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Cebeci D, Kaya Z, Bideci A, Koçak Ü, Yilmaz C, Gürsel T. The Prevalence, Risk Factors and Cardiometabolic Complications of Obesity in Childhood Survivors of Acute Lymphoblastic Leukemia. Indian J Hematol Blood Transfus 2024; 40:415-422. [PMID: 39011269 PMCID: PMC11246365 DOI: 10.1007/s12288-024-01734-w] [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: 01/03/2023] [Accepted: 01/11/2024] [Indexed: 07/17/2024] Open
Abstract
Prevalence, risk factors and metabolic complications of overweight/obesity (OW/OB) are not well described in the childhood survivors of acute lymphoblastic leukemia (ALL). Longitudinal changes in body mass index-z score (BMIz) from diagnosis to the last follow-up visit after the end of treatment were evaluated in 73 children at first complete remission. Of them, 40 were tested for adipokine profiles at visit. The mean BMIz increased gradually from diagnosis (0.07 ± 1.68) to the end of dexamethasone containing reinduction therapy (0.70 ± 1.48, P:0.007), followed by a fall at the end of treatment (0.15 ± 1.24) and a rise again at visit (0.40 ± 1.23, P:0.007). OW/OB percentage of 15% at diagnosis, increased to 35% at visit (p < 0.05). Post-treatment OW/OB in survivors was related with being OW/OB at diagnosis (OR 5.4, 95% CI [0.94-31.7]; P = 0.02) and after dexamethasone containing reinduction therapy (OR 5.1, 95% CI [1.1-21.4]; P = 0.05), but not with age at diagnosis, gender, treatment intensity and cranial irradiation. Metabolic syndrome (MetS) was more prevalent in survivors (13%) than in Turkish children (2%). As compared with controls, survivors had higher leptin level (8.1 ± 8.6 vs 3.2 ± 2.2 ng/ml, P = 0.01) and leptin/adiponectin ratio (2.1 ± 3.5 vs 0.6 ± 0.5, P = 0.03). Leptin/adiponectin ratio was correlated with HOMA-IR (r: 0.57, P = 0.001). The prevalence of OW/OB and MetS are elevated in the childhood survivors of ALL. Post-treatment OW/OB in survivors is related with OW/OB at diagnosis and dexamethasone containing therapy. Elevated leptin level and leptin: adiponectin ratio may serve as an early sign of metabolic derangement increasing the risk for early cardiovascular disease.
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Affiliation(s)
- Dilek Cebeci
- Department of Pediatric Hematology and Oncology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Zühre Kaya
- Department of Pediatric Hematology and Oncology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Aysun Bideci
- Department of Pediatric Endocrinology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ülker Koçak
- Department of Pediatric Hematology and Oncology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Canan Yilmaz
- Department of Biochemistry, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Türkiz Gürsel
- Department of Pediatric Hematology and Oncology, Faculty of Medicine, Gazi University, Ankara, Turkey
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Liu Y, Wang X, Fang Z. Evaluating the impact of exercise on intermediate disease markers in overweight and obese individuals through a network meta-analysis of randomized controlled trials. Sci Rep 2024; 14:12137. [PMID: 38802439 PMCID: PMC11130208 DOI: 10.1038/s41598-024-62677-w] [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: 05/14/2023] [Accepted: 05/20/2024] [Indexed: 05/29/2024] Open
Abstract
The aim of this study is to investigate the impact of exercise on intermediate disease markers in populations with overweight and obesity, providing evidence-based recommendations for clinicians to utilize these markers in developing exercise prescriptions for this group. The study was conducted by retrieving data from PubMed, Embase, Cochrane Library, Web of Science, and CNKI and only including Randomized Controlled Trials (RCTs) to examine the effect of different exercise interventions on intermediate disease markers in overweight and obese people. The quality of the included studies was evaluated using the Cochrane Bias Risk Assessment tool and the data was analyzed using Stata 15.1 data analysis software. The RCTs were collected from January 2017 to March 2024. A total of 56 RCTs were included and the results of 10 outcomes were analyzed using random effects meta-analysis. The total sample size used in the study was 3193 The results showed that resistance training significantly reduced total cholesterol (SUCRA: 99.9%), triglycerides (SUCRA: 100.0%), low-density lipoprotein (SUCRA: 100.0%), systolic pressure (SUCRA: 92.5%), and increased high-density lipoprotein (SUCRA: 100.0%). Aerobic exercise significantly reduced insulin (SUCRA: 89.1%) and HbA1c (SUCRA: 95.3%). Concurrent training significantly reduced HOMA-IR (SUCRA: 93.8%), diastolic blood pressure (SUCRA: 71.2%) and Glucose (SUCRA: 87.6%). Exercise has a significant impact on intermediate disease markers in populations with overweight and obese. Compared with no exercise, exercise lowers total cholesterol, triglycerides, LDL, systolic blood pressure, diastolic blood pressure, HOMA-IR, insulin, and HbA1c, and increases HDL in people with overweight and obese. These findings provide evidence-based recommendations for exercise interventions aimed at weight reduction and the prevention of chronic diseases in individuals with overweight and obese.
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Affiliation(s)
- Yuanyuan Liu
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Haidian District, Beijing, 100084, China
| | - Xianzi Wang
- School of Computer Science, Anhui University of Technology, Huashan District, Ma'anshan City, 243002, China
| | - Zilong Fang
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Haidian District, Beijing, 100084, China.
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Razavi AC, Jain V, Grandhi GR, Patel P, Karagiannis A, Patel N, Dhindsa DS, Liu C, Desai SR, Almuwaqqat Z, Sun YV, Vaccarino V, Quyyumi AA, Sperling LS, Mehta A. Does Elevated High-Density Lipoprotein Cholesterol Protect Against Cardiovascular Disease? J Clin Endocrinol Metab 2024; 109:321-332. [PMID: 37437107 PMCID: PMC11032254 DOI: 10.1210/clinem/dgad406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 06/15/2023] [Accepted: 07/07/2023] [Indexed: 07/14/2023]
Abstract
High-density lipoprotein (HDL) contributes to reverse cholesterol transport, which is 1 of the main explanations for the described inverse association between HDL-cholesterol (HDL-C) and atherosclerotic cardiovascular disease (ASCVD) risk. However, efforts to therapeutically raise HDL-C levels with niacin, fibrates, or cholesteryl ester transfer protein inhibitors have not demonstrated a reduction in ASCVD events when compared with placebo among individuals treated with statins. Furthermore, mendelian randomization studies suggest that HDL-C is unlikely to be a direct biologic variable impacting ASCVD risk. More recently, observations from well-conducted epidemiologic studies have indicated a nonlinear U-shaped relationship between HDL-C and subclinical atherosclerosis, and that very high HDL-C (≥80 mg/dL in men, ≥100 mg/dL in women) is paradoxically associated with higher all-cause and ASCVD-related mortality. These observations suggest that HDL-C is not a universal protective factor for atherosclerosis. Thus, there are several opportunities for reframing the contribution of HDL-C to ASCVD risk and related clinical calculators. Here, we examine our growing understanding of HDL-C and its role in ASCVD risk assessment, treatment, and prevention. We discuss the biological functions of HDL-C and its normative values in relation to demographics and lifestyle markers. We then summarize original studies that observed a protective association between HDL-C and ASCVD risk and more recent evidence indicating an elevated ASCVD risk at very high HDL-C levels. Through this process, we advance the discussion regarding the future role of HDL-C in ASCVD risk assessment and identify knowledge gaps pertaining to the precise role of HDL-C in atherosclerosis and clinical ASCVD.
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Affiliation(s)
- Alexander C Razavi
- Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Vardhmaan Jain
- Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Gowtham R Grandhi
- Virginia Commonwealth University Health Pauley Heart Center, Virginia Commonwealth University School of Medicine, Richmond, VA 23298, USA
| | - Parth Patel
- Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Angelos Karagiannis
- Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Nidhi Patel
- Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Devinder S Dhindsa
- Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Chang Liu
- Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA 30322, USA
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA 30322, USA
| | - Shivang R Desai
- Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Zakaria Almuwaqqat
- Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Yan V Sun
- Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA 30322, USA
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA 30322, USA
| | - Viola Vaccarino
- Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA 30322, USA
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA 30322, USA
| | - Arshed A Quyyumi
- Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Laurence S Sperling
- Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Anurag Mehta
- Virginia Commonwealth University Health Pauley Heart Center, Virginia Commonwealth University School of Medicine, Richmond, VA 23298, USA
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Sengani M, V B, Banerjee M, Choudhury AA, Chakraborty S, Ramasubbu K, Rajeswari V D, Al Obaid S, Alharbi SA, Subramani B, Brindhadevi K. Evaluation of the anti-diabetic effect of biogenic silver nanoparticles and intervention in PPARγ gene regulation. ENVIRONMENTAL RESEARCH 2022; 215:114408. [PMID: 36154863 DOI: 10.1016/j.envres.2022.114408] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/03/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023]
Abstract
The current study demonstrated a green, friendly, low-cost biosynthesis of silver nanoparticles (AgNPs) from Kigelia africana leaves (Lam.) Benth. extract (KAE) as both a major capping and reducing agent. The produced AgNPs were characterized using a variety of analytical methods, like the X-ray powder diffraction (XRD), HRTEM, Fourier transforms infrared (FTIR), and UV-Vis spectrophotometer. The formation of AgNPs with maximum absorbance at max = 435 nm was endorsed by surface plasmon resonance. FTIR analysis revealed that biological macromolecules of KAE were involved in the stabilization and synthesis of AgNPs. At the same time, HRTEM images revealed that the average particle size of the spherical AgNPs ranged from about 25 nm to 35 nm. Further, cytotoxicity assessment of AgNPs was done using the RINm5F insulinoma cell line with an MTT assay. Followed by, the RINm5F insulinoma cells treated with AgNPs and KAE, the expression of the Peroxisome proliferator-activated receptor gamma (PPARγ) gene was accessed. The results showed gene expression was upregulated in the RINm5F insulinoma cell line thus confirming AgNPs and KAE anti-diabetic efficacy. Furthermore, the findings show that nanotechnology has enhanced the effectiveness of current methodologies in gene expression and regulation which has contributed to the emergence of different forms of advanced regulatory systems.
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Affiliation(s)
- Manimegalai Sengani
- Department of Biotechnology, College of Science and Humanities, SRM Institute of Science and Technology, Ramapuram, Chennai, 600087, India
| | - Bavithra V
- School of Biosciences and Technology, VIT University, Vellore, 632014, Tamil Nadu, India
| | - Manosi Banerjee
- School of Biosciences and Technology, VIT University, Vellore, 632014, Tamil Nadu, India
| | - Abbas Alam Choudhury
- School of Biosciences and Technology, VIT University, Vellore, 632014, Tamil Nadu, India
| | - Shreya Chakraborty
- School of Biosciences and Technology, VIT University, Vellore, 632014, Tamil Nadu, India
| | - Kanagavalli Ramasubbu
- School of Biosciences and Technology, VIT University, Vellore, 632014, Tamil Nadu, India
| | - Devi Rajeswari V
- School of Biosciences and Technology, VIT University, Vellore, 632014, Tamil Nadu, India.
| | - Sami Al Obaid
- Department of Botany and Microbiology, College of Science, King Saud University, PO Box -2455, Riyadh, 11451, Saudi Arabia
| | - Sulaiman Ali Alharbi
- Department of Botany and Microbiology, College of Science, King Saud University, PO Box -2455, Riyadh, 11451, Saudi Arabia
| | - Baskaran Subramani
- Division of Hematology and Oncology, Department of Medicine, Mays Cancer Center, University of Texas Health, San Antonio, TX, USA
| | - Kathirvel Brindhadevi
- Center for Transdisciplinary Research (CFTR), Department of Pharmacology, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India.
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Fabiani E, Strand MF, Lindberg M, Goswami N, Fredriksen PM. Variation in Child Serum Cholesterol and Prevalence of Familiar Hypercholesterolemia: The Health Oriented Pedagogical Project (HOPP). Glob Pediatr Health 2022; 9:2333794X221079558. [PMID: 35360145 PMCID: PMC8961391 DOI: 10.1177/2333794x221079558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 01/22/2022] [Indexed: 11/26/2022] Open
Abstract
Early stages of atherosclerosis may develop in childhood due to hyperlipidemia.
The aims are to investigate the prevalence of familiar hypercholesterolemia in 6
to 12-year-old children and to study the deviation in cholesterol measures.
Anthropometric data and venous blood were collected from children participating
in the Health Oriented Pedagogical Project (HOPP). Out of 18 children with
TC > 6.0 mmol/L, 15 were tested genetically and none diagnosed with FH. The
prevalence of TC > 6.0 mmol/L declined from 1.3% in 2015 to 0.5% in 2016. The
mean TC was 4.30 mmol/L both years, which is lower than in earlier studies.
Usage of a single TC measurement and a threshold of TC > 6.0 mmol/L in
screening children for FH, may not be a good screening strategy. While lipid
values have a good reliability across 2 measurements, there are variations in
individual TC levels across 1 year.
