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Łupińska A, Aszkiełowicz S, Kowalik D, Jeziorny K, Kolasa-Kicińska M, Smalczewska P, Zygmunt A, Lewiński A, Stawerska R. Comparison of the Clinical Utility of Two Insulin Resistance Indices: IRI-HOMA and IRI-Belfiore in Diagnosing Insulin Resistance and Metabolic Complications in Children Based on the Results Obtained for the Polish Population. J Clin Med 2024; 13:2865. [PMID: 38792408 PMCID: PMC11122103 DOI: 10.3390/jcm13102865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 05/06/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024] Open
Abstract
Background: Recognizing insulin resistance (IR) in children remains challenging due to uncertain IRI-HOMA cut-offs and unclear recommendations for evaluating IR based on OGTT. In our study, we compare the effectiveness of IRI-HOMA and IRI-Belfiore (OGTT-based) in detecting IR and its metabolic complications in children. Methods: The analysis included 553 children who were hospitalized at the Department of Endocrinology and Metabolic Diseases of the Polish Mother's Memorial Hospital Research Institute (PMMH-RI) in Lodz, Poland, between 2002 and 2018 due to various reasons-of these, 67.5% were girls. All underwent OGTT for glucose and insulin assessment. IR diagnosis relied on IRI-HOMA and IRI-Belfiore. IR based on IRI-HOMA was evaluated using three criteria: (A) >2.5; (B) >2.67 in boys and >2.22 in girls before puberty and >5.22 and >3.82 during puberty, respectively; (C) >95th percentile according to charts for IRI-HOMA in children. Results: Prepubertal children exhibited significantly lower IRI-HOMA and IRI-Belfiore than their pubertal counterparts (p < 0.00005). IRI-HOMA and IRI-Belfiore values positively correlated with age and BMI SDS value (p < 0.000001 for all calculations). As many as 26% to 46.9% of children with normal IRI-HOMA showed elevated IRI-Belfiore, with notably higher levels of triglycerides, a lower HDL cholesterol fraction, and a lower HDL/total cholesterol ratio in this subgroup. Conclusions: A notable proportion of children exhibited elevated IRI-Belfiore levels despite having normal IRI-HOMA values. This suggests the possibility of peripheral IR preceding hepatic IR in children-omitting an OGTT may therefore lead to overlooking cases of IR. Children diagnosed with IR via OGTT displayed significantly poorer lipid profiles compared to those without IR (characterized by normal values in both IRI-HOMA and IRI-Belfiore). This underscores the ability of OGTT-derived IR indices to identify individuals at risk of developing complications associated with obesity and IR before the onset of metabolic syndrome (MS) symptoms. If IR is already detected in children based on fasting glucose and insulin levels (IRI-HOMA), further evaluation may not be warranted, as OGTT results often simply confirm the diagnosis.
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Affiliation(s)
- Anna Łupińska
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital Research Institute of Lodz, 93-338 Lodz, Poland; (A.Ł.); (S.A.); (D.K.); (K.J.); (A.Z.); (A.L.)
- Department of Pediatric Endocrinology, Medical University of Lodz, 90-419 Lodz, Poland
| | - Sara Aszkiełowicz
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital Research Institute of Lodz, 93-338 Lodz, Poland; (A.Ł.); (S.A.); (D.K.); (K.J.); (A.Z.); (A.L.)
| | - Dorota Kowalik
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital Research Institute of Lodz, 93-338 Lodz, Poland; (A.Ł.); (S.A.); (D.K.); (K.J.); (A.Z.); (A.L.)
| | - Krzysztof Jeziorny
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital Research Institute of Lodz, 93-338 Lodz, Poland; (A.Ł.); (S.A.); (D.K.); (K.J.); (A.Z.); (A.L.)
- Department of Pediatric Endocrinology, Medical University of Lodz, 90-419 Lodz, Poland
| | - Marzena Kolasa-Kicińska
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital Research Institute of Lodz, 93-338 Lodz, Poland; (A.Ł.); (S.A.); (D.K.); (K.J.); (A.Z.); (A.L.)
| | - Paula Smalczewska
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital Research Institute of Lodz, 93-338 Lodz, Poland; (A.Ł.); (S.A.); (D.K.); (K.J.); (A.Z.); (A.L.)
| | - Arkadiusz Zygmunt
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital Research Institute of Lodz, 93-338 Lodz, Poland; (A.Ł.); (S.A.); (D.K.); (K.J.); (A.Z.); (A.L.)
- Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, 90-419 Lodz, Poland
| | - Andrzej Lewiński
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital Research Institute of Lodz, 93-338 Lodz, Poland; (A.Ł.); (S.A.); (D.K.); (K.J.); (A.Z.); (A.L.)
- Department of Pediatric Endocrinology, Medical University of Lodz, 90-419 Lodz, Poland
| | - Renata Stawerska
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital Research Institute of Lodz, 93-338 Lodz, Poland; (A.Ł.); (S.A.); (D.K.); (K.J.); (A.Z.); (A.L.)
- Department of Pediatric Endocrinology, Medical University of Lodz, 90-419 Lodz, Poland
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Flores-Guillén E, Castro-Quezada I, Irecta-Nájera CA, Núñez-Ortega PE, Solís-Hernández R, García-Miranda R, Cruz-Cruz P, Medina-Gómez C, Sánchez-Chino XM, Olivo-Vidal ZE, Cruz M, Ochoa-Díaz-López H. Sociodemographic inequalities in cardiovascular risk factors among adolescents from indigenous areas in Chiapas, Mexico. CAD SAUDE PUBLICA 2023; 39:e00024623. [PMID: 37970940 PMCID: PMC10644975 DOI: 10.1590/0102-311xen024623] [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: 02/14/2023] [Revised: 06/24/2023] [Accepted: 08/17/2023] [Indexed: 11/19/2023] Open
Abstract
This study was aimed to determine the prevalence of cardiovascular risk factors among different sociodemographic groups of adolescents from indigenous communities in Chiapas, Mexico. A cross-sectional prevalence study was performed in urban and rural communities in the Tzotzil-Tzeltal and Selva regions of Chiapas. A sample of 253 adolescents was studied, of whom 48% were girls and 52% were boys. A descriptive analysis of quantitative variables was performed using measures of central tendency and dispersion. The prevalence of cardiovascular risk factors stratified by sex, geographical area, years of schooling, and ethnicity of the mothers was estimated. The prevalence of cardiovascular risk factors was analyzed in relation to the sociodemographic characteristics of the study population. Low HDL-c (51%) was the predominant cardiovascular risk factor. Girls had a higher prevalence of abdominal obesity, hypertriglyceridemia, and borderline total cholesterol than boys. High diastolic blood pressure was more prevalent in boys. Adolescents from urban areas had a higher prevalence of overweight/obesity and insulin resistance than adolescents from rural areas. The prevalence of overweight/obesity and abdominal obesity was higher in adolescents whose mothers had ≥ 7 years of schooling compared with adolescents with less educated mothers. Differences by maternal ethnicity also influenced the prevalence of insulin resistance. Among the main findings, this study associated sociodemographic and geographical inequalities with cardiovascular risk factors. Promoting a healthy lifestyle for this young population is absolutely necessary to prevent cardiovascular diseases in adulthood.
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Affiliation(s)
- Elena Flores-Guillén
- El Colegio de la Frontera Sur, San Cristóbal de Las Casas, México
- Universidad de Ciencias y Artes de Chiapas, Tuxtla Gutiérrez, México
| | | | | | | | | | - Rosario García-Miranda
- El Colegio de la Frontera Sur, San Cristóbal de Las Casas, México
- Escuelas de Lenguas, Universidad Autónoma de Chiapas, San Cristóbal de Las Casas, México
| | - Paola Cruz-Cruz
- El Colegio de la Frontera Sur, San Cristóbal de Las Casas, México
| | | | | | | | - Miguel Cruz
- Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Ciudad de México, México
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Raducha D, Ratajczak J, Kostrzeba E, Berus E, Walczak M, Petriczko E. Assessment of Biochemical Parameters in 8- and 9-Year-Old Children with Excessive Body Weight Participating in a Year-Long Intervention Program. J Clin Med 2023; 12:6560. [PMID: 37892696 PMCID: PMC10607870 DOI: 10.3390/jcm12206560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/01/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023] Open
Abstract
Childhood obesity represents a significant challenge both clinically and socio-economically. This study aimed to assess specific biochemical parameters, particularly glucose, insulin and lipid profile, before and after a year-long intervention program in 8- and 9-year-old children with excessive body weight living in Szczecin, Poland from 2016 to 2018. The research comprised two phases: screening in elementary schools and intervention in the outpatient clinic of the clinical Pomeranian Medical University hospital. Out of 11,494 8- to 9-year-olds in Szczecin, 42.54% (4890) participated in the screening. In the intervention phase, 515 children were examined. Anthropometric measurements were recorded at each visit, and blood samples were collected during the first and fourth visits. In the statistical analysis, the Kolmogorov-Smirnov, t-Student and ANOVA tests were employed (with statistical significance when p ≤ 0.05). Results highlighted a significant proportion of children exhibiting disruptions in carbohydrate and lipid metabolism. A total of 8.6% of participants had elevated total cholesterol, 9.7% had reduced HDL, 13.4% had elevated LDL, and 21.2% had elevated triglycerides. Initially, abnormal fasting glucose was detected in 4.7% of children, and elevated insulin levels in 3.1%. Metabolic disorders persisted post-intervention despite BMI improvement. The results emphasize the necessity for prolonged programs with frequent follow-ups targeting weight normalization in children.
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Affiliation(s)
- Dominika Raducha
- Department of Paediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of Developmental Age, Pomeranian Medical University in Szczecin, 71-252 Szczecin, Poland; (D.R.); (E.B.); (M.W.); (E.P.)
| | - Joanna Ratajczak
- Institute of Physical Culture Sciences, University of Szczecin, 70-237 Szczecin, Poland;
| | - Ewa Kostrzeba
- Department of Paediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of Developmental Age, Pomeranian Medical University in Szczecin, 71-252 Szczecin, Poland; (D.R.); (E.B.); (M.W.); (E.P.)
| | - Ewa Berus
- Department of Paediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of Developmental Age, Pomeranian Medical University in Szczecin, 71-252 Szczecin, Poland; (D.R.); (E.B.); (M.W.); (E.P.)
| | - Mieczysław Walczak
- Department of Paediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of Developmental Age, Pomeranian Medical University in Szczecin, 71-252 Szczecin, Poland; (D.R.); (E.B.); (M.W.); (E.P.)
| | - Elżbieta Petriczko
- Department of Paediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of Developmental Age, Pomeranian Medical University in Szczecin, 71-252 Szczecin, Poland; (D.R.); (E.B.); (M.W.); (E.P.)
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Ekperikpe US, Mandal S, Holt SJ, Daniels JK, Johnson TD, Cooper JS, Safir SM, Cornelius DC, Williams JM. Metformin reduces insulin resistance and attenuates progressive renal injury in prepubertal obese Dahl salt-sensitive rats. Am J Physiol Renal Physiol 2023; 325:F363-F376. [PMID: 37498548 PMCID: PMC10639024 DOI: 10.1152/ajprenal.00078.2023] [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: 04/06/2023] [Revised: 07/12/2023] [Accepted: 07/24/2023] [Indexed: 07/28/2023] Open
Abstract
Prepubertal obesity is currently an epidemic and is considered as a major risk factor for renal injury. Previous studies have demonstrated that insulin resistance contributes to renal injury in obesity, independent of diabetes. However, studies examining the relationship between insulin resistance and renal injury in obese children are lacking. Recently, we reported that progressive renal injury in Dahl salt-sensitive (SS) leptin receptor mutant (SSLepRmutant) rats was associated with insulin resistance before puberty. Therefore, the aim of the present study was to examine whether decreasing insulin resistance with metformin will reduce renal injury in SSLepRmutant rats. Four-wk-old SS and SSLepRmutant rats were separated into the following two groups: 1) vehicle and 2) metformin (300 mg/kg/day) via chow diet for 4 wk. Chronic administration of metformin markedly reduced insulin resistance and dyslipidemia in SSLepRmutant rats. We did not detect any differences in mean arterial pressure between vehicle and metformin-treated SS and SSLepRmutant rats. Proteinuria was significantly greater in SSLepRmutant rats versus SS rats throughout the study, and metformin administration significantly reduced proteinuria in SSLepRmutant rats. At the end of the protocol, metformin prevented the renal hyperfiltration observed in SSLepRmutant rats versus SS rats. Glomerular and tubular injury and renal inflammation and fibrosis were significantly higher in vehicle-treated SSLepRmutant rats versus SS rats, and metformin reduced these parameters in SSLepRmutant rats. These data suggest that reducing insulin resistance with metformin prevents renal hyperfiltration and progressive renal injury in SSLepRmutant rats before puberty and may be therapeutically useful in managing renal injury during prepubertal obesity.NEW & NOTEWORTHY Childhood/prepubertal obesity is a public health concern that is associated with early signs of proteinuria. Insulin resistance has been described in obese children. However, studies investigating the role of insulin resistance during childhood obesity-associated renal injury are limited. This study provides evidence of an early relationship between insulin resistance and renal injury in a rat model of prepubertal obesity. These data also suggest that reducing insulin resistance with metformin may be renoprotective in obese children.
