Terrell S, Chow EJ, Ehrhardt MJ, Hardy KK, Chemaitilly W, Hein W, Winick N, Teachey D, Esbenshade A, Armenian SH, Partin RE, Ness KK. Design and methods of a randomized web-based physical activity intervention among children with cancer: A report from the Children's Oncology Group. Contemp Clin Trials 2022; 122:106961. [PMID: 36228982 PMCID: PMC9669240 DOI: 10.1016/j.cct.2022.106961] [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: 07/06/2022] [Revised: 10/04/2022] [Accepted: 10/06/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Promoting physical activity soon after treatment for childhood cancer may benefit health because sedentary lifestyle during curative therapy may perpetuate physical and emotional complications. The primary goals of this study are to evaluate the effects of a 6-month web-based, rewards-based physical activity intervention on fitness, biomarkers of cardiometabolic health, inflammation, adipokine status, quality of life and school attendance, and determine if effect of intervention on markers of cardiometabolic health is mediated by changes in fitness. The primary outcome of interest is fitness (physiological cost index, six-minute walk test) measured at end of intervention. METHODS This ongoing study is a two-arm, prospective, randomized design with accrual goals of 192 children for intervention and control groups. Children ≥8 years and < 16 years of age, not meeting recommended levels of physical activity, who completed therapy within the past 12 months are eligible. Both groups receive: 1) educational materials encouraging physical activity, 2) activity monitor, 3) access to web-based interface designed to motivate physical activity, 4) rewards based on physical activity levels, and 5) access to their activity data on the web-interface. Those randomized to intervention: 1) can view others' activity and interact with other participants, and 2) receive rewards based on physical activity levels throughout the intervention (vs. at the end of the intervention for control group). CONCLUSION Unique, scalable, and portable physical activity interventions that motivate young survivors are needed. This study will inform future web-based physical activity interventions for children with cancer by demonstrating effects of rewards and social interaction. CLINICAL TRIALS ClinicalTrials.gov Identifier: NCT03223753; COG Identifier: ALTE1631.
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Affiliation(s)
- Megan E Ware
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, United States of America
| | | | - Meenakshi Devidas
- Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, United States of America
| | - Sarah Terrell
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, United States of America
| | - Eric J Chow
- Fred Hutchinson Cancer Center, Seattle, WA, United States of America
| | - Matthew J Ehrhardt
- Oncology Department, St. Jude Children's Research Hospital, Memphis, TN, United States of America
| | - Kristina K Hardy
- Department of Psychiatry and Behavioral Sciences, George Washington University School of Medicine and Health Sciences, Washington, DC, United States of America
| | - Wassim Chemaitilly
- UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, United States of America
| | - Wendy Hein
- Children's Mercy, Kansas City, MO, United States of America
| | - Naomi Winick
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, United States of America
| | - David Teachey
- Division of Oncology, The Children's Hospital of Philadelphia, Philadelphia, PA, United States of America
| | - Adam Esbenshade
- Department of Pediatrics, Vanderbilt University, Nashville, TN, United States of America
| | - Saro H Armenian
- Department of Pediatrics, City of Hope, Duarte, CA, United States of America
| | - Robyn E Partin
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, United States of America
| | - Kirsten K Ness
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, United States of America.
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Ezzatvar Y, Izquierdo M, Ramírez-Vélez R, Del Pozo Cruz B, García-Hermoso A. Accuracy of different cutoffs of the waist-to-height ratio as a screening tool for cardiometabolic risk in children and adolescents: A systematic review and meta-analysis of diagnostic test accuracy studies. Obes Rev 2022; 23:e13375. [PMID: 34751482 DOI: 10.1111/obr.13375] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 09/24/2021] [Indexed: 12/11/2022]
Abstract
The present systematic review with meta-analysis sought to estimate the accuracy of different waist-to-height ratio (WHtR) cutoff ranges as risk indicators for cardiometabolic health in different populations of children and adolescents. Systematic searches were undertaken to identify studies in apparently healthy participants aged 3-18 years that conducted receiver operating characteristic curve analysis and reported area under the receiver operating characteristic curves for WHtR with any cardiometabolic biomarker. Forty-one cross-sectional studies were included in the meta-analysis, including 138,561 young individuals (50% girls). Higher area under summary receiver operating characteristic (AUSROC) values were observed in cutoffs between 0.46 and 0.50 (AUSROC = 0.83, 95%CI: 0.80-0.86) and ≥0.51 (AUSROC = 0.87, 95%CI: 0.84-0.90) (p < 0.001 in comparison with cutoffs 0.41 to 0.45), with similar results in both sexes. The AUSROC value increased in the East and Southeast Asian regions using a WHtR cutoff of ≥0.46 (AUSROC = 0.90, 95%CI: 0.87 to 0.92). A cutoff of ≥0.54 was optimal for the Latin American region (AUSROC = 0.96, 95%CI: 0.94-0.97). Our meta-analysis identified optimal cutoff values of WHtR for use in children and adolescents from different regions. Despite the widely accepted WHtR cutoff of 0.50, the present study indicated that a single cutoff value of WHtR may be inappropriate.
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Affiliation(s)
- Yasmin Ezzatvar
- Department of Nursing, Universitat de València, Valencia, Spain
| | - Mikel Izquierdo
- Navarrabiomed, Navarra Hospital Complex (CHN), Public University of Navarra (UPNA), Pamplona, Spain
| | - Robinson Ramírez-Vélez
- Navarrabiomed, Navarra Hospital Complex (CHN), Public University of Navarra (UPNA), Pamplona, Spain
| | - Borja Del Pozo Cruz
- Centre for Active and Healthy Ageing, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Antonio García-Hermoso
- Navarrabiomed, Navarra Hospital Complex (CHN), Public University of Navarra (UPNA), Pamplona, Spain.,Sciences of Physical Activity, Sports and Health School, University of Santiago of Chile (USACH), Santiago, Chile
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Soheilipour F, Hatami M, Salehiniya H, Alaei M. Indicators of Obesity and Cardio-metabolic Risks: Important Consideration in Adults and Children. Curr Diabetes Rev 2022; 18:e160721194839. [PMID: 34279205 DOI: 10.2174/1573399817666210716122123] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 04/27/2021] [Accepted: 05/23/2021] [Indexed: 11/22/2022]
Abstract
The prevalence of obesity has dramatically increased all over the world. Body mass index (BMI) has been used as the most common available measure to determining obesity status. While the site of excessive fat mass accumulation is a stronger determinant of cardio-metabolic complication, with respect to systemic and generalized obesity, which is only determined through BMI. So, it is concluded that using traditional anthropometric indices such as BMI for interpreting the obesity status and cardio-metabolic risk has considerable limitations. Thus, the main aims of the present study are to discuss possible drawbacks of anthropometric indices especially BMI, which in epidemiological studies are usually neglected, as well as lend important consideration to using other anthropometric indices such as measurement of obesity and related cardio-metabolic complications with a special emphasis on the use of waist circumference, waist-to-hip ratio and waist-to-height ratio.
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Affiliation(s)
- Fahimeh Soheilipour
- Pediatric growth and development research center, institute of endocrinology and metabolism, Iran University of Medical Science, Tehran,Iran
| | - Mahsa Hatami
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran | Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Salehiniya
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Mohammadreza Alaei
- Department of Pediatric Endocrinology, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR ,Iran
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Assessment of the influence of physical activity and screen time on somatic features and physical fitness in 6 to 7-year-old girls. ANTHROPOLOGICAL REVIEW 2022. [DOI: 10.2478/anre-2021-0031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Aim of the study is to assess the relationship between screen time, physical activity and physical fitness among girls 6–7 years-old.
21,528 girls aged 6 and 7 from Poland were assessed in terms of physical fitness. Arm strength, abdominal strength and explosive strength of the lower limbs were measured using the EUROFIT test. Basic somatic features were measured and BMI and WHtR indices were calculated. Spontaneous and organized physical activities as well screen time were assessed by the parents utilizing a questionnaire. The multiple logistic regression method was used to evaluate the influence of screen time and spontaneous physical activity on various components of physical fitness.
Physically active (PA) girls (≥1h/day) and those who participated in additional physical activities (APA) during the week had significantly higher height, weight, and BMI (p<0.001), but not WHtR. They had a higher level of flexibility, explosive strength of the lower limbs and arm strength (p<0.001). With an increase in screen time, the BMI, WHtR increased significantly and explosive strength of the lower limbs, abdominal strength and arm strength were lower. Regression analysis showed that more frequent participation in extracurricular activities increased the values of BMI and WHtR in quartile 4 (Q4), and strength components: Q2–Q4 (p<0.05). Spontaneous physical activity was positively related to the values of BMI, WHtR (both: Q4; p<0.05), explosive force of lower limbs (Q3–Q4; p=0.001), and negatively related to arm strength (Q2; p=0.001). Screen time (≥2hrs/day) increased odds for higher BMI values (p<0.05). Each screen time category decreased the odds of achieving abdominal muscle strength related to the quartiles: Q2–Q4 (p<0.05), arm strength (Q4: p<0.05). ST (1 <2hrs/day) decreased arm strength (Q3; p= 0.045). Our research has shown that screen time-related sedentary behavior and physical activity affect overweight and obesity indices (especially BMI) and strength abilities. The observed associations more often affected girls with a higher level of fitness The results observed in girls aged 6-7 indicate a need for early intervention aimed at limiting time spent watching TV and computer use, as well as to encourage both spontaneous and organized physical activities.
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Waist Circumference Is Not Associated with Impaired Fasting Blood Glucose in a Sample of Mexican Children and Teenagers: Results from a State Screening Program. CHILDREN-BASEL 2021; 8:children8030172. [PMID: 33668305 PMCID: PMC7996355 DOI: 10.3390/children8030172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 02/18/2021] [Accepted: 02/20/2021] [Indexed: 11/16/2022]
Abstract
A high waist circumference (WC) is used as a risk factor for impaired fasting blood glucose (IFG) in adults. This association is less studied in children and teenagers. The purpose of this study was to analyze the association between having a high WC and IFG by sex and age in a sample of Mexican children and teenagers. We analyzed the data of 12979 participants aged 5 to 17 years to calculate percentile references for uncorrected WC, corrected for height (WC/HT) and by height squared (WC/HT2) with quantile regression. A subsample of 2309 participants with fasting blood glucose samples (FBG), WC, WC/HT and WC/HT2 values was analyzed with logistic regression. A high WC, WC/HT, and WC/HT2 were considered at the sex- and age-specific 90th percentile from the subsample. The IFG was considered as FBG ≥100 mg/dL. Having a high WC, WC/HT, nor WC/HT2 was not significantly associated with IFG for either sex and age group (all p > 0.05). A high WC, either on its uncorrected or corrected for height values, was not an important assessment for predicting IFG in a sample of Mexican children and teenagers. This study provides percentile reference values specific for sex and age.