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Affiliation(s)
- Ester Fabiani
- University Medical Centre Ljubljana, Slovenia
- Alma Mater Europaea-ECM Maribor, Maribor, Slovenia
| | | | | | - Nandu Goswami
- Medical University of Graz, Graz, Steiermark, Austria
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Hassannejad R, Sharrouf H, Haghighatdoost F, Kirk B, Amirabdollahian F. Diagnostic Power of Circulatory Metabolic Biomarkers as Metabolic Syndrome Risk Predictors in Community-Dwelling Older Adults in Northwest of England (A Feasibility Study). Nutrients 2021; 13:nu13072275. [PMID: 34209146 PMCID: PMC8308366 DOI: 10.3390/nu13072275] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/23/2021] [Accepted: 06/25/2021] [Indexed: 12/15/2022] Open
Abstract
Background: Metabolic Syndrome (MetS) is a cluster of risk factors for diabetes and cardiovascular diseases with pathophysiology strongly linked to aging. A range of circulatory metabolic biomarkers such as inflammatory adipokines have been associated with MetS; however, the diagnostic power of these markers as MetS risk correlates in elderly has yet to be elucidated. This cross-sectional study investigated the diagnostic power of circulatory metabolic biomarkers as MetS risk correlates in older adults. Methods: Hundred community dwelling older adults (mean age: 68.7 years) were recruited in a study, where their blood pressure, body composition and Pulse Wave Velocity (PWV) were measured; and their fasting capillary and venous blood were collected. The components of the MetS; and the serum concentrations of Interleukin-6 (IL-6), Tumor Necrosis Factor-α (TNF-α), Plasminogen Activator Inhibitor-I (PAI-I), Leptin, Adiponectin, Resistin, Cystatin-C, C-Reactive Protein (CRP), insulin and ferritin were measured within the laboratory, and the HOMA1-IR and Atherogenic Index of Plasma (AIP) were calculated. Results: Apart from other markers which were related with some cardiometabolic (CM) risk, after Bonferroni correction insulin had significant association with all components of Mets and AIP. These associations also remained significant in multivariate regression. The multivariate odds ratio (OR with 95% confidence interval (CI)) showed a statistically significant association between IL-6 (OR: 1.32 (1.06–1.64)), TNF-α (OR: 1.37 (1.02–1.84)), Resistin (OR: 1.27 (1.04–1.54)) and CRP (OR: 1.29 (1.09–1.54)) with MetS risk; however, these associations were not found when the model was adjusted for age, dietary intake and adiposity. In unadjusted models, insulin was consistently statistically associated with at least two CM risk factors (OR: 1.33 (1.16–1.53)) and MetS risk (OR: 1.24 (1.12–1.37)) and in adjusted models it was found to be associated with at least two CM risk factors and MetS risk (OR: 1.87 (1.24–2.83) and OR: 1.25 (1.09–1.43)) respectively. Area under curve (AUC) for receiver operating characteristics (ROC) demonstrated a good discriminatory diagnostics power of insulin with AUC: 0.775 (0.683–0.866) and 0.785 by cross validation and bootstrapping samples for at least two CM risk factors and AUC: 0.773 (0.653–0.893) and 0.783 by cross validation and bootstrapping samples for MetS risk. This was superior to all other AUC reported from the ROC analysis of other biomarkers. Area under precision-recall curve for insulin was also superior to all other markers (0.839 and 0.586 for at least two CM risk factors and MetS, respectively). Conclusion: Fasting serum insulin concentration was statistically linked with MetS and its risk, and this link is stronger than all other biomarkers. Our ROC analysis confirmed the discriminatory diagnostic power of insulin as CM and MetS risk correlate in older adults.
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Affiliation(s)
- Razieh Hassannejad
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan 8158388994, Iran; (R.H.); (F.H.)
| | - Hamsa Sharrouf
- School of Health Sciences, Liverpool Hope University, Liverpool L16 9JD, UK; (H.S.); (B.K.)
| | - Fahimeh Haghighatdoost
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan 8158388994, Iran; (R.H.); (F.H.)
| | - Ben Kirk
- School of Health Sciences, Liverpool Hope University, Liverpool L16 9JD, UK; (H.S.); (B.K.)
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, Furlong Road, St. Albans, Melbourne, VIC 3021, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), Geroscience & Osteosarcopenia Research Program, The University of Melbourne and Western Health, St. Albans, Melbourne, VIC 3201, Australia
| | - Farzad Amirabdollahian
- School of Health Sciences, Liverpool Hope University, Liverpool L16 9JD, UK; (H.S.); (B.K.)
- Correspondence:
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Fonseca MJ, Moreira C, Santos AC. Adiposity rebound and cardiometabolic health in childhood: results from the Generation XXI birth cohort. Int J Epidemiol 2021; 50:1260-1271. [PMID: 33523213 DOI: 10.1093/ije/dyab002] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 01/08/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND We aimed to evaluate the association of adiposity rebound (AR) timing on cardiometabolic health in childhood. METHODS Participants were part of the Generation XXI birth cohort, enrolled in 2005/2006 in Porto. All measurements of the child's weight and height performed by health professionals as part of routine healthcare were collected. Individual body mass index (BMI) curves were fitted for 3372 children, using mixed-effects models with smooth spline functions for age and random effects. The AR was categorized into very early (<42 months), early (42-59 months), normal (60-83 months) and late (≥84 months). At age 10 years, cardiometabolic traits were assessed and age- and sex-specific z-scores were generated. Adjusted regression coefficients and 95% confidence intervals [β (95% CI)] were computed. RESULTS The mean age at AR was 61.9 months (standard deviations 15.7). Compared with children with normal AR, children with very early or early AR had higher z-scores for BMI [β = 0.40 (95% CI: 0.28; 0.53); β = 0.21 (95% CI: 0.12; 0.30)], waist circumference [β = 0.33 (95% CI: 0.23; 0.43); β = 0.18 (95% CI: 0.10; 0.25)], waist-height ratio [β = 0.34 (95% CI: 0.24; 0.44); β = 0.14 (95% CI: 0.07; 0.22)], fat mass index [β = 0.24 (95% CI: 0.15; 0.33); β = 0.14 (95% CI: 0.08; 0.21)], fat-free mass index [β = 0.25 (95% CI: 0.14; 0.35); β = 0.11 (95% CI: 0.03; 0.19)], systolic blood pressure [β = 0.10 (95% CI: 0.01; 0.20); β = 0.08 (95% CI: 0.01; 0.15)], insulin [β = 0.16 (95% CI: 0.04; 0.29); β = 0.10 (95% CI: 0.01; 0.19)], HOMA-IR [β = 0.17 (95% CI: 0.04; 0.29); β = 0.10 (95% CI: 0.03; 0.19)] and C-reactive protein [β = 0.14 (95% CI: 0.02; 0.26); β = 0.10 (95% CI: 0.01; 0.19)]. Children with very early AR also had worse levels of diastolic blood pressure [β = 0.09 (95% CI: 0.02; 0.16)], triglycerides [β = 0.21 (95% CI: 0.08; 0.34)] and high-density lipoprotein cholesterol [β=-0.18 (95% CI: -0.31; -0.04)]. When analysed continuously, each additional month of age at the AR was associated with healthier cardiometabolic traits. CONCLUSION The earlier the AR, the worse the cardiometabolic health in late childhood, which was consistently shown across a wide range of outcomes and in the categorical and continuous approach.
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Affiliation(s)
- Maria João Fonseca
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Carla Moreira
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,CMAT, Departamento de Matemática e Aplicações, Universidade do Minho, Braga, Portugal
| | - Ana Cristina Santos
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Portugal
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Sehn AP, Gaya AR, Dias AF, Brand C, Mota J, Pfeiffer KA, Sayavera JB, Renner JDP, Reuter CP. Relationship between sleep duration and TV time with cardiometabolic risk in adolescents. Environ Health Prev Med 2020; 25:42. [PMID: 32825824 PMCID: PMC7442988 DOI: 10.1186/s12199-020-00880-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 08/06/2020] [Indexed: 12/17/2022] Open
Abstract
Objective To verify the association between sleep duration and television time with cardiometabolic risk and the moderating role of age, gender, and skin color/ethnicity in this relationship among adolescents. Methods Cross-sectional study with 1411 adolescents (800 girls) aged 10 to 17 years. Television time, sleep duration, age, gender, and skin color/ethnicity were obtained by self-reported questionnaire. Cardiometabolic risk was evaluated using the continuous metabolic risk score, by the sum of the standard z-score values for each risk factor: high-density lipoprotein cholesterol, triglycerides, glycemia, cardiorespiratory fitness, systolic blood pressure, and waist circumference. Generalized linear regression models were used. Results There was an association between television time and cardiometabolic risk (β, 0.002; 95% CI, 0.001; 0.003). Short sleep duration (β, 0.422; 95% CI, 0.012; 0.833) was positively associated with cardiometabolic risk. Additionally, age moderated the relationship between television time and cardiometabolic risk (β, − 0.009; 95% CI, − 0.002; − 0.001), suggesting that this relationship was stronger at ages 11 and 13 years (β, 0.004; 95% CI, 0.001; 0.006) compared to 13 to 15 years (β, 0.002; 95% CI, 0.001; 0.004). No association was found in older adolescents (β, 0.001; 95% CI, − 0.002; 0.002). Conclusions Television time and sleep duration are associated with cardiometabolic risk; adolescents with short sleep have higher cardiometabolic risk. In addition, age plays a moderating role in the relationship between TV time and cardiometabolic risk, indicating that in younger adolescents the relationship is stronger compared to older ones.
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Affiliation(s)
- Ana Paula Sehn
- Graduate Program in Health Promotion, University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, RS, Brazil
| | - Anelise Reis Gaya
- Graduate Program in Human Movement Sciences, Physical Education, Physiotherapy and Dance School, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Arieli Fernandes Dias
- Graduate Program in Human Movement Sciences, Physical Education, Physiotherapy and Dance School, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Caroline Brand
- Graduate Program in Health Promotion, University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, RS, Brazil
| | - Jorge Mota
- Research Center on Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
| | | | | | - Jane Dagmar Pollo Renner
- Graduate Program in Health Promotion, Department of Life Sciences, University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, RS, Brazil
| | - Cézane Priscila Reuter
- Graduate Program in Health Promotion, Department of Health Sciences, University of Santa Cruz do Sul (UNISC), Av. Independência, 2293, Santa Cruz do Sul, RS, 96815-900, Brazil.
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Heshmati J, Morvaridzadeh M, Sepidarkish M, Fazelian S, Rahimlou M, Omidi A, Palmowski A, Asadi A, Shidfar F. Effects of Melissa officinalis (Lemon Balm) on cardio-metabolic outcomes: A systematic review and meta-analysis. Phytother Res 2020; 34:3113-3123. [PMID: 32614129 DOI: 10.1002/ptr.6744] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 04/07/2020] [Accepted: 05/13/2020] [Indexed: 01/24/2023]
Abstract
Recent evidence indicates a beneficial effect of Melissa officinalis (MO) intake on several chronic diseases. However, the effects of MO intake have not yet been systematically reviewed. Therefore, we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the effect of MO intake and focused on several cardiometabolic outcomes. MEDLINE, Scopus, EMBASE, Web of Science and the Cochrane Central Register of Controlled Trials were searched for MO-RCTs evaluating cardiometabolic outcomes. Random-effects meta-analyses estimated the pooled standardized mean differences (SMD) between intervention and control groups. Risk of bias was assessed with the Cochrane Collaboration's tool for assessing the risk of bias in RCTs. Seven RCTs were finally deemed eligible. MO intake was associated with a reduced total cholesterol (TC) (SMD: -0.26; 95% CI: -0.52, -0.01; I2 = 13.7%; k = 6) and a reduced systolic blood pressure (SBP) (SMD: -0.56; 95% CI: -0.85, -0.27; I2 = 00.0%; k = 3). MO intake was not associated with statistically significant changes in triglycerides, low-density lipoprotein, diastolic blood pressure, high sensitivity c-reactive protein levels, fasting blood sugar, HbA1c, insulin or high-density lipoprotein levels. No serious adverse events were reported. The risk of bias was high in a considerable amount of studies. Our study suggests that MO is a safe supplement with beneficial effects on TC and SBP. However, the findings of our study must be seen in the light of major limitations such as a low number of included studies and a serious risk of bias. High-quality RCTs are needed for firm conclusions concerning the effects of MO on cardiometabolic outcomes.
