Hypertriglyceridemic waist and metabolic abnormalities in Brazilian schoolchildren

Hypertriglyceridemic Waist Phenotype and Its Association with Metabolic Syndrome Components, among Greek Children with Excess Body Weight

The hypertriglyceridemic waist (HTGW) phenotype is characterized by abdominal obesity and elevated serum triglycerides. We aimed to assess the prevalence of the HTGW phenotype among children with overweight or obesity and its association with indices of insulin resistance (IR) and dyslipidemia. A total of 145 children with mean age of 10.2 years (SD = 2.31 years), 97.2% of whom with obesity, were analyzed. The HTGW phenotype was defined as WC > 90th Centers for Disease Control and Prevention (CDC) percentile and triglyceride levels of ≥100 mg/dL and ≥130 mg/dL for children 0 to 9 or >10 years of age, respectively. In total, 77.9% of the children had a waist circumference above the 90th percentile and 22.8% had elevated triglycerides. The prevalence of the HTGW phenotype in this sample was 19.3%. Patients with the HTGW phenotype had significantly lower levels of High-Density Lipoprotein (p < 0.001) and were insulin-resistant, as evident by an increased mean Triglycerides Glucose Index 8.64 (SD = 0.24) vs. 7.92 (SD = 0.41) for those without the HTGW phenotype (p < 0.001), and increased prevalence (54.5%) of Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) in ≥2.5 in patients with HTGW (p = 0.045). Children with the HTGW phenotype were more likely to have increased HOMA-IR [OR 7.9 95% CI (1.94, 32.1)]. The HTGW phenotype is a low-cost and easily available index that might help to identify children with increased cardiometabolic risk.

Vitamin D is associated with the hypertriglyceridemic waist phenotype in Brazilian children

BACKGROUND

Prevalence of cardiometabolic risk factors is increasing and vitamin D insufficiency/deficiency has become a worldwide public health problem, even in tropical countries. Therefore, we identified the prevalence of hypertriglyceridemic waist phenotype (HWP) and evaluate its relationship with vitamin D insufficiency/deficiency.

METHODS

A cross-sectional study with 378 children aged 8 and 9 enrolled in all urban schools in the city of Viçosa, MG, Brazil. Anthropometric measurements, body composition (dual energy X-ray absorptiometry), biochemical tests and clinical evaluation were performed. Poisson regression was used to analyze the association between vitamin D and HWP.

RESULTS

Prevalence of HWP was 16.4%. This prevalence was higher among children with vitamin D insufficiency and deficiency and in those with a greater number of other cardiometabolic risk factors. Multiple regression analysis showed that children with vitamin D insufficiency and deficiency had, respectively, prevalence 85% (95% CI: 1.03-3.30) and 121% (95% CI: 1.11-4.45) higher of HWP than the vitamin D sufficiency group.

CONCLUSION

Vitamin D insuffiency and deficiency were associated with a higher prevalence of HWP among children, regardless of the presence of other cardiometabolic risk factors, indicating an additional risk of inadequate vitamin D status to cardiometabolic health in childhood.

HYPERTRIGLYCERIDEMIC WAIST AND ASSOCIATED FACTORS IN CHILDREN AND ADOLESCENTS WITH TYPE 1 DIABETES MELLITUS

Objective:

To assess the frequency of the hypertriglyceridemic waist phenotype and its associated factors in children and adolescents with type 1 diabetes mellitus.

Methods:

This is an observational analytical study with individuals with type 1 diabetes mellitus, aged 5 to 18 years, of both genders, followed in a university hospital in the Brazilian Northeast. Weight, height, and waist circumference were measured, and the lipid profile and glycated hemoglobin were analyzed. The hypertriglyceridemic waist phenotype was defined by the simultaneous presence of increased waist circumference (≥90^th percentile for age and gender) and elevated serum triglyceride levels (≥75 mg/dL for children and ≥90 mg/dL for adolescents). We also investigated the family history of cardiovascular diseases and diabetes, as well as sociodemographic and behavioral variables. In the statistical inference tests, the proportions were compared by Pearson’s chi-square test ­and/­or Fisher’s exact test, being significant p<0.05.