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RIBEIRO ARDAB, CARVALHO DFD, CANTALICE ADSC, SIMÕES MODS, TEIXEIRA A, MEDEIROS CCM. Association between breakfast omission and abdominal adiposity in low-income adolescents. REV NUTR 2021. [DOI: 10.1590/1678-9865202134e190245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective To assess the association between breakfast omission, overweight/obesity, abdominal adiposity, and unhealthy lifestyle of low-income adolescents. Methods A cross-sectional population study involving 571 public school students aged between 15 and 19 years old. The habit of having breakfast was assessed using a form, checking the weekly frequency of a given meal and considered as breakfast omission when these adolescents did not have breakfast for at least 5 days in the past week. Sociodemographic and lifestyle variables (sedentarism, physical activity level, and sleep duration) were also assessed. Overweight/obesity was defined as a body mass index above a Z-score of +1, and the presence of abdominal adiposity was determined by a waist circumference/height ratio greater than 0.5. The association between breakfast omission and lifestyle variables was assessed using the chi-square test and a multivariate logistic regression of the anthropometric indicators. Results The omission of breakfast was found in 31% of the adolescents and was associated with physical inactivity (p<0.001). Regarding anthropometric indicators, breakfast omission was an independent factor for determining abdominal adiposity, with a 1.8 times greater chance of having this condition among those who omitted breakfast (p=0.037). Conclusions Omitting breakfast was frequent among the students assessed, and was associated with abdominal adiposity, a cardiometabolic risk factor. Investigation and early intervention are fundamental to change this behavior.
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Ashwell M, Gibson S. Comments on the article 'Optimum waist circumference-height indices for evaluating adult adiposity: An analytic review': Consideration of relationship to cardiovascular risk factors and to the public health message. Obes Rev 2020; 21:e13074. [PMID: 32578318 DOI: 10.1111/obr.13074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 05/14/2020] [Indexed: 01/25/2023]
Affiliation(s)
- Margaret Ashwell
- Ashwell Associates, Ashwell St, Ashwell, United Kingdom, SG7 5PZ, UK
| | - Sigrid Gibson
- Sig-Nurture Ltd, Furzey Lane, Beaulieu, Hants, SO427WB, UK
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Barreto TLN, Kotchetkoff ECDA, Lago CSA, Sarni ROS. Agreement of cardiovascular risk in ataxia-telangiectasia mutated heterozygotes and their children with Ataxia-telangiectasia. Expert Opin Orphan Drugs 2020. [DOI: 10.1080/21678707.2020.1780117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Prevalence of Metabolic Syndrome in Middle School Children and Evaluation of Components of Metabolic Syndrome. MEDICAL BULLETIN OF SISLI ETFAL HOSPITAL 2020; 53:403-408. [PMID: 32377116 PMCID: PMC7192298 DOI: 10.14744/semb.2018.50479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 11/12/2018] [Indexed: 11/20/2022]
Abstract
Objectives: This study was designed to determine the prevalence of metabolic syndrome (MS) in Turkish children and to examine the relationship between MS components in this age group. Methods: A total of 395 students in Istanbul aged 10 to 14 years in the 2004-2005 school year were enrolled in the study. Body weight, height, waist circumference, hip circumference, and systolic-diastolic blood pressure were measured. Of the total, 353 provided blood samples for analysis of fasting glucose level, basal insulin, total cholesterol, triglyceride, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and very-low-density lipoprotein (VLDL) levels. Modified World Health Organization criteria were used for the diagnosis of MS. Results: In this study, 44.5% of the children were female and 55.5% were male. The mean body mass index (BMI) was 20.57±3.48 kg/m², 10.4% (n=41) were overweight, and 12.7% (n=50) were obese. MS was diagnosed in 0.85% of the entire study group and in 6% of the obese children. There was a positive correlation between BMI and waist circumference (p<0.001), waist/hip ratio (p<0.001), systolic blood pressure (p<0.001), diastolic blood pressure (p<0.001), basal insulin level (p<0.001), homeostasis model assessment of insulin resistance (p<0.001), triglyceride value (p<0.001), total cholesterol level (p<0.05), LDL (p<0.001), and VLDL level (p<0.001), and a negative correlation with HDL level (p<0.001). Conclusion: The study results confirmed that MS is present in children and not limited to adults, and this is an important health problem. The prevalence of MS is more common in obese children. Therefore, early diagnosis of obese children and examination of cardiovascular risk factors and metabolic syndrome criteria is very important.
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LMX1B rs10733682 Polymorphism Interacts with Macronutrients, Dietary Patterns on the Risk of Obesity in Han Chinese Girls. Nutrients 2020; 12:nu12051227. [PMID: 32357537 PMCID: PMC7281971 DOI: 10.3390/nu12051227] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 04/22/2020] [Accepted: 04/24/2020] [Indexed: 02/06/2023] Open
Abstract
Previous studies have found that LMX1B rs10733682 polymorphism is associated with Body Mass Index (BMI) in European and American Indian adults. In this study, the association of rs10733682 polymorphism with obesity-related indicators, and its interaction with macronutrients and dietary patterns (DPs) were explored in Chinese children (n = 798). The rs10733682 polymorphism was genotyped by improved Multiple Ligase Detection Reaction (iMLDR). Four DPs were identified by factor analysis. The AA genotype had a higher incidence of overweight/obesity than GG+GA genotypes (P = 0.010) in girls (n = 398), but no difference in boys. The AA genotype in girls could interact with intake of energy, fat and carbohydrate, causing an increased triglyceride (TG), (P = 0.021, 0.003, 0.002, respectively), and also could interact with energy from protein, causing an elevated BMI (P = 0.023) and waist (P = 0.019). Girls inclining to the HED (high-energy density)-DP were associated with increased TG (P = 0.033), and girls inclining to the VEF (vegetables, eggs, and fishes based)-DP were associated with decreased total cholesterol (TC, P = 0.045) and decreased low density lipoprotein cholesterin (LDL, P = 0.016). The findings indicated that the AA genotype of rs10733682 and the HED-DP are potential risk factors of obesity in Chinese girls.
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Interaction of the CMTM7 rs347134 Polymorphism with Dietary Patterns and the Risk of Obesity in Han Chinese Male Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051515. [PMID: 32111069 PMCID: PMC7084264 DOI: 10.3390/ijerph17051515] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 02/19/2020] [Accepted: 02/25/2020] [Indexed: 12/17/2022]
Abstract
A genome-wide association study (GWAS) in the Han Chinese population had found that single nucleotide polymorphism (SNP) on the CMTM7 gene rs347134 was significantly associated with Body Mass Index (BMI). In the present study, the association of the rs347134 SNP with obesity and its interaction with dietary patterns (DPs) were explored in Han Chinese children. This cross-sectional study group included 1292 children, in whom obesity-related indicators were evaluated, the rs347134 SNP was genotyped by improved Multiple Ligase Detection Reaction (iMLDR), and the DPs were identified by principal component factor analysis. The GG genotype exhibited higher odds of general overweight/obesity (P = 0.038) and central obesity (P = 0.039) than AA + GA genotypes in boys. Four DPs of boys were identified: healthy balanced (HBDP), nuts and sweets-based (NSDP), animal food-based (AFDP), and wheaten and dairy-based (WDDP). Boys with the GG genotype were significantly more inclined to AFDP (P = 0.028) and had a shorter sleep duration (P = 0.031). Significant interactions were observed; boys with the GG genotype displayed a higher LDL in AFDP (P = 0.031) and higher FBG in NSDP (P = 0.038), respectively. Our findings indicate for the first time that the GG genotype of CMTM7 rs347134 is potentially a novel obesity risk factor for Han Chinese male children and is associated with dietary patterns more or less.
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Development and validation of a bespoke phantom to test accuracy of Cobb angle measurements. Radiography (Lond) 2020; 26:e78-e87. [PMID: 32052769 DOI: 10.1016/j.radi.2019.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 11/05/2019] [Accepted: 11/10/2019] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Adolescent idiopathic scoliosis (AIS) is a spinal deformity that causes the spine to bend laterally. Patients with AIS undergo frequent X-ray examinations to monitor the progression of the disorder by through the measurement of the Cobb angle. Frequent exposure of adolescents poses the risk of radiation-induced cancer. The aim of this research was to design and build a bespoke phantom representing a 10-year-old child with AIS to allow optimisation of imaging protocols for AIS assessment through the accuracy of Cobb angle measurements. METHODS Poly-methyl methacrylate (PMMA) and plaster of Paris (PoP) were used to represent human soft tissue and bone tissue, respectively, to construct a phantom exhibiting a 15° lateral curve of the spine. The phantom was validated by comparing the Hounsfield unit (HU) of its vertebrae with that of human and sheep. Additionally, comparisons of signal-to-noise ratio (SNR) to those from a commercially available phantom. An assessment of the accuracy of the radiographic assessment of the Cobb angle measurement was performed. RESULTS The HU of the PoP vertebrae was 628 (SD = 56), human vertebrae was 598 (SD = 79) and sheep vertebra was 605 (SD = 83). The SNR values of the two phantoms correlated strongly (r = 0.93 (p = 0.00)). The measured scoliosis angle was 14°. CONCLUSION The phantom has physical characteristics (in terms of spinal deformity) and radiological characteristics (in terms of HU and SNR values) of the spine of a 10-year-old child with AIS. This phantom has utility for the optimisation of x-ray imaging techniques in 10 year old children. IMPLICATIONS FOR PRACTICE A phantom to investigate new x-ray imaging techniques and technology in the assessment of scoliosis and to optimise currently used protocols.
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Predictive Ability of Waist Circumference and Waist-to-Height Ratio for Cardiometabolic Risk Screening among Spanish Children. Nutrients 2020; 12:nu12020415. [PMID: 32033484 PMCID: PMC7071136 DOI: 10.3390/nu12020415] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 01/16/2020] [Accepted: 02/02/2020] [Indexed: 11/17/2022] Open
Abstract
An excess of fat mass has been associated with adverse cardiometabolic risk factors. Different anthropometric measures have been proposed as alternative non-invasive measures for obesity-related cardiometabolic risk. To evaluate the magnitude of association between waist circumference (WC) and waist-to-height ratio (WtHR) with cardiometabolic risk factors and metabolic syndrome and to determine the WtHR cutoff associated with a more favorable cardiometabolic risk profile in Spanish children, data were taken from a cross-sectional survey conducted in 2010 among 848 schoolchildren aged 8–11 years from 20 public schools in the province of Cuenca (Spain). Anthropometric variables, glucose, insulin, triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), systolic (SBP) and diastolic blood pressure (DBP) and metabolic syndrome (MetS) were also analyzed. WtHR and WC had a good accuracy for TG, insulin, and MetS. The diagnostic odds ratio ranged from 2.95 to 9.07 for WtHR and from 5.30 to 27.40 for WC. The main result of the present study suggests that both WtHR and WC could be used as a screening tool to identify children with cardiometabolic abnormalities.