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Affiliation(s)
- Javad Heshmati
- Department of Nutritional Science, School of Nutritional Science and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mojgan Morvaridzadeh
- Department of Nutritional Science, School of Nutritional Science and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mahdi Sepidarkish
- Department of Biostatistics and Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, Iran
| | - Siavash Fazelian
- Clinical Research Development Unit, Ayatollah Kashani Hospital, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Mehran Rahimlou
- Department of Nutrition, School of Allied Medical Sciences, Jundishapour University of Medical Sciences, Ahvaz, Iran
| | - Amirhossein Omidi
- Department of Nutritional Science, School of Nutritional Science and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Andriko Palmowski
- Department of Rheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Akbar Asadi
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Farzad Shidfar
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
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Zanatta LB, Heinzmann-Filho JP, Vendrusculo FM, Campos NE, Oliveira MDS, Feoli AMP, Gustavo ADS, Donadio MVF. Effect of an interdisciplinary intervention with motivational approach on exercise capacity in obese adolescents: a randomized controlled clinical trial. EINSTEIN-SAO PAULO 2020; 18:eAO5268. [PMID: 32428066 PMCID: PMC7233282 DOI: 10.31744/einstein_journal/2020ao5268] [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] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 11/29/2019] [Indexed: 11/30/2022] Open
Abstract
Objective To evaluate the effect of an interdisciplinary intervention with a motivational approach on exercise capacity and usual physical activity levels in overweight and obese adolescents. Methods This is a randomized, controlled clinical trial with single blinding of subjects. Adolescents aged 15 to 18 years with overweight and obesity (body mass index ≥ 85 percentile) were included. The adolescents were randomized into two groups: interdisciplinary intervention or control - traditional approach aiming at lifestyle modifications. The initial evaluations were carried out, including the cardiopulmonary exercise test and the physical activity level measurement by using the International Physical Activity Questionnaire and a pedometer. The evaluations were performed in two moments: time zero (time of inclusion in the study) and after 3 months (end of intervention). There were 12 sessions with weekly meetings. Results A total of 37 participants were included, 19 in the Intervention Group. There were no significant differences in the baseline demographic, anthropometric and physical activity characteristics between groups, with mean age of 17.3±1.0 years in the Control Group, and 16.8±0.9 years in the Intervention Group (p=0.14). The motivational intervention did not cause significant differences (p>0.05) in the comparison of the variables of exercise capacity and usual physical activity (questionnaire and pedometer) between groups. Conclusion The intervention with a motivational approach did not alter exercise capacity and levels of usual physical activity in overweight and obese adolescents. Clinical Trial Registry: NCT02455973 and REBEC: RBR-234nb5.
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Affiliation(s)
- Letiane Bueno Zanatta
- Pontifícia Universidade Católica do Rio Grande do SulPorto AlegreRSBrazil Pontifícia Universidade Católica do Rio Grande do Sul , Porto Alegre , RS , Brazil .
| | - João Paulo Heinzmann-Filho
- Pontifícia Universidade Católica do Rio Grande do SulPorto AlegreRSBrazil Pontifícia Universidade Católica do Rio Grande do Sul , Porto Alegre , RS , Brazil .
| | - Fernanda Maria Vendrusculo
- Pontifícia Universidade Católica do Rio Grande do SulPorto AlegreRSBrazil Pontifícia Universidade Católica do Rio Grande do Sul , Porto Alegre , RS , Brazil .
| | - Natália Evangelista Campos
- Pontifícia Universidade Católica do Rio Grande do SulPorto AlegreRSBrazil Pontifícia Universidade Católica do Rio Grande do Sul , Porto Alegre , RS , Brazil .
| | - Margareth da Silva Oliveira
- Pontifícia Universidade Católica do Rio Grande do SulPorto AlegreRSBrazil Pontifícia Universidade Católica do Rio Grande do Sul , Porto Alegre , RS , Brazil .
| | - Ana Maria Pandolfo Feoli
- Pontifícia Universidade Católica do Rio Grande do SulPorto AlegreRSBrazil Pontifícia Universidade Católica do Rio Grande do Sul , Porto Alegre , RS , Brazil .
| | - Andréia da Silva Gustavo
- Pontifícia Universidade Católica do Rio Grande do SulPorto AlegreRSBrazil Pontifícia Universidade Católica do Rio Grande do Sul , Porto Alegre , RS , Brazil .
| | - Márcio Vinícius Fagundes Donadio
- Pontifícia Universidade Católica do Rio Grande do SulPorto AlegreRSBrazil Pontifícia Universidade Católica do Rio Grande do Sul , Porto Alegre , RS , Brazil .
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Benestad B, Júlíusson PB, Siegfried W, Lekhal S, Småstuen MC, Hertel JK, Agosti F, Marazzi N, Hjelmesæth J, Sartorio A. Cardiometabolic risk factors differ among adolescents with obesity in three European countries - a cross-sectional study. Acta Paediatr 2019; 108:493-501. [PMID: 30118191 PMCID: PMC6585823 DOI: 10.1111/apa.14542] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 08/09/2018] [Accepted: 08/14/2018] [Indexed: 12/20/2022]
Abstract
Aim We aimed to compare modifiable cardiometabolic risk factors among treatment‐seeking adolescents with obesity in Italy, Germany and Norway. Methods This retrospective, registry‐based, cross‐sectional cohort study included 2,327 (59% girls) 12–18 year‐old adolescents with obesity from three tertiary care outpatient clinics in Europe, between 1999 and 2015. The prevalence of cardiometabolic risk factors was compared between clinics, and multivariate logistic regression models including gender, age, waist circumference and body mass index were used to assess the associations between population and cardiometabolic risk. Results In total, 1,396 adolescents (60% girls) from Italy, 654 (58% girls) from Germany and 277 (51% girls) from Norway were included. The mean ± SD age was 15.2 ± 1.6 years, body mass index 38.8 ± 6.5 kg/m2 and body mass index standard deviation score 3.21 ± 0.43. The prevalence of elevated nonhigh‐density lipoprotein‐cholesterol in Norway, Germany and Italy was 60%, 54% and 45%, while the prevalence of high systolic or diastolic blood pressure (≥130 or ≥85 mmHg) were 15%, 46% and 66%, respectively. Conclusion Cardiometabolic risk factors among treatment‐seeking adolescents with obesity from Italy, Germany and Norway differed across the populations in this study, which might imply that preventive clinical work should reflect such differences.
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Affiliation(s)
- Beate Benestad
- The Morbid Obesity Centre (MOC) Department of Medicine Vestfold Hospital Trust Tønsberg Norway
- Faculty of Medicine University of Oslo Oslo Norway
| | - Pétur B. Júlíusson
- The Morbid Obesity Centre (MOC) Department of Medicine Vestfold Hospital Trust Tønsberg Norway
- Department of Clinical Science University of Bergen Bergen Norway
| | | | - Samira Lekhal
- The Morbid Obesity Centre (MOC) Department of Medicine Vestfold Hospital Trust Tønsberg Norway
| | | | - Jens Kristoffer Hertel
- The Morbid Obesity Centre (MOC) Department of Medicine Vestfold Hospital Trust Tønsberg Norway
| | - Fiorenza Agosti
- Istituto Auxologico Italiano, IRCCS Division of Metabolic Diseases and Auxology Experimental Laboratory for Auxo‐endocrinological Research, Research Center for Growth Disorders Verbania and Milan Italy
| | - Nicoletta Marazzi
- Istituto Auxologico Italiano, IRCCS Division of Metabolic Diseases and Auxology Experimental Laboratory for Auxo‐endocrinological Research, Research Center for Growth Disorders Verbania and Milan Italy
| | - Jøran Hjelmesæth
- The Morbid Obesity Centre (MOC) Department of Medicine Vestfold Hospital Trust Tønsberg Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Alessandro Sartorio
- Istituto Auxologico Italiano, IRCCS Division of Metabolic Diseases and Auxology Experimental Laboratory for Auxo‐endocrinological Research, Research Center for Growth Disorders Verbania and Milan Italy
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12
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Yang L, Bovet P, Ma C, Zhao M, Liang Y, Xi B. Prevalence of underweight and overweight among young adolescents aged 12-15 years in 58 low-income and middle-income countries. Pediatr Obes 2019; 14:e12468. [PMID: 30156015 DOI: 10.1111/ijpo.12468] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 07/14/2018] [Accepted: 07/16/2018] [Indexed: 12/01/2022]
Abstract
BACKGROUND The co-existence of underweight and overweight is a great challenge for public health in low-income and middle-income countries (LMICs). OBJECTIVES The objective of the study is to report the prevalence of underweight, overweight and obesity among young adolescents in 58 LMICs. METHODS Data were from the Global School-based Student Health Survey (2007-2013) in 57 LMICs and from the Chinese National Surveys on Students' Constitution and Health (2010). A total of 177 325 young adolescents aged 12-15 years from 58 LMICs were included. Weight status was defined based on both the updated International Obesity Task Force (IOTF) and World Health Organization (WHO) criteria. RESULTS Based on the IOTF/WHO criteria, the overall prevalence of weight categories among young adolescents in LMICs was 13.4%/4.7% for underweight, 15.4%/17.3% for overweight and 5.6%/8.6% for obesity. However, the prevalence varied largely across countries and regions. Based on the IOTF criteria, the prevalence of underweight ranged from 0.0% in Niue to 48.8% in Sri Lanka and obesity ranged from 0.1% in Vanuatu to 35.0% in Niue; a prevalence exceeding 10.0% for both underweight and excess weight (overweight and obesity combined) was found in 29.3% of these countries. Underweight was more prevalent in Southeast Asia and Africa, while obesity was more frequent in Central and South Americas. There were no age and sex differences in the prevalence of weight categories for most countries. CONCLUSIONS Our data confirm the continued dual burden of underweight and overweight in young adolescents in many LMICs and the need for policy and programmes to address both conditions.
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Affiliation(s)
- L Yang
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - P Bovet
- Institute of Social and Preventive Medicine, University of Lausanne, Lausanne, Switzerland
| | - C Ma
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - M Zhao
- Department of Nutrition and Food Hygiene, School of Public Health, Shandong University, Jinan, China
| | - Y Liang
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
| | - B Xi
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
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Joseph-Shehu EM, Ncama BP. Evaluation of health status and its predictor among university staff in Nigeria. BMC Cardiovasc Disord 2018; 18:183. [PMID: 30236072 PMCID: PMC6148776 DOI: 10.1186/s12872-018-0918-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 09/10/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Hypertension, diabetes mellitus and obesity share some characteristics in relation to diagnosis, management, and prevention. Overweight, obesity and waist-hip ratio (WHR) are associated with increased risk for development of diabetes and hypertension. Surveillance and regular screening exercises are essential in control and prevention of overweight, obesity, diabetes and hypertension. There is limited literature that reported on these health status parameters among university staff in low- and middle-income countries such as Nigeria. It is currently unclear whether Nigerian have a high or low proportion of metabolic risk factors. Therefore, the study aims to examine health status parameters and their predictors among university staff in Nigeria. METHODS The study used a cross-sectional descriptive design. Data were collected from 280 university staff in Nigeria. A self-administered questionnaire with sections for sociodemographic data and physical assessment was used to gather information from the participants. Data were analysed using the Statistical Package for Social Science (IBM-SPSS version 25). Univariable and multivariable logistic regression was conducted to explore the association between predictors and health status parameters of the participants. RESULT The response rate was 87.5%. University staff had mean systolic blood pressure of 132.04 mmHg ± 19.20 mmHg, diastolic blood pressure of 78.11 mmHg ± 10.81 mmHg, body mass index of 27.74 ± 5.22, waist-hip ratio of 0.88 ± 0.68 and random blood sugar of 98.65 ± 21.30 mg/dL. Predictors of high blood pressure were age (adjusted odds ratio [aOR] = 1.10, CI 95%: [1.05-1.14]) and gender (aOR = 0.5, CI 95%: [0.8-0.9]) and predictors of body mass index were gender (aOR = 2.3, CI 95%: [1.3-4.2]) and religion (aOR = 0.3, CI 95%: [0.2-0.7]). Gender and age had statistically significant association with waist-hip ratio and random blood sugar respectively. CONCLUSION The prevalence rates of high blood pressure and random blood sugar; overweight, obesity and risk WHR are on the increase compared to previous studies. Lifestyle modification, organized and explicit health campaigns coupled with regular screening and surveillance will contribute to the prevention and control of noncommunicable diseases.
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Affiliation(s)
- Elizabeth M. Joseph-Shehu
- School of Nursing and Public Health, Postgraduate Office, Ground Floor, George Campbell Building, Howard College Campus, University of KwaZulu-Natal, Durban, South Africa
- Department of Nursing Science, Faculty of Health Sciences, National Open University of Nigeria, Abuja, Nigeria
| | - Busisiwe P. Ncama
- School of Nursing and Public Health, Postgraduate Office, Ground Floor, George Campbell Building, Howard College Campus, University of KwaZulu-Natal, Durban, South Africa
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14
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Deng WH, Lindberg M, Hjelle OP, Mamen A, Fredriksen PM. Cardiovascular risk factors in a child population: The Health Oriented Pedagogical Project (HOPP). Scand J Public Health 2018; 46:28-37. [DOI: 10.1177/1403494818770130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims: The main aim of the present study was to investigate the clustering of risk factors for cardiovascular diseases and metabolic syndrome in a large, healthy representative Norwegian child population. Methods: From a population of 2817, parents of 2297 children agreed to participate. Values of waist circumference (WC), total cholesterol (TC), high-density lipoprotein (HDL), systolic blood pressure (sysBP), haemoglobin-A1c (HbA1c) and Andersen aerobic fitness test were used to test clustering of cardiometabolic risk factors in this sample. Expected distributions of probability for zero to five risk factors are, respectively, 23.7%, 39.6%, 26.4%, 8.8%, 1.5% and 0.1%. A cardiometabolic risk score from zero to five for each individual was derived by adding the number of variables in the least desirable quartile (highest for WC, sysBP, TC and HbA1c; lowest for aerobic fitness and HDL). Results: A risk ratio of 5.8 (95% confidence interval 0.7–46.9) was found for five risk factors, though the small sample size rendered the results non-significant. An explorative analysis combining children with four and five risk factors did not reveal any significant clustering either. Conclusions: No clustering of risk factors was found among Norwegian children aged 6–12 years.