Results:

A total of 102 patients were evaluated, most of them females (54.9%) and adolescents (66.7%). The frequency of hypertriglyceridemic waist was 23.5%, which was associated with females (p=0.043), overweight (p=0.023), hypercholesterolemia (p=0.002), high LDL (p=0.001), and borderline VLDL (<0.001).

Conclusions:

The frequency of the hypertriglyceridemic waist phenotype was associated with females, atherogenic lipid profile, and overweight, indicating the importance of the nutritional monitoring of this population, aiming at reducing future cardiovascular diseases.

Genetic effects on hypertriglyceridemic waist phenotype: rs780094, rs10830963, rs151290, and rs972283 polymorphisms and the interactions between them and behavior risk factors

BACKGROUNDS

We aimed to evaluate the association of SNPs in GCKR, MTNR1B, KCNQ1, and KLF14 genes confirmed in previous studies and hapertriglyceridemic waist (HTGW) in Han Chinese, and assess the interactions between genes and behavior risk factors.

METHODS

We genotyped the single nucleotide polymorphisms (SNPs) for GCKR, MTNR1B, KCNQ1, and KLF14 gene were genotyped in 373 patients with HTGW and 466 normal healthy subjects. We used logistic regression to investigate the gene-gene, gene-behavior interactions for the risk of HTGW.

RESULTS

Among the 4 SNPs, the AG genotype of rs780094 was protective factor, whereas the recessive model of rs151290 was risk factor after adjusting for confounders. Stratified by sex, only for women, the recessive model of rs151290 was still significance. The significant synergies interactions between SNPs were found between rs780094 in GCKR and rs972283 in KLF14 and rs10830963 in MTNR1B, respectively; meanwhile, the antagonistic interaction was revealed for rs151290 and rs780094 only for women. For male, there were significant synergies interactions between rs780094, smoking and alcohol drinking; and antagonistic interaction was revealed between rs780094 and severe activity both for men and women.

CONCLUSIONS

GCKR and KLF14 genes play a significant role in risk of HTGW in a Han Chinese population.

Hypertriglyceridemic Waist Phenotype and Changes in the Fasting Glycemia and Blood Pressure in Children and Adolescents Over One-Year Follow-Up Period

BACKGROUND:

The hypertriglyceridemic waist (HTW) phenotype is defined as the simultaneous presence of increased waist circumference (WC) and serum triglycerides (TG) levels and it has been associated with cardiometabolic risk in children and adolescents.

OBJECTIVE:

The objective was to evaluate the influence of HTW phenotype in the fasting glycemia and blood pressure in children and adolescents over one-year follow-up period.

METHODS:

It is a cohort study involving 492 children and adolescents from 7 to 15 years old, both genders, who were submitted to anthropometric, biochemical and clinical evaluation at the baseline, and also after 6 and 12 months of follow-up. Generalized Estimating Equation (GEE) models were calculated to evaluate the longitudinal influence of the HTW phenotype in the glycemia and blood pressure over one-year.

RESULTS:

It was observed a prevalence of 10.6% (n = 52) of HTW phenotype in the students. The GEE models identified that students with HTW phenotype had an increase of 3.87 mg/dl in the fasting glycemia mean (CI: 1.68-6.05) and of 3.67mmHg in the systolic blood pressure (SBP) mean (CI: 1.55-6.08) over one-year follow-up, after adjusting for confounding variables.

CONCLUSIONS:

The results of this study suggest that HTW phenotype is a risk factor for longitudinal changes in glycemia and SBP in children and adolescents over one-year follow-up period.

FUNDAMENTO:

O fenótipo de cintura hipertrigliceridêmica (CHT) é definido como a presença simultânea de circunferência de cintura (CC) e níveis séricos de triglicérides (TG) aumentados e tem sido associado com risco cardiometabólico em crianças e adolescentes.

OBJETIVO:

Avaliar a influência do fenótipo CHT na glicemia de jejum e na pressão arterial em crianças e adolescentes em um período de acompanhamento de um ano.

MÉTODOS:

Trata-se de um estudo de coorte envolvendo 492 crianças e adolescentes de 7 a 15 anos de ambos os sexos, que foram submetidos à avaliação antropométrica, bioquímica e clínica no início e também após 6 e 12 meses de seguimento. Os modelos de Equação de Estimulação Generalizada (GEE) foram calculados para avaliar a influência longitudinal do fenótipo CHT na glicemia e na pressão arterial ao longo de um ano.