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Sjöholm P, Pahkala K, Davison B, Juonala M, Singh G. Socioeconomic status, remoteness and tracking of nutritional status from childhood to adulthood in an Australian Aboriginal Birth Cohort: the ABC study. BMJ Open 2020; 10:e033631. [PMID: 31992605 PMCID: PMC7045147 DOI: 10.1136/bmjopen-2019-033631] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVES To determine prevalences of underweight and overweight as well as low and high waist-to-height ratio (WHtR) in three prospective follow-ups and to explore tracking of these measures of nutritional status from childhood to adolescence and adulthood. The influence of socioeconomic status, remoteness, maternal body mass index (BMI) and birth weight on weight status was assessed. DESIGN Longitudinal birth cohort study of Indigenous Australians. SETTING Data derived from three follow-ups of the Aboriginal Birth Cohort study with mean ages of 11.4, 18.2 and 25.4 years for the participants. PARTICIPANTS Of the 686 Indigenous babies recruited to the study between 1987 and 1990, 315 had anthropometric measurements for all three follow-ups and were included in this study. PRIMARY AND SECONDARY OUTCOME MEASURES BMI categories (underweight, normal weight, overweight and obesity),WHtR categories (low and high), sex, areal socioeconomic disadvantage as defined by the Indigenous Relative Socioeconomic Outcomes index, urban/remote residence, maternal BMI and birth weight. Logistic regression was used to calculate ORs for belonging to a certain BMI category in adolescence and adulthood according to BMI category in childhood and adolescence. RESULTS Underweight was common (38% in childhood and 24% in adulthood) and the prevalence of overweight/obesity increased with age (12% in childhood and 35% in adulthood). Both extremes of weight status as well as low and high WHtR tracked from childhood to adulthood. Underweight was more common and overweight was less common in remote and more disadvantaged areas. Birth weight and maternal BMI were associated with later weight status. There were significant sex differences for prevalences and tracking of WHtR but not for BMI. CONCLUSIONS Socioeconomic factors, remoteness and gender must be addressed when assessing nutrition-related issues in the Indigenous communities due to the variation in nutritional status and its behaviour over time within the Indigenous population.
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Affiliation(s)
- Pauline Sjöholm
- Department of Medicine, University of Turku, Turku, Finland
- Department of Anesthesiology, Vaasa Central Hospital, Vaasa, Finland
| | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Paavo Nurmi Centre, Sports & Exercise Medicine Unit, Department of Physical Activity and Health, University of Turku, Turku, Finland
| | - Belinda Davison
- Menzies School of Health Research, Casuarina, Northern Territory, Australia
| | - Markus Juonala
- Department of Medicine, University of Turku, Turku, Finland
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Gurmeet Singh
- Menzies School of Health Research, Casuarina, Northern Territory, Australia
- Northern Territory Medical Program, Flinders University, Darwin, Northern Territory, Australia
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A simple cut-off for waist-to-height ratio (0·5) can act as an indicator for cardiometabolic risk: recent data from adults in the Health Survey for England. Br J Nutr 2019; 123:681-690. [DOI: 10.1017/s0007114519003301] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
AbstractThe National Institute for Health and Care Excellence (NICE) has acknowledged the value of waist-to-height ratio (WHtR) as an indicator for ‘early health risk’. We used recent UK data to explore whether classification based on WHtR identifies more adults at cardiometabolic risk than the ‘matrix’ based on BMI and waist circumference, currently used for screening. Data from the Health Survey for England (4112 adults aged 18+ years) were used to identify cardiometabolic risk, indicated by raised glycated Hb, dyslipidaemia and hypertension. HbA1c, total/HDL-cholesterol and systolic blood pressure (BP) were more strongly associated with WHtR than the ‘matrix’. In logistic regression models for HbA1c ≥ 48 mmol/mol, total/HDL-cholesterol > 4 and hypertension (BP > 140/90 mmHg or on medication), WHtR had a higher predictive value than the ‘matrix’. AUC was significantly greater for WHtR than the ‘matrix’ for raised HbA1c and hypertension. Of adults with raised HbA1c, 15 % would be judged as ‘no increased risk’ using the ‘matrix’ in contrast to 3 % using WHtR < 0·5. For hypertension, comparative values were 23 and 9 %, and for total/HDL-cholesterol > 4, 26 and 13 %. Nearly one-third of the ‘no increased risk’ group in the ‘matrix’ had WHtR ≥ 0·5 and hence could be underdiagnosed for cardiometabolic risk. WHtR has the potential to be a better indicator of cardiometabolic risks associated with central obesity than the current NICE ‘matrix’. The cut-off WHtR 0·5 in early screening translates to a simple message, ‘your waist should be less than half your height’, that allows individuals to be aware of their health risks.
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Lian Q, Mao Y, Luo S, Zhang S, Tu X, Zuo X, Lou C, Zhou W. Puberty timing associated with obesity and central obesity in Chinese Han girls. BMC Pediatr 2019; 19:1. [PMID: 30606158 PMCID: PMC6317212 DOI: 10.1186/s12887-018-1376-4] [Citation(s) in RCA: 95] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 12/18/2018] [Indexed: 12/30/2022] Open
Abstract
Background There is growing scientific evidence supports a link between increased childhood adiposity and early onset of puberty in girls worldwide in recent decades. However, the data from Chinese girls remain ambiguous. The aims of this study were to estimate the puberty milestones and examine attainment of puberty associated with obesity and central obesity in Chinese Han schoolgirls. Methods The cross-sectional school-based study examined 2996 Han schoolgirls aged 9 to 19 years from 6 provinces in China. Trained clinicians assessed the girls for height, weight, waist circumference, Tanner stages of breast and pubic hair development, and menarcheal status. We classified girls as normal weight, overweight, or obese based on BMI, and as normal weight or central obese based on the waist-height ratio, then estimated and compared median age at a given Tanner stage or greater by weight class using Probit models. Results The median age at menarche was 12.36 years. The median ages at breast stages(B) 2 through 5 were 10.03, 11.38, 13.39, and 15.79 years, respectively, and at pubic hair stages(PH) 2 through 5 were 11.62, 12.70, 14.38, and 16.92 years, respectively. Girls from urban areas experienced menarche, B3 and B4 stages, and PH3 through PH5 stages earlier. Girls with central obesity and overweight/obesity reached puberty earlier at almost every Tanner stage of breast and pubic hair than normal girls. Girls with obesity developed PH2 and PH3 earlier than their overweight peers. However, we did not find any significant differences between girls with overweight and obesity at all stages of breast development. Conclusions Childhood obesity, including both overweight/obesity and central obesity, is associated with earlier attainment of puberty in Chinese Han schoolgirls.
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Affiliation(s)
- Qiguo Lian
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), School of Public Health, Fudan University, 779 Laohumin Road, Shanghai, 200237, China
| | - Yanyan Mao
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), School of Public Health, Fudan University, 779 Laohumin Road, Shanghai, 200237, China
| | - Shan Luo
- West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Shucheng Zhang
- National Research Institute for Family Planning, Beijing, China
| | - Xiaowen Tu
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), School of Public Health, Fudan University, 779 Laohumin Road, Shanghai, 200237, China
| | - Xiayun Zuo
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), School of Public Health, Fudan University, 779 Laohumin Road, Shanghai, 200237, China.
| | - Chaohua Lou
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), School of Public Health, Fudan University, 779 Laohumin Road, Shanghai, 200237, China
| | - Weijin Zhou
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), School of Public Health, Fudan University, 779 Laohumin Road, Shanghai, 200237, China.,Key Laboratory of Birth Defects and Reproductive Health of National Health and Family Planning Commission (Chongqing Population and Family Planning Science and Technology Research Institute), Chongqing, China
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Wariri O, Jalo I, Bode-Thomas F. Discriminative ability of adiposity measures for elevated blood pressure among adolescents in a resource-constrained setting in northeast Nigeria: a cross-sectional analysis. BMC OBESITY 2018; 5:35. [PMID: 30524740 PMCID: PMC6276203 DOI: 10.1186/s40608-018-0211-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 08/28/2018] [Indexed: 11/30/2022]
Abstract
Background Several studies examining the association and discriminative ability of adiposity measures for prehypertension and hypertension among adolescents have reported varying outcomes. We aimed to determine the discriminative ability of the Body Mass index (BMI), Waist Circumference (WC), and Waist-to-Height Ratio (WHtR) adiposity measures for elevated blood pressure (prehypertension and hypertension combined) among adolescents in Gombe, northeast Nigeria. Methods This cross-sectional study used a multi-stage sampling technique and involved 367 secondary school adolescent (10–18 years) boys and girls in Gombe Local Government Area, Gombe State, northeast Nigeria from January to September 2015. We examined and compared the associations and discriminative ability of the BMI, WC and the WHtR for elevated blood pressure using multiple logistic regression and receiver operating characteristics (ROC) curves. Area under the curves (AUC), odds ratio (OR) and 95% confidence intervals (CI) are reported. Results All three measures of adiposity were strongly and positively associated with elevated blood pressure. The BMI obesity showed the strongest association with elevated blood pressure with odds that was double the odds of WC and triple that of WHtR [adjusted OR for BMI 15.3, 95% CI (4.8–27.9)]. The discriminative ability of adiposity measures for elevated blood pressure using AUC was comparable (0.786 for BMI, vs 0.780 for WC, vs 0.761 for WHtR). Conclusion We provide evidence, here on the BMI, WC and WHtR to support the use of simple indirect measures of adiposity in evaluating adiposity-related risk including prehypertension and hypertension among Nigerian adolescents. Electronic supplementary material The online version of this article (10.1186/s40608-018-0211-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Oghenebrume Wariri
- Vaccines and Immunity Theme, MRC Unit, The Gambia at The London School of Hygience and Tropical Medicine, Fajara, The Gambia
| | - Iliya Jalo
- Department of Paediatrics, Federal Teaching Hospital (FTH), Gombe, Nigeria.,3Department of Paediatrics, College of Medical Sciences, Gombe State University, Gombe, Nigeria
| | - Fidelia Bode-Thomas
- 4Paediatric Cardiology Unit, Department of Paediatrics, Jos University Teaching Hospital (JUTH), Jos, Nigeria
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Kim MS, Kim SY, Kim JH. Secular change in waist circumference and waist-height ratio and optimal cutoff of waist-height ratio for abdominal obesity among Korean children and adolescents over 10 years. KOREAN JOURNAL OF PEDIATRICS 2018; 62:261-268. [PMID: 30514064 PMCID: PMC6642921 DOI: 10.3345/kjp.2018.07038] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 12/03/2018] [Indexed: 01/05/2023]
Abstract
PURPOSE This study aimed to evaluate the time trends of waist circumference (WC) and waist-height ratio (WHR), and to present WC and WHR distributions with optimal WHR cutoff for abdominal obesity in Korean children and adolescents. METHODS We performed a retrospective cross-sectional analysis of data from 13,257 children and adolescents (6,987 boys and 6,270 girls) aged 6-18 years who were included in the third to sixth Korea National Health and Nutrition Examination Survey (KNHANES, 2005-2015). Linear regression analyses were used to identify secular changes in WC and WHR by age, sex, and KNHANES waves. A receiver operating characteristic curve analysis was used to determine the optimal WHR cutoff values for abdominal obesity and cardiometabolic risk factors. RESULTS The mean WC and WHR distributions from 2005 to 2015 showed no significant secular changes between the KNHANES 4 waves (P for trend ≥0.05 in all ages and both sexes). The mean WCs in the present study were lower than those in the 2007 Korean National Growth Charts. The mean WHR at ages <13 years was statistically higher in the boys than in the girls, but did not significantly differ between the sexes among those aged 13 to 18 years. The optimal WHR cutoff for abdominal obesity was 0.48 (area under the curve, 0.985; 95% confidence interval, 0.985-0.985) in the 13- to 18-yearold adolescents. CONCLUSION WC and WHR showed no secular changes over 10 years. The optimal WHR cutoff for abdominal obesity of 0.48 is useful for diagnosing and managing obesity and thus preventing obesityrelated cardiometabolic complications in 13- to 18-year-old Korean adolescents.