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Affiliation(s)
- Wei Hai Deng
- Department of Health Sciences, Kristiania University College, Norway
| | | | - Ole Petter Hjelle
- Department of Health Sciences, Kristiania University College, Norway
| | - Asgeir Mamen
- Department of Health Sciences, Kristiania University College, Norway
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Benmohammed K, Valensi P, Nguyen MT, Benmohammed F, Lezzar A. Prevalence and complications of obesity and overweight among Algerian adolescents. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2018. [DOI: 10.3233/mnm-17173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE: To determine the prevalence of overweight and obesity in Algerian adolescents and investigate the associated cardiometabolic complications. METHODS: The study was conducted in the city of Constantine (Algeria). The population included 1100 schooled adolescent, aged 12–18 years, randomly selected. All had anthropometric measurements, and 989 had blood tests. The BMI was calculated and the prevalence of overweight and obesity was determined using the International Obesity Task Force reference values. RESULTS: 179 (16.3%) adolescents were overweight including 74 boys (13.8%) and 105 girls (18.6%), 51 (4.6%) adolescents were obese including 25 (4.6%) boys vs 26 (4.6%) girls (p = 0.09). Overweight and obese adolescents had higher systolic blood pressure/diastolic blood pressure (p = 0.001/p < 0.0001) and abnormal blood lipid levels. Furthermore, the HOMA index was higher in overweight and obese adolescents (p < 0.0001). CONCLUSION: These findings show a high prevalence of overweight and obesity in a population of Algerian adolescents leading to significant cardiometabolic abnormalities.
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Affiliation(s)
- Karima Benmohammed
- Department of Endocrinology and Diabetology, Benbadis University Hospital, Constantine University, Algeria
| | - Paul Valensi
- Department of Endocrinology Diabetology Nutrition, Jean Verdier Hospital, AP-HP, Paris Nord University, CRNH-IdF, CINFO, Bondy, France
| | - Minh Tuan Nguyen
- Department of Endocrinology Diabetology Nutrition, Jean Verdier Hospital, AP-HP, Paris Nord University, CRNH-IdF, CINFO, Bondy, France
| | - Farah Benmohammed
- Hôpital Santa Cabrini Ospedal, Montreal University, Montréal, Canada
| | - Alkassem Lezzar
- Department of Endocrinology and Diabetology, Benbadis University Hospital, Constantine University, Algeria
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Alías-Hernández I, Galera-Martínez R, García-García E, Muñoz-Vico FJ, Vázquez Lopez MÁ, Olvera-Porcel MC, Bonillo Perales A. Insulinaemia and insulin resistance in Caucasian general paediatric population aged 2 to 10 years: Associated risk factors. Pediatr Diabetes 2018; 19:45-52. [PMID: 28493411 DOI: 10.1111/pedi.12533] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 03/04/2017] [Accepted: 03/28/2017] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The aim of this study is to determine values of insulinaemia, homeostasis model assessment (HOMA) index and quantitative insulin sensitivity check index (QUICKI) among a population of prepubertal Caucasian children, to analyse factors associated with insulin resistance (IR), and to study its association with cardiovascular risk factors. MATERIALS AND METHODS Population-based study conducted on a randomly selected sample of prepubescent Caucasian subjects aged 2.00 to 9.99 years old. Anthropometric measurements, blood pressure, and fasting blood samples were obtained, including fasting glucose, triglycerides, High Density Lipoprotein (HDL)-cholesterol, and insulin. In addition, QUICKI and HOMA indices were calculated. Generalised additive models for location, scale and shape (GAMLSS) was used to calculate centiles curves and multivariate logistic regression analysis to assess factors associated with IR. RESULTS A total of 654 subjects were included. Mean values obtained for insulinaemia, HOMA index, and QUICKI were 3.74 μIU/mL, 0.73, and 0.44, respectively, in the overall population and 3.32 μIU/mL, 0.64 and 0.46, respectively, in normal weight subjects. The main factor associated with IR was abdominal obesity (odds ratio [OR] 3.38 [95% CI 1.44-7.94] in the subgroup aged 2.00-5.99 years and OR 9.14 [3.42-24.41] for those aged 6.00-9.99 years). An increased risk of hyperglycaemia (P = 0.043), hypertriglyceridaemia (P < .001), and HDL < p10 (P = 0.021) was described among children aged 2.00 to 5.99 years with IR, and among those aged 6.00 to 9.99 years, IR was associated with an increased risk of hypertriglyceridaemia (P < .001). CONCLUSION Abdominal obesity was the main factor associated with IR. Metabolic changes associated with IR seem to be present from early stages of life, which highlights the importance of the prevention, early diagnosis and treatment of obesity.
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Benmohammed K, Valensi P, Nguyen MT, Benmohammed F, Benlatreche M, Benembarek K, Lezzar A. Influence of waist circumference on blood pressure status in non-obese adolescents. Int J Adolesc Med Health 2018; 32:ijamh-2017-0127. [PMID: 29332014 DOI: 10.1515/ijamh-2017-0127] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 10/09/2017] [Indexed: 11/15/2022]
Abstract
Objectives To check whether excess in abdominal adiposity and metabolic factors were associated with blood pressure abnormalities in non-obese adolescents. Methods We randomly selected 1100 adolescent students, aged 12-18 years, from schools and classrooms in the city of Constantine, Algeria. Among them 179 were overweight and 51 were obese (IOTF criteria). Waist circumference (WC) was considered high if >74 cm in boys and 75 cm in girls (mean of WC of all population studied). Hypertension (HBP) and prehypertension (preHBP) were defined by the NHBPEP's 2004 criteria. Results The prevalence of HBP/preHBP were 13.0%/12.4% with no difference between boys and girls. The percentages of HBP/preHBP patients were 15.6%/15.6% in overweight adolescents, 5.9%/31.4% in obese adolescents and 12.9%/10.6% in adolescents with normal body weight (p < 0.0001). In obese adolescents, the prevalence of HBP was higher among boys than girls (36% vs. 27%, p = 0.002). In normal and overweight adolescents, the prevalence of HBP and preHBP was similar in boys and girls (11.9% vs. 11.0% and 14.7% vs. 12.1%); the association of WC (high vs. not high) with HBP was found in boys (16.1% vs. 8.8%, p = 0.009) but not in girls (12.1% vs. 10.2%), and with preHBP in girls (15.5% vs. 8.0%, p = 0.029) but not in boys (16.2% vs. 13.6%). Waist circumference [OR: 1.04 (1.03-1.06); p < 0.0001] and HOMA index [OR: 1.65 (1.13-2.39); p = 0.009] were associated with an increased risk of HBP. Conclusion In non-obese adolescents, a high WC, defined by values over the mean WC observed in our population, is associated with a higher risk of HBP in boys.
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Affiliation(s)
- Karima Benmohammed
- Department of Endocrinology and Diabetology, Dr Benbadis University Hospital, Constantine University 3, Constantine, Algeria
| | - Paul Valensi
- Department of Endocrinology, Diabetology and Nutrition, Jean Verdier hospital, APHP, Paris Nord University, CRNH-IDF, CINFO, Bondy, France
| | - Minh Tuan Nguyen
- Department of Endocrinology, Diabetology and Nutrition, Jean Verdier hospital, APHP, Paris Nord University, CRNH-IDF, CINFO, Bondy, France
| | | | - Moufida Benlatreche
- Department of Animal Biology, Faculty of Life and Natural Sciences, University of Constantine 1, Biology and genetics research laboratory, Constantine, Algeria
| | - Karima Benembarek
- Department of Biochemistry, Research Laboratory on Biology and Genetic, Constantine University3, Constantine, Algeria
| | - Alkassem Lezzar
- Department of Endocrinology and Diabetology, Dr Benbadis University Hospital, Constantine University 3, Constantine, Algeria
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Kovacs VA, Bakacs M, Kaposvari C, Illes E, Erdei G, Martos E, Breda J. Weight Status of 7-Year-Old Hungarian Children between 2010 and 2016 Using Different Classifications (COSI Hungary). Obes Facts 2018; 11:195-205. [PMID: 29788023 PMCID: PMC6103376 DOI: 10.1159/000487327] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 01/31/2018] [Indexed: 11/19/2022] Open
Abstract
AIMS To describe the prevalence of thinness, overweight, and obesity in Hungarian children (age 7.0-7.9 years) according to different classifications, to assess the progress between 2010 and 2016, and to investigate whether tendencies differ according to gender. METHODS A national representative sample was generated by two-stage cluster sampling, and a total of 2,651 children (50.9% boys; age 7.49 ± 0.3 years) were measured (weight and height) in October 2016. Population estimates were calculated using the WHO, IOTF, and national cut-offs. RESULTS Prevalence of thinness (including grade 1 and 2) was 12.6% based on the IOTF criteria and 15.6% based on the WHO definition. 22.5% of children were identified as overweight or obese according to the IOTF classification, compared with 28.4% according to the WHO definition. Between 2010 and 2016, each classification indicated possible stability in overweight and obesity prevalence. In contrast, the prevalence of thinness grade 2 almost doubled in 6 years according to all definitions (p < 0.05). No significant gender difference was observed in the progress. CONCLUSION Overweight and obesity appeared to be stable over 6 years, but we detected growing thinness rates. Routine collection of high-quality data that are based on standardized and comparable methods is essential to monitor the childhood obesity problem.
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Affiliation(s)
- Viktoria Anna Kovacs
- Division of Nutrition Physiology and Epidemiology, National Institute of Pharmacy and Nutrition, Budapest, Hungary
- *Viktoria Anna Kovacs, MD PhD, Division of Nutrition Physiology and Epidemiology, National Institute of Pharmacy and Nutrition, Albert Florian u. 3/a, 1097 Budapest, Hungary,
| | - Marta Bakacs
- Division of Nutrition Physiology and Epidemiology, National Institute of Pharmacy and Nutrition, Budapest, Hungary
| | - Csilla Kaposvari
- Division of Nutrition Physiology and Epidemiology, National Institute of Pharmacy and Nutrition, Budapest, Hungary
| | - Eva Illes
- Division of Nutrition Physiology and Epidemiology, National Institute of Pharmacy and Nutrition, Budapest, Hungary
| | - Gergo Erdei
- Division of Applied Nutrition, National Institute of Pharmacy and Nutrition, Budapest, Hungary
| | - Eva Martos
- University of Physical Education, Budapest, Hungary
| | - Joao Breda
- World Health Organization, European Office for Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation
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Amirabdollahian F, Haghighatdoost F. Anthropometric Indicators of Adiposity Related to Body Weight and Body Shape as Cardiometabolic Risk Predictors in British Young Adults: Superiority of Waist-to-Height Ratio. J Obes 2018; 2018:8370304. [PMID: 30515323 PMCID: PMC6236774 DOI: 10.1155/2018/8370304] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 09/07/2018] [Accepted: 10/02/2018] [Indexed: 02/06/2023] Open
Abstract
Frequently reported poor dietary habits of young adults increase their risk of metabolic syndrome (MetS). Excess adiposity is the most established predictor of MetS, and numerous anthropometric measures have been proposed as proxy indicators of adiposity. We aimed to assess prevalence of MetS in young adult population and to make comparison between weight- and shape-oriented measures of adiposity to identify the best index in association with measured body fat and as a risk predictor for MetS. Healthy males and females aged 18-25 years from the Northwest of England were recruited using convenience sampling (n=550). As part of the assessment of the overall health of young adults, the biochemical variables and adiposity measures BMI, waist circumference (WC), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), new BMI, Body Adiposity Index (BAI), Clinica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE), and A Body Shape Index (ABSI) were assessed. Linear regression analysis was used to investigate the association between the proxy indices of adiposity and measured percentage body fat. The odds ratio with 95% confidence interval was used to investigate the relationship between cardiometabolic (CM) risk factors and proxy measures of adiposity. The discriminatory power of these measures for diagnosis of MetS was investigated using area under the receiver operating characteristic curve. Body weight-related indicators of adiposity, particularly CUN-BAE, had stronger association with measured body fat compared with body shape-related indices. In relation with MetS, body shape-related indices, particularly elevated WC and WHtR, had stronger associations with CM risk compared with body weight-related measures. Amongst all indices, the best predictor for CM risk was WHtR, while ABSI had the weakest correlation with body fat, MetS, and CM risk. Indices directly associated with WC and specifically WHtR had greater diagnostic power in detection of CM risk in young adults.