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Affiliation(s)
- Ubong S Ekperikpe
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi, United States
| | - Sautan Mandal
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi, United States
| | - Stephen J Holt
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi, United States
| | - Jacori K Daniels
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi, United States
| | - Tyler D Johnson
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi, United States
| | - Jonita S Cooper
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi, United States
| | - Sarah M Safir
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi, United States
| | - Denise C Cornelius
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi, United States
| | - Jan M Williams
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi, United States
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La Valle A, d'Annunzio G, Campanello C, Tantari G, Pistorio A, Napoli F, Patti G, Crocco M, Bassi M, Minuto N, Piccolo G, Maghnie M. Are glucose and insulin levels at all time points during OGTT a reliable marker of diabetes mellitus risk in pediatric obesity? J Endocrinol Invest 2023:10.1007/s40618-023-02030-6. [PMID: 36763246 DOI: 10.1007/s40618-023-02030-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 02/01/2023] [Indexed: 02/11/2023]
Abstract
PURPOSE Childhood overweight and obesity associated with insulin resistance and metabolic syndrome represent the new global pandemic and the main causative factors for dysglycemia, prediabetes, and Type 2 Diabetes Mellitus (T2DM). Predictors, such as HOMA-IR, HOMA-β%, and QUICKI lack specific reference values in children. OGTT is a gold standard for glycometabolic assessment. Recently, a glycemic level higher than 155 mg/dl at + 60' after glucose ingestion has been defined as a risk factor for T2DM in obese adolescents. We aim to analyze and correlate fasting insulin-resistance markers with OGTT results in overweight/obese children and adolescents. METHODS We retrospectively evaluated glucose and insulin values during a 2-h OGTT every 30 min in 236 overweight/obese patients. Glucose values and insulin sum during OGTT were compared to glycometabolic indexes and different cut-off values for insulin sum. RESULTS A 1-h glucose > 155 mg/dl and insulin sum > 535 microU/ml at all times during OGTT are the best predictors of diabetes risk in obese youths. A1-h glucose > 155 mg/dl is significantly associated with HbA1c > 5.7%, while no association was observed between HbA1c > 5.7% and glucose levels at baseline and 2 h. The ability of the standardized HOMA-IR to predict the prediabetes status is clearly lower than the total insulin sum at OGTT. CONCLUSION Our study demonstrates that also 1-h post-OGTT glucose, together with HbA1c, is an effective diabetes predictor.
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Affiliation(s)
- A La Valle
- Pediatric Clinic and Endocrinology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - G d'Annunzio
- Pediatric Clinic and Endocrinology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - C Campanello
- Pediatric Clinic and Endocrinology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - G Tantari
- Pediatric Clinic and Endocrinology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - A Pistorio
- Epidemiology and Biostatistics Department, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - F Napoli
- Pediatric Clinic and Endocrinology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - G Patti
- Pediatric Clinic and Endocrinology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - M Crocco
- Gastroenterology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - M Bassi
- Pediatric Clinic and Endocrinology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - N Minuto
- Pediatric Clinic and Endocrinology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - G Piccolo
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy.
- Neurooncology Unit, IRCCS Istituto Giannina Gaslini, Via G. Gaslini 5, 16147, Genoa, Italy.
| | - M Maghnie
- Pediatric Clinic and Endocrinology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
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Severe Quantitative Scale of Acanthosis Nigricans in Neck is Associated with Abdominal Obesity, HOMA-IR, and Hyperlipidemia in Obese Children from Mexico City: A Cross-Sectional Study. Dermatol Res Pract 2022; 2022:2906189. [PMID: 35386232 PMCID: PMC8979734 DOI: 10.1155/2022/2906189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 02/07/2022] [Accepted: 03/12/2022] [Indexed: 11/17/2022] Open
Abstract
Background. Acanthosis nigricans (AN) is a clinical sign that commonly occurs in obesity; however, its specificity and sensitivity have been controversial. It is unknown if AN severity degree can be a useful marker for cardiometabolic disorders screening. We suggest that the stratified analysis of AN severity degree in neck by Burke’s scale could be a useful tool in the screening of cardiometabolic alterations in obese children. Objective. The aim of this study was the association of AN severity degree in neck by Burke’s scale with anthropometric, biochemical, and inflammatory parameters in obese school-age children from Mexico City. Methods. A cross-sectional study was conducted, including 95 obese school-age children stratified by AN severity degree in neck by Burke’s scale. Anthropometric and fasting biochemical measurements were determined. Variables were compared by x2 test for frequencies and one-way ANOVA with Bonferroni posttest for continuous variables. Linear regression analysis adjusted by gender, BMI, and age was performed to evaluate the association between AN severity degree and cardiometabolic alterations. Statistical significance was set at
. Results. As AN severity degree in neck by Burke’s scale increased, diastolic blood pressure (
) and triglycerides (
) significantly increased and adiponectin significantly decreased (
). Positive associations between grade 3 AN and waist circumference, HOMA-IR, triglycerides, total cholesterol, and LDL cholesterol were observed. Conclusion. Our findings could be used to identify an easier clinical tool to prevent obesity progression and its complications in pediatrics. There are no similar studies.
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Cho AY, Roh JG, Shim YS, Lee HS, Hwang JS. Biochemical predictors of metabolically unhealthy obesity in children and adolescents. J Pediatr Endocrinol Metab 2022; 35:97-103. [PMID: 34802201 DOI: 10.1515/jpem-2021-0542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 11/02/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Children and adolescents with obesity can now be classified according to metabolic profile, as those with metabolically healthy obesity (MHO) and those with metabolically unhealthy obesity (MUO). We aimed to determine the prevalence of MUO and identify its biochemical predictors in pediatric patients with obesity. METHODS We evaluated the medical records of 187 boys and girls with obesity. The children were divided into MHO and MUO groups, and anthropometric and biochemical parameters were assessed. Oral glucose tolerance test (OGTT) was used to identify impaired glucose regulation and hyperinsulinism, and binary logistic regression analysis was used to determine predictors of MUO in children with obesity. RESULTS Of the 187 children, MUO was found in 71.7% (n=134) and MHO in 28.3% (n=53); those in the MHO group were younger than those in the MUO group. Blood pressure, triglyceride, total cholesterol, and uric acid levels were significantly higher in the MUO group than in the MHO group. Further, the MUO group exhibited a significantly higher level of insulin resistance (p<0.05) than the MHO group. Serum levels of uric acid and homeostasis model assessment of insulin resistance index (HOMA-IR) were confirmed as biochemical predictors of the MUO phenotype in children with obesity. CONCLUSIONS The ratio of MUO in children with obesity was relatively high; further, serum levels of uric acid and HOMA-IR can be used as biochemical predictors of MUO.
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Affiliation(s)
- Ah Young Cho
- Department of Pediatrics, Ajou University School of Medicine, Ajou University Hospital, Suwon, Korea
| | - Jung Gi Roh
- Department of Pediatrics, Ajou University School of Medicine, Ajou University Hospital, Suwon, Korea
| | - Young Suk Shim
- Department of Pediatrics, Ajou University School of Medicine, Ajou University Hospital, Suwon, Korea
| | - Hae Sang Lee
- Department of Pediatrics, Ajou University School of Medicine, Ajou University Hospital, Suwon, Korea
| | - Jin Soon Hwang
- Department of Pediatrics, Ajou University School of Medicine, Ajou University Hospital, Suwon, Korea
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Du R, Li L, Li P, Wang Y. Impact of Insulin Resistance on Cardiometabolic Risk Factors and an Anthropometry-Based Predictive Nomogram for Insulin Resistance Among Adolescents in China. Front Endocrinol (Lausanne) 2022; 13:852395. [PMID: 35418950 PMCID: PMC8995502 DOI: 10.3389/fendo.2022.852395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/28/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE We aimed to investigate the impact of insulin resistance (IR), as determined by the homeostasis model assessment of insulin resistance (HOMA-IR), on cardiometabolic risk factors (CMRFs), and develop an anthropometry-based predictive nomogram for IR among adolescents in China. DESIGN Data were acquired from a cross-sectional study with a stratified cluster sampling method, conducted among adolescents in Northeast China. PARTICIPANTS A total of 882 adolescents (aged 12-16 years, 468 boys) were included. MEASUREMENTS All participants underwent anthropometric and biochemical examinations. The thresholds of IR included the 90th percentile of the HOMA-IR for adolescents with a normal body mass index (BMI) and fasting plasma glucose (FPG) level within each sex group (Cutoff A), and the 75th percentile for all participants of the same sex (Cutoff B). RESULTS The HOMA-IR was associated with CMRFs. IR, as defined by both cutoffs A and B, was significantly associated with most CMRFs, except decreased HDL-C levels. Excellent concordance (κ = 0.825) was found between these two criteria in diagnosing IR. However, IR using cutoff A, was more closely associated with cardiometabolic risk. The incidence of IR, as defined by cutoff A, was 18.93% and increased from 10.99% to 43.87% based on the different BMI categories. Further, an anthropometry-based predictive model for IR, incorporating sex, age, waist-to-hip ratio, weight and BMI, was developed and presented as a nomogram. CONCLUSIONS IR among adolescents is strongly related to cardiometabolic risk. We developed an anthropometry-based predictive nomogram for IR among adolescents, which may facilitate health counselling and self-risk assessments.
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Distribution of TyG index and homeostasis model assessment insulin resistance for the evaluation of insulin sensitivity on late adolescence in Mexicans. NUTR HOSP 2022; 39:1349-1356. [DOI: 10.20960/nh.04120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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10
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Risk Assessment and Determination of Factors That Cause the Development of Hyperinsulinemia in School-Age Adolescents. MEDICINA (KAUNAS, LITHUANIA) 2021; 58:medicina58010009. [PMID: 35056318 PMCID: PMC8778979 DOI: 10.3390/medicina58010009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/19/2021] [Accepted: 12/19/2021] [Indexed: 12/14/2022]
Abstract
Background and Objectives: Hyperinsulinemia and insulin resistance are not synonymous; if the risk of developing insulin resistance in adolescents is monitored, they do not necessarily have hyperinsulinemia. It is considered a condition of pre-diabetes and represents a condition of increased risk of developing DM (diabetes mellitus); it can exist for many years without people having the appropriate symptoms. This study aims to determine the risk of developing hyperinsulinemia at an early age in adolescents by examining which factors are crucial for its occurrence. Materials and Methods: The cross-sectional study lasting from 2019 to 2021 (2 years) was realized at the school children’s department in the Valjevo Health Center, which included a total of 822 respondents (392 male and 430 female) children and adolescents aged 12 to 17. All respondents underwent a regular, systematic examination scheduled for school children. BMI is a criterion according to which respondents are divided into three groups. Results: After summary analyzes of OGTT test respondents and calculated values of HOMA-IR (homeostatic model assessment for insulin resistance), the study showed that a large percentage of respondents, a total of 12.7%, are at risk for hyperinsulinemia. The research described in this paper aimed to use the most popular AI (artificial intelligence) model, ANN (artificial neural network), to show that 13.1% of adolescents are at risk, i.e., the risk is higher by 0.4%, which was shown by statistical tests as a significant difference. Conclusions: It is estimated that a model using three different ANN architectures, based on Taguchi’s orthogonal vector plans, gives more precise and accurate results with much less error. In addition to monitoring changes in each individual’s risk, the risk assessment of the entire monitored group is updated without having to analyze all data.
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The epidemiology, clinical, biochemical, immunological and radiological features of youth onset type 2 diabetes mellitus in the state of Qatar. Diabetol Int 2021; 13:381-386. [DOI: 10.1007/s13340-021-00548-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 10/01/2021] [Indexed: 01/16/2023]
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12
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Metwalley K, Farghaly H. Hormone resistance in children: what primary care physicians need to know. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021255. [PMID: 34487068 PMCID: PMC8477115 DOI: 10.23750/abm.v92i4.11613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 05/28/2021] [Indexed: 01/13/2023]
Abstract
Hormone resistance is defined as a reduced or absence of target tissues responsiveness to a hormone, where the presentation is related to either a relative lack or excess of hormones. Various disorders of hormone resistance were encountered including, Laron syndrome, nephrogenic diabetes insipidus, thyroid hormone resistance syndrome, pseudohypoparathyroidism, insulin resistance, familial glucocorticoid deficiency, pseudohypoaldosteronism, X linked hypophosphatemic rickets and androgen insensitivity syndrome. The article gives a summary that presents, in concentrated form, what the primary care physicians need to know about recognition, clinical presentation, diagnosis, and management of various hormone resistance in children.
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Affiliation(s)
- Kotb Metwalley
- Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt..
| | - Hekma Farghaly
- Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt..
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13
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Damar Ç, Işık E, Güngör Ş. Relationship between Quantitative Sonographic Measurements and Serum Biochemical Parameters in Childhood Obesity. Pediatr Gastroenterol Hepatol Nutr 2021; 24:470-482. [PMID: 34557399 PMCID: PMC8443855 DOI: 10.5223/pghn.2021.24.5.470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 03/12/2021] [Accepted: 07/10/2021] [Indexed: 11/19/2022] Open
Abstract
PURPOSE We investigated the relationship between sonographic measurements of fatty liver and body mass index standard deviation score (BMI-Z score), abdominal wall fat thickness (AWFT), and serum biochemical parameters in childhood obesity. METHODS Anthropometric, laboratory, and ultrasonography data were obtained from 174 children with BMI-Z score >1. After the qualitative grading of hepatosteatosis (grades 0-3), the quantitative liver-kidney echogenicity ratio (LKER) was calculated using a software tool. Groups according to sex, age (AG-I to AG-III), BMI-Z score (BMG-I to BMG-III), and hepatosteatosis degree (HS-I and HS-II) were formed. The differences and distributions of the variables were statistically analyzed and compared among the groups. RESULTS Serum transaminase and glucose levels showed a positive correlation with LKER, whereas the HDL level showed a negative correlation. BMI-Z score and AWFT showed a positive correlation with fasting insulin level and HOMA-IR value. LKER was significantly higher in girls than in boys (p=0.008). In the AG-I group (age 3-8.9 years), the BMI-Z score was significantly higher, whereas AWFT was significantly lower than in the other age groups (p<0.001). The cutoff point of LKER for predicting grade 2 or higher steatosis (HS-II group) was determined to be 1.83. Cardiovascular disease risk was significantly higher in the HS-II group (p=0.035). CONCLUSION As a valuable quantitative measurement tool, LKER can be used for the sonographic screening of fatty liver. AWFT, on the basis of its correlation with fasting insulin level and HOMA-IR value, may be a useful sonographic parameter in the management of childhood obesity.