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Affiliation(s)
- Min Sub Kim
- 1Department of Pediatrics, Bundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, Korea
| | - Se Young Kim
- 1Department of Pediatrics, Bundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, Korea
| | - Jae Hyun Kim
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
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Kim KE, Baek KS, Han S, Kim JH, Shin YH. Serum alanine aminotransferase levels are closely associated with metabolic disturbances in apparently healthy young adolescents independent of obesity. KOREAN JOURNAL OF PEDIATRICS 2018; 62:48-54. [PMID: 30477286 PMCID: PMC6382960 DOI: 10.3345/kjp.2018.06639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Accepted: 09/04/2018] [Indexed: 12/27/2022]
Abstract
PURPOSE Liver metabolism plays a pivotal role in the development of metabolic disorders. We aimed to investigate the clinical and laboratory risk factors associated with alanine aminotransferase (ALT) levels in young adolescents from an urban population in Korea. METHODS A population of 120 apparently healthy adolescents aged 12-13 years was included in the cross-sectional design study; 58 were overweight or obese and 62 were of normal weight. We estimated anthropometric and laboratory measurements, including waist-to-height ratio, blood pressure, insulin sensitivity, aspartate aminotransferases (AST), ALT, and lipid profiles. RESULTS The mean ages of the overweight or obese and normal weight participants were 12.9±0.3 and 13.0±0.3 years, respectively. Height, weight, body mass index, waist circumference, waist-to-height ratio, systolic and diastolic blood pressure, AST, ALT, total cholesterol, low-density lipoprotein-cholesterol, triglyceride, insulin, and the homeostatic model assessment of insulin resistance (HOMA-IR) score were significantly higher and the high-density lipoprotein-cholesterol and quantitative insulin-sensitivity check index were significantly lower in the overweight/obese participants in comparison to the normal-weight participants (all P<0.05). In multivariate linear regression analysis, waist-to-height ratio, systolic blood pressure, and HOMA-IR score were independently and positively associated with serum ALT levels. CONCLUSION Screening for ALT levels in adolescents may help to differentiate those at risk of metabolic abnormalities and thus prevent disease progression at an early age.
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Affiliation(s)
- Ki Eun Kim
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea
| | - Kyung Suk Baek
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea
| | - Sol Han
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea
| | - Jung Hyun Kim
- Atmin Radiology and Health Promotion Center, Seoul, Korea
| | - Youn Ho Shin
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea
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Children with Obesity and Asthma: Which Are the Best Options for Their Management? Nutrients 2018; 10:nu10111634. [PMID: 30400197 PMCID: PMC6267365 DOI: 10.3390/nu10111634] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 10/27/2018] [Accepted: 10/31/2018] [Indexed: 12/12/2022] Open
Abstract
Obesity and asthma are complex disorders related to gene-environment interactions and various lifestyle factors. At present, they represent two of the most significant paediatric health problems worldwide, particularly in industrialized nations. The aim of this narrative review is to evaluate possible therapeutic strategies to manage asthma in children with overweight/obesity. PubMed was used to search for all of the studies published from January 2008 to June 2018 using the following key words: “asthma” and “overweight” or “obesity” or “obese” and “children” or “paediatric”. The literature review showed that growing evidence underlines the existence of an “obese asthma” phenotype characterised by difficult-to-control asthma with additional symptoms, worse control, more frequent and severe exacerbations, reduced response to inhaled corticosteroids, and lower quality of life than other phenotypes. Currently, therapeutic strategies centred on prevention are suggested and the development of resources to assist families with weight loss strategies seems useful for effective weight control and optimal asthma management. Studies on vitamin D supplementation and further knowledge are needed to better define the best therapeutic options to manage asthma in children with overweight/obesity and to reduce the onset and severity of this chronic respiratory disease through the design of a multifactorial intervention.
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Gomes TN, Nevill A, Katzmarzyk PT, Pereira S, dos Santos MM, Buranarugsa R, dos Santos FK, Souza M, Chaves R, Maia J. Identifying the best body-weight-status index associated with metabolic risk in youth. Scand J Med Sci Sports 2018; 28:2375-2383. [DOI: 10.1111/sms.13249] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 06/20/2018] [Indexed: 02/06/2023]
Affiliation(s)
- Thayse Natacha Gomes
- Faculty of Sport; CIFI D; University of Porto; Porto Portugal
- Department of Physical Education; Federal University of Sergipe; São Cristóvão Brazil
| | - Alan Nevill
- Faculty of Education, Health and Wellbeing; University of Wolverhampton; Walsall UK
| | | | - Sara Pereira
- Faculty of Sport; CIFI D; University of Porto; Porto Portugal
| | | | - Rojapon Buranarugsa
- Faculty of Education; Department of Physical Education; Khon Kaen University; Khon Kaen Thailand
| | | | - Michele Souza
- Centre of Sports; Federal University of Santa Catarina; Florianópolis Brazil
| | - Raquel Chaves
- Federal University of Technology-Paraná; Curitiba Brazil
| | - José Maia
- Faculty of Sport; CIFI D; University of Porto; Porto Portugal
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杨 兴, 邵 孟, 周 琴, 夏 悦, 邹 和. [Association of waist-to-hip ratio with insulin resistance in non-diabetic normal-weight individuals: a cross-sectional study]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2017; 37:1540-1544. [PMID: 29180338 PMCID: PMC6779637 DOI: 10.3969/j.issn.1673-4254.2017.11.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To explore the relationship between waist-to-hip ratio (WHR) and insulin resistance(IR) in non-diabetic normal-weight individuals and investigate how this association differs between male and femalesubjects. METHODS From June to October, 2012, we performed a cross-sectional survey among 2142 community-based non-diabetic Chinese participants, who were divided into 4 groups according to the gender-specific quartiles of WHR. Homeostatic model assessment of insulin resistance (HOMA-IR), calculated as the product of fasting plasma glucose (mmol/L) and fasting insulin (mU/L) divided by 22.5, was used as the indicator of insulin resistance. Logistic regression models were used to explore the association of WHR with IR in these subjects. RESULTS In the unadjusted model, WHR was significantly associated with IR in women (OR=6.60, 95%CI: 2.86-15.26, P<0.001); the association was still significant (OR=3.28, 95%CI: 1.34-8.04, P=0.009) after adjustment for the potential confounders including the history of hypertension, coronary heartdisease, current smoker, physical inactivity, and body mass index. CONCLUSION WHR is independently associated with IR in non-diabetic Chinese women with normal body weight.
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Affiliation(s)
- 兴燕 杨
- />南方医科大学第三附属医院肾内科,广东 广州 510630Department of Nephrology, Institute of Nephrology and Urology, Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
| | - 孟佼 邵
- />南方医科大学第三附属医院肾内科,广东 广州 510630Department of Nephrology, Institute of Nephrology and Urology, Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
| | - 琴 周
- />南方医科大学第三附属医院肾内科,广东 广州 510630Department of Nephrology, Institute of Nephrology and Urology, Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
| | - 悦 夏
- />南方医科大学第三附属医院肾内科,广东 广州 510630Department of Nephrology, Institute of Nephrology and Urology, Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
| | - 和群 邹
- />南方医科大学第三附属医院肾内科,广东 广州 510630Department of Nephrology, Institute of Nephrology and Urology, Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
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杨 兴, 邵 孟, 周 琴, 夏 悦, 邹 和. [Association of waist-to-hip ratio with insulin resistance in non-diabetic normal-weight individuals: a cross-sectional study]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2017; 37:1540-1544. [PMID: 29180338 PMCID: PMC6779637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Indexed: 10/15/2023]
Abstract
OBJECTIVE To explore the relationship between waist-to-hip ratio (WHR) and insulin resistance(IR) in non-diabetic normal-weight individuals and investigate how this association differs between male and femalesubjects. METHODS From June to October, 2012, we performed a cross-sectional survey among 2142 community-based non-diabetic Chinese participants, who were divided into 4 groups according to the gender-specific quartiles of WHR. Homeostatic model assessment of insulin resistance (HOMA-IR), calculated as the product of fasting plasma glucose (mmol/L) and fasting insulin (mU/L) divided by 22.5, was used as the indicator of insulin resistance. Logistic regression models were used to explore the association of WHR with IR in these subjects. RESULTS In the unadjusted model, WHR was significantly associated with IR in women (OR=6.60, 95%CI: 2.86-15.26, P<0.001); the association was still significant (OR=3.28, 95%CI: 1.34-8.04, P=0.009) after adjustment for the potential confounders including the history of hypertension, coronary heartdisease, current smoker, physical inactivity, and body mass index. CONCLUSION WHR is independently associated with IR in non-diabetic Chinese women with normal body weight.
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Affiliation(s)
- 兴燕 杨
- />南方医科大学第三附属医院肾内科,广东 广州 510630Department of Nephrology, Institute of Nephrology and Urology, Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
| | - 孟佼 邵
- />南方医科大学第三附属医院肾内科,广东 广州 510630Department of Nephrology, Institute of Nephrology and Urology, Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
| | - 琴 周
- />南方医科大学第三附属医院肾内科,广东 广州 510630Department of Nephrology, Institute of Nephrology and Urology, Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
| | - 悦 夏
- />南方医科大学第三附属医院肾内科,广东 广州 510630Department of Nephrology, Institute of Nephrology and Urology, Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
| | - 和群 邹
- />南方医科大学第三附属医院肾内科,广东 广州 510630Department of Nephrology, Institute of Nephrology and Urology, Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
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Christofaro DGD, Farah BQ, Vanderlei LCM, Delfino LD, Tebar WR, Barros MVGD, Ritti-Dias RM. Analysis of different anthropometric indicators in the detection of high blood pressure in school adolescents: a cross-sectional study with 8295 adolescents. Braz J Phys Ther 2017; 22:49-54. [PMID: 29169996 PMCID: PMC5816077 DOI: 10.1016/j.bjpt.2017.10.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 05/17/2017] [Accepted: 07/24/2017] [Indexed: 11/24/2022] Open
Abstract
Overweight adolescents classified in any of three anthropometric indices have more HBP. The sensitivity of the indicators was low and the specificity was high in detecting HBP. Parents must be aware that high BMI, WC or WTHR are highly associated with HBP.