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Affiliation(s)
| | - Fahimeh Haghighatdoost
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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Teixeira FC, Pereira FEF, Pereira AF, Ribeiro BG. Metabolic syndrome's risk factors and its association with nutritional status in schoolchildren. Prev Med Rep 2017; 6:27-32. [PMID: 28239539 PMCID: PMC5318537 DOI: 10.1016/j.pmedr.2017.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 01/22/2017] [Accepted: 02/06/2017] [Indexed: 11/15/2022] Open
Abstract
The metabolic risk factors (RF) to the diagnosis of metabolic syndrome (MetS) have been evidenced at early ages, including children. The aim of the present study was to identify the prevalence of RF to the diagnosis of MetS and its association with nutritional status of schoolchildren from 6 to 10 years old. A cross-sectional study was carried out in 505 students of municipal schools in Macae, Brazil, conducted from 2013 to 2014. The RF evaluated were: blood pressure (mm Hg), triglycerides (mmol/L), HDL-cholesterol (mmol/L) fasting glucose (mmol/L) and waist circumference (cm). At least one RF was present in 61% (n = 308) of the sample. By nutritional status, there was higher prevalence of RF in overweight/obese schoolchildren compared to those with normal weight, except in the concentration of HDL-c. The prevalence of one, two and three RF (MetS) were 34.7% (n = 175), 21.0% (n = 106) and 5.3% (n = 27), respectively. Two RF were more present in overweight (28.2% 95%CI 19.0; 39.0) and obese (41.5% 95%CI 31.4; 52.1) compared to normal weight children (13.5% 95%CI 9.9; 17.8). Three or more RF were more frequent among obese (25.5% 95%CI 17.0; 35.5) in relation to overweight (2.4% 95%CI 0.2; 8.2) and normal weight children (0.3% 95%CI 0; 1.7). The data indicate high prevalence of RF and its relationship with the magnitude of body weight excess. Therefore, the identification and early treatment of these RF might minimize the risk of MetS and related diseases.
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Key Words
- 95%CI, 95% confidence interval
- Abdominal obesity
- BMI, body mass index
- BP, blood pressure
- CVD, cardiovascular disease
- Children
- DBP, diastolic blood pressure
- DM2, type 2 diabetes mellitus
- Dyslipidemia
- HAS, hypertension
- HDL-c, high density lipoprotein cholesterol concentration
- Hypertension
- IR, insulin resistance
- MetS, metabolic syndrome
- Metabolic syndrome
- RF, metabolic risk factors
- SBP, systolic blood pressure
- TG, triglycerides
- WC, waist circumference
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Affiliation(s)
- Fabiana Costa Teixeira
- Programa Pós Graduação em Nutrição, Instituto de Nutrição UFRJ, Laboratório Integrado de Pesquisa em Ciências do Esporte, UFRJ Campus Macaé, RJ,Brazil
| | - Flavia Erika Felix Pereira
- Programa Pós Graduação em Alimentação, Nutrição e Saúde, Universidade do Estado do Rio de Janeiro UERJ, RJ, Laboratório Integrado de Pesquisa em Ciências do Esporte, UFRJ Campus Macaé, RJ,Brazil
| | | | - Beatriz Gonçalves Ribeiro
- Prof. Curso de Nutrição, Laboratório Integrado de Pesquisa em Ciências do Esporte, UFRJ Campus Macaé, RJ, Brazil
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Agirbasli M, Tanrikulu AM, Berenson GS. Metabolic Syndrome: Bridging the Gap from Childhood to Adulthood. Cardiovasc Ther 2016; 34:30-6. [PMID: 26588351 DOI: 10.1111/1755-5922.12165] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Childhood and adolescence are particularly vulnerable periods of life to the effects of cardiometabolic risk and later development of atherosclerosis, hypertension, and diabetes mellitus. Developing countries with limited resources suffer most heavily from the consequences of cardiometabolic risk in children and its future implications to the global health burden. A better understanding of mechanisms leading to cardiometabolic risk in early life may lead to more effective prevention and intervention strategies to reduce metabolic stress in children and later disease. Longitudinal "tracking" studies of cardiometabolic risk in children provide a tremendous global resource to direct prevention strategies for cardiovascular disease. In this review, we will summarize the pathophysiology, existing definitions for cardiometabolic risk components in children. Screening and identifying children and adolescents of high cardiometabolic risk and encouraging them and their families through healthy lifestyle changes should be implemented to as a global public health strategy.
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Affiliation(s)
- Mehmet Agirbasli
- Department of Cardiology, Medeniyet University Medical School, Istanbul, Turkey
| | - Azra M Tanrikulu
- Department of Cardiology, Maltepe State Hospital, Istanbul, Turkey
| | - Gerald S Berenson
- Bogalusa Heart Study, Tulane Center of Cardiovascular Health, Tulane University Health Sciences Center, New Orleans, LA, USA
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Chirita-Emandi A, Barbu CG, Cinteza EE, Chesaru BI, Gafencu M, Mocanu V, Pascanu IM, Tatar SA, Balgradean M, Dobre M, Fica SV, Ichim GE, Pop R, Puiu M. Overweight and Underweight Prevalence Trends in Children from Romania - Pooled Analysis of Cross-Sectional Studies between 2006 and 2015. Obes Facts 2016; 9:206-20. [PMID: 27319017 PMCID: PMC5644837 DOI: 10.1159/000444173] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 01/14/2016] [Indexed: 01/03/2023] Open
Abstract
AIM High-quality national representative data on obesity in Romanian children are needed to shape public health policies. To provide a unified data landscape on national prevalence, trends and other factors associated with underweight, overweight, and obesity in Romanian children aged 6-19 years, across the last decade (2006-2015). METHODS Using a common protocol, we selected published and unpublished studies that measured Romanian children in schools between 2006 and 2015. Children's BMI was classified using the current WHO, IOTF, and CDC references. RESULTS 25,060 children from 8 Romanian counties were included in the analysis. The prevalence of underweight children was 5%/4.5%/8.5% (WHO/IOTF/CDC), while the prevalence of overweight (including obese) children was 28.3%/23%/23.2% (WHO/IOTF/CDC). The prevalence of overweight children did not change significantly over the last decade (chi-square test p = 0.6). Male gender (odds ratio (OR) 1.37; 95% CI 1.29-1.45, compared to female); prepubertal age (OR = 3.86; 95% CI 3.41-4.36,compared to postpubertal age), and urban environment (OR 1.12; 95% CI 1.01-1.26, compared to rural environment) had higher risk for overweight. CONCLUSION While the prevalence of underweight children was low, almost one in four children in Romania was overweight or obese (according to WHO criteria) between 2006 and 2015. This prevalence remained relatively stable over the last decade. Male gender, prepubertal age, and urban environment, were the most relevant risk factors associated with overweight status in Romanian children.
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Affiliation(s)
- Adela Chirita-Emandi
- Genetics Department, University of Medicine and Pharmacy x2018;Victor Babes', Timisoara, Romania
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Physical Therapy as Treatment for Childhood Obesity in Primary Health Care: Clinical Recommendation From AXXON (Belgian Physical Therapy Association). Phys Ther 2016; 96:850-64. [PMID: 26637641 DOI: 10.2522/ptj.20150206] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 11/05/2015] [Indexed: 02/07/2023]
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Burrows R, Correa-Burrows P, Reyes M, Blanco E, Albala C, Gahagan S. High cardiometabolic risk in healthy Chilean adolescents: associations with anthropometric, biological and lifestyle factors. Public Health Nutr 2016; 19:486-93. [PMID: 25990645 PMCID: PMC4654715 DOI: 10.1017/s1368980015001585] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 03/31/2015] [Accepted: 04/14/2015] [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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Affiliation(s)
- Raquel Burrows
- Institute of Nutrition and Food Technology, University of Chile, Avda. El Líbano 5524, Macul 7840390, Santiago de Chile, Chile
| | - Paulina Correa-Burrows
- Institute of Nutrition and Food Technology, University of Chile, Avda. El Líbano 5524, Macul 7840390, Santiago de Chile, Chile
| | - Marcela Reyes
- Institute of Nutrition and Food Technology, University of Chile, Avda. El Líbano 5524, Macul 7840390, Santiago de Chile, Chile
| | - Estela Blanco
- Division of Child Development and Community Health, University of California, San Diego, La Jolla, CA, USA
| | - Cecilia Albala
- Institute of Nutrition and Food Technology, University of Chile, Avda. El Líbano 5524, Macul 7840390, Santiago de Chile, Chile
| | - Sheila Gahagan
- Division of Child Development and Community Health, University of California, San Diego, La Jolla, CA, USA
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Reyes Y, Paoli M, Camacho N, Molina Y, Santiago J, Lima-Martínez MM. Epicardial adipose tissue thickness in children and adolescents with cardiometabolic risk factors. ACTA ACUST UNITED AC 2015; 63:70-8. [PMID: 26654426 DOI: 10.1016/j.endonu.2015.09.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 09/07/2015] [Accepted: 09/08/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To assess the relationship of epicardial adipose tissue (EAT) thickness with cardiometabolic risk factors (CRFs) in children and adolescents. METHODS Seventy-seven subjects of both sexes aged 7-18 years were selected. Medical history, clinical parameters, and glucose, insulin, and lipid levels were collected. EAT thickness was measured using transthoracic echocardiography. Study subjects were divided into two groups based on whether they had less than two or two or more CRFs. RESULTS The group with two or more CRFs had higher EAT thickness, insulin, and HOMA-IR values (P<.05). EAT thickness showed a statistically significant positive correlation with body mass index (BMI) (r=0.561, P=.0001), waist circumference (r=.549, P=.0001), systolic blood pressure (SBP) (r=.256, P=.028), insulin (r=0.408, P=.0001), and HOMA-IR (r=.325, P=.005). However, these correlations were not significant after adjustment for BMI. The cut-off point for EAT thickness as predictor of two or more CRFs was 3.17mm. The risk (odds ratio) of having two or more CRFs if EAT thickness was >3.17mm was 3.1 (95% CI: 1.174-8.022). BMI was the independent variable that most affected EAT thickness and the presence of two or more CRFs. CONCLUSION In this group of children and adolescents, the relationship of EAT thickness with CRFs was found to be dependent on BMI.
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Affiliation(s)
- Yubriangel Reyes
- Unidad de Endocrinología, Instituto Autónomo Hospital Universitario de los Andes, Mérida, Venezuela
| | - Mariela Paoli
- Unidad de Endocrinología, Instituto Autónomo Hospital Universitario de los Andes, Mérida, Venezuela.
| | - Nolis Camacho
- Unidad de Nutrición, Crecimiento y Desarrollo Infantil, Instituto Autónomo Hospital Universitario de los Andes, Mérida, Venezuela
| | - Yudisay Molina
- Instituto de Investigaciones Cardiovasculares, Instituto Autónomo Hospital Universitario de los Andes, Mérida, Venezuela
| | - Justo Santiago
- Instituto de Investigaciones Cardiovasculares, Instituto Autónomo Hospital Universitario de los Andes, Mérida, Venezuela
| | - Marcos M Lima-Martínez
- Departamento de Ciencias Fisiológicas, Universidad de Oriente, Núcleo Bolívar, Ciudad Bolívar, Venezuela
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Omisore B, Omisore A, Abioye-Kuteyi E. Original research: obesity prevalence and metabolic differences between obese and non-obese school adolescents in south-western Nigeria. S Afr Fam Pract (2004) 2015. [DOI: 10.1080/20786190.2014.977010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Savolainen MJ. Epidemiology: disease associations and modulators of HDL-related biomarkers. Handb Exp Pharmacol 2015; 224:259-283. [PMID: 25522991 DOI: 10.1007/978-3-319-09665-0_7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Epidemiological studies have shown an inverse association between high-density lipoprotein cholesterol (HDL-C) levels and risk of ischemic heart disease. In addition, a low level of HDL-C has been shown to be a risk factor for other diseases not related to atherosclerosis. However, recent studies have not supported a causal effect of HDL-C in the development of atherosclerosis. Furthermore, new drugs markedly elevating HDL-C levels have been disappointing with respect to clinical endpoints. Earlier, most studies have focused almost exclusively on the total HDL-C without regard to the chemical composition or multiple subclasses of HDL particles. Recently, there have been efforts to dissect the HDL fraction into as many well-defined subfractions and individual molecules of HDL particles as possible. On the other hand, the focus is shifting from the structure and composition to the function of HDL particles. Biomarkers and mechanisms that could potentially explain the beneficial characteristics of HDL particles unrelated to their cholesterol content have been sought with sophisticated methods such as proteomics, lipidomics, metabonomics, and function studies including efflux capacity. These new approaches have been used in order to resolve the complex effects of diseases, conditions, environmental factors, and genes in relation to the protective role of HDL but high-throughput methods are still needed for large-scale epidemiological studies.
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Affiliation(s)
- Markku J Savolainen
- Department of Internal Medicine, Institute of Clinical Medicine, University of Oulu, Kajaanintie 50, 5000, 90014, Oulu, Finland,
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Gilardini L, Croci M, Pasqualinotto L, Caffetto K, Invitti C. Dietary Habits and Cardiometabolic Health in Obese Children. Obes Facts 2015; 8:101-9. [PMID: 26087840 PMCID: PMC5644861 DOI: 10.1159/000381157] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 11/14/2014] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Prevalence rates of cardiometabolic risk factors vary largely among overweight children. This study investigated the relationships between dietary habits and cardiometabolic health among obese children living in a city of Northern Italy. METHODS Dietary habits were collected in 448 obese subjects aged 6-18 years, attending an obesity outpatient center in Milan. Anthropometry, blood pressure (BP), lipids, fasting and post-load glucose, and insulin were measured. Physical activity was assessed in adolescents using a questionnaire. RESULTS Frequency of glucose intolerance, hypertension and dyslipidemia was 0.7%, 13% and 27.2%, respectively. Plausible reporters consumed more animal protein and sodium and less legumes than recommended in nutritional recommendations and adequate amounts of fiber mainly derived from whole grains. Subjects skipping breakfast had unhealthy diets and greater body fatness. After adjustment for confounders, waist/height and fasting glucose were associated with sodium intake (r =0.149 and r = 0.142, respectively; p < 0.05), 2-hour glucose with fiber (r = -0.172; p < 0.01), and BP with vegetable protein intake (systolic r = -0.120 (p < 0.05); diastolic r = -0.267 (p < 0.01)). Hypertensive children consumed less vegetable protein than normotensive children. CONCLUSIONS The cardiometabolic health of obese children improves with vegetable protein and whole grain intake, whereas dysglycemia and adiposity increase with sodium intake.