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Affiliation(s)
- Çağrı Damar
- Department of Pediatric Radiology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Emregül Işık
- Clinics of Pediatric Endocrinology, Department of Pediatrics, Gaziantep Children's Hospital, Gaziantep, Turkey
| | - Şükrü Güngör
- Clinics of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaraş, Turkey
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Smetanina N, Valickas R, Vitkauskiene A, Albertsson-Wikland K, Verkauskienė R. Prevalence of Metabolic Syndrome and Impaired Glucose Metabolism among 10- to 17-Year-Old Overweight and Obese Lithuanian Children and Adolescents. Obes Facts 2021; 14:271-282. [PMID: 33951670 PMCID: PMC8255643 DOI: 10.1159/000514720] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 01/19/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Overweight (Ow) and obesity among adults and children increases the risk of metabolic consequences. Metabolic syndrome (MS) and impaired glucose metabolism are well-known risk factors for cardiovascular diseases and type 2 diabetes. The aim of this study was to evaluate the prevalence of MS and impaired glucose metabolism among Ow and obese (Ob) children and adolescents (aged 10-17 years) in Lithuania, and to evaluate the associations between insulin resistance (IR) indices and anthropometric parameters as well as metabolic disturbances. METHODS The study population consisted of 344 OwOb children and adolescents of all pubertal stages. Oral glucose tolerance tests (OGTTs), IR and β cell function indices, lipid profile, and anthropometric parameters of all subjects were analyzed. MS was defined according to the International Diabetes Federation consensus guidelines. RESULTS MS was found in 21.3% of the OwOb children and adolescents, and 12.1% had impaired glucose metabolism (6.9% with impaired fasting glucose, 4.5% with impaired glucose tolerance, and 0.6% with type 2 diabetes). IR was directly related to body mass index and waist circumference, waist-to-height and waist-to-hip ratios, and sum of skin-fold thicknesses. Children with MS were more insulin-resistant, had higher odds ratio for prediabetes and had a more disturbed lipid profile than subjects without MS. Moreover, total cholesterol and low-density lipoprotein cholesterol levels were significantly lower in the more mature OwOb adolescents. CONCLUSION MS and lipid profile disturbances are common in OwOb children and adolescents. MS is directly associated with IR. Therefore, OwOb children and adolescents should be carefully followed up for metabolic abnormalities during late childhood as these can persist into adulthood.
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Affiliation(s)
- Natalija Smetanina
- Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
- *Natalija Smetanina,
| | - Raimondas Valickas
- Department of Radiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Astra Vitkauskiene
- Department of Laboratory Medicine, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Kerstin Albertsson-Wikland
- Department of Physiology/Endocrinology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Rasa Verkauskienė
- Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
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15
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Lee SH, Ahn MB, Choi YJ, Kim SK, Kim SH, Cho WK, Cho KS, Suh BK, Jung MH. Comparison of different criteria for the definition of insulin resistance and its relationship to metabolic risk in children and adolescents. Ann Pediatr Endocrinol Metab 2020; 25:227-233. [PMID: 32871651 PMCID: PMC7788347 DOI: 10.6065/apem.2040002.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 04/03/2020] [Indexed: 12/19/2022] Open
Abstract
PURPOSE Childhood obesity frequently persists into adulthood and is associated with insulin resistance (IR) and increased long-term morbidity and mortality. We compared IR criteria concerning 'age-specific cutoff point' (ACOP) and 'fixed cutoff point' (FCOP) for the identification of IR and investigated their correlation with metabolic syndrome (MS). METHODS Data were acquired from the 5th Korea National Health and Nutrition Examination Survey (2010-2011). Participants ranged from 10 to 17 years of age and underwent fasting plasma glucose, insulin concentration, and lipid panel measurements. High fasting plasma insulin levels or increased homeostatic model assessment insulin resistance (HOMA-IR) were defined as IR. We analyzed MS and IR frequencies according to FCOP or ACOP. RESULTS Among 719 participants, 165 (22.9%) were overweight or obese based on their body mass index. We found no prevalence of MS in underweight/normal weight participants and 12.7% prevalence rate in overweight or obese participants. IR according to ACOP was more closely associated with MS than IR according to FCOP. No differences were found in predicting the frequency of MS using FCOP or ACOP in both fasting plasma insulin and HOMA-IR. CONCLUSION The frequency of MS in participants with IR defined using ACOP and FCOP was similar. However, IR using ACOP was more closely associated with MS than IR using FCOP.
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Affiliation(s)
- Seon Hwa Lee
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Moon Bae Ahn
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yu Jung Choi
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seul Ki Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Shin Hee Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Won Kyoung Cho
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyoung Soon Cho
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Byung-Kyu Suh
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Min Ho Jung
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea,Address for correspondence: Min Ho Jung, MD Department of Pediatrics, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 1063(yuksam)-ro, Yeongdeungpogu, Seoul 07345, Korea Tel: +82-2-3779-1131 Fax: +82-2-783-2589 E-mail:
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16
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Chao C, Wang R, Jones M, Karson N, Jussel A, Smith J, Richdale K, Harrison W. The Relationship Between Corneal Nerve Density and Hemoglobin A1c in Patients With Prediabetes and Type 2 Diabetes. Invest Ophthalmol Vis Sci 2020; 61:26. [PMID: 33112943 PMCID: PMC7594598 DOI: 10.1167/iovs.61.12.26] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 10/15/2020] [Indexed: 01/02/2023] Open
Abstract
Purpose Decreased corneal nerve fiber density and higher corneal epithelial dendritic cells have been reported in established patients with type 2 diabetes; however, alterations in the subbasal nerve plexus in prediabetes with healthy subjects or subjects with diabetes is limited. The study aimed to determine corneal nerve fiber density and morphology and dendritic cell density between healthy subjects and those with prediabetes or type 2 diabetes. Methods Fifty-two subjects (aged 30-70 years) were recruited. Blood samples and body metrics were taken. Subjects were grouped as: healthy controls (hemoglobin A1c [HbA1c] < 5.7%), prediabetes (5.7-6.4%), and type 2 diabetes (> 6.4% or physician diagnosis). Central corneal subbasal nerve plexus was imaged using in vivo confocal microscopy. Corneal nerve fiber density and morphology, including interconnections and tortuosity, and dendritic cell density were assessed. Kruskal-Wallis tests were carried out to compare differences in the examined variables between groups. Spearman correlations were carried out to examine the associations between body metrics with HbA1c and corneal findings. Results Seventeen healthy controls, 20 subjects with prediabetes, and 15 subjects with type 2 diabetes completed this study. Central corneal nerve fiber density was significantly lower in type 2 diabetes compared to prediabetes (P = 0.045) and healthy controls (P = 0.001). No differences were found in central corneal nerve fiber interconnections, tortuosity, or dendritic cell density between groups. There was a significant association between HbA1c and corneal nerve fiber density (rho = -0.45, P = 0.001) and body mass index (BMI; rho = -0.30, P = 0.04). Conclusions Increased HbA1c values are associated with decreased corneal nerve fiber density across the spectrum of type 2 diabetes.
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Affiliation(s)
- Cecilia Chao
- University of Houston, College of Optometry, Houston, Texas, United States
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Rachel Wang
- University of Houston, College of Optometry, Houston, Texas, United States
| | - Morgan Jones
- University of Houston, College of Optometry, Houston, Texas, United States
| | - Nicole Karson
- University of Houston, College of Optometry, Houston, Texas, United States
| | - Allison Jussel
- University of Houston, College of Optometry, Houston, Texas, United States
| | - Jennyffer Smith
- University of Houston, College of Optometry, Houston, Texas, United States
| | - Kathryn Richdale
- University of Houston, College of Optometry, Houston, Texas, United States
| | - Wendy Harrison
- University of Houston, College of Optometry, Houston, Texas, United States
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López-Contreras IN, Vilchis-Gil J, Klünder-Klünder M, Villalpando-Carrión S, Flores-Huerta S. Dietary habits and metabolic response improve in obese children whose mothers received an intervention to promote healthy eating: randomized clinical trial. BMC Public Health 2020; 20:1240. [PMID: 32795294 PMCID: PMC7427732 DOI: 10.1186/s12889-020-09339-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 08/03/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lifestyles habits such as eating unhealthy foodscommence at home and are associated with the development of obesity and comorbidities such as insulin resistance, metabolic syndrome, and chronic degenerative diseases, which are the main causes of death in adults. The present study compared changes in dietary habits, behaviors and metabolic profiles of obese children whose mothers attended at the hospital to group sessions, with those who received the usual nutritional consultation. METHODS Randomized clinical trial, 177 mother/obese child pairs participated, 90 in the intervention group and 87 in the control group. The intervention group attended six group education sessions to promote healthy eating, being this an alternative of change of habits in children with obesity. The control group received the usual nutritional consultation; both groups were followed up for 3 months. Frequency of food consumption, behaviors during feeding in the house and metabolic profile was evaluated. Mixed effect linear regression models were used to evaluate the effect of the intervention on the variables of interest, especially in HOMA-IR. RESULTS The intervention group reduced the filling of their dishes (p = 0.009), forcing the children to finish meals (p = 0.003) and food substitution (p < 0.001), moreover increased the consumption of roasted foods (p = 0.046), fruits (p = 0.002) and vegetables (p < 0.001). The children in the control group slightly increased HOMA-IR levels (0.51; 95% CI - 0.48 to 1.50), while the children in the intervention group significantly decreased (- 1.22; 95% CI - 2.28 to - 1.16). The difference in HOMA-IR between the control and intervention group at the end of the follow-up was - 1.67; 95% CI: - 3.11 to - 0.24. CONCLUSIONS The educational intervention improved some eating habits at home, as well as HOMA-IR levels; why we consider that it can be an extra resource in the management of childhood obesity. TRIAL REGISTRATION Clinicaltrials.gov, NCT04374292 (Date assigned: May 5, 2020). Retrospectively registered.
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Affiliation(s)
- Iris Nallely López-Contreras
- Gastroenterology and Nutrition Department, Hospital Infantil de México Federico Gómez, Ministry of Health (SSA), Mexico City, Mexico
| | - Jenny Vilchis-Gil
- Epidemiological Research Unit in Endocrinology and Nutrition, Hospital Infantil de México Federico Gomez, Ministry of Health (SSA), Dr. Márquez No 162, 06720, Mexico City, Mexico.,Medicine Faculty, National Autonomous University of Mexico, Mexico City, Mexico
| | - Miguel Klünder-Klünder
- Deputy Director of Research, Hospital Infantil de México Federico Gómez, Ministry of Health (SSA), Mexico City, Mexico.,Research Committee, Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN), Mexico City, Mexico
| | - Salvador Villalpando-Carrión
- Gastroenterology and Nutrition Department, Hospital Infantil de México Federico Gómez, Ministry of Health (SSA), Mexico City, Mexico
| | - Samuel Flores-Huerta
- Epidemiological Research Unit in Endocrinology and Nutrition, Hospital Infantil de México Federico Gomez, Ministry of Health (SSA), Dr. Márquez No 162, 06720, Mexico City, Mexico.
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Rotondo E, Chiarelli F. Endocrine-Disrupting Chemicals and Insulin Resistance in Children. Biomedicines 2020; 8:E137. [PMID: 32481506 PMCID: PMC7344713 DOI: 10.3390/biomedicines8060137] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/24/2020] [Accepted: 05/25/2020] [Indexed: 12/25/2022] Open
Abstract
The purpose of this article is to review the evidence linking background exposure to endocrine-disrupting chemicals (EDCs) with insulin resistance in children. Although evidence in children is scarce since very few prospective studies exist even in adults, evidence that EDCs might be involved in the development of insulin resistance and related diseases such as obesity and diabetes is accumulating. We reviewed the literature on both cross-sectional and prospective studies in humans and experimental studies. Epidemiological studies show a statistical link between exposure to pesticides, polychlorinated bisphenyls, bisphenol A, phthalates, aromatic polycyclic hydrocarbides, or dioxins and insulin resistance.
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Affiliation(s)
- Eleonora Rotondo
- Department of Pediatrics, University of Chieti, I-66100 Chieti, Italy;
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Lima RDD, Pereira RM, Muñoz VR, Canciglieri RDS, Canciglieri PH. Occurrence of overweight in schoolchildren and analysis of agreement between anthropometric methods. REVISTA BRASILEIRA DE CINEANTROPOMETRIA E DESEMPENHO HUMANO 2020. [DOI: 10.1590/1980-0037.2020v22e67037] [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] Open
Abstract
Abstract The child population is strongly affected by obesity. Accessible and reliable strategies for the obesity diagnosis are of utmost importance.. The aim of this study was to identify childhood obesity according the WHO (World Health Organization): malnourished, healthy weight, overweight and obese. It was collected measures of height, Body Mass Index (BMI), Waist Circumference (WC) and Triceps Skinfold Thickness (TSF) of 449 children from Municipal School of Araras/SP, from 7 to 10 years old. It was performed a Spearman correlation test between BMI, WC and TSF variables. Also, was realized cross tabulation between the found results by the different methods, constructing a contingency table 2x2, with absolute frequency of boys and girls classified as “without overweight” and “with overweight”. The concordance between methods was analyzed by kappa index. In the results, 28.3% of children presented overweight according to BMI, with higher prevalence in boys. Generally, the found results through TSF showed strong correlation with both BMI and WC (rs=0.7994 e rs=0.7519, respectively). The same was observed when data was analyzed separately by sex. When crossed the TSF data with BMI and WC, the kappa index demonstrated a satisfactory concordance (0.4419 e 0.5161, respectively). The TSF can be suggested a method to body composition assessment and cardiometabolic risk in children.
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Bitew ZW, Alemu A, Ayele EG, Tenaw Z, Alebel A, Worku T. Metabolic syndrome among children and adolescents in low and middle income countries: a systematic review and meta-analysis. Diabetol Metab Syndr 2020; 12:93. [PMID: 33117455 PMCID: PMC7590497 DOI: 10.1186/s13098-020-00601-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 10/19/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is a clustering of cardiovascular risk factors, which is rising in the low and middle income countries (LMICs). There are various studies with inconsistent findings that are inconclusive for policy makers and program planners. Thus, this systematic review and meta-analysis aimed at estimating the pooled prevalence of MetS and its components in LMICs. METHODS Electronic searches were conducted in international databases including PubMed, Web of Science, EMBASE (Elsevier), Scopus, CINAHL (EBSCOhost), Science direct (Elsevier), Food Science and Technology Abstracts (FSTA), Global Health and Medline, and other sources (World Cat, Google Scholar, and Google). The pooled estimates were computed in the random effect model. The pooled prevalence was computed using the three diagnostic methods (IDF, ATP III and de Ferranti). Publication bias was verified using funnel plot and Egger's regression test. Subgroup and sensitivity analysis were performed to identify the possible sources of heterogeneity among the included studies. RESULT In this study, 142,142 children and adolescents from 76 eligible articles were included to compute the pooled prevalence of MetS and its components in LMCIs. MeTs among overweight and obese population was computed from 20 articles with the pooled prevalence of 24.09%, 36.5%, and 56.32% in IDF, ATP III and de Ferranti criteria, respectively. Similarly, a total of 56 articles were eligible to compute the pooled prevalence of MetS in the general population of children and adolescents. Hence, Mets was found in 3.98% (IDF), 6.71% (ATP III) and 8.91% (de Ferranti) of study subjects. Regarding the components of MetS, abdominal obesity was the major component in overweight and obese population and low HDL-C was the most common component in the general population. This study also revealed that males were highly affected by MetS than females. CONCLUSION This study illustrates that MetS among children and adolescents is an emerging public health challenge in LMICs, where the prevalence of obesity is on the move. Preventive strategies such as community and school based intervention need to be designed. Promoting physical activities and healthy eating behaviors could avert this problem.