RESULTADOS:

Foi observada uma prevalência de 10,6% (n = 52) do fenótipo CHT nos estudantes. Os modelos GEE identificaram que os estudantes com fenótipo CHT apresentaram aumento de 3,87 mg/dl na média de glicemia em jejum (IC: 1,68-6,05) e de 3,67 mmHg na pressão arterial sistólica media (PAS) (IC: 1,55-6,08) depois de um ano de acompanhamento, após ajuste para variáveis de confusão.

CONCLUSÕES:

Os resultados deste estudo sugerem que o fenótipo CHT é um fator de risco para alterações longitudinais da glicemia e da PAS em crianças e adolescentes em um período de um ano de seguimento.

Hypertriglyceridemic Waist Phenotype Indicates Insulin Resistance in Adolescents According to the Clamp Technique in the BRAMS Study

OBJECTIVE

This study aimed to identify cutoff points for detecting hypertriglyceridemic waist phenotype (HTWP) in adolescents and to investigate the association of the HTWP with insulin resistance (IR) and metabolic syndrome components.

METHODS

A multicentric cross-sectional study of 861 adolescents (10-19 years of age, 504 girls) was conducted. Pubertal stage, anthropometric, and laboratory parameters were assessed. IR was assessed by Homeostasis Model Assessment for Insulin Resistance (HOMA1-IR) index and hyperglycemic clamp (n = 80). HTWP was defined by the presence of increased plasma triglycerides (TGs) and increased waist circumference (WC) according to cutoff points obtained in ROC curve analysis given the HOMA1-IR index as a reference method.

RESULTS

Cutoffs for WC and TGs, with a higher sum of sensitivity (S) and specificity (E), were, respectively: >84 cm (S:65.1%, E:71.9%) and >87 mg/dL (S:65.1%, E:73.4%) in pubertal girls; >88.5 cm (S:80.2%, E:60.2%) and >78 mg/dL (S:60.5%, E:53.2%) in postpubertal girls; >94 cm (S:73.1%, E:83.1%) and >79 mg/dL (S:61.5%, E:60.2%) in pubertal boys; and >99 cm (S:81.3%, E:78.7%) and >86 mg/dL in postpubertal boys (S:68.1%, E:60.7%). HTWP frequency was 27.5%. In the phenotype presence, after adjustment for age and pubertal stage, blood pressure and fasting glucose levels were elevated and high-density lipoprotein cholesterol was lower (p < 0.001). Adolescents with the HTWP showed more IR, evaluated both by the HOMA1-IR and by the clamp test (p < 0.003).

CONCLUSION

The findings suggest HTWP as an IR status in adolescents. Cutoff point standardization for gender and pubertal stage, combined with the ease of application of the method, may allow their use for screening adolescents who would most benefit from lifestyle changes.

Genetic polymorphisms of the drug-metabolizing enzyme cytochrome P450 3A5 in a Uyghur Chinese population

1.  Detection of CYP3A5 variant alleles, and knowledge about their allelic frequency in Uyghur ethnic groups, is important to establish the clinical relevance of screening for these polymorphisms to optimize pharmacotherapy. 2. We used DNA sequencing to investigate the promoter, exons and surrounding introns, and 3'-untranslated region of the CYP3A5 gene in 96 unrelated healthy Uyghur individuals. We also used SIFT and PolyPhen-2 to predict the protein function of the novel non-synonymous mutation in CYP3A5 coding regions. 3. We found 24 different CYP3A5 polymorphisms in the Uyghur population, three of which were novel: the synonymous mutation 43C > T in exon 1, two mutations 32120C > G and 32245T > C in 3'-untranslated region, and we detected the allele frequencies of CYP3A5*1 and *3 as 64.58% and 35.42%, respectively. While no subjects with CYP3A5*6 were identified. Other identified genotypes included the heterozygous genotype 1A/3A (59.38%) and 1A/3E (11.46%), which lead to decreased enzyme activity. In addition, the frequency of haplotype "TTAGGT" was the most prevalent with 0.781. 4. Our data provide new information regarding CYP3A5 genetic polymorphisms in Uyghur individuals, which may help to improve individualization of drug therapy and offer a preliminary basis for more rational use of drugs.