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Affiliation(s)
| | | | | | | | - Cecilia Invitti
- *Dr. Cecilia Invitti, Department of Medical Sciences and Rehabilitation, Istituto Auxologico Italiano, Via Ariosto 13, 20145 Milan, Italy,
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Karatzi K, Moschonis G, Barouti AA, Lionis C, Chrousos GP, Manios Y. Dietary patterns and breakfast consumption in relation to insulin resistance in children. The Healthy Growth Study. Public Health Nutr 2014; 17:2790-7. [PMID: 24477051 PMCID: PMC10282397 DOI: 10.1017/s1368980013003327] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Revised: 09/23/2013] [Accepted: 11/08/2013] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Insulin resistance is a significant cross-point for the manifestation of several chronic diseases in children and adults. The aim of the present study was to investigate the possible relationship of certain dietary patterns and breakfast consumption habits with insulin resistance in children. SUBJECTS A representative sample of 1912 schoolchildren (aged 9-13 years) participated in a cross-sectional epidemiological study, the Healthy Growth Study, which was initiated in May 2007 and completed in June 2009. SETTING It was conducted in seventy-seven primary schools in four large regions in Greece. DESIGN Dietary intake, breakfast consumption, anthropometric and physical examination data, biochemical indices and socio-economic information collected from parents were assessed in all children. Principal components analysis was used to identify dietary patterns. RESULTS A dietary pattern of increased consumption of margarine, sweets (candies, lollipops, jellies, traditional fruit in heavy syrup) and savoury snacks (chips, cheese puffs and not home-made popcorn) was associated with homeostasis model assessment of insulin resistance index (HOMA-IR; β = 0·08, P < 0·001) in multivariate models. Children in the third tertile of this dietary pattern had a 2·51 (95 % CI 1·30, 4·90) times higher risk of insulin resistance (HOMA-IR > 3·16) than those in the first tertile. Breakfast consumption had an inverse correlation with insulin resistance, but the correlation lost its significance after adjustments for waist circumference, birth weight, parental BMI and socio-economic status. CONCLUSIONS Increased consumption of margarine, sweets and savoury snacks, which is a common dietary pattern in childhood, was positively associated with insulin resistance, while breakfast consumption had an inverse association with HOMA-IR, in schoolchildren (aged 9-13 years). Identification of dietary behaviours that might affect insulin resistance in children offers valuable advice in cardiometabolic risk prevention strategies.
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Affiliation(s)
- Kalliopi Karatzi
- Department of Nutrition and Dietetics, Harokopio University of Athens, 70 El. Venizelou Avenue, 17671 Kallithea, Athens, Greece
| | - George Moschonis
- Department of Nutrition and Dietetics, Harokopio University of Athens, 70 El. Venizelou Avenue, 17671 Kallithea, Athens, Greece
| | - Afroditi-Alexandra Barouti
- Department of Nutrition and Dietetics, Harokopio University of Athens, 70 El. Venizelou Avenue, 17671 Kallithea, Athens, Greece
| | - Christos Lionis
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | | | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University of Athens, 70 El. Venizelou Avenue, 17671 Kallithea, Athens, Greece
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Abstract
BACKGROUND In the past decades, the obesity epidemic in children of all ages has been an important research field for detecting the metabolic causes and consequences of obesity, the major focus being on insulin and adipocytokine levels. Metabolic work-up in obese children is recommended in the age group as young as 2-6 years. There is evidence that birth weight can be a factor causing obesity later in life accompanied by metabolic complications. METHODS Insulin, leptin, and adiponectin levels were analyzed in 269 obese children and 60 controls, as well as 110 newborn children with different birth weight and different length of gestation, using standard methods. RESULTS In 53.6% of the obese children, complications of obesity such as diabetes mellitus, obesity, hyperlipidemia, heart attack or stroke were found in family members. The peak insulinemia on OGTT was significantly higher in the pubertal compared to the prepubertal group (110.5± 75.9 μU/mL versus 72.2±62.7 μU/mL) (p<0.005). Glucose intolerance was confirmed in 24%. The leptin level was significantly higher and the adiponectin level was lower in pubertal obese children compared to the prepubertal children and controls (p<0.05). In newborns the leptin and adiponectin levels were in correlation with anthropometric parameters: body weight (BW), body length (BL), BW/BL, BMI, and the pondered index (p<0.05). CONCLUSION Obese children have high insulinemia in all ages, reaching its peak towards puberty. The leptin and adiponectin levels might be indicators of the metabolic syndrome. Our findings in newborns might influence the nutritional approach in the future in order to prevent complications of obesity.
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Early adiposity rebound is associated with metabolic risk in 7-year-old children. Int J Obes (Lond) 2014; 38:1299-304. [PMID: 24909827 DOI: 10.1038/ijo.2014.97] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Revised: 04/02/2014] [Accepted: 05/05/2014] [Indexed: 12/22/2022]
Abstract
BACKGROUND Early adiposity rebound (AR <5 years) has been consistently associated with increased obesity risk, but its relationship with metabolic markers is less clear; in addition, the biologic mechanisms involved in these associations have not been established. OBJECTIVE The objective of this study was to assess the association between timing of AR and metabolic status at age 7 years, evaluating the potential role of adiposity, adipose functionality and skeletal maturation in this association. DESIGN We estimated the age of AR from the body mass index (BMI) trajectories from 0 to 7 years in 910 children from the Growth and Obesity Chilean Cohort Study (GOCS). At 7 years, we measured waist circumference (WC) and blood glucose, insulin, triglycerides and high-density lipoprotein-cholesterol levels and constructed a metabolic risk score. We also measured percent fat mass (adiposity), plasma concentrations of leptin and adiponectin (adipose functionality) and bone age using wrist ultrasound (skeletal maturation). RESULTS We found that 44% of the children had an AR <5 years. Earlier AR was associated with larger WC (β: 5.10 (95% confidence interval (CI): 4.29-5.91)), higher glucose (β: 1.02 (1.00-1.03)), insulin resistance (β Homeostatic Model Assessment: 1.06 (1.03-1.09)), triglycerides (β: 10.37 (4.01-6.73)) and adverse metabolic score (β: 0.30 (0.02-0.37)). Associations decreased significantly if adiposity was added to the models (i.e. β WC: 0.85 (0.33-1.38)) and, to a lesser extent, when adipokines (i.e. β WC: 0.73 (0.14-1.32)) and skeletal maturation (i.e. β WC: 0.65 (0.10-1.20)) were added. CONCLUSION In GOCS children, AR at a younger age predicts higher metabolic risk at 7 years; these associations are mostly explained by increased adiposity, but adipose dysfunction and accelerated skeletal maturation also have a role.
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Comparison of childhood size and dietary differences at age 4 years between three European countries. Eur J Clin Nutr 2014; 68:786-92. [DOI: 10.1038/ejcn.2014.43] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Revised: 12/12/2013] [Accepted: 01/08/2014] [Indexed: 11/09/2022]
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Lalanza JF, Caimari A, del Bas JM, Torregrosa D, Cigarroa I, Pallàs M, Capdevila L, Arola L, Escorihuela RM. Effects of a post-weaning cafeteria diet in young rats: metabolic syndrome, reduced activity and low anxiety-like behaviour. PLoS One 2014; 9:e85049. [PMID: 24482678 PMCID: PMC3895047 DOI: 10.1371/journal.pone.0085049] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Accepted: 11/25/2013] [Indexed: 01/15/2023] Open
Abstract
Among adolescents, overweight, obesity and metabolic syndrome are rapidly increasing in recent years as a consequence of unhealthy palatable diets. Animal models of diet-induced obesity have been developed, but little is known about the behavioural patterns produced by the consumption of such diets. The aim of the present study was to determine the behavioural and biochemical effects of a cafeteria diet fed to juvenile male and female rats, as well as to evaluate the possible recovery from these effects by administering standard feeding during the last week of the study. Two groups of male and female rats were fed with either a standard chow diet (ST) or a cafeteria (CAF) diet from weaning and for 8 weeks. A third group of males (CAF withdrawal) was fed with the CAF diet for 7 weeks and the ST in the 8th week. Both males and females developed metabolic syndrome as a consequence of the CAF feeding, showing overweight, higher adiposity and liver weight, increased plasma levels of glucose, insulin and triglycerides, as well as insulin resistance, in comparison with their respective controls. The CAF diet reduced motor activity in all behavioural tests, enhanced exploration, reduced anxiety-like behaviour and increased social interaction; this last effect was more pronounced in females than in males. When compared to animals only fed with a CAF diet, CAF withdrawal increased anxiety in the open field, slightly decreased body weight, and completely recovered the liver weight, insulin sensitivity and the standard levels of glucose, insulin and triglycerides in plasma. In conclusion, a CAF diet fed to young animals for 8 weeks induced obesity and metabolic syndrome, and produced robust behavioural changes in young adult rats, whereas CAF withdrawal in the last week modestly increased anxiety, reversed the metabolic alterations and partially reduced overweight.
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Affiliation(s)
- Jaume F Lalanza
- Institut de Neurociències, Departament de Psiquiatria i Medicina Legal, Universitat Autònoma de Barcelona, Barcelona, Spain ; Laboratori de Psicologia de l'Esport, Departament de Psicologia Bàsica, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Antoni Caimari
- Centre Tecnològic de Nutrició i Salut (CTNS), TECNIO, CEICS, Reus, Spain
| | - Josep M del Bas
- Centre Tecnològic de Nutrició i Salut (CTNS), TECNIO, CEICS, Reus, Spain
| | - Daniel Torregrosa
- Institut de Neurociències, Departament de Psiquiatria i Medicina Legal, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Igor Cigarroa
- Institut de Neurociències, Departament de Psiquiatria i Medicina Legal, Universitat Autònoma de Barcelona, Barcelona, Spain ; Grado de Kinesiología, sede Los Ángeles, Facultad de Salud, Universidad Santo Tomás, Chile
| | - Mercè Pallàs
- Secció de Farmacologia i Farmacognòsia, Facultat de Farmàcia, Institut de Biomedicina (IBUB), Universitat de Barcelona, Barcelona, Spain ; Centros de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Lluís Capdevila
- Laboratori de Psicologia de l'Esport, Departament de Psicologia Bàsica, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Lluís Arola
- Centre Tecnològic de Nutrició i Salut (CTNS), TECNIO, CEICS, Reus, Spain ; Departament de Bioquímica i Biotecnologia, Nutrigenomics Research Group, Universitat Rovira i Virgili, Tarragona, Spain
| | - Rosa M Escorihuela
- Institut de Neurociències, Departament de Psiquiatria i Medicina Legal, Universitat Autònoma de Barcelona, Barcelona, Spain
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Garoufi A, Koemtzidou E, Katsarou E, Dinopoulos A, Kalimeraki I, Fotinou A, Drakatos A, Attilakos A. Lipid profile and thyroid hormone concentrations in children with epilepsy treated with oxcarbazepine monotherapy: a prospective long-term study. Eur J Neurol 2013; 21:118-23. [DOI: 10.1111/ene.12262] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2013] [Accepted: 08/15/2013] [Indexed: 11/28/2022]
Affiliation(s)
- A. Garoufi
- Second Department of Pediatrics; University of Athens; ‘Panagiotis and Aglaia Kyriakou’ Children's Hospital; Athens Greece
| | - E. Koemtzidou
- Second Department of Pediatrics; University of Athens; ‘Panagiotis and Aglaia Kyriakou’ Children's Hospital; Athens Greece
| | - E. Katsarou
- Department of Neurology; ‘Panagiotis and Aglaia Kyriakou’ Children's Hospital; Athens Greece
| | - A. Dinopoulos
- Third Department of Pediatrics University of Athens; ‘Attikon’ Hospital; Athens Greece
| | - I. Kalimeraki
- Second Department of Pediatrics; University of Athens; ‘Panagiotis and Aglaia Kyriakou’ Children's Hospital; Athens Greece
| | - A. Fotinou
- Hormonological Laboratory; ‘Panagiotis and Aglaia Kyriakou’ Children's Hospital; Athens Greece
| | - A. Drakatos
- Department of Biochemistry; ‘Panagiotis and Aglaia Kyriakou’ Children's Hospital; Athens Greece
| | - A. Attilakos
- Third Department of Pediatrics University of Athens; ‘Attikon’ Hospital; Athens Greece
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Chaput JP, Saunders TJ, Mathieu MÈ, Henderson M, Tremblay MS, O'Loughlin J, Tremblay A. Combined associations between moderate to vigorous physical activity and sedentary behaviour with cardiometabolic risk factors in children. Appl Physiol Nutr Metab 2013; 38:477-83. [DOI: 10.1139/apnm-2012-0382] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The objective of this study was to examine the combined associations between time spent in moderate- to vigorous-intensity physical activity (MVPA) and time spent sedentary in relation to cardiometabolic risk factors in a cohort of Canadian children. A cross-sectional study was conducted on 536 white children aged 8–10 years with at least 1 obese biological parent. Time spent in MVPA and sedentary behaviour over 7 days was measured using accelerometry and participants were stratified by tertiles. Daily screen time over 7 days was also self-reported by the child. Outcomes included waist circumference, systolic and diastolic blood pressure, fasting triglycerides, high-density lipoprotein cholesterol, and glucose concentrations. Analyses of covariance comparing tertiles of sedentary time/MVPA showed that higher levels of MVPA were associated with lower waist circumference, fasting triglycerides and diastolic blood pressure, and higher high-density lipoprotein (HDL) cholesterol, irrespective of sedentary time. In linear regression, MVPA was inversely associated with waist circumference and diastolic blood pressure and positively associated with HDL cholesterol, independent of covariates including sedentary time. In contrast, sedentary time was positively associated with diastolic blood pressure but after adjustment for MVPA the association was no longer statistically significant. Self-reported screen time was positively associated with waist circumference and negatively associated with HDL cholesterol independent of covariates including MVPA. Overall, a high level of MVPA was associated with reduced cardiometabolic risk in this sample of children, regardless of their amount of sedentary behaviour. The type of sedentary behaviour (i.e., screen time) might be more important than overall sedentary time in relation to cardiometabolic risk.