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Affiliation(s)
| | | | | | - Zelalem Tenaw
- College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Anmut Alebel
- College of Health Science, Debremarkose University, Debre Markos, Ethiopia
- Australian Centre for Public and Population Health Research, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW Australia
| | - Teshager Worku
- College of Health and Medical Sciences, School of Nursing and Midwifery, Haramaya University, Harar, Ethiopia
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Li GH, Chen XF, Liang XY, Lin H, Zhang L, Xu XQ, Wu W, Huang K, Dong GP, Zhang JW, Rose SR, Ullah R, Zeitler P, Fu JF. β-Cell function in obese children and adolescents with metabolic syndrome compared to isolated obesity. Pediatr Diabetes 2019; 20:861-870. [PMID: 31408243 DOI: 10.1111/pedi.12905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 05/05/2019] [Accepted: 05/08/2019] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To evaluate β-cell function in obese children and adolescents meeting clinical criteria for isolated obesity (iOB), isolated components of dysmetabolism (cMD), or metabolic syndrome (MS), and in obese children and adolescents with normal glucose tolerance (NGT), impaired glucose regulation (IGR), or type 2 diabetes (T2DM). STUDY DESIGN We undertook a prospective study of Han Chinese children and adolescents aged 8-16 years (median 11 ± 1.4) seen in an obesity clinic between May 2013 and 2018. Patients were classified as iOB (53), cMD (139), and MS (139) groups based on clinical criteria. The same patients were also classified as NGT (212), IGR (111), or T2DM (8) based on results of an oral glucose tolerance test (OGTT). The MS patients were classified as NGT [MS](59) and IGR [MS](72) for the further study. All participants also completed a mixed-meal tolerance test (MMTT). RESULTS Compared with the iOB group, the MS group had significantly higher area under the curve of C-peptide up to the 2 hours (AUC CP) (P = .03) and peak C-peptide (P = .03), adjusted for BMI, age and Tanner stage, on MMTT. However, there was no difference in the insulinogenic index (ΔI30/ΔG30) or oral disposition index (oDI) derived from the OGTT among the three groups. However, 52% of participants with MS had IGR, compared to 28% in the cMD group. Compared with the NGT group, the individuals with IGR had significantly lower ΔI30/ΔG30 (P = .001) and oDI (P < .001). Compared with the iOB group, the NGT[MS] had significantly higher AUC CP (P = .004), peak C-peptide (P = .004) and ΔI30/ΔG30 (P = .007) adjusted for age, but no difference in oDI. Compared with the NGT[MS], the IGR[MS] had significantly lower ΔI30/ΔG30 (P = .005) and oDI (P < .001), but the AUC CP and peak C-peptide had no difference. CONCLUSION Although the MS youth have β-cell hyperfunction as a whole, β-cell dysfunction is present in the early stages of dysmetabolism in obese youth with cMD or MS and worsened across the spectrum from iOB to cMD and MS, contributing to development of T2DM.
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Affiliation(s)
- Guo-Hua Li
- Department of Endocrinology, The Children's Hospital of the Zhejiang University School of Medicine, Hangzhou, China
| | - Xue-Feng Chen
- Department of Endocrinology, The Children's Hospital of the Zhejiang University School of Medicine, Hangzhou, China
| | - Xin-Yi Liang
- Department of Endocrinology, The Children's Hospital of the Zhejiang University School of Medicine, Hangzhou, China
| | - Hu Lin
- Department of Endocrinology, The Children's Hospital of the Zhejiang University School of Medicine, Hangzhou, China
| | - Li Zhang
- Department of Endocrinology, The Children's Hospital of the Zhejiang University School of Medicine, Hangzhou, China
| | - Xiao-Qin Xu
- Department of Endocrinology, The Children's Hospital of the Zhejiang University School of Medicine, Hangzhou, China
| | - Wei Wu
- Department of Endocrinology, The Children's Hospital of the Zhejiang University School of Medicine, Hangzhou, China
| | - Ke Huang
- Department of Endocrinology, The Children's Hospital of the Zhejiang University School of Medicine, Hangzhou, China
| | - Guan-Ping Dong
- Department of Endocrinology, The Children's Hospital of the Zhejiang University School of Medicine, Hangzhou, China
| | - Jian-Wei Zhang
- Department of Endocrinology, The Children's Hospital of the Zhejiang University School of Medicine, Hangzhou, China
| | - Susan R Rose
- Pediatric Endocrinology and Metabolism, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Rahim Ullah
- Department of Endocrinology, The Children's Hospital of the Zhejiang University School of Medicine, Hangzhou, China
| | - Phil Zeitler
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
| | - Jun-Fen Fu
- Department of Endocrinology, The Children's Hospital of the Zhejiang University School of Medicine, Hangzhou, China
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Guilherme FR, Nascimento MAD, Molena-Fernandes CA, Guilherme VR, Santos SRD, Elias RGM, Rinaldi W. COMPARISON OF DIFFERENT CRITERIA IN THE PREVALENCE OF METABOLIC SYNDROME IN STUDENTS FROM PARANAVAÍ, PARANÁ. REVISTA PAULISTA DE PEDIATRIA 2019; 37:332-337. [PMID: 31166466 PMCID: PMC6868564 DOI: 10.1590/1984-0462/;2019;37;3;00007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 04/10/2018] [Indexed: 01/19/2023]
Abstract
Objective: To investigate the difference in the proportion of students with metabolic
syndrome, diagnosed according to different criteria. Methods: The sample consisted of 241 students (136 boys and 105 girls) aged 10 to 14
years, from public and private schools in Paranavaí, Paraná. We used three
distinct diagnostic criteria for metabolic syndrome, considering the
presence of at least three of the following risk factors: increased waist
circumference, hypertension, fasting hyperglycemia, low HDL-C, and elevated
triglycerides. Results: The prevalence of metabolic syndrome found was 1.7% (confidence interval of
95% - 95%CI 0-3.3) for the IDF criterion; 3.3% (95%CI 1.0-5.6) for Cook; and
17.4% (95%CI 12.6-22.3) for Ferranti. Analyzing the criteria in pairs, the
agreement between IDF and Cook was 97.5% (k=0.95); between IDF and Ferranti,
83.4% (k=0.67); and between Cook and Ferranti, 85.9% (k=0.72). Onlyone
student (0.4%) was diagnosed with metabolic syndrome solely by the IDF
criterion, while 34 (14.1%) were diagnosed exclusively by Ferranti. The
comparison of the three criteria showed that Ferranti presented the highest
proportion of metabolic syndrome (p<0.001), and Cook had a greater
proportion than IDF (p<0.001). Conclusions: We found a significant difference in the proportion of metabolic syndrome in
the three criteria. The choice of which criterion to use can compromise not
only the percentage of metabolic syndrome prevalence but also interfere in
strategies of intervention and prevention in children and adolescents with
and without metabolic syndrome, respectively.
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Affiliation(s)
- Flávio Ricardo Guilherme
- Universidade Estadual do Paraná, Brazil; Faculdade de Tecnologia e Ciências do Norte do Paraná, Brazil
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García AG, Urbina Treviño MV, Villalpando Sánchez DC, Aguilar CA. Diagnostic accuracy of triglyceride/glucose and triglyceride/HDL index as predictors for insulin resistance in children with and without obesity. Diabetes Metab Syndr 2019; 13:2329-2334. [PMID: 31405638 DOI: 10.1016/j.dsx.2019.05.020] [Citation(s) in RCA: 12] [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: 04/24/2019] [Accepted: 05/22/2019] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To investigate which of two indexes (TyG or TG/HDL) are the best predictors for insulin resistance (IR) and to evaluate the magnitude of each cardiometabolic risk factor in Mexican schoolchildren of 5-9 years with overweight-obesity and normal weight. MATERIAL AND METHODS We realized a comparative cross-sectional prospective study in accordance of STARD guidelines. Setting was Family Medicine Unit (FMU) No. 80 of Mexican Institute of Social Security(IMSS) of Morelia, Michoacán, Mexico. Children between 5 and 9 years, both genders, 104 with normal weight(NW), 97 with Overweight-Obesity(OO Group) were included. Once the informed consent was signed we obtained the BMI, waist circumference, blood pressure(BP) and 5 mL of blood collected for glucose, cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, uric acid and insulin. As main outcome measures TyG or TG/HDL, HOMA-IR, and Receiving Operating Curves(ROC), sensitivity, specificity by ROC were obtained. RESULTS Cutoff point TyG: 8.5 by ROC had an area under curve (AUC):0.802 IC95% 0.77to0.893, P = 0.0001; diagnostic accuracy of 73%. TG/HDL 2.22; AUC:0.729 IC95% 0.622to0.837, P = 0.014; diagnostic accuracy of 52%. TyG can identify cardiometabolic alterations more than HOMA and TG/HDL. Cardiometabolic alterations in the OO group were hypertriglyceridemia:49.5%, low HDL:63.9%, IR:39.2% and in NW group were hypertriglyceridemia:30.8%, low HDL:60.6%, IR:9.6%. CONCLUSIONS We reported high frequency of hypertriglyceridemia and low HDL in Mexican children. TyG and TG/HDL are good predictors for IR. TyG has a better diagnostic accuracy. We need implementing TyG for identifying alterations and intervening in a timely manner to delay the onset of chronic diseases in children.
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Affiliation(s)
- Anel Gómez García
- Center of Biomedical Research of Michoacán, Clinic Investigation Division, Mexican Institute of Security Social, Mexico.
| | | | | | - Cleto Alvarez Aguilar
- Medical Auxiliary Coordination of Health Research, Michoacán, Mexican Institute of Security Social, Mexico
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Tagi VM, Giannini C, Chiarelli F. Insulin Resistance in Children. Front Endocrinol (Lausanne) 2019; 10:342. [PMID: 31214120 PMCID: PMC6558106 DOI: 10.3389/fendo.2019.00342] [Citation(s) in RCA: 94] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 05/13/2019] [Indexed: 12/28/2022] Open
Abstract
Insulin resistance (IR) is a pathological condition strongly associated with obesity. However, corticosteroids or growth hormone therapy and genetic diseases may affect insulin sensitivity lifelong. In obese children and adolescents of any age there is an evident association between IR and an increased prevalence of type 2 diabetes (T2D) and other elements contributing to the metabolic syndrome, leading to a higher cardiovascular risk. Therefore, early diagnosis and interventions in the attempt to prevent T2D when glycemia values are still normal is fundamental. The gold standard technique used to evaluate IR is the hyperinsulinemic euglycemic clamp, however it is costly and difficult to perform in clinical and research sets. Therefore, several surrogate markers have been proposed. Although the treatment of insulin resistance in children is firstly targeted to lifestyle interventions, in selected cases the integration of a pharmacological intervention might be taken into consideration. The aim of this review is to present the current knowledge on IR in children, starting with an outline of the recent evidences about the congenital forms of deficiency in insulin functioning and therefore focusing on the physiopathology of IR, its appropriate measurement, consequences, treatment options and prevention strategies.
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Pulungan AB, Afifa IT, Annisa D. Type 2 diabetes mellitus in children and adolescent: an Indonesian perspective. Ann Pediatr Endocrinol Metab 2018; 23:119-125. [PMID: 30286566 PMCID: PMC6177658 DOI: 10.6065/apem.2018.23.3.119] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 09/01/2018] [Accepted: 09/17/2018] [Indexed: 02/03/2023] Open
Abstract
The prevalence of type 2 diabetes mellitus (T2DM) in children and adolescents has increased globally over the past 2 decades. Metabolic syndrome, including obesity and overweight at a young age, increases the occurrence of T2DM. Studies in Indonesia have found that obese children and adolescents are more likely to have insulin resistance, a risk factor for T2DM. There are no data on the current incidence of T2DM in youth in Indonesia, but there has been a significant rise in the prevalence of overweight in adolescents. The diagnosis of T2DM in youth is similar to that in adults, with special consideration of when to test asymptomatic children. Management of T2DM in Indonesia follows the recommendations of the Indonesian Pediatric Society, which include lifestyle modifications, such as improving dietary habits and exercise, as well as appropriate medications. Metformin is the drug of choice for young T2DM patients; if marked hyperglycemia is present, basal insulin is given with metformin. Monitoring of T2DM is generally done through selfmonitoring of blood glucose and glycosylated hemoglobin.
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Affiliation(s)
- Aman Bhakti Pulungan
- Endocrinology Division, Child Health Department, Faculty of Medicine University of Indonesia – Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | | | - Diadra Annisa
- Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
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26
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Ávila-Curiel A, Galindo-Gómez C, Juárez-Martínez L, Osorio-Victoria ML. [Metabolic syndrome in children aged 6 to 12 years with obesity in public schools of seven municipalities in the State of Mexico]. SALUD PUBLICA DE MEXICO 2018; 60:395-403. [PMID: 30137941 DOI: 10.21149/8470] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 12/07/2017] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE To estimate the prevalence of Metabolic Syndrome (MS), its components and its association with obesity and cardiovascular risk in school age children. MATERIALS AND METHODS A cross-sectional study of 1,017 children from 6 to 12 years of age. Anthropometric information, blood pressure, glucose, insulin, cholesterol, HDLc, LDLc and triglycerides were collected. The presence of MS and its components were determined by criteria of Cook et. al. (2003), modified for children and adolescents. In the analysis, the children were grouped by aged group of 6 to 9 and 10 to 12 years. The association between MS, obesity and cardiovascular risk was estimated using Student's t-test and Mann-Whitney U test, Chi-square test and logistic regression. RESULTS The MS was present with 54.6% in obese children. Obesity was the characteristic of greater association to suffer from MS with an OR=8.62 p<0.001. CONCLUSIONS MS is high among children with obesity, and is mostly associated with insulin resistance and atherogenic risk.