Background High blood pressure is strongly associated with obesity in different populations. However, it is unclear whether different anthropometric indicators of obesity can satisfactorily predict high blood pressure in the school setting. Objectives This study evaluated the sensitivity and specificity of body mass index, waist circumference, and waist to height ratio in the detection of high blood pressure in adolescents. Methods The sample consisted of 8295 adolescents aged 10–17 years. Weight was measured using a digital scale, height with a stadiometer, and waist circumference using a tape measure. Blood pressure was measured by an automatic blood pressure measuring device. ROC curves were used for the analysis of sensitivity and specificity of the three anthropometric indices in identifying high blood pressure. Binary Logistic Regression was used to assess the association of body mass index, waist circumference, and waist to height ratio with high blood pressure. Results Low values of sensitivity were observed for body mass index (0.35), waist circumference (0.37), and waist to height ratio (0.31) and high values of specificity for body mass index (0.86), waist circumference (0.82), and waist to height ratio (0.83) in the detection of high blood pressure. An association was observed between adolescents classified with high body mass index (OR = 3.57 [95% CI = 3.10–4.10]), waist cirumference (OR = 3.24 [95% CI = 2.83–3.72]), and waist to height ratio (OR = 2.94 [95% CI = 2.54–3.40]) with high blood pressure. Conclusions Body mass index, waist circumference, and waist to height ratio presented low sensitivity to identify adolescents with high blood pressure. However, adolescents classified with high body mass index, waist circumference, and waist to height ratio demonstrated a high association of presenting high blood pressure.
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Affiliation(s)
- Diego G D Christofaro
- Universidade Estadual Paulista (UNESP), Department of Physical Education, Presidente Prudente, SP, Brazil.
| | - Breno Q Farah
- Universidade de Pernambuco (UPE), Department of Physical Education, Recife, PE, Brazil
| | - Luiz Carlos M Vanderlei
- Universidade Estadual Paulista (UNESP), Department of Physical Therapy, Presidente Prudente, SP, Brazil
| | - Leandro D Delfino
- Universidade Estadual Paulista (UNESP), Department of Physical Education, Presidente Prudente, SP, Brazil
| | - William R Tebar
- Universidade Estadual Paulista (UNESP), Department of Physical Education, Presidente Prudente, SP, Brazil
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Syed Meraj A, Mohammed Al M. A study on the prevalence of risk factors for diabetes and hypertension among school children in Majmaah, Kingdom of Saudi Arabia. J Public Health Res 2017; 6:829. [PMID: 29071251 PMCID: PMC5641670 DOI: 10.4081/jphr.2017.829] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 08/31/2017] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The prevalence of risk factors for diabetes and hypertension in Saudi school children has achieved epidemic proportions because of enriched lifestyles. The aim of this study is to conduct a baseline study of such risk factors in a young population at the cusp of high-end technology and material comfort. MATERIALS AND METHODS A cross-sectional study was done among school children using parental assisted self-questionnaires and anthropometric assessment of their vital statistics. This study, including planning, data collection and analysis, and the writing of the first draft, was conducted from March 2015 to October 2016 after ethical approval was obtained. Cluster sampling was done for the schools, and stratified randomized sampling was performed to choose a total of 794 male and female school children. SPSS software was used for data analysis. RESULTS It was found that 11.6% of the children had a body mass index (BMI) above the normal range. The waist-to-height ratio was elevated in 16.8% of the children. Other risk factors of note were a high prevalence of sedentary habits (43%), daily consumption of carbonated sugary drinks (36.4%), and eating at fast food restaurants most days of the week (17%). CONCLUSIONS This gradual buildup of risk factors for diabetes and hypertension at an early age is a morbid indicator of an epidemic whose outcome has been determined. Most of these modifiable risk factors are amenable to change through concentrated efforts to educate, train and inculcate healthy habits among children and their families.
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Affiliation(s)
| | - Mansour Mohammed Al
- Department of Family Medicine, College of Medicine, Majmaah University, Majmaah, Saudi Arabia
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Jacota M, Forhan A, Saldanha-Gomes C, Charles MA, Heude B. Maternal weight prior and during pregnancy and offspring's BMI and adiposity at 5-6 years in the EDEN mother-child cohort. Pediatr Obes 2017; 12:320-329. [PMID: 27135441 DOI: 10.1111/ijpo.12145] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 04/06/2016] [Accepted: 04/11/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Beyond pre-pregnancy BMI, maternal weight change before and during pregnancy may also affect offspring adiposity. OBJECTIVE To investigate the relationship between maternal weight history before and during pregnancy with children's adiposity at 5-6 years. METHODS In 1069 mother-child dyads from the EDEN Cohort, we examined by linear regression the associations of children's BMI, fat mass and abdominal adiposity at 5-6 years with maternal pre-pregnancy BMI, pre-pregnancy average yearly weight change from age 20 and gestational weight gain. The shapes of relationships were investigated using splines and polynomial functions were tested. RESULTS Children's BMI and adiposity parameters were positively associated with maternal pre-pregnancy BMI, but these relationships were mainly seen in thin mothers, with no substantial variation for maternal BMI ranging from 22 to 35 kg/m2 . Gestational weight gain was positively associated with children's BMI Z-score, but again more so in thin mothers. We found no association with pre-pregnancy weight change. CONCLUSIONS Before the adiposity rebound, maternal pre-pregnancy thinness explains most of the relationship with children's BMI. The relationship may emerge at older ages in children of overweight and obese mothers, and this latency may be an obstacle to early prevention.
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Affiliation(s)
- M Jacota
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Team 'Early origin of the child's health and development' (ORCHAD), Paris Descartes University, Paris, France
- University Paris-Sud, France
| | - A Forhan
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Team 'Early origin of the child's health and development' (ORCHAD), Paris Descartes University, Paris, France
| | - C Saldanha-Gomes
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Team 'Early origin of the child's health and development' (ORCHAD), Paris Descartes University, Paris, France
- University Paris-Sud, France
| | - M A Charles
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Team 'Early origin of the child's health and development' (ORCHAD), Paris Descartes University, Paris, France
| | - B Heude
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Team 'Early origin of the child's health and development' (ORCHAD), Paris Descartes University, Paris, France
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Bastos da Cunha C, Sicuro F, Maranhão PA, Borges MA, Cyrino FZ, Gazolla FM, Madeira IR, Bordallo MAN, Bouskela E, Kraemer-Aguiar LG. Microcirculation, Adiposity, and Traditional and Emerging Cardiovascular Risk Factors in Prepubertal Children. J Endocr Soc 2017; 1:908-917. [PMID: 29264541 PMCID: PMC5686770 DOI: 10.1210/js.2017-00130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 06/06/2017] [Indexed: 01/12/2023] Open
Abstract
PURPOSE Previous studies have shown that microvascular dysfunction (MD) is associated with a number of cardiovascular risk factors, including obesity. Few studies have assessed microvascular reactivity in children, and in most of these, results were confounded by the effects of puberty. Our aim was to establish whether MD is already present in obese prepubertal children. METHODS This cross-sectional study included 52 obese, 18 overweight, and 28 eutrophic children, with a mean ± standard deviation age of 7.44 ± 1.22 years. We evaluated cardiovascular risk factors and nutritive microvascular function by using nailfold dynamic videocapillaroscopy and determined functional capillary density (FCD), red blood cell velocity at resting conditions (RBCV) and at peak (RBCVmax), and time to reach peak velocity during the post-occlusive reactive hyperemic response following 1 minute ischemia. RESULTS On univariate analysis, differences in microvascular reactivity were not observed among the groups. Obese and overweight children had significantly higher scores than eutrophic children for the following parameters: body mass index, waist circumference, waist-to-height ratio, mean arterial pressure, homeostasis model assessment for insulin resistance, levels of insulin, leptin, glucose, triglycerides, total cholesterol, uric acid, and C-reactive protein. Multivariate analysis demonstrated the association between metabolic, anthropometric, and microvascular variables, stratified according to the degree of adiposity and body fat distribution. CONCLUSIONS Univariate analysis did not show any difference in microvascular reactivity between groups but, by testing these variables by multivariate means, we noticed a common and direct variation between cardiovascular/metabolic risk factors and microvascular reactivity occurring early in life.
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Affiliation(s)
- Carolina Bastos da Cunha
- Endocrinology, Department of Internal Medicine, Faculty of Medical Sciences, State University of Rio Janeiro, Rio de Janeiro, Brazil 20550-170
| | - Fernando Sicuro
- Clinical and Experimental Research Laboratory on Vascular Biology (BioVasc), Biomedical Center, State University of Rio de Janeiro, Rio de Janeiro, Brazil 20550-013
| | - Priscila Alves Maranhão
- Department of Information Sciences and Health Decision (CIDES) of the Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
| | - Marcos Antonio Borges
- Endocrinology, Department of Internal Medicine, Faculty of Medical Sciences, State University of Rio Janeiro, Rio de Janeiro, Brazil 20550-170
| | - Fátima Z. Cyrino
- Clinical and Experimental Research Laboratory on Vascular Biology (BioVasc), Biomedical Center, State University of Rio de Janeiro, Rio de Janeiro, Brazil 20550-013
| | - Fernanda Mussi Gazolla
- Endocrinology, Department of Internal Medicine, Faculty of Medical Sciences, State University of Rio Janeiro, Rio de Janeiro, Brazil 20550-170
| | - Isabel Rey Madeira
- Endocrinology, Department of Internal Medicine, Faculty of Medical Sciences, State University of Rio Janeiro, Rio de Janeiro, Brazil 20550-170
| | - Maria Alice Neves Bordallo
- Endocrinology, Department of Internal Medicine, Faculty of Medical Sciences, State University of Rio Janeiro, Rio de Janeiro, Brazil 20550-170
| | - Eliete Bouskela
- Clinical and Experimental Research Laboratory on Vascular Biology (BioVasc), Biomedical Center, State University of Rio de Janeiro, Rio de Janeiro, Brazil 20550-013
| | - Luiz Guilherme Kraemer-Aguiar
- Endocrinology, Department of Internal Medicine, Faculty of Medical Sciences, State University of Rio Janeiro, Rio de Janeiro, Brazil 20550-170
- Clinical and Experimental Research Laboratory on Vascular Biology (BioVasc), Biomedical Center, State University of Rio de Janeiro, Rio de Janeiro, Brazil 20550-013
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Usefulness of the Waist Circumference-to-Height Ratio in Screening for Obesity and Metabolic Syndrome among Korean Children and Adolescents: Korea National Health and Nutrition Examination Survey, 2010-2014. Nutrients 2017; 9:nu9030256. [PMID: 28287410 PMCID: PMC5372919 DOI: 10.3390/nu9030256] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 02/28/2017] [Accepted: 03/01/2017] [Indexed: 01/22/2023] Open
Abstract
The aims of this study were to assess the diagnostic value of the weight-to-height ratio (WHtR) for the detection of obesity and metabolic syndrome (MS) in Korean children and adolescents, and to determine the advantages of WHtR as a population-based screening tool in comparison with other obesity indicators, such as body mass index (BMI) and waist circumference (WC). We performed a cross-sectional analysis of data from 3057 children and adolescents (1625 boys, 1332 girls) aged 10-19 years who were included in the fifth Korean National Health and Nutrition Examination Survey (KNHANES, 2010-2012) up to the second year of the sixth KNHANES (2013-2014). Receiver operation characteristic (ROC) curves were generated to determine the optimal cutoff value and accuracy of WHtR for predicting individual obesity indicators or more than two non-WC components of MS. The area under the ROC curve (AUC) is a measure of the diagnostic power of a test. A perfect test will have an AUC of 1.0, and an AUC equal to 0.5 means that the test performs no better than chance. The optimal WHtR cutoff for the evaluation of general obesity and central obesity was 0.50 in boys and 0.47-0.48 in girls, and the AUC was 0.9. Regarding the assessment of each MS risk factor, the optimal WHtR cutoff was 0.43-0.50 in boys and 0.43-0.49 in girls, and these cutoffs were statistically significant only for the detection of high triglyceride and low High-density lipoprotein (HDL) cholesterol levels. When a pairwise comparison of the AUCs was conducted between WHtR and BMI/WC percentiles to quantify the differences in power for MS screening, the WHtR AUC values (boys, 0.691; girls, 0.684) were higher than those of other indices; however, these differences were not statistically significant (boys, p = 0.467; girls, p = 0.51). The WHtR cutoff value was 0.44 (sensitivity, 67.7%; specificity, 64.6%) for boys and 0.43 (sensitivity, 66.4%; specificity, 66.9%) for girls. There was no significant difference between the diagnostic power of WHtR and that of BMI/WC when screening for MS. Although the use of WHtR was not superior, WHtR is still useful as a screening tool for metabolic problems related to obesity because of its convenience.