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Affiliation(s)
- Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Travis John Saunders
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Marie-Ève Mathieu
- Department of Kinesiology, University of Montreal, Montreal, QC H3T 1J4, Canada
| | - Mélanie Henderson
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC H3A 0G4, Canada
| | - Mark Stephen Tremblay
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Jennifer O'Loughlin
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada
| | - Angelo Tremblay
- Department of Kinesiology, Faculty of Medicine, Laval University, Quebec City, QC G1V 0A6, Canada
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Three- and five-year follow-up of a combined inpatient-outpatient treatment of obese children and adolescents. Int J Pediatr 2013; 2013:856743. [PMID: 23690795 PMCID: PMC3652157 DOI: 10.1155/2013/856743] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Revised: 12/23/2012] [Accepted: 02/27/2013] [Indexed: 01/06/2023] Open
Abstract
Aim. “The combined DAK therapy for obesity in children and adolescents” combines a 6-week inpatient with a 10.5-month outpatient treatment. The aim of the study is to evaluate whether the therapeutic achievements are maintained two and four years after intervention. Method. All subjects who had participated in the 12-month program in 2004/2005 were included in the follow-up study. Body weight, height, and physical fitness were assessed through direct measurements, behaviour, and quality of life by self-report questionnaires. Statistical analysis is based on an intention-to-treat analysis. Results. The response rate after three years was 63.4% and 42.2% after five years. Within three years, participants reduced their BMI-SDS significantly by 0.20 (SD 0.49) and by 0.15 (SD 0.51) within five years. Significant positive changes could be observed with respect to the participants eating behaviour. Similarly, the food intake, particularly the consumption of calorie-reduced beverages, increased significantly while that of nonrecommended foods decreased. Improvement was also seen in the subjective quality of life as well as several aspects of self-perception. Conclusion. Compared to baseline data, significant reduction of BMI-SDS and positive changes of health-related behaviours could be observed even three and five years after the start of the initial program.
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Nacci C, Leo V, De Benedictis L, Carratù MR, Bartolomeo N, Altomare M, Giordano P, Faienza MF, Montagnani M. Elevated endothelin-1 (ET-1) levels may contribute to hypoadiponectinemia in childhood obesity. J Clin Endocrinol Metab 2013; 98:E683-93. [PMID: 23457411 DOI: 10.1210/jc.2012-4119] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
CONTEXT Pediatric obesity is associated with endothelial dysfunction and hypoadiponectinemia, but the relationship between these two conditions remains to be fully clarified. Whether enhanced release of endothelin-1 (ET-1) may directly impair adiponectin (Ad) production in obese children is not known. OBJECTIVE The aim of the study was to explore whether and how high circulating levels of ET-1 may contribute to impair Ad production, release, and vascular activity. DESIGN AND PARTICIPANTS Sixty children were included into obese (Ob; n = 30), overweight (OW; n = 11), and lean (n = 19) groups. Total and high-molecular-weight Ad, ET-1, vascular cell adhesion molecule-1, and von Willebrand factor levels were measured in serum samples. Adipocytes were stimulated with exogenous ET-1 or with sera from lean, OW, and Ob, and Ad production and release measured in the absence or in the presence of ETA (BQ-123) and ETB (BQ-788) receptor blockers, p42/44 MAPK inhibitor PD-98059, or c-Jun NH2-terminal protein kinase inhibitor SP-600125. Vasodilation to Ad was evaluated in rat isolated arteries in the absence or in the presence of BQ-123/788. RESULTS Total and high-molecular-weight Ad was significantly decreased and ET-1 levels significantly increased in OW (P < .01) and Ob (P < .001) children. A statistically significant linear regression (P < .01) was found between Ad and ET-1. Exposure of adipocytes to exogenous ET-1 or serum from OW and Ob significantly decreased Ad mRNA and protein levels (P < 0.001). The inhibitory effect of ET-1 on Ad was reverted by BQ-123/788 or PD-98059 but not SP-600125. Ad-mediated vasodilation was further increased in arteries pretreated with BQ-123/788. CONCLUSIONS ET-1-mediated inhibition of Ad synthesis via p42/44 MAPK signaling may provide a possible explanation for hypoadiponectinemia in pediatric obesity and contribute to the development of cardiovascular complications.
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Affiliation(s)
- Carmela Nacci
- Department of Biomedical Sciences and Human Oncology, University of Bari, Medical School, 70124 Bari, Italy
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Changes in screen time activity in Norwegian children from 2001 to 2008: two cross sectional studies. BMC Public Health 2013; 13:80. [PMID: 23356930 PMCID: PMC3567933 DOI: 10.1186/1471-2458-13-80] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Accepted: 01/22/2013] [Indexed: 11/18/2022] Open
Abstract
Background There has been an increase in screen-based communication, leading to concerns about the negative health effects of screen-based activities in children and adolescents. The present study aimed to (1) analyze changes in screen time activity in Norwegian children from 2001 to 2008, and (2) to analyze associations between the changes in screen time activity over time and sex, grade level and parental educational level. Methods Within the project Fruits and Vegetables Make the Marks (FVMM), 1488 6th and 7th grade pupils from 27 Norwegian elementary schools completed a questionnaire including a question about time spent on television viewing and personal computer use in 2001 and 1339 pupils from the same schools completed the same questionnaire in 2008. Data were analyzed by multilevel linear mixed models. Results The proportions of 6th and 7th grade pupils at the 27 schools that reported screen time activity outside school of 2 hours/day or more decreased from 55% to 45% (p<0.001) from 2001 to 2008 when adjusting for sex, grade level and parental education. The decrease was most evident in 6th graders (51% to 37%) and in children with highly educated parents (54% to 39%). Conclusion The present study shows that there has been a marked reduction in screen time activity outside school in this group of Norwegian 10–12 year olds from 2001 to 2008.
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Giuffrida FMA, Guedes AD, Rocco ER, Mory DB, Dualib P, Matos OS, Chaves-Fonseca RM, Cobas RA, Negrato CA, Gomes MB, Dib SA. Heterogeneous behavior of lipids according to HbA1c levels undermines the plausibility of metabolic syndrome in type 1 diabetes: data from a nationwide multicenter survey. Cardiovasc Diabetol 2012; 11:156. [PMID: 23270560 PMCID: PMC3547761 DOI: 10.1186/1475-2840-11-156] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Accepted: 12/25/2012] [Indexed: 12/21/2022] Open
Abstract
Background Cardiovascular risk factors (CVRF) may cluster in type 1 diabetes, analogously to the metabolic syndrome described in type 2 diabetes. The threshold of HbA1c above which lipid variables start changing behavior is unclear. This study aims to 1) assess the behavior of dyslipidemia according to HbA1c values; 2) detect a threshold of HbA1c beyond which lipids start to change and 3) compare the clustering of lipids and other non-lipid CVRF among strata of HbA1c individuals with type 1 diabetes. Methods Effects of HbA1c quintiles (1st: ≤7.4%; 2nd: 7.5-8.5%; 3rd: 8.6-9.6%; 4th: 9.7-11.3%; and 5th: >11.5%) and covariates (gender, BMI, blood pressure, insulin daily dose, lipids, statin use, diabetes duration) on dyslipidemia were studied in 1275 individuals from the Brazilian multi-centre type 1 diabetes study and 171 normal controls. Results Body size and blood pressure were not correlated to lipids and glycemic control. OR (99% CI) for high-LDL were 2.07 (1.21-3.54) and 2.51 (1.46-4.31), in the 4th and 5th HbA1c quintiles, respectively. Hypertriglyceridemia increased in the 5th quintile of HbA1c, OR 2.76 (1.20-6.37). OR of low-HDL-cholesterol were 0.48 (0.24-0.98) and 0.41 (0.19-0.85) in the 3rd and 4th HbA1c quintiles, respectively. HDL-cholesterol correlated positively (0.437) with HbA1c in the 3rd quintile. HDL-cholesterol and insulin dose correlated inversely in all levels of glycemic control. Conclusions Correlation of serum lipids with HbA1c is heterogeneous across the spectrum of glycemic control in type 1 diabetes individuals. LDL-cholesterol and triglycerides worsened alongside HbA1c with distinct thresholds. Association of lower HDL-cholesterol with higher daily insulin dose is consistent and it points out to a role of exogenous hyperinsulinemia in the pathophysiology of the CVRF clustering. These data suggest diverse pathophysiological processes depending on HbA1c, refuting a unified explanation for cardiovascular risk in type 1 diabetes.
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Rathsman B, Rosfors S, Sjöholm A, Nyström T. Early signs of atherosclerosis are associated with insulin resistance in non-obese adolescent and young adults with type 1 diabetes. Cardiovasc Diabetol 2012. [PMID: 23185996 PMCID: PMC3538551 DOI: 10.1186/1475-2840-11-145] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background Patients with type 1 diabetes have a substantial risk of developing cardiovascular complications early in life. We aimed to explore the role of insulin sensitivity (Si) as an early factor of atherosclerosis in young type 1 diabetes vs. non-diabetic subjects. Methods Forty adolescent and young adult individuals (20 type 1 diabetics and 20 non-diabetics), age 14–20 years, without characteristics of the metabolic syndrome, participated in this cross-sectional study. After an overnight fast, Si was measured by hyperinsulinemic euglycemic clamp (40 mU/m2) and calculated by glucose infusion rate (GIR). Carotid intima-media thickness (cIMT) was measured in the common carotid artery with high-resolution ultrasonography. Risk factors of atherosclerosis (Body mass index [BMI], waist circumference, systolic blood pressure [sBP], triglycerides, low HDL-cholesterol and HbA1c) were also investigated. Results cIMT was increased (0.52 ± 0.1 vs. 0.47 ± 0.1 mm, P < 0.01), whereas GIR was decreased (5.0 ± 2.1 vs. 7.1 ± 2.2 mg/kg/min, P < 0.01) in type 1 diabetics vs. non-diabetics. The differences in cIMT were negatively associated with Si (r = −0.4, P < 0.01) and positively associated with waist circumference (r = 0.34, P = 0.03), with no such associations between BMI (r = 0.15, P = 0.32), sBP (r = 0.09, P = 0.58), triglycerides (r = 0.07, P = 0.66), HDL-cholesterol (r = 0.10, P = 0.55) and HbA1c (r = 0.24, P = 0.13). In a multivariate regression model, between cIMT (dependent) and group (explanatory), only adjustment for Si affected the significance (ß = 0.08, P = 0.11) vs. (ß = 0.07, P < 0.01) for the whole model. No interaction between cIMT, groups and Si was observed. Conclusions cIMT is increased and associated with insulin resistance in adolescent, non-obese type 1 diabetic subjects. Although, no conclusions toward a causal relationship can be drawn from current findings, insulin resistance emerges as an important factor reflecting early signs of atherosclerosis in this small cohort.
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Affiliation(s)
- Björn Rathsman
- Karolinska Institutet, Department of Clinical Science and Education, Sachs' Childrens' Hospital, Södersjukhuset AB, Stockholm, SE-118 83, Sweden.