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Affiliation(s)
- Abelardo Ávila-Curiel
- Dirección de Nutrición, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Ciudad de México, México
| | - Carlos Galindo-Gómez
- Dirección de Nutrición, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Ciudad de México, México
| | - Liliana Juárez-Martínez
- Dirección de Nutrición, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Ciudad de México, México
| | - Mario Luis Osorio-Victoria
- Dirección de Nutrición, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Ciudad de México, México
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27
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López-Contreras BE, Morán-Ramos S, Villarruel-Vázquez R, Macías-Kauffer L, Villamil-Ramírez H, León-Mimila P, Vega-Badillo J, Sánchez-Muñoz F, Llanos-Moreno LE, Canizalez-Román A, Del Río-Navarro B, Ibarra-González I, Vela-Amieva M, Villarreal-Molina T, Ochoa-Leyva A, Aguilar-Salinas CA, Canizales-Quinteros S. Composition of gut microbiota in obese and normal-weight Mexican school-age children and its association with metabolic traits. Pediatr Obes 2018; 13:381-388. [PMID: 29388394 DOI: 10.1111/ijpo.12262] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 10/25/2017] [Accepted: 10/31/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND Childhood obesity is a serious public health problem in Mexico. Adult gut microbiota composition has been linked to obesity, but few studies have addressed the role of gut microbiota in childhood obesity. OBJECTIVES The aim of this study is to compare gut microbiota composition in obese and normal-weight children and to associate gut microbiota profiles with amino acid serum levels and obesity-related metabolic traits. METHODS Microbial taxa relative abundance was determined by 16S rRNA sequencing in 67 normal-weight and 71 obese children aged 6-12 years. Serum amino acid levels were measured by mass spectrometry. Associations between microbiota composition, metabolic parameters and amino acid serum levels were tested. RESULTS No significant differences in phyla abundances or Firmicutes/Bacteroidetes ratios were observed between normal-weight and obese children. However, Bacteroides eggerthii abundance was significantly higher in obese children and correlated positively with body fat percentage and negatively with insoluble fibre intake. Additionally, Bacteroides plebeius and unclassified Christensenellaceae abundances were significantly higher in normal-weight children. Abundance of both these species correlated negatively with phenylalanine serum levels, a metabolite also found to be associated with obesity in Mexican children. CONCLUSIONS The study identified bacterial species associated with obesity, metabolic complications and amino acid serum levels in Mexican children.
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Affiliation(s)
- B E López-Contreras
- Unidad de Genómica de Poblaciones Aplicada a la Salud, Facultad de Química, UNAM/Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, Mexico
| | - S Morán-Ramos
- Unidad de Genómica de Poblaciones Aplicada a la Salud, Facultad de Química, UNAM/Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, Mexico.,Consejo Nacional de Ciencia y Tecnología (CONACYT), Mexico City, Mexico
| | - R Villarruel-Vázquez
- Unidad de Genómica de Poblaciones Aplicada a la Salud, Facultad de Química, UNAM/Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, Mexico
| | - L Macías-Kauffer
- Unidad de Genómica de Poblaciones Aplicada a la Salud, Facultad de Química, UNAM/Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, Mexico
| | - H Villamil-Ramírez
- Unidad de Genómica de Poblaciones Aplicada a la Salud, Facultad de Química, UNAM/Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, Mexico
| | - P León-Mimila
- Unidad de Genómica de Poblaciones Aplicada a la Salud, Facultad de Química, UNAM/Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, Mexico
| | - J Vega-Badillo
- Unidad de Genómica de Poblaciones Aplicada a la Salud, Facultad de Química, UNAM/Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, Mexico
| | - F Sánchez-Muñoz
- Departamento de Inmunología, Instituto Nacional de Cardiología 'Ignacio Chávez', Mexico City, Mexico
| | - L E Llanos-Moreno
- Unidad de Genómica de Poblaciones Aplicada a la Salud, Facultad de Química, UNAM/Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, Mexico
| | - A Canizalez-Román
- CIASaP, Facultad de Medicina, Universidad Autónoma de Sinaloa, Culiacán, Mexico
| | | | - I Ibarra-González
- Instituto de Investigaciones Biomédicas, UNAM/Instituto Nacional de Pediatría, Mexico City, Mexico.,Laboratorio de Errores Innatos del Metabolismo y Tamiz, Instituto Nacional de Pediatría, Mexico City, Mexico
| | - M Vela-Amieva
- Laboratorio de Errores Innatos del Metabolismo y Tamiz, Instituto Nacional de Pediatría, Mexico City, Mexico
| | - T Villarreal-Molina
- Laboratorio de Genómica de Enfermedades Cardiovasculares, INMEGEN, Mexico City, Mexico
| | - A Ochoa-Leyva
- Unidad de Genómica de Poblaciones Aplicada a la Salud, Facultad de Química, UNAM/Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, Mexico.,Departamento de Microbiología Molecular, Instituto de Biotecnología, Universidad Nacional Autónoma de México, Cuernavaca, Mexico
| | - C A Aguilar-Salinas
- Departamento de Endocrinología y Metabolismo, Instituto Nacional de Ciencias Médicas y Nutrición, Mexico City, Mexico
| | - S Canizales-Quinteros
- Unidad de Genómica de Poblaciones Aplicada a la Salud, Facultad de Química, UNAM/Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, Mexico
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Panchal SK, Bliss E, Brown L. Capsaicin in Metabolic Syndrome. Nutrients 2018; 10:E630. [PMID: 29772784 PMCID: PMC5986509 DOI: 10.3390/nu10050630] [Citation(s) in RCA: 84] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 05/07/2018] [Accepted: 05/14/2018] [Indexed: 12/21/2022] Open
Abstract
Capsaicin, the major active constituent of chilli, is an agonist on transient receptor potential vanilloid channel 1 (TRPV1). TRPV1 is present on many metabolically active tissues, making it a potentially relevant target for metabolic interventions. Insulin resistance and obesity, being the major components of metabolic syndrome, increase the risk for the development of cardiovascular disease, type 2 diabetes, and non-alcoholic fatty liver disease. In vitro and pre-clinical studies have established the effectiveness of low-dose dietary capsaicin in attenuating metabolic disorders. These responses of capsaicin are mediated through activation of TRPV1, which can then modulate processes such as browning of adipocytes, and activation of metabolic modulators including AMP-activated protein kinase (AMPK), peroxisome proliferator-activated receptor α (PPARα), uncoupling protein 1 (UCP1), and glucagon-like peptide 1 (GLP-1). Modulation of these pathways by capsaicin can increase fat oxidation, improve insulin sensitivity, decrease body fat, and improve heart and liver function. Identifying suitable ways of administering capsaicin at an effective dose would warrant its clinical use through the activation of TRPV1. This review highlights the mechanistic options to improve metabolic syndrome with capsaicin.
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Affiliation(s)
- Sunil K Panchal
- Functional Foods Research Group, University of Southern Queensland, Toowoomba QLD 4350, Australia.
| | - Edward Bliss
- Functional Foods Research Group, University of Southern Queensland, Toowoomba QLD 4350, Australia.
- School of Health and Wellbeing, University of Southern Queensland, Toowoomba QLD 4350, Australia.
| | - Lindsay Brown
- Functional Foods Research Group, University of Southern Queensland, Toowoomba QLD 4350, Australia.
- School of Health and Wellbeing, University of Southern Queensland, Toowoomba QLD 4350, Australia.
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29
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Vázquez-Frias R, García-Ortiz J, Valencia-Mayoral P, Castro-Narro G, Medina-Bravo P, Santillán-Hernández Y, Flores-Calderón J, Mehta R, Arellano-Valdés C, Carbajal-Rodríguez L, Navarrete-Martínez J, Urbán-Reyes M, Valadez-Reyes M, Zárate-Mondragón F, Consuelo-Sánchez A. Mexican consensus on lysosomal acid lipase deficiency diagnosis. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO (ENGLISH EDITION) 2018. [DOI: 10.1016/j.rgmxen.2018.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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30
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Vázquez-Frias R, García-Ortiz JE, Valencia-Mayoral PF, Castro-Narro GE, Medina-Bravo PG, Santillán-Hernández Y, Flores-Calderón J, Mehta R, Arellano-Valdés CA, Carbajal-Rodríguez L, Navarrete-Martínez JI, Urbán-Reyes ML, Valadez-Reyes MT, Zárate-Mondragón F, Consuelo-Sánchez A. Mexican consensus on lysosomal acid lipase deficiency diagnosis. REVISTA DE GASTROENTEROLOGIA DE MEXICO (ENGLISH) 2018; 83:51-61. [PMID: 29287906 DOI: 10.1016/j.rgmx.2017.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 07/09/2017] [Accepted: 08/16/2017] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Lysosomal acid lipase deficiency (LAL-D) causes progressive cholesteryl ester and triglyceride accumulation in the lysosomes of hepatocytes and monocyte-macrophage system cells, resulting in a systemic disease with various manifestations that may go unnoticed. It is indispensable to recognize the deficiency, which can present in patients at any age, so that specific treatment can be given. The aim of the present review was to offer a guide for physicians in understanding the fundamental diagnostic aspects of LAL-D, to successfully aid in its identification. METHODS The review was designed by a group of Mexican experts and is presented as an orienting algorithm for the pediatrician, internist, gastroenterologist, endocrinologist, geneticist, pathologist, radiologist, and other specialists that could come across this disease in their patients. An up-to-date review of the literature in relation to the clinical manifestations of LAL-D and its diagnosis was performed. The statements were formulated based on said review and were then voted upon. The structured quantitative method employed for reaching consensus was the nominal group technique. RESULTS A practical algorithm of the diagnostic process in LAL-D patients was proposed, based on clinical and laboratory data indicative of the disease and in accordance with the consensus established for each recommendation. CONCLUSION The algorithm provides a sequence of clinical actions from different studies for optimizing the diagnostic process of patients suspected of having LAL-D.
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Affiliation(s)
- R Vázquez-Frias
- Departamento de Gastroenterología y Nutrición, Hospital Infantil de México Federico Gómez, Secretaría de Salud, Ciudad de México, México
| | - J E García-Ortiz
- Centro de Investigación Biomédica de Occidente, CMNO-IMSS, Guadalajara, Jalisco, México
| | - P F Valencia-Mayoral
- Dirección de Planeación, Hospital Infantil de México Federico Gómez, Secretaría de Salud, Ciudad de México, México
| | - G E Castro-Narro
- Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
| | - P G Medina-Bravo
- Departamento de Endocrinología, Hospital Infantil de México Federico Gómez, Secretaría de Salud, Ciudad de México, México
| | - Y Santillán-Hernández
- Departamento de Genética, Centro Médico Nacional 20 de Noviembre, ISSSTE, Ciudad de México, México
| | - J Flores-Calderón
- Servicio de Gastroenterología, Hospital de Pediatría «Dr. Silvestre Frenk Freund», Centro Médico Nacional Siglo XXI, IMSS, Ciudad de México, México
| | - R Mehta
- Departamento de Endocrinología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
| | | | - L Carbajal-Rodríguez
- Departamento de Medicina Interna, Instituto Nacional de Pediatría, Ciudad de México, México
| | - J I Navarrete-Martínez
- Departamento de Genética, Hospital Central Sur de Alta Especialidad de Petróleos Mexicanos, Ciudad de México, México
| | - M L Urbán-Reyes
- Departamento de Gastroenterología y Nutrición, Hospital Infantil de México Federico Gómez, Secretaría de Salud, Ciudad de México, México
| | - M T Valadez-Reyes
- Departamento de Imagenología, Hospital Infantil de México Federico Gómez, Secretaría de Salud, Ciudad de México, México
| | - F Zárate-Mondragón
- Departamento de Gastroenterología y Nutrición, Instituto Nacional de Pediatría, Ciudad de México, México
| | - A Consuelo-Sánchez
- Departamento de Gastroenterología y Nutrición, Hospital Infantil de México Federico Gómez, Secretaría de Salud, Ciudad de México, México.
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Nogueira-de-Almeida CA, de Mello ED. Different Criteria for the Definition of Insulin Resistance and Its Relation with Dyslipidemia in Overweight and Obese Children and Adolescents. Pediatr Gastroenterol Hepatol Nutr 2018; 21:59-67. [PMID: 29383306 PMCID: PMC5788952 DOI: 10.5223/pghn.2018.21.1.59] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 10/24/2017] [Accepted: 10/26/2017] [Indexed: 02/06/2023] Open
Abstract
PURPOSE to compare cut off points corrected for age and gender (COOP) with fixed cut off points (FCOP) for fasting plasma insulin and Homeostatic model assessment-insulin resistance (HOMA-IR) for the diagnosis of IR in obese children and adolescents and their correlation with dyslipidemia. METHODS A multicenter, cross-sectional study including 383 subjects aged 7 to 18 years, evaluating fasting blood glucose, plasma insulin, and lipid profile. Subjects with high insulin levels and/or HOMA-IR were considered as having IR, based on two defining criteria: FCOP or CCOP. The frequency of metabolic abnormalities, the presence of IR, and the presence of dyslipidemia in relation to FCOP or CCOP were analyzed using Fisher and Mann-Whitney exact tests. RESULTS Using HOMA-IR, IR was diagnosed in 155 (40.5%) and 215 (56.1%) patients and, using fasting insulin, 150 (39.2%) and 221 (57.7%), respectively applying FCOP and CCOP. The use of CCOP resulted in lower insulin and HOMA-IR values than FCOP. Dyslipidemia was not related to FCOP or CCOP. Blood glucose remained within normal limits in all patients with IR. There was no difference in the frequency of IR identified by plasma insulin or HOMA-IR, both for FCOP and CCOP. CONCLUSION The CCOP of plasma insulin or of HOMA-IR detected more cases of IR as compared to the FCOP, but were not associated with the frequency of dyslipidemia. As blood glucose has almost no fluctuation in this age group, even in the presence of IR, fasting plasma insulin detected the same cases of IR that would be detected by HOMA-IR.