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Lo K, Wong M, Khalechelvam P, Tam W. Waist-to-height ratio, body mass index and waist circumference for screening paediatric cardio-metabolic risk factors: a meta-analysis. Obes Rev 2016; 17:1258-1275. [PMID: 27452904 DOI: 10.1111/obr.12456] [Citation(s) in RCA: 165] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 06/17/2016] [Accepted: 06/29/2016] [Indexed: 02/01/2023]
Abstract
Waist-to-height ratio (WHtR) is superior to body mass index and waist circumference for measuring adult cardio-metabolic risk factors. However, there is no meta-analysis to evaluate its discriminatory power in children and adolescents. A meta-analysis was conducted using multiple databases, including Embase and Medline. Studies were included that utilized receiver-operating characteristics curve analysis and published area under the receiver-operating characteristics curves (AUC) for adiposity indicators with hyperglycaemia, elevated blood pressure, dyslipidemia, metabolic syndrome and other cardio-metabolic outcomes. Thirty-four studies met the inclusion criteria. AUC values were extracted and pooled using a random-effects model and were weighted using the inverse variance method. The mean AUC values for each index were greater than 0.6 for most outcomes including hypertension. The values were the highest when screening for metabolic syndrome (AUC > 0.8). WHtR did not have significantly better screening power than other two indexes in most outcomes, except for elevated triglycerides when compared with body mass index and high metabolic risk score when compared with waist circumference. Although not being superior in discriminatory power, WHtR is convenient in terms of measurement and interpretation, which is advantageous in practice and allows for the quick identification of children with cardio-metabolic risk factors at an early age.
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Affiliation(s)
- K Lo
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - M Wong
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong
| | - P Khalechelvam
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - W Tam
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Yoo EG. Waist-to-height ratio as a screening tool for obesity and cardiometabolic risk. KOREAN JOURNAL OF PEDIATRICS 2016; 59:425-431. [PMID: 27895689 PMCID: PMC5118501 DOI: 10.3345/kjp.2016.59.11.425] [Citation(s) in RCA: 127] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 06/06/2016] [Accepted: 06/07/2016] [Indexed: 02/07/2023]
Abstract
The waist-to-height ratio (WHtR), calculated by dividing the waist circumference (WC) by height, has recently gained attention as an anthropometric index for central adiposity. It is an easy-to-use and less age-dependent index to identify individuals with increased cardiometabolic risk. A WHtR cutoff of 0.5 can be used in different sex and ethnic groups and is generally accepted as a universal cutoff for central obesity in children (aged ≥6 years) and adults. However, the WHtR has not been validated in preschool children, and the routine use of WHtR in children under age 6 is not recommended. Prospective studies and meta-analysis in adults revealed that the WHtR is equivalent to or slightly better than WC and superior to body mass index (BMI) in predicting higher cardiometabolic risk. In children and adolescents, studies have shown that the WHtR is similar to both BMI and WC in identifying those at an increased cardiometabolic risk. Additional use of WHtR with BMI or WC may be helpful because WHtR considers both height and central obesity. WHtR may be preferred because of its simplicity and because it does not require sex- and age-dependent cutoffs; additionally, the simple message 'keep your WC to less than half your height' may be particularly useful. This review article summarizes recent publications on the usefulness of using WHtR especially when compared to BMI and WC as a screening tool for obesity and related cardiometabolic risks, and recommends the use of WHtR in clinical practice for obesity screening in children and adolescents.
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Affiliation(s)
- Eun-Gyong Yoo
- Department of Pediatrics, CHA Bundang Medical Center, CHA University, Seongnam, Korea
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Strufaldi MWL, Souza FISD, Puccini RF, Franco MDCP. Family history of cardiovascular disease and non-HDL cholesterol in prepubescent non-obese children. Rev Assoc Med Bras (1992) 2016; 62:347-52. [PMID: 27437681 DOI: 10.1590/1806-9282.62.04.347] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 06/21/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To describe the values of non-HDL cholesterol (NHDL-c) and the frequency of a family history of early cardiovascular disease (family HCVD) in healthy prepubescent children. Analyze the association between NHDL-c and family HCVD, and possible associations with other risk factors for cardiovascular disease (CVD). METHOD Cross-sectional study including 269 prepubescent (aged 6-10 years) schoolchildren with a normal body mass index (+1SD<BMI>-2SD). DATA COLLECTED Family HCVD; weight and height, waist circumference and systemic blood pressure; lipid profile (total cholesterol TC, HDL-c, triglycerides and LDL-c), NHDL-c calculation (CT-HDL-c, cut-off = 145 mg/dL) and insulin resistance (HOMA-IR). RESULTS High levels were found for NHDL-c in 10 (3.7%) of these schoolchildren, and family early HCVD was found in 46 (17.1%) of them. There was a weak association between family HCVD and NHDL-c (Cramer's-V-test = 0.120; p=0.050). Among the children with NHDL-c≥145 mg/dL, 4 (40%) have family HCVD. The presence of family HCVD was not associated with the variables being studied. The variables independently associated with NHDL-c ≥ 145 mg/dL were: HOMA-IR (OR=1.7; 95CI 1.1-2.6) and diastolic blood pressure (OR=1.1; 95CI 1.02-1.2). CONCLUSION NHDL-c values were associated with blood pressure and insulin resistance. Family HCVD was not associated with other classic risk factors for CVD, even though the frequency found was five times higher than that of high NHDL-c.
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Affiliation(s)
- Maria Wany Louzada Strufaldi
- PhD - Adjunct Professor, Department of Pediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil
| | - Fabíola Isabel Suano de Souza
- PhD - Adjunct Professor, Department of Pediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil.,PhD - Professor, Department of Pediatrics, Faculdade de Medicina do ABC (FMABC), Santo André, SP, Brazil
| | - Rosana Fiorini Puccini
- PhD - Full Professor, Department of Pediatrics, Escola Paulista de Medicina, Unifesp, São Paulo, SP, Brazil
| | - Maria do Carmo Pinho Franco
- PhD - Adjunct Professor, Department of Physiology, Escola Paulista de Medicina, Unifesp, São Paulo, SP, Brazil
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Mishra PE, Shastri L, Thomas T, Duggan C, Bosch R, McDonald CM, Kurpad AV, Kuriyan R. Waist-to-Height Ratio as an Indicator of High Blood Pressure in Urban Indian School Children. Indian Pediatr 2016; 52:773-8. [PMID: 26519712 DOI: 10.1007/s13312-015-0715-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To examine the utility of waist-to-height ratio to identify risk of high blood pressure when compared to body mass index and waist circumference in South Indian urban school children. DESIGN Secondary data analysis from a cross-sectional study. SETTING Urban schools around Bangalore, India. PARTICIPANTS 1913 children (58.1% males) aged 6-16 years with no prior history of chronic illness (PEACH study). METHODS Height, weight, waist circumference and of blood pressure were measured. Children with blood pressure ?90th percentile of age-, sex-, and height-adjusted standards were labelled as having high blood pressure. RESULTS 13.9% had a high waist-to-height ratio, 15.1% were overweight /obese and 21.7% had high waist circumference. High obesity indicators were associated with an increased risk of high blood pressure. The adjusted risk ratios (95% CI) of high systolic blood pressure with waist-to-height ratio, body mass index and waist circumference were 2.48 (1.76, 3.47), 2.59 (1.66, 4.04) and 2.38 (1.74, 3.26), respectively. Similar results were seen with high diastolic blood pressure. CONCLUSION Obesity indicators, especially waist-to-height ratio due to its ease of measurement, can be useful initial screening tools for risk of high blood pressure in urban Indian school children.
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Affiliation(s)
- P E Mishra
- St. Johns Medical College, and; Divisions of #Epidemiology and Biostatistics, and Nutrition, St. Johns Research Institute; Bangalore, India; Division of Gastroenterology, Hepatology and Nutrition, and Boston Childrens Hospital, Boston, MA, USA; Department of Biostatistics, Harvard School of Public Health; Boston, MA, USA. Correspondence to: Dr Rebecca Kuriyan, Division of Nutrition, St. Johns Research Institute, Bangalore 560 034, India.
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Zheng W, Zhao A, Xue Y, Zheng Y, Chen Y, Mu Z, Wang P, Zhang Y. Gender and urban-rural difference in anthropometric indices predicting dyslipidemia in Chinese primary school children: a cross-sectional study. Lipids Health Dis 2016; 15:87. [PMID: 27129304 PMCID: PMC4851820 DOI: 10.1186/s12944-016-0255-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 04/22/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Childhood dyslipidemia is a critical factor of lifelong health. Therefore, screening and controlling dyslipidemia from childhood is a practical healthy strategy. However, few studies have examined the performance of anthropometric predictors of dyslipidemia in Chinese children, let alone the potential gender and urban-rural disparity. Thus, we evaluated anthropometric indices predicting dyslipidemia by genders and living areas in Chinese children. METHODS Data were from a health and nutrition survey conducted in seven urban areas and two rural areas in China between 2011 and 2012. The serum lipid levels of the participants were compared between genders and living areas. The body mass index z-score (BMI z-score), waist-hip ratio (WHR), waist-height ratio (WHtR), and mid-upper arm height ratio (MaHtR) were used as predictors. The receiver operating characteristic (ROC) analysis was performed to investigate the ability of anthropometric indices predicting dyslipidemia. RESULTS A total of 773 participants (average age = 9.3 ± 1.7 y) were included. The prevalence of dyslipidemia was 10.9%. Anthropometric indices were all significantly related to blood lipid profiles in boys after adjustment for age. The areas under the ROC curves (ACUs) were significantly larger than 0.5 in boys (ranged between 0.66-0.73), and were larger in rural boys (ranged between 0.68 and 0.94). MaHtR and WHR were associated with the highest specificity (93.8%) and highest sensitivity (100%), respectively. CONCLUSION Using anthropometric indices, screening for dyslipidemia may be more appropriate in boys than in girls in China, especially in rural boys. The BMI z-score, WHR, WHtR, and MaHtR were all significantly associated with dyslipidemia in boys; using WHR and MaHtR as indicators achieved the highest sensitivity and specificity, respectively.