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Pediatric metabolic syndrome: from prevention to treatment. CHOLESTEROL 2012; 2012:374168. [PMID: 23198141 PMCID: PMC3502760 DOI: 10.1155/2012/374168] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Accepted: 10/08/2012] [Indexed: 12/20/2022]
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LA de Hoog M, van Eijsden M, Stronks K, Gemke RJBJ, Vrijkotte TGM. Association between body size and blood pressure in children from different ethnic origins. Cardiovasc Diabetol 2012; 11:136. [PMID: 23126496 PMCID: PMC3495733 DOI: 10.1186/1475-2840-11-136] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Accepted: 10/26/2012] [Indexed: 01/18/2023] Open
Abstract
Objective To assess associations between body size and blood pressure in children (5-6 years) from different ethnic origins. Method Five ethnic groups of the ABCD cohort were examined: Dutch (n=1 923), Turkish (n=99), Moroccan (n=187), Black-African (n=67) and Black-Caribbean (n=121). Data on body-mass-index (BMI), waist-to-height ratio (WHtR), fat-mass-index (FMI), and systolic blood pressure (SBP) and diastolic blood pressure (DBP), were collected. Linear regression analysis with restricted cubic splines was used to examine non-linear associations between body size and blood pressure, adjusted for age, sex, height and birth weight. Results Ethnic differences were found in associations of BMI with SBP and DBP (SBP: p=0.001 and DBP: p=0.01) and FMI with SBP (p=0.03). BMI and FMI had a relatively large positive association with SBP in Turkish children (BMI: β=2.46mmHg; 95%CI:1.20-3.72; FMI: β=2.41mmHg; 95%CI:1.09-3.73) compared to Dutch (BMI: β=1.31mmHg; 95%CI:0.71-1.92; FMI: β=0.84mmHg; 95%CI:0.23-1.45). Black-Caribbean and Moroccan children showed high blood pressure with low BMI and FMI. Moroccan children showed higher SBP with high BMI and FMI. WHtR was positively associated with SBP and DBP, similar in all ethnic groups. Generally, strongest associations with blood pressure were found for BMI in all ethnic groups. Conclusion Ethnic-specific associations between BMI, and FMI and blood pressure are present at young age, with Turkish children showing the highest increase in blood pressure with increasing body size. The higher blood pressure in the Black-Caribbean and Moroccan children with low BMI needs further research. WHtR or FMI do not seem to be associated more strongly to blood pressure than BMI in any ethnic group.
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Affiliation(s)
- Marieke LA de Hoog
- Department of Public Health, Academic Medical Centre, University of Amsterdam, P,O, Box 22660, 1100 DD, Amsterdam, the Netherlands.
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Abstract
Epidemiologic studies, animal models, and preliminary clinical trials in children implicate uric acid in the development of essential hypertension. Controversy remains as to whether the observations indicate a general mechanism or a surrogate phenomenon. We sought to determine whether uric acid is a causative mediator of increased blood pressure (BP) and impaired vascular compliance. We report a randomized, double-blinded, placebo-controlled trial comparing 2 mechanisms of urate reduction with placebo in prehypertensive, obese, adolescents, aged 11 to 17 years. Subjects were randomized to the xanthine oxidase inhibitor, allopurinol, uricosuric, probenecid, or placebo. Subjects treated with urate-lowering therapy experienced a highly significant reduction in BP. In clinic systolic BP fell 10.2 mm Hg and diastolic BP fell 9.0 mm Hg in treated patients compared with a rise of 1.7 mm Hg and 1.6 mm Hg systolic and diastolic BP, respectively in patients on placebo. Urate-lowering therapy also resulted in significant reduction in systemic vascular resistance. These data indicate that, at least in adolescents with prehypertension, uric acid causes increased BP that can be mitigated by urate lowering therapy.
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Gurka MJ, Ice CL, Sun SS, Deboer MD. A confirmatory factor analysis of the metabolic syndrome in adolescents: an examination of sex and racial/ethnic differences. Cardiovasc Diabetol 2012; 11:128. [PMID: 23062212 PMCID: PMC3489601 DOI: 10.1186/1475-2840-11-128] [Citation(s) in RCA: 120] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Accepted: 10/10/2012] [Indexed: 01/21/2023] Open
Abstract
Objective The metabolic syndrome (MetS) is a cluster of clinical indices that signals increased risk for cardiovascular disease and Type 2 diabetes. The diagnosis of MetS is typically based on cut-off points for various components, e.g. waist circumference and blood pressure. Because current MetS criteria result in racial/ethnic discrepancies, our goal was to use confirmatory factor analysis to delineate differential contributions to MetS by sub-group. Research Design and Methods Using 1999–2010 data from the National Health and Nutrition Examination Survey (NHANES), we performed a confirmatory factor analysis of a single MetS factor that allowed differential loadings across sex and race/ethnicity, resulting in a continuous MetS risk score that is sex and race/ethnicity-specific. Results Loadings to the MetS score differed by racial/ethnic and gender subgroup with respect to triglycerides and HDL-cholesterol. ROC-curve analysis revealed high area-under-the-curve concordance with MetS by traditional criteria (0.96), and with elevations in MetS-associated risk markers, including high-sensitivity C-reactive protein (0.71), uric acid (0.75) and fasting insulin (0.82). Using a cut off for this score derived from ROC-curve analysis, the MetS risk score exhibited increased sensitivity for predicting elevations in ≥2 of these risk markers as compared with traditional pediatric MetS criteria. Conclusions The equations from this sex- and race/ethnicity-specific analysis provide a clinically-accessible and interpretable continuous measure of MetS that can be used to identify children at higher risk for developing adult diseases related to MetS, who could then be targeted for intervention. These equations also provide a powerful new outcome for use in childhood obesity and MetS research.
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Affiliation(s)
- Matthew J Gurka
- Department of Biostatistics, School of Public Health, West Virginia University, Morgantown, West Virginia, USA.
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Tenenbaum A, Fisman EZ. Fibrates are an essential part of modern anti-dyslipidemic arsenal: spotlight on atherogenic dyslipidemia and residual risk reduction. Cardiovasc Diabetol 2012; 11:125. [PMID: 23057687 PMCID: PMC3489608 DOI: 10.1186/1475-2840-11-125] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Accepted: 10/09/2012] [Indexed: 02/06/2023] Open
Abstract
Currently the world faces epidemic of several closely related conditions: obesity, metabolic syndrome and type 2 diabetes (T2DM). The lipid profile of these patients and those with metabolic syndrome is characterized by the concurrent presence of qualitative as well as quantitative lipoprotein abnormalities: low levels of HDL, increased triglycerides, and prevalence of LDL particles that are smaller and denser than normal. This lipid phenotype has been defined as atherogenic dyslipidemia. Overwhelming evidences demonstrate that all components of the atherogenic dyslipidemia are important risk-factors for cardiovascular diseases. Optimal reduction of cardiovascular risk through comprehensive management of atherogenic dyslipidemias basically depends of the presence of efficacious lipid-modulating agents (beyond statin-based reduction of LDL-C). The most important class of medications which can be effectively used nowadays to combat atherogenic dyslipidemias is the fibrates. From a clinical point of view, in all available 5 randomized control trials beneficial effects of major fibrates (gemfibrozil, fenofibrate, bezafibrate) were clearly demonstrated and were highly significant in patients with atherogenic dyslipidemia. In these circumstances, the main determinant of the overall results of the trial is mainly dependent of the number of the included appropriate patients with atherogenic dyslipidemia. In a meta-analysis of dyslipidemic subgroups totaling 4726 patients a significant 35% relative risk reduction in cardiovascular events was observed compared with a non significant 6% reduction in those without dyslipidemia. However, different fibrates may have a somewhat different spectrum of effects. Currently only fenofibrate was investigated and proved to be effective in reducing microvascular complications of diabetes. Bezafibrate reduced the severity of intermittent claudication. Cardinal differences between bezafibrate and other fibrates are related to the effects on glucose metabolism and insulin resistance. Bezafibrate is the only clinically available pan - (alpha, beta, gamma) PPAR balanced activator. Bezafibrate decreases blood glucose level, HbA1C, insulin resistance and reduces the incidence of T2DM compared to placebo or other fibrates. Among major fibrates, bezafibrate appears to have the strongest and fenofibrate the weakest effect on HDL-C. Current therapeutic use of statins as monotherapy is still leaving many patients with atherogenic dyslipidemia at high risk for coronary events because even intensive statin therapy does not eliminate the residual cardiovascular risk associated with low HDL and/or high triglycerides. As compared with statin monotherapy (effective mainly on LDL-C levels and plaque stabilization), the association of a statin with a fibrate will also have a major impact on triglycerides, HDL and LDL particle size. Moreover, in the specific case of bezafibrate one could expect neutralizing of the adverse pro-diabetic effect of statins. Though muscle pain and myositis is an issue in statin/fibrate treatment, adverse interaction appears to occur to a significantly greater extent when gemfibrozil is administered. However, bezafibrate and fenofibrate seems to be safer and better tolerated. Combined fibrate/statin therapy is more effective in achieving a comprehensive lipid control and may lead to additional cardiovascular risk reduction, as could be suggested for fenofibrate following ACCORD Lipid study subgroup analysis and for bezafibrate on the basis of one small randomized study and multiple observational data. Therefore, in appropriate patients with atherogenic dyslipidemia fibrates- either as monotherapy or combined with statins - are consistently associated with reduced risk of cardiovascular events. Fibrates currently constitute an indispensable part of the modern anti-dyslipidemic arsenal for patients with atherogenic dyslipidemia.
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Affiliation(s)
- Alexander Tenenbaum
- Cardiac Rehabilitation Institute, Sheba Medical Center, Tel-Hashomer, 52621, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel
- Cardiovascular Diabetology Research Foundation, Holon 58484, Israel
| | - Enrique Z Fisman
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel
- Cardiovascular Diabetology Research Foundation, Holon 58484, Israel
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de Hoog MLA, van Eijsden M, Stronks K, Gemke RJBJ, Vrijkotte TGM. Ethnic differences in cardiometabolic risk profile at age 5-6 years: the ABCD study. PLoS One 2012; 7:e43667. [PMID: 22916294 PMCID: PMC3423381 DOI: 10.1371/journal.pone.0043667] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Accepted: 07/23/2012] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND To examine ethnic differences in cardiometabolic risk profile in early age, and explore whether such differences can be explained by differences in body mass index (BMI) or waist circumference (WC). METHOD Anthropometric measurements, blood pressure and (in a subsample) fasting blood were collected during a health check of 2,509 children aged 5-6 years. Four ethnic groups were distinguished: Dutch (n=2,008; blood n=1,300), African descent (n=199; blood n=105), Turkish (n=108; blood n=57) and Moroccan (n=194; blood n=94). Ethnic differences in diastolic and systolic blood pressure (DBP/SBP), fasting glucose, low-density lipoprotein (LDL), high-density lipoprotein (HDL) and triglyceride levels were determined and the explanatory role of BMI and WC was examined with regression analysis. RESULTS After adjustment for confounders, African descent children showed higher DBP (β2.22 mmHg; 95%CI:1.09-3.36) and HDL levels (β:0.09 mmol/l; 95%CI:0.03-0.16) compared to Dutch children (reference group). Turkish children showed higher SBP (β:1.89 mmHg; 95%CI:0.25-3.54), DBP (β:2.62 mmHg; 95%CI:1.11-4.13), glucose (β:0.12 mmol/L; 95%CI:0.00-0.25) and triglyceride levels (β:0.13 mmol/L; 95%CI:0.02-0.25). Higher BMI values were found in all non-Dutch groups (differences ranged from 0.53-1.03 kg/m(2)) and higher WC in Turkish (β:1.68 cm; 95%CI:0.99-2.38) and Moroccan (β:1.65 cm; 95%CI:1.11-2.19) children. BMI and WC partly explained the higher SBP/DBP and triglyceride levels in Turkish children. CONCLUSION Ethnic differences in cardiometabolic profile exist early in life and are partly explained by differences in BMI and WC. African children showed favourable HDL levels and Turkish children the most unfavourable overall profile, whereas their Moroccan peers have less increased cardiometabolic risk in spite of their high BMI and WC.
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Affiliation(s)
- Marieke L A de Hoog
- Department of Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
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Sharma S, Merchant J, Fleming SE. Lp(a)-cholesterol is associated with HDL-cholesterol in overweight and obese African American children and is not an independent risk factor for CVD. Cardiovasc Diabetol 2012; 11:10. [PMID: 22283971 PMCID: PMC3292927 DOI: 10.1186/1475-2840-11-10] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2011] [Accepted: 01/27/2012] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The role of lipoprotein (a) cholesterol {Lp(a)-C}as an additional and/or independent risk factor for cardiovascular disease (CVD) is not clear. We evaluated the associations between Lp(a)-C and other CVD risk factors including plasma lipoprotein concentrations and body fatness in overweight and obese African American children. METHODS A cross-sectional analysis was carried out using data from a sample of 121 African American children aged 9-11 years with body mass index (BMI)'s greater than the 85th percentile. Body height, weight and waist circumference (WC) were measured. Fasting plasma concentrations of Lp(a)-C, total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), very low density lipoprotein cholesterol (VLDL-C), intermediate density lipoprotein cholesterol (IDL-C), low density lipoprotein cholesterol (LDL-C), and triacylglycerides (TAG) were analyzed using the vertical auto profile (VAP) cholesterol method. RESULTS After adjusting for child age, gender, and pubertal status, Lp(a)-C was positively associated with both HDL-C and TC, and negatively associated with VLDL-C and TAG. Including BMIz and WC as additional covariates did not alter the direction of the relationships between Lp(a)-C and the other lipoproteins. Finally, after adjusting for the other plasma lipoproteins, Lp(a)-C remained strongly associated with HDL-C, whereas the associations of Lp(a)-C with the other lipoproteins were not significant when HDL-C was simultaneously included in the regression models. CONCLUSIONS Lp(a)-C was positively associated with HDL-C and this association is not influenced by other lipoprotein subclasses or by the degree of obesity. We conclude that Lp(a) cholesterol is not an independent risk factor for CVD in African American children.
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Affiliation(s)
- Sushma Sharma
- Dr Robert C and Veronica Atkins Center for Weight and Health, University of California, Berkeley, CA 94720-3104, USA.
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