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Affiliation(s)
| | - Elza Daniel de Mello
- Department of Pediatric, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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Insulin Resistance and Its Association with Metabolic Syndrome in Korean Children. BIOMED RESEARCH INTERNATIONAL 2017; 2017:8728017. [PMID: 29457038 PMCID: PMC5804402 DOI: 10.1155/2017/8728017] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 11/21/2017] [Accepted: 12/03/2017] [Indexed: 01/27/2023]
Abstract
Background This study investigated the association between insulin resistance (IR) and metabolic syndrome (MetS) in children. Methods A cross-sectional study involving 1036 healthy children aged between 7 and 13 years was conducted. Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated as an index of IR. Participants were classified according to the HOMA-IR quartiles. Results Incremental, linear trends were found in age (p < 0.001), body mass index (BMI) (p < 0.001), body fat (p < 0.001), waist circumference (p < 0.001), resting blood pressures (BP) (p < 0.001), triglycerides (TG) (p < 0.001), total cholesterol (TC) (p < 0.001), high density lipoprotein-cholesterol (HDL-C) (p < 0.001), FBG (p < 0.001), and insulin (<0.001) according to incremental HOMA-IR categories (from the 1st to 4th quartile). Compared with children in the 1st HOMA-IR quartile, children in the 4th HOMA-IR quartile had significantly higher odd ratios (ORs) of abnormalities in systolic (p = 0.051) and diastolic BP (p = 0.005), FBG (p < 0.001), TG (p < 0.001), TC (p = 0.016), and HDL-C (p = 0.006) even after adjustments for age, gender, BMI, and body fat percentage. Children in the 3rd HOMA-IR quartile had significant abnormalities in FBG (p < 0.001), TG (p = 0.001), and HDL-C (p = 0.010) even after adjustments for the covariates. Conclusion The current findings suggest that IR is significantly associated with the clustering of MetS risk factors in children in Korea.
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Barbosa-Cortés L, López-Alarcón M, Mejía-Aranguré JM, Klünder-Klünder M, del Carmen Rodríguez-Zepeda M, Rivera-Márquez H, de la Vega-Martínez A, Martin-Trejo J, Shum-Luis J, Solis-Labastida K, López-Aguilar E, Matute-González G, Bernaldez-Rios R. Adipokines, insulin resistance, and adiposity as a predictors of metabolic syndrome in child survivors of lymphoma and acute lymphoblastic leukemia of a developing country. BMC Cancer 2017; 17:125. [PMID: 28193268 PMCID: PMC5307882 DOI: 10.1186/s12885-017-3097-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 01/31/2017] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND There is a growing body of evidence indicating that pediatric survivors of cancer are at a greater risk of developing metabolic syndrome. This study evaluated some probable predictors of metabolic syndrome (MS), such as leptin and adiponectin concentrations, the leptin/adiponectin ratio, insulin resistance, and adiposity, in a sample of child survivors of lymphoma and leukemia in Mexico City. METHODS Fifty two children (leukemia n = 26, lymphoma n = 26), who were within the first 5 years after cessation of therapy, were considered as eligible to participate in the study. Testing included fasting insulin, glucose, adipokines and lipids; body fat mass was measured by DXA. The MS components were analyzed according to tertiles of adipokines, insulin resistance, and adiposity. Comparisons between continuous variables were performed according to the data distribution. The MS components were analyzed according to tertiles of adipokines, insulin resistance, and adiposity. With the purpose of assessing the risk of a present MS diagnosis, odds ratios (OR) with a 95% confidence interval (95% IC) were obtained using logistic regression analysis according to the various metabolic markers. RESULTS The median children age was 12.1 years, and the interval time from the completion of therapy to study enrollment was 4 years. Among the MS components, the prevalence of HDL-C low was most common (42%), followed by central obesity (29%). The HOMA-IR (OR 9.0, 95% CI 2.0; 41.1), body fat (OR 5.5, 95% CI 1.6; 19.3), leptin level (OR 5.7, 95% CI 1.6; 20.2) and leptin/adiponectin ratio (OR 9.4, 95% CI 2.0; 49.8) in the highest tertile, were predictive factors of developing MS; whereas the lowest tertile of adiponectin was associated with a protective effect but not significant. CONCLUSIONS Biomarkers such as HOMA-IR, leptin and leptin/adiponectin are associated with each of the components of the MS and with a heightened risk of suffering MS among children survivors of cancer. Given the close relationship between MS with risk of developing type 2 diabetes and cardiovascular disease, it is imperative to implement prevention measures in this population and especially in developing countries where these pathologies have become the leading cause of death.
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Affiliation(s)
- Lourdes Barbosa-Cortés
- Medical Nutrition Research Unit, 21st Century Pediatric Hospital, National Medical Center, MexicanInstitute of Social Security, México City, México
- Medical Nutrition Research Unit, 21st Century Pediatric Hospital, National Medical Center, Mexican Institute of Social Security, Avenida Cuauhtémoc 330 Col. Doctores, México City, C.P. 06720 México
| | - Mardia López-Alarcón
- Medical Nutrition Research Unit, 21st Century Pediatric Hospital, National Medical Center, MexicanInstitute of Social Security, México City, México
| | - Juan Manuel Mejía-Aranguré
- Health Research Coordination, 21st Century Pediatric Hospital, National Medical Center, Mexican Institute of Social Security, México City, México
| | - Miguel Klünder-Klünder
- Department of Community Health Research, Federico Gómez Children’s, México Secretary of Health, and Research Committee, Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN), México City, México
| | - María del Carmen Rodríguez-Zepeda
- Department of Hematology, Pediatric Hospital, 21st Century National Medical Center, Mexican Institute of Social Security, México City, México
| | - Hugo Rivera-Márquez
- Department of Hemato-Oncology, General Hospital of México, México Secretary of Health, México City, México
| | - Alan de la Vega-Martínez
- Medical Nutrition Research Unit, 21st Century Pediatric Hospital, National Medical Center, MexicanInstitute of Social Security, México City, México
| | - Jorge Martin-Trejo
- Department of Hematology, Pediatric Hospital, 21st Century National Medical Center, Mexican Institute of Social Security, México City, México
| | - Juan Shum-Luis
- Department of Hematology, Pediatric Hospital, 21st Century National Medical Center, Mexican Institute of Social Security, México City, México
| | - Karina Solis-Labastida
- Department of Hematology, Pediatric Hospital, 21st Century National Medical Center, Mexican Institute of Social Security, México City, México
| | - Enrique López-Aguilar
- Department of Oncology, Pediatric Hospital, 21st Century National Medical Center, Mexican Institute of Social Security, México City, México
| | - Guadalupe Matute-González
- Medical Nutrition Research Unit, 21st Century Pediatric Hospital, National Medical Center, MexicanInstitute of Social Security, México City, México
| | - Roberto Bernaldez-Rios
- Medical Nutrition Research Unit, 21st Century Pediatric Hospital, National Medical Center, MexicanInstitute of Social Security, México City, México
- Health Research Coordination, 21st Century Pediatric Hospital, National Medical Center, Mexican Institute of Social Security, México City, México
- Department of Community Health Research, Federico Gómez Children’s, México Secretary of Health, and Research Committee, Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN), México City, México
- Department of Hematology, Pediatric Hospital, 21st Century National Medical Center, Mexican Institute of Social Security, México City, México
- Department of Hemato-Oncology, General Hospital of México, México Secretary of Health, México City, México
- Department of Oncology, Pediatric Hospital, 21st Century National Medical Center, Mexican Institute of Social Security, México City, México
- Medical Nutrition Research Unit, 21st Century Pediatric Hospital, National Medical Center, Mexican Institute of Social Security, Avenida Cuauhtémoc 330 Col. Doctores, México City, C.P. 06720 México
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Rodríguez-Cruz M, Cruz-Guzmán OR, Escobar RE, López-Alarcón M. Leptin and metabolic syndrome in patients with Duchenne/Becker muscular dystrophy. Acta Neurol Scand 2016; 133:253-60. [PMID: 26133644 DOI: 10.1111/ane.12450] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2015] [Indexed: 01/22/2023]
Abstract
OBJECTIVES To determine whether patients with Duchenne/Becker muscular dystrophy (DMD/BMD) have components of metabolic syndrome (MetSy) and to evaluate whether leptin is associated with components of MetSy. METHODS This study included 78 patients (nine, <6 years of age; 54, 6 to <16 years of age; and 15 patients, ≥16 years of age). Obesity and body fat mass were determined by waist circumference and dual-energy X-ray absorptiometry, respectively. A 12-h fasting blood sample was collected in the morning. Patients were categorized into four groups according to the number of criteria for MetSy: group 0: none; group 1: one; group 2: two and group 3: three or more criteria. RESULTS All age groups showed components of MetSy. The concentration of these components was significantly higher in patients ≥16 years old. The prevalence of hypertriglyceridemia was from ~37% to 46% in all age groups. The prevalence of MetSy was 7.1% for patients from 6 to <16 years of age and 24% for patients ≥16 years of age. Serum leptin levels increased significantly (P < 0.05) with age; the highest (13.43 ± 9.4 ng/ml) value was observed in patients >16 years of age. Total leptin was correlated with the number of patients with MetSy (r = 0.383; P = 0.001). CONCLUSIONS Components of MetSy are significant in patients with DMD/BMD. A high prevalence of hypertriglyceridemia was observed. Younger patients with DMD/BMD have risk factors for MetSy. Although leptin increased according to different degrees of MetSy, this relation disappeared when the body fat was corrected by leptin; therefore, the association could be caused by a common risk factor-fat.
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Affiliation(s)
- M. Rodríguez-Cruz
- Laboratorio de Biología Molecular; Unidad de Investigación Médica en Nutrición; Hospital de Pediatría; Centro Médico Nacional Siglo XXI; IMSS; México D.F. México
| | - O. R. Cruz-Guzmán
- Laboratorio de Biología Molecular; Unidad de Investigación Médica en Nutrición; Hospital de Pediatría; Centro Médico Nacional Siglo XXI; IMSS; México D.F. México
| | - R. E. Escobar
- Servicio de Electrodiagnóstico y Distrofia Muscular; Instituto Nacional de la Rehabilitación; México D.F. México
| | - M. López-Alarcón
- Laboratorio de Biología Molecular; Unidad de Investigación Médica en Nutrición; Hospital de Pediatría; Centro Médico Nacional Siglo XXI; IMSS; México D.F. México
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de Morais PRS, Sousa ALL, Jardim TDSV, Nascente FMN, Mendonça KL, Povoa TIR, Carneiro CDS, Ferreira VR, de Souza WKSB, Jardim PCBV. Correlation of Insulin Resistance with Anthropometric Measures and Blood Pressure in Adolescents. Arq Bras Cardiol 2016; 106:319-26. [PMID: 27007222 PMCID: PMC4845705 DOI: 10.5935/abc.20160041] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 11/11/2015] [Accepted: 11/19/2015] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Blood pressure is directly related to body mass index, and individuals with increased waist circumference have higher risk of developing hypertension, insulin resistance, and other metabolic changes, since adolescence. OBJECTIVE to evaluate the correlation of blood pressure with insulin resistance, waist circumference and body mass index in adolescents. METHODS Cross-section study on a representative sample of adolescent students. One group of adolescents with altered blood pressure detected by casual blood pressure and/or home blood pressure monitoring (blood pressure > 90th percentile) and one group of normotensive adolescents were studied. Body mass index, waist circumference were measured, and fasting glucose and plasma insulin levels were determined, using the HOMA-IR index to identify insulin resistance. RESULTS A total of 162 adolescents (35 with normal blood pressure and 127 with altered blood pressure) were studied; 61% (n = 99) of them were boys and the mean age was 14.9 ± 1.62 years. Thirty-eight (23.5%) adolescents had altered HOMA-IR. The group with altered blood pressure had higher values of waist circumference, body mass index and HOMA-IR (p<0.05). Waist circumference was higher among boys in both groups (p<0.05) and girls with altered blood pressure had higher HOMA-IR than boys (p<0.05). There was a significant moderate correlation between body mass index and HOMA-IR in the group with altered blood pressure (ρ = 0.394; p < 0.001), and such correlation was stronger than in the normotensive group. There was also a significant moderate correlation between waist circumference and HOMA-IR in both groups (ρ = 0.345; p < 0.05). Logistic regression showed that HOMA-IR was as predictor of altered blood pressure (odds ratio - OR = 2.0; p = 0.001). CONCLUSION There was a significant association of insulin resistance with blood pressure and the impact of insulin resistance on blood pressure since childhood. The correlation and association between markers of cardiovascular diseases was more pronounced in adolescents with altered blood pressure, suggesting that primary prevention strategies for cardiovascular risk factors should be early implemented in childhood and adolescence.