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Affiliation(s)
- Wei Zheng
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Ai Zhao
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Yong Xue
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Science, Beijing, China
| | - Yingdong Zheng
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Yun Chen
- Dairy Research Institute, Inner Mongolia Mengniu Dairy (Group) Co. Ltd., Inner Mongolia, China
| | - Zhishen Mu
- Dairy Research Institute, Inner Mongolia Mengniu Dairy (Group) Co. Ltd., Inner Mongolia, China
| | - Peiyu Wang
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Yumei Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, Xueyuan Road 38, Haidian District, 100191, Beijing, China. .,Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, Beijing, China.
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George GL, Schneider C, Kaiser L. Healthy Lifestyle Fitness Camp: A Summer Approach to Prevent Obesity in Low-Income Youth. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2016; 48:208-12.e1. [PMID: 26965098 DOI: 10.1016/j.jneb.2015.12.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 12/18/2015] [Accepted: 12/21/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To examine the effect of participation in a summer camp focused on nutrition and fitness among low-income youth. METHODS In 2011-2012, overweight and obese youth (n = 126) from Fresno, CA participated in a free 6-week summer program, Healthy Lifestyle Fitness Camp (HLFC), which included 3 h/wk of nutrition education provided by University of California CalFresh and 3 hours of daily physical activity through Fresno Parks and Recreation. The researchers used repeated-measures ANOVA to examine changes in weight, waist circumference, and waist-to-height ratio (WHtR) between HLFC and the comparison group (n = 29). RESULTS Significant pre-post WHtR reductions were observed in HLFC: 0.64 to 0.61 (P < .001). In addition, WHtR reductions were maintained in HLFC 2 months afterward whereas an increase occurred in the comparison group (P < .007). CONCLUSIONS AND IMPLICATIONS Understanding the impact of nutrition- and fitness-themed summer camps during unstructured months of summer is integral to obesity prevention among low-income youth.
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Affiliation(s)
- Gretchen Lynn George
- Department of Consumer and Family Studies/Dietetics, San Francisco State University, San Francisco, CA.
| | - Constance Schneider
- Youth, Families, and Communities Statewide Program, University of California, Agriculture and Natural Resources, Davis, CA
| | - Lucia Kaiser
- Department of Nutrition, University of California, Davis, David, CA
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Burns RD, Brusseau TA, Fang Y, Fu Y, Hannon JC. Establishing Waist-to-Height Ratio Standards from Criterion-Referenced BMI Using ROC Curves in Low-Income Children. J Obes 2016; 2016:2740538. [PMID: 27885339 PMCID: PMC5112308 DOI: 10.1155/2016/2740538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Revised: 10/06/2016] [Accepted: 10/16/2016] [Indexed: 11/26/2022] Open
Abstract
The purpose of this study was to establish health-related waist-to-height ratio (WHtR) cut-points associating with FITNESSGRAM's body mass index (BMI) criterion-referenced standards in low-income children. A secondary aim was to examine the classification agreement between the derived WHtR cut-points and various cardiometabolic blood markers using current recommendations. Participants were 219 children from low-income schools (mean age = 10.5 ± 0.6 years). Waist circumference, height, weight, and cardiometabolic blood markers were collected in a fasting state before school hours. Receiver operating characteristic (ROC) curves were used to determine WHtR cut-points that associated with a child meeting FITNESSGRAM's age- and sex-specific criterion-referenced standards for BMI. The derived WHtR cut-point was 0.50 (AUC = 0.89, p < 0.001; sensitivity = 0.86, specificity = 0.82, and accuracy = 84.3%). Classification agreement using the derived WHtR cut-point with various blood marker standards was statistically significant but considered weak to fair (kappa 0.14-0.34, agreement = 59%-67%, and p < 0.01). The WHtR cut-point of 0.50 can be used with strong accuracy to distinguish low-income children who met FITNESSGRAM's criterion-referenced standards for body composition; however, the evidence was weaker for its use in distinguishing low-income children meeting specific cardiometabolic blood marker recommendations.
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Affiliation(s)
- Ryan D. Burns
- Department of Health, Kinesiology, and Recreation, University of Utah, 250 S. 1850 E., HPER North, RM 241, Salt Lake City, UT 84112, USA
- *Ryan D. Burns:
| | - Timothy A. Brusseau
- Department of Health, Kinesiology, and Recreation, University of Utah, 250 S. 1850 E., HPER North, RM 241, Salt Lake City, UT 84112, USA
| | - Yi Fang
- Department of Health, Kinesiology, and Recreation, University of Utah, 250 S. 1850 E., HPER North, RM 241, Salt Lake City, UT 84112, USA
| | - You Fu
- School of Community Health Sciences, University of Nevada, Reno, 1664 North Virginia Street, Reno, NV 89557, USA
| | - James C. Hannon
- College of Physical Activity and Sport Sciences, West Virginia University, P.O. Box 6116, 375 Birch St., Morgantown, WV 26505-6116, USA
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Kongkiattikul L, Sritippayawan S, Chomtho S, Deerojanawong J, Prapphal N. Relationship between Obesity Indices and Pulmonary Function Parameters in Obese Thai Children and Adolescents. Indian J Pediatr 2015; 82:1112-6. [PMID: 25947270 DOI: 10.1007/s12098-015-1777-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 04/15/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To determine the correlation between various obesity indices and pulmonary function parameters in obese Thai children and adolescents. METHODS Obese children and adolescents aged from 8 to 18 y and diagnosed under the criteria of International Obesity Task Force (IOTF) were enrolled. Anthropometric and body composition measurements (bioelectrical impedance analysis) of all eligible participants were recorded. Pulmonary function studies (spirometry and body plethysmography) were also performed on the same day. RESULTS Forty-five children and adolescents [84 % boys; mean age 11.9 ± 2.4 y; mean BMI 31.8 ± 5.1 kg/m(2); and, mean body mass index (BMI) z-score 3.2 ± 0.5] were studied. Mean body fat percentage, mean fat mass index (FMI), mean fat free mass index, and mean truncal fat percentage were 47.4 ± 10.2 %, 15.2 ± 5.2 kg/m(2), 16.3 ± 3.1 kg/m(2), and 47.7 ± 11.5 %, respectively. Abnormal lung functions were found in 73.2 % of subjects; the most common was decreased functional residual capacity (FRC) (29 cases; 64.4 %). There was a negative correlation between FRC and BMI z-score (r = -0.32; p 0.03), waist-height ratio (r = -0.32; p 0.02), body fat percentage (r = -0.32; p 0.03), FMI (r = -0.36; p 0.02), and truncal fat percentage (r = -0.32; p 0.04). Obese individuals who had FMI > 17 kg/m(2) were 5.7 times more likely to have decreased FRC than those who had lower FMI (95 % CI 1.1-29.7; p 0.016). CONCLUSIONS Decreased FRC was the most common pulmonary function abnormality in obese children and adolescents. BMI z-score, waist-height ratio, body fat percentage, FMI, and truncal fat percentage were all negatively correlated with FRC. FMI had the highest negative correlation. Obese individuals with FMI > 17 kg/m(2) had a 5.7 times increased risk of low FRC. Appropriate planning for respiratory care and follow-up may be required in this population.
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Affiliation(s)
- Lalida Kongkiattikul
- Division of Pulmonology and Critical Care, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Rama IV Rd., Bangkok, 10330, Thailand
| | - Suchada Sritippayawan
- Division of Pulmonology and Critical Care, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Rama IV Rd., Bangkok, 10330, Thailand.
| | - Sirinuch Chomtho
- Division of Nutrition, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Jitladda Deerojanawong
- Division of Pulmonology and Critical Care, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Rama IV Rd., Bangkok, 10330, Thailand
| | - Nuanchan Prapphal
- Division of Pulmonology and Critical Care, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Rama IV Rd., Bangkok, 10330, Thailand
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Lek N, Yan W, Zhang Y, Wang Q, Cheung YB. Indices of central and general obesity and cardiometabolic risk among adolescents in three ethnic groups in north-west China. Ann Hum Biol 2015; 43:18-24. [DOI: 10.3109/03014460.2015.1014418] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Sharaye KO. Association of atherogenic indices and abdominal obesity indices among non obese adults in Zaria, Northern Nigeria. ACTA ACUST UNITED AC 2015. [DOI: 10.5897/jpap2014.0089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Cho WK, Kim H, Lee HY, Han KD, Jeon YJ, Jung IA, Kim SH, Cho KS, Park SH, Jung MH, Suh BK. Insulin Resistance of Normal Weight Central Obese Adolescents in Korea Stratified by Waist to Height Ratio: Results from the Korea National Health and Nutrition Examination Surveys 2008-2010. Int J Endocrinol 2015; 2015:158758. [PMID: 26257779 PMCID: PMC4519535 DOI: 10.1155/2015/158758] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 07/08/2015] [Indexed: 11/25/2022] Open
Abstract
Background. To evaluate insulin resistance of normal weight central obese 13-18-year-old male and female adolescents stratified by waist to height ratio (WHR). Methods. Data were obtained from the Korea National Health and Nutrition Examination Survey (K-NHANES) conducted during 2008-2010. Central obesity was defined as that in the upper quartile of age and sex specific WHR. Subjects were classified into no central obesity normal weight (NW), central obesity normal weight (CONW), no central obesity overweight (OW), and central obesity overweight (COOW). Results. The prevalence of CONW was 9.6% (83/832) in female and 7.0% (61/909) in male. CONW showed higher levels of insulin (P < 0.006), HOMA-IR (P < 0.006), and ALT (P < 0.001) than NW in female. CONW had higher levels of insulin (P < 0.0001), HOMA-IR (P < 0.0001), and WBC count (P < 0.021) and lower level of HDL (P < 0.0001) than NW in male. WHR and BMI had similar significant correlations with MS components. CONW showed 2.5 times (95% confidence interval, 1.21-5.00) more likelihood to have high insulin resistance than NW in male. Conclusions. Screening for central obesity using WHR in clinical setting is recommended.