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Affiliation(s)
| | - Ana Luiza Lima Sousa
- Liga de Hipertensão Arterial/Hospital das Clínicas da
Universidade Federal de Goiás (UFG), GO - Brazil
| | | | | | - Karla Lorena Mendonça
- Liga de Hipertensão Arterial/Hospital das Clínicas da
Universidade Federal de Goiás (UFG), GO - Brazil
| | - Thaís Inácio Rolim Povoa
- Liga de Hipertensão Arterial/Hospital das Clínicas da
Universidade Federal de Goiás (UFG), GO - Brazil
| | | | - Vanessa Roriz Ferreira
- Liga de Hipertensão Arterial/Hospital das Clínicas da
Universidade Federal de Goiás (UFG), GO - Brazil
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Ortega-Cortes R, Trujillo X, Hurtado López EF, López Beltrán AL, Colunga Rodríguez C, Barrera-de Leon JC, Tlacuilo-Parra A. Models Predictive of Metabolic Syndrome Components in Obese Pediatric Patients. Arch Med Res 2016; 47:40-8. [PMID: 26820798 DOI: 10.1016/j.arcmed.2016.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Accepted: 01/14/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND AIMS Components of metabolic syndrome (MetS) are complications caused by abdominal obesity and insulin resistance (IR). Diagnosis of MetS by clinical indicators could help to identify patients at risk of cardiovascular disease and type 2 diabetes. We undertook this study to propose predictive indicators of MetS in obese children and adolescents. METHODS A cross-sectional study was carried out. After obtaining informed consent and the registration of the study with an institutional research committee, 172 obese patients from an Obesity Clinic, aged 6-15 years, were included. Variables included were waist circumference (WC), glucose, high-density lipoprotein (HDL), triglycerides (TGL), blood pressure, insulin resistance (by homeostatic model assessment HOMA-index), acanthosis nigricans (AN), uric acid, serum glutamic oxaloacetic transaminase (GOT) and alanine transaminase, and hepatic sonogram. International standards for age and sex variables were used. Multivariate analysis was applied. RESULTS Variables predicted components of MetS in children: HOMA-IR (insulin resistance by HOMA index) was increased by 2.4 in hepatic steatosis, by 0.6 for each unit of SUA (serum uric acid), and by 0.009 for every mg/dL of triglycerides. In adolescents, every cm of waist circumference increased systolic blood pressure by 0.6 mmHg, and each unit of SUA increased it by 2.9 mmHg. CONCLUSIONS Serum uric acid and waist circumference are useful and accessible variables that can predict an increased risk of cardiovascular disease in obese pediatric patients.
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Affiliation(s)
- Rosa Ortega-Cortes
- Department of Pediatric Emergency, UMAE Pediatric Hospital of the West National Medical Center, IMSS, Guadalajara, Mexico.
| | - Xóchitl Trujillo
- Biomedical Research Unit, Post-Graduates of Medical Sciences, Medical School of the University of Colima, Mexico
| | - Erika Fabiola Hurtado López
- Department of Pediatric Emergency, UMAE Pediatric Hospital of the West National Medical Center, IMSS, Guadalajara, Mexico
| | - Ana Laura López Beltrán
- Department of Pediatric Endocrinology, UMAE Pediatric Hospital of the National Medical Center West, IMSS, Guadalajara, Mexico
| | - Cecilia Colunga Rodríguez
- Division of Education and Research in Health, UMAE Pediatric Hospital of the National Medical Center West, IMSS, Guadalajara, Mexico
| | - Juan Carlos Barrera-de Leon
- Division of Education and Research in Health, UMAE Pediatric Hospital of the National Medical Center West, IMSS, Guadalajara, Mexico
| | - Alberto Tlacuilo-Parra
- Division of Education and Research in Health, UMAE Pediatric Hospital of the National Medical Center West, IMSS, Guadalajara, Mexico
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Gamboa-Meléndez MA, Galindo-Gómez C, Juárez-Martínez L, Gómez FE, Diaz-Diaz E, Ávila-Arcos MA, Ávila-Curiel A. Novel association of the R230C variant of the ABCA1 gene with high triglyceride levels and low high-density lipoprotein cholesterol levels in Mexican school-age children with high prevalence of obesity. Arch Med Res 2015; 46:495-501. [PMID: 26256050 DOI: 10.1016/j.arcmed.2015.07.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Accepted: 07/31/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND AIMS Metabolic syndrome (MetS) is a disorder that includes a cluster of several risk factors for the development of type 2 diabetes and cardiovascular disease. The R230C variant of the ABCA1 gene has been associated with low HDL-cholesterol in several studies, but its association with MetS in children remains to be determined. The aim of this study was to analyze the association of the R230C variant with MetS and other metabolic traits in school-aged Mexican children. METHODS The study was performed in seven urban primary schools in the State of Mexico. Four hundred thirty-two Mexican school-age children 6-13 years old were recruited. MetS was identified using the International Diabetes Federation definition. The R230C variant of the ABCA1 gene was genotyped to seek associations with MetS and other metabolic traits. RESULTS The prevalence of MetS was 29% in children aged 10-13 years. The R230C variant was not associated with MetS (OR = 1.65; p = 0.139). Furthermore, in the whole population, the R230C variant was associated with low HDL-cholesterol levels (β coefficient = -3.28, p <0.001). Interestingly, in the total population we found a novel association of this variant with high triglyceride levels (β coefficient = 14.34; p = 0.027). CONCLUSIONS We found a new association of the R230C variant of the ABCA1 gene with high triglyceride levels. Our findings also replicate the association of this variant with low HDL-cholesterol levels in Mexican school-age children.
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Affiliation(s)
| | - Carlos Galindo-Gómez
- Dirección de Nutrición, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, D.F., Mexico
| | - Liliana Juárez-Martínez
- Dirección de Nutrición, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, D.F., Mexico
| | - F Enrique Gómez
- Departamento de Fisiología de la Nutrición, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, D.F., Mexico
| | - Eulises Diaz-Diaz
- Departamento de Biología de la Reproducción, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, D.F., Mexico
| | - Marco Antonio Ávila-Arcos
- Dirección de Nutrición, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, D.F., Mexico
| | - Abelardo Ávila-Curiel
- Dirección de Nutrición, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, D.F., Mexico.
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Gobato AO, Vasques ACJ, Zambon MP, Barros Filho ADA, Hessel G. Metabolic syndrome and insulin resistance in obese adolescents. ACTA ACUST UNITED AC 2015; 32:55-62. [PMID: 24676191 PMCID: PMC4182990 DOI: 10.1590/s0103-05822014000100010] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Accepted: 07/10/2013] [Indexed: 02/06/2023]
Abstract
Objective: To verify the prevalence of metabolic syndrome and insulin resistance in obese
adolescents and its relationship with different body composition indicators. Methods: A cross-sectional study comprising 79 adolescents aged ten to 18 years old. The
assessed body composition indicators were: body mass index (BMI), body fat
percentage, abdominal circumference, and subcutaneous fat. The metabolic syndrome
was diagnosed according to the criteria proposed by Cook et al.
The insulin resistance was determined by the Homeostasis Model Assessment
for Insulin Resistance (HOMA-IR) index for values above 3.16. The
analysis of ROC curves was used to assess the BMI and the abdominal circumference,
aiming to identify the subjects with metabolic syndrome and insulin resistance.
The cutoff point corresponded to the percentage above the reference value used to
diagnose obesity. Results: The metabolic syndrome was diagnosed in 45.5% of the patients and insulin
resistance, in 29.1%. Insulin resistance showed association with HDL-cholesterol
(p=0.032) and with metabolic syndrome
(p=0.006). All body composition indicators were correlated with
insulin resistance (p<0.01). In relation to the cutoff point
evaluation, the values of 23.5 and 36.3% above the BMI reference point allowed the
identification of insulin resistance and metabolic syndrome. The best cutoff point
for abdominal circumference to identify insulin resistance was 40%. Conclusions: All body composition indicators, HDL-cholesterol and metabolic syndrome showed
correlation with insulin resistance. The BMI was the most effective anthropometric
indicator to identify insulin resistance.
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Affiliation(s)
| | | | | | | | - Gabriel Hessel
- Faculdade de Ciencias Medicas, Unicamp, Campinas, SP, Brasil
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High cardiometabolic risk in healthy Chilean adolescents: associations with anthropometric, biological and lifestyle factors. Public Health Nutr 2015; 19:486-93. [PMID: 25990645 PMCID: PMC4654715 DOI: 10.1017/s1368980015001585] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To analyse the prevalence of cardiovascular risk factors in healthy adolescents of low to middle socio-economic status and to study the influence of anthropometric, biological and lifestyle factors on the risk of metabolic syndrome (MetS). DESIGN Cross-sectional study. BMI, waist circumference, blood pressure, fat and lean mass (by dual-energy X-ray absorptiometry), TAG, HDL-cholesterol, glucose, insulin, homeostatic model assessment-insulin resistance index (HOMA-IR), food intake and physical activity were measured. Cardiovascular risk factors were defined using the International Diabetes Federation criteria and insulin resistance using HOMA-IR ≥2.6. Bivariate and multivariate regressions examined the associations between MetS and anthropometric, biological and lifestyle factors. SETTING Observational cohort study including Chilean adolescents, who were part of a follow-up study beginning in infancy. SUBJECTS Adolescents aged 16-17 years (n 667). RESULTS In the sample, 16.2% had obesity and 9.5% had MetS. Low HDL-cholesterol (69.9%), abdominal obesity (33.3%) and fasting hyperglycaemia (8.7%) were the most prevalent cardiovascular risk factors. In males, obesity (OR=3.7; 95% CI 1.2, 10.8), insulin resistance (OR=3.0; 95% CI 1.1, 8.2), physical inactivity (OR=2.9; 95% CI 1.1, 7.7) and sarcopenia (OR=21.2; 95% CI 4.2, 107.5) significantly increased the risk of MetS. In females, insulin resistance (OR=4.9; 95% CI 1.9, 12.6) and sarcopenia (OR=3.6; 95% CI 1.1, 11.9) were significantly associated with MetS. CONCLUSIONS High prevalences of obesity, abdominal obesity, dyslipidaemia, fasting hyperglycaemia and MetS were found in healthy adolescents. In both sexes, sarcopenia and insulin resistance were important risk factors of MetS. Promotion of active lifestyles at the school level and regulation of the sale of energy-dense foods are needed.
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El-Karaksy HM, El-Raziky MS, Fouad HM, Anwar GM, El-Mougy FM, El-Koofy NM, El-Hennawy AM. The value of different insulin resistance indices in assessment of non-alcoholic fatty liver disease in overweight/obese children. Diabetes Metab Syndr 2015; 9:114-119. [PMID: 25470627 DOI: 10.1016/j.dsx.2013.10.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The aim of the present study was to determine the association between insulin resistance (IR) and both non-alcoholic fatty liver disease (NAFLD) and metabolic syndrome (MetS) in a group of Egyptian overweight/obese children and adolescents and to evaluate different IR indices in detection of NAFLD. PATIENTS AND METHODS The study included 76 overweight/obese children aged 2-15 years; 52.6% were males. Laboratory analysis included fasting blood glucose, serum insulin, lipid profile, liver biochemical profile, and liver ultrasound. IR was calculated using the following indices; the homeostasis model assessment method (HOMA-IR), the quantitative insulin-sensitivity check index (QUICKI) and hepatic insulin sensitivity. The National Cholesterol Education Program Adult Treatment Panel III criteria were used to estimate prevalence of MetS. Liver biopsy was done when medically indicated and accepted by parents. RESULTS IR was detected in 43.4% and 34.2% by using QUICKI and HOMA, respectively. MetS was detected in 36.8% and NAFLD was detected in 45.5% among those performing liver biopsy. Cases with NAFLD had more frequent IR than children with normal histology. QUICKI showed significant difference between normal subjects and both steatosis and non-alcoholic steatohepatitis; while HOMA-IR was sensitive in cases with NASH only. MetS was present in 100% of patients with NASH and in 75% of those with steatosis and they were all obese. Patients with NASH had significantly higher ALT than those with normal histology. CONCLUSION IR was significantly associated with NAFLD. QUICKI is considered more sensitive than HOMA-IR in differentiating simple steatosis from normal liver histology.
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Affiliation(s)
| | | | - Hanan M Fouad
- Department of Pediatrics, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt
| | - Ghada M Anwar
- Department of Pediatrics, Cairo University, Cairo, Egypt
| | - Fatma M El-Mougy
- Department of Chemical Pathology, Cairo University, Cairo, Egypt
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Samaan MC, Anand SS, Sharma AM, Samjoo IA, Tarnopolsky MA. Sex differences in skeletal muscle phosphatase and tensin homolog deleted on chromosome 10 (PTEN) levels: a cross-sectional study. Sci Rep 2015; 5:9154. [PMID: 25777795 PMCID: PMC4366049 DOI: 10.1038/srep09154] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 02/10/2015] [Indexed: 02/08/2023] Open
Abstract
Women have higher adiposity but maintain insulin sensitivity when compared to men. Phosphatase and tensin homolog deleted on chromosome 10 (PTEN) inhibits insulin signaling, but it is not known if PTEN regulate insulin resistance in a sex-specific manner. In this cross-sectional study, muscle biopsies from participants in the Molecular Study of Health and Risk in Ethnic Groups (Mol-SHARE) were used to test for sex differences in PTEN expression. Quantitative real-time PCR was performed to determine PTEN gene expression (n = 53), and western blotting detected total and phosphorylated PTEN protein (n = 36). Study participants were comparable in age and body mass index. Women had higher fat mass percentage compared to men (40.25 ± 9.9% in women versus 27.6 ± 8.8% in men; mean difference -0.18, 95%CI (-0.24, -0.11), p-value <0.0001), with similar HOMA-IR (2.46 ± 2.05 in men versus 2.34 ± 3.06 in women; mean difference 0.04; 95% CI (-0.12, 0.21), p-value 0.59). Women had significant downregulation of PTEN gene expression (p-value 0.01) and upregulation of PTEN protein phosphorylation (inactivation) (p-value 0.001) when compared to men after correction for age, ethnicity, HOMA-IR, fat mass and sex. We conclude that the downregulation of muscle PTEN may explain the retention of insulin sensitivity with higher adiposity in women compared to men.
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Affiliation(s)
- M Constantine Samaan
- 1] Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada [2] Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Sonia S Anand
- 1] Population Genomics Program, Chanchlani Research Centre, McMaster University, Hamilton, ON, Canada [2] Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada [3] Department of Medicine, McMaster University, Hamilton, Ontario, Canada [4] Department of Clinical Epidemiology/Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | | | - Imtiaz A Samjoo
- 1] Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada [2] Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Mark A Tarnopolsky
- 1] Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada [2] Department of Medicine, McMaster University, Hamilton, Ontario, Canada
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Prevalencia de síndrome metabólico en niños con obesidad y sin ella. Med Clin (Barc) 2015; 144:198-203. [DOI: 10.1016/j.medcli.2013.10.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Revised: 10/18/2013] [Accepted: 10/24/2013] [Indexed: 11/22/2022]
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Kelishadi R, Mirmoghtadaee P, Najafi H, Keikha M. Systematic review on the association of abdominal obesity in children and adolescents with cardio-metabolic risk factors. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2015; 20:294-307. [PMID: 26109978 PMCID: PMC4468236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 11/01/2014] [Accepted: 01/07/2015] [Indexed: 10/24/2022]
Abstract
BACKGROUND The adverse health effects of abdominal obesity are well documented in adults, but such association remains to be determined in the pediatric age group. This study aims to perform a systematic review on the association between abdominal obesity and cardio-metabolic factors such as dyslipidemia, hypertension, and hyperglycemia among children and adolescents. MATERIALS AND METHODS A systematic literature search was conducted using PubMed, Scopus and Google Scholar databases to May 2014. Two independent reviewers identified relevant papers in several steps. After studying the titles and texts of documents, repeated and irrelevant ones were excluded. The search was refined to the English language. We did not consider any time limitation. Studies with different measuring methods of abdominal obesity were included. Studies with abdominal obese patients secondary to other disease were excluded from the study. In final, the data of association of cardio-metabolic risk factors and abdominal obesity extracted from studies. RESULTS Overall, 3966 articles were reviewed, and 61 of them were studied according to the inclusion and exclusion criteria. Waist circumference (WC), waist-to-height ratio, and waist-to-hip ratio were the most common indexes used for defining abdominal obesity. The association of high blood pressure with increasing WC was seen in several studies. The association of other cardio-metabolic risk factors was seen in some studies. CONCLUSION Whatever the definition used for abdominal obesity and whatever the methods used for anthropometric measurements, central body fat deposition in children and adolescents increases the risk of cardio-metabolic risk factors. Therefore, more attention should be paid to abdominal obesity of children and adolescents both in clinical practice and in epidemiological studies.
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Affiliation(s)
- Roya Kelishadi
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran,Department of Pediatrics, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parisa Mirmoghtadaee
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hananeh Najafi
- Department of Pediatrics, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mojtaba Keikha
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran,Address for correspondence: Mr. Mojtaba Keikha, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Hezar Jerib Avenue, Isfahan, Iran. E-mail:
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Arduc A, Isik S, Ozuguz U, Tutuncu YA, Kucukler FK, Ozcan HN, Berker D, Guler S. Relationship between thyroid nodules and non-functioning adrenal incidentalomas and their association with insulin resistance. Endocr Res 2014; 39:99-104. [PMID: 24152247 DOI: 10.3109/07435800.2013.840653] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The relationship between insulin resistance and thyroid nodules in patients with non-functional adrenal incidentalomas (AI) is not clearly understood. The aim of this study was to determine the frequency of thyroid nodules in AI patients, as well as to evaluate any possible associations with disorders of insulin resistance. METHODS Patients diagnosed with a non-functional AI were approached for inclusion in the study. Insulin resistance was evaluated using homeostasis model assessment (HOMA-IR). All participants were screened for the presence of thyroid nodule by ultrasonography, and fine needle aspiration biopsies were obtained from consenting subjects. RESULTS One-hundred-thirteen patients with AI and 152 age-, BMI- and gender-matched healthy controls were enrolled. AI patients had higher waist circumference and waist/hip ratio than the control group. Metabolic syndrome, hypertension and type 2 diabetes mellitus rates were significantly higher in AI patients. HOMA-IR was similar between the groups. At least one thyroid nodule was observed in 42 (27.6%) of the controls compared to 55 (48.7%) of AI patients (p < 0.001). The mean number of thyroid nodules in AI patients was significantly higher than the control subjects (2.4 ± 0.9 versus 1.7 ± 1.0, p = 0.008). Mean nodule volume was similar between AI patients and the controls. A correlation could not be established between adrenal tumor/thyroid nodule volumes and the number of thyroid nodules, HOMA-IR, waist circumference, waist/hip ratio, BMI and thyroid function tests. CONCLUSION A higher prevalence of thyroid nodule and a higher number of thyroid nodules were determined in patients with AI compared to healthy controls.
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Affiliation(s)
- Ayse Arduc
- Department of Endocrinology and Metabolism, Ankara Numune Research and Training Hospital, Ministry of Health , Ankara , Turkey
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Irigoyen-Camacho ME, Sanchez-Perez L, Molina-Frechero N, Velazquez-Alva C, Zepeda-Zepeda M, Borges-Yanez A. The relationship between body mass index and body fat percentage and periodontal status in Mexican adolescents. Acta Odontol Scand 2014; 72:48-57. [PMID: 23692334 DOI: 10.3109/00016357.2013.797100] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To assess the association between obesity indicators and the periodontal status of high school students. MATERIALS AND METHODS High school students (15-year-olds) in Mexico City participated in the survey (n = 257). International Obesity Task Force cut-off values (ISO-BMI) were applied to identify overweight and obesity. Also, bioelectrical impedance analysis was performed to estimate body fat percentage (BF%). The simplified detritus index (DI-S) was used to evaluate oral hygiene. The periodontal community index (CPI) was obtained to assess the periodontal status of the participants. RESULTS Overweight/obesity was identified in 30.0% of the students. BF% was 37.5% in women and 21.2% in men and 16.7% of the participants smoked and 33.5% of the students presented DI-S >1. Based on CPI, 59.5% of the participants showed good periodontal status (CPI = 0); bleeding on probing without further periodontal involvement was found in 13.6% of the participants (CPI = 1), 23.8% showed a CPI = 2 (dental calculus) and a CPI = 3 (shallow periodontal pockets) was detected in 3.1% of the participants. The results of the multinomial logistical regression model fitting CPI ≥2 identified an association BF% (OR = 1.06), having poor oral hygiene (OR = 20.09) and smoking (OR = 2.49). Similarly, overweight/obesity was associated with CPI ≥2 (OR = 1.78) adjusting for school attended (public school OR = 0.35), oral hygiene (DI-S >1, OR = 23.92) and tobacco consumption (smoker OR = 1.81). CONCLUSIONS Excess body fat indicators were associated with bleeding on probing and dental calculus in adolescents. The relationship between overweight/obesity and periodontal status in adolescents should be considered in oral health preventive programs.
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Juárez-López C, Klünder-Klünder M, Madrigal-Azcárate A, Flores-Huerta S. Omega-3 polyunsaturated fatty acids reduce insulin resistance and triglycerides in obese children and adolescents. Pediatr Diabetes 2013; 14:377-83. [PMID: 23438101 DOI: 10.1111/pedi.12024] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2012] [Revised: 01/04/2013] [Accepted: 01/04/2013] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Approximately 50% of obese children are insulin resistant. It has been suggested that pharmacological and nutritional options should be considered to improve the management of insulin resistance (IR). OBJECTIVE To assess the effect of metformin (Met) or omega-3 (ω-3) polyunsaturated fatty acids (PUFA) on the homeostasis model assessment-estimated insulin resistance (HOMA-IR) index, lipid profile, and body mass index (BMI) of obese children. METHODS We included 201 obese and insulin-resistant children and adolescents. Ninety-eight of them received 500 mg of Met, and 103 received 1.8 g of ω-3 PUFA for 12 wk. This was an open-label study with assignment of treatment based on which school the child attended. At the baseline and at the end of study, the following parameters were measured: weight, height, waist circumference, blood pressure, insulin, glucose, lipid profile, and HOMA-IR index. There were no lifestyle interventions. RESULTS At baseline, the age, BMI, and IR in children of both groups were comparable. The treatment assigned for each group was well tolerated. Metabolic changes were adjusted for age, sex, and change in BMI. Concerning the IR profile at the end of intervention, ω-3 significantly decreased the concentrations of glucose and insulin while reducing HOMA-IR values; meanwhile, Met negligibly affected insulin levels. Regarding lipids, Met increased high density lipoprotein cholesterol (HDL-C) and decreased low density lipoprotein cholesterol (LDL-C), but triglycerides were not affected; in contrast, triglycerides were decreased significantly by ω-3. The effects on BMI were marginal under Met but were significant with ω-3. CONCLUSION The results of this work suggest that ω-3 may be useful as an adjuvant therapy in obese children and adolescents with IR.
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Affiliation(s)
- Carlos Juárez-López
- Department for Innovation and Quality, Institute for Decentralized Public Health Services, INDESALUD, Campeche, Campeche 24040, Mexico
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Mendoza-Lorenzo P, Salazar AM, Cortes-Arenas E, Saucedo R, Taja-Chayeb L, Flores-Dorantes MT, Pánico P, Sordo M, Ostrosky-Wegman P. The reduction of Calpain-10 expression is associated with risk polymorphisms in obese children. Gene 2013; 516:126-31. [DOI: 10.1016/j.gene.2012.12.053] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Accepted: 12/03/2012] [Indexed: 11/17/2022]
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Mejía-Benítez A, Klünder-Klünder M, Yengo L, Meyre D, Aradillas C, Cruz E, Pérez-Luque E, Malacara JM, Garay ME, Peralta-Romero J, Flores-Huerta S, García-Mena J, Froguel P, Cruz M, Bonnefond A. Analysis of the contribution of FTO, NPC1, ENPP1, NEGR1, GNPDA2 and MC4R genes to obesity in Mexican children. BMC MEDICAL GENETICS 2013; 14:21. [PMID: 23375129 PMCID: PMC3577489 DOI: 10.1186/1471-2350-14-21] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Accepted: 01/29/2013] [Indexed: 11/11/2022]
Abstract
Background Recent genome wide association studies (GWAS) and previous positional linkage studies have identified more than 50 single nucleotide polymorphisms (SNPs) associated with obesity, mostly in Europeans. We aimed to assess the contribution of some of these SNPs to obesity risk and to the variation of related metabolic traits, in Mexican children. Methods The association of six European obesity-related SNPs in or near FTO, NPC1, ENPP1, NEGR1, GNPDA2 and MC4R genes with risk of obesity was tested in 1,463 school-aged Mexican children (Ncases = 514; Ncontrols = 949). We also assessed effects of these SNPs on the variation of body mass index (BMI), fasting serum insulin levels, fasting plasma glucose levels, total cholesterol and triglyceride levels, in a subset of 1,171 nonobese Mexican children. Results We found a significant effect of GNPDA2 rs10938397 on risk of obesity (odds ratio [OR] = 1.30; P = 1.34 × 10-3). Furthermore, we found nominal associations between obesity risk or BMI variation and the following SNPs: ENPP1 rs7754561, MC4R rs17782313 and NEGR1 rs2815752. Importantly, the at-risk alleles of both MC4R rs17782313 and NPC1 rs1805081 showed significant effect on increased fasting glucose levels (β = 0.36 mmol/L; P = 1.47 × 10-3) and decreased fasting serum insulin levels (β = −0.10 μU/mL; P = 1.21 × 10-3), respectively. Conclusion Our present results suggest that some obesity-associated SNPs previously reported in Europeans also associate with risk of obesity, or metabolic quantitative traits, in Mexican children. Importantly, we found new associations between MC4R and fasting glucose levels, and between NPC1 and fasting insulin levels.
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Affiliation(s)
- Aurora Mejía-Benítez
- Departamento de Genética y Biología Molecular, Centro de Investigación yde Estudios Avanzados del Instituto Politécnico Nacional, Mexico City, Mexico
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Adiponectin in eutrophic and obese children as a biomarker to predict metabolic syndrome and each of its components. BMC Public Health 2013; 13:88. [PMID: 23363707 PMCID: PMC3570482 DOI: 10.1186/1471-2458-13-88] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Accepted: 01/22/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Obesity is associated with the rise of noncommunicable diseases worldwide. The pathophysiology behind this disease involves the increase of adipose tissue, being inversely related to adiponectin, but directly related to insulin resistance and metabolic syndrome (MetS). Therefore, this study aimed to determine the relationship between adiponectin levels with each component of MetS in eutrophic and obese Mexican children. METHODS A cross sectional study was conducted in 190 school-age children classified as obese and 196 classified as eutrophic. Adiponectin, glucose, insulin, high density lipoprotein cholesterol (HDL-C) and triglycerides were determined from a fasting blood sample. Height, weight, waist circumference, systolic and diastolic blood pressures (BP) were measured; MetS was evaluated with the IDF definition. The study groups were divided according to tertiles of adiponectin, using the higher concentration as a reference. Linear regression analysis was used to assess the association between adiponectin and components of the MetS. Finally, stepwise forward multiple logistic regression analysis controlling for age, gender, basal HOMA-IR values and BMI was performed to determine the odds ratio of developing MetS according to adiponectin tertiles. RESULTS Anthropometric and metabolic measurements were statistically different between eutrophic and obese children with and without MetS (P <0.001). The prevalence of MetS in obese populations was 13%. Adiponectin concentrations were 15.5 ± 6.1, 12.0 ± 4.8, 12.4 ± 4.9 and 9.4 ± 2.8 μg/mL for eutrophic and obese subjects, obese without MetS, and obese with MetS, respectively (P <0.001). Obese children with low values of adiponectin exhibited a higher frequency of MetS components: abdominal obesity, 49%; high systolic BP, 3%; high diastolic BP, 2%; impaired fasting glucose, 17%; hypertriglyceridemia, 31%; and low HDL-C values, 42%. Adjusted odds ratio of presenting MetS according to adiponectin categories was 10.9 (95% CI 2.05; 48.16) when the first tertile was compared with the third. CONCLUSION In this sample of eutrophic and obese Mexican children we found that adiponectin concentrations and MetS components have an inversely proportional relationship, which supports the idea that this hormone could be a biomarker for identifying individuals with risk of developing MetS.
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Bindler RJ, Bindler RC, Daratha KB. Biological correlates and predictors of insulin resistance among early adolescents. J Pediatr Nurs 2013; 28:20-7. [PMID: 22484110 DOI: 10.1016/j.pedn.2012.03.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Revised: 02/20/2012] [Accepted: 03/07/2012] [Indexed: 11/27/2022]
Abstract
Abnormal glucose metabolism is associated with obesity, insulin resistance (IR), and Type 2 diabetes mellitus. The purposes of this study were to describe anthropometric and laboratory markers of adolescents, examine correlates of IR, and test ability of anthropometric and laboratory markers to predict risk of exhibiting IR. A total of 150 early adolescents participated. Participants with obesity had increased IR, high-sensitivity C-reactive protein, triglycerides, and blood pressure. Waist circumference and triglycerides were predictive of IR. Multiple risk factors compound and lead to long-term health consequences among youth. Nurses can evaluate these factors to identify IR.
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Affiliation(s)
- Ross J Bindler
- Washington State University, College of Pharmacy, Spokane, WA, USA.
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