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Affiliation(s)
- Won Kyoung Cho
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul 137-701, Republic of Korea
| | - Hyojin Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul 137-701, Republic of Korea
| | - Hyun Young Lee
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul 137-701, Republic of Korea
| | - Kyung Do Han
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul 137-701, Republic of Korea
| | - Yeon Jin Jeon
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul 137-701, Republic of Korea
| | - In Ah Jung
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul 137-701, Republic of Korea
| | - Shin Hee Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul 137-701, Republic of Korea
| | - Kyoung Soon Cho
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul 137-701, Republic of Korea
| | - So Hyun Park
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul 137-701, Republic of Korea
| | - Min Ho Jung
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul 137-701, Republic of Korea
| | - Byung-Kyu Suh
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul 137-701, Republic of Korea
- *Byung-Kyu Suh:
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Associations between adiposity indicators and elevated blood pressure among Chinese children and adolescents. J Hum Hypertens 2014; 29:236-40. [DOI: 10.1038/jhh.2014.95] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Revised: 06/18/2014] [Accepted: 07/18/2014] [Indexed: 11/09/2022]
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Waist-to-Height Ratio: a simple, effective and practical screening tool for childhood obesity and metabolic syndrome. Prev Med 2014; 67:35-40. [PMID: 24967955 DOI: 10.1016/j.ypmed.2014.06.025] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 06/03/2014] [Accepted: 06/16/2014] [Indexed: 02/01/2023]
Abstract
OBJECTIVE This study aimed to evaluate the diagnostic value of Waist-to-Height Ratio in early detection of obesity and metabolic syndrome in Chinese children and adolescents. METHOD A cross-sectional study was conducted in six cities in China in 2010 with 16,914 children and adolescents aged 7-17 years. Participants were randomly divided into the training and testing sets. Diagnostic values were estimated using sensitivity, specificity and areas under receiver operating characteristic curves. RESULTS The coefficients of variation of Waist-to-Height Ratio among age groups were lower than that of body mass index and waist circumstance. The area under receiver operating characteristic curve of Waist-to-Height Ratio was 0.968 in boys and 0.949 in girls for general obesity evaluation, and 0.983 in boys and 0.984 in girls for central obesity. The optimal cut-offs of Waist-to-Height Ratio were 0.47 in boys and 0.45 in girls in the training set and validated in the testing set. For metabolic syndrome evaluation, the sensitivity and specificity were 0.858 and 0.825 in boys, 0.864 and 0.812 in girls under the suggested cut-offs. CONCLUSION Waist-to-Height Ratio was a simple, effective and practical tool for mass screening childhood obesity and metabolic syndrome in China. It will have potential values in public health practice.
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Reference curves of anthropometric indices in two national studies conducted among Iranian children in 2003-2004 and 2009-2010: The Caspian study. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2014; 19:709-14. [PMID: 25422654 PMCID: PMC4235089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2013] [Revised: 02/26/2014] [Accepted: 08/20/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Reference percentile curves are usually used as a screening tool to determine growth disorders. Anthropometric indices are population-dependent and may differ according to ethnicity, dietary pattern and lifestyle habits. This study aims to compare the curves of anthropometric measures obtained in two national studies conducted among Iranian children and adolescents in 2003-2004 and 2009-2010. MATERIALS AND METHODS Anthropometric measures obtained in two nationwide surveys conducted in 10-18-year-old Iranian students were compared. Lambda-mu-sigma (LMS) Chart Maker Pro program was used to develop age- and gender-specific percentiles and to smooth and fit the model. RESULTS In 2003-2004, the mean and standard deviation (SD) of body mass index (BMI) and waist circumference (WC) were 18.98 ± 3.81 kg/m(2) and 67.50 ± 11.05 cm in boys; and 19.44 ± 3.78 kg/m(2) and 66.55 ± 9.89 cm in girls, respectively. In 2009-2010, the corresponding figures were 19.16 ± 4.07 kg/m(2), 69.42 ± 11.43 cm, 19.63 ± 4.11 kg/m(2), and 67.29 ± 9.69 cm, respectively. Height curves did not show considerable changes in two studies. Comparison of two series of studies showed that the weight, BMI, WC, and waist-to-height ratio were lower in adolescent girls than boys especially in higher percentiles. Moreover, in both genders, weight, BMI, and WC percentiles decreased. CONCLUSION The growth charts of Iranian children and adolescents aged 10-18 years have changed over 5 years. The reference growth curves change over time in the pediatric age group, repeated surveys should be conducted to update the age- and gender-specific reference curves in different populations.
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Ribeiro-Silva RDC, Florence TCM, Conceição-Machado MEPD, Fernandes GB, Couto RD. Indicadores antropométricos na predição de síndrome metabólica em crianças e adolescentes: um estudo de base populacional. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2014. [DOI: 10.1590/s1519-38292014000200007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objetivos: avaliar a capacidade dos indicadores antropométricos e pontos de corte na predição da síndrome metabólica (SM) em crianças e adolescentes. Métodos: estudo transversal, envolvendo amostra probabilística de 879 crianças e adolescentes de ambos os sexos. Dados metabólicos, antropométricos e sociodemográficos foram coletados. Para diagnóstico da SM, foi utilizada a definição modificada do National Cholesterol Education Program's Adult Treatment Panel III (NCEP-ATP III). A capacidade dos indicadores antropométricos na predição do SM foi avaliada por meio da curva Receiver Operating Characteristic (ROC). Resultados: a prevalência de SM foi de 6,6%. Na predição da SM, a área sob a curva ROC foi de 0,79 (0,72; 0,85) para índice de massa corporal (IMC), de 0,79 (0,73; 0,85) para circunferência da cintura (CC) e de 0,83 (0,78; 0,89) para circunferência da cintura corrigida pela estatura (RCE). O ponto de corte identificado para RCE na predição da SM foi de 0,448 (ambos os gêneros). Conclusões: todos os indicadores antropométricos utilizados, com pequena superioridade da RCE, foram bons preditores da SM. O ponto de corte identificado para RCE na predição da SM aproxima-se daquele proposto por alguns autores como universal. Sugere-se o uso deste índice dado a sua simples operacionalidade em estudos clínicos e epidemiológicos como preditor da SM.
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Bai YM, Chiou WF, Su TP, Li CT, Chen MH. Pro-inflammatory cytokine associated with somatic and pain symptoms in depression. J Affect Disord 2014; 155:28-34. [PMID: 24176538 DOI: 10.1016/j.jad.2013.10.019] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Revised: 09/23/2013] [Accepted: 10/10/2013] [Indexed: 12/11/2022]
Abstract
BACKGROUND More than two-thirds of depressed patients complain of somatic and pain symptoms, which are frequently regarded as a psychological reaction. Although there is a growing body of evidence showing that depression is related to immune abnormalities, few studies have investigated the association between inflammatory cytokines and somatic/pain symptoms. METHOD Patients with depressive disorder but without any medical disorders, and age/gender/body mass index (BMI)-matched healthy subjects were enrolled. All the subjects completed the self-rating scales of the Beck Depression Inventory-II and the Depression and Somatic Symptoms Scale, which was comprised of depressive, somatic, and pain subscales. Pro-inflammatory cytokines, including C-reactive protein (CRP), interleukin-2 receptor (sIL-2R), soluble interleukin 6 receptor (sIL-6R), soluble TNF-receptors (sTNF-R), soluble P-selectin (sP-selectin), monocyte chemotactic protein-1 (MCP-1), and adiponectin, were assessed by enzyme-linked immunosorbent assays. RESULTS In all, 109 patients with depressive disorder and 126 normal controls were enrolled. The patients with depressive disorder had significantly more severe depression, somatic and pain symptoms (all p<0.001), and higher levels of sIL-2R (p<0.0001), sTNF-R (p<0.001), and sP-selectin (p=0.005) than the normal control group. Using multivariate regression analysis with controlling of age, gender, BMI, and other pro-inflammatory cytokines, sIL-2R was the most significant predictor for depressive symptoms (p<0.0001); with further controlling of severity of depressive symptom, sP-selectin was the only predictor for somatic (p=0.002) and pain (p=0.059) symptoms. CONCLUSION The elevated sP-selectin associated with somatic symptoms in depression, may indicate early micro-vascular changes occur subtly, and provide neurobiological evidence for somatic and pain symptom in depression.
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Affiliation(s)
- Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan.
| | - Wen-Fei Chiou
- National Research Institute of Chinese Medicine, Taipei, Taiwan; Institute of Life Science, National Taitung University, Taitung, Taiwan; Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
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Alves DLR, Farias CRLD, Costa IFAFD, Simões MODS, Medeiros CCM, Carvalho DFD. Lipoprotein (a) and Ultrasensitive C-Reactive Protein in Overweight Adolescents. Health (London) 2014. [DOI: 10.4236/health.2014.617270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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50
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Abu Hanifah R, Mohamed MNA, Jaafar Z, Mohsein NASA, Jalaludin MY, Majid HA, Murray L, Cantwell M, Su TT. The correlates of body composition with heart rate recovery after step test: an exploratory study of Malaysian adolescents. PLoS One 2013; 8:e82893. [PMID: 24349388 PMCID: PMC3857804 DOI: 10.1371/journal.pone.0082893] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Accepted: 10/29/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND In adults, heart rate recovery is a predictor of mortality, while in adolescents it is associated with cardio-metabolic risk factors. The aim of this study was to examine the relationship between body composition measures and heart rate recovery (HRR) after step test in Malaysian secondary school students. METHODS In the Malaysian Health and Adolescents Longitudinal Research Team (MyHEART) study, 1071 healthy secondary school students, aged 13 years old, participated in the step test. Parameters for body composition measures were body mass index z-score, body fat percentage, waist circumference, and waist height ratio. The step test was conducted by using a modified Harvard step test. Heart rate recovery of 1 minute (HRR1min) and heart rate recovery of 2 minutes (HRR2min) were calculated by the difference between the peak pulse rate during exercise and the resting pulse rate at 1 and 2 minutes, respectively. Analysis was done separately based on gender. Pearson correlation analysis was used to determine the association between the HRR parameters with body composition measures, while multiple regression analysis was used to determine which body composition measures was the strongest predictor for HRR. RESULTS For both gender groups, all body composition measures were inversely correlated with HRR1min. In girls, all body composition measures were inversely correlated with HRR2min, while in boys all body composition measures, except BMI z-score, were associated with HRR2min. In multiple regression, only waist circumference was inversely associated with HRR2min (p=0.024) in boys, while in girls it was body fat percentage for HRR2min (p=0.008). CONCLUSION There was an inverse association between body composition measurements and HRR among apparently healthy adolescents. Therefore, it is important to identify cardio-metabolic risk factors in adolescent as an early prevention of consequent adulthood morbidity. This reiterates the importance of healthy living which should start from young.
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Affiliation(s)
- Redzal Abu Hanifah
- Sports Medicine Unit, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | | | - Zulkarnain Jaafar
- Sports Medicine Unit, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Nabilla Al-Sadat Abdul Mohsein
- Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | | | - Hazreen Abdul Majid
- Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Liam Murray
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Science, Queen's University, Belfast, Northern Ireland
| | - Marie Cantwell
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Science, Queen's University, Belfast, Northern Ireland
| | - Tin Tin Su
- Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
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