Metabolic syndrome severity and lifestyle factors among adolescents

Second-generation antipsychotic medications and metabolic disturbance in children and adolescents

Background

The second-generation antipsychotics (SGAs) are a group of antipsychotic drugs, used to treat psychiatric conditions. SGAs have been shown to precipitate rapid weight gain and dyslipidemia, as well as to promote insulin resistance, leading to the emergence of type 2 diabetes and metabolic syndrome. Prescriptions of SGAs in children have increased 6- to 10-fold during the last decade. This research work designed to find correlation between duration of second-generation antipsychotics (SGA) use, in children and adolescent, and the increase in metabolic syndrome disturbance components including weight gain, hypertension, hyperlipidemia and diabetes mellitus. This is cross-sectional analytic study was carried out in Suez Canal University Hospital, Psychiatry Outpatient Clinic on Children and adolescent aged 4–17 years. It included 151 children and adolescents diagnosed by Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5). They were divided into two groups, 72 patients who regular on (SGA) as treated group and 79 patients who did not receive pharmacological medication as control group.

Results

The overall prevalence of metabolic syndrome in the current study was high 27.81% in SGA-treated children compared to 0.60% in control group. In the SGA-treated group, 22.22% had type 2 diabetes, compared with 2.53% in the control group. SGA-treated patients showed a highly significant increase in their weight, body mass index and waist circumference compared to their control group patients. The correlation of different metabolic syndrome indices and SGAs duration showed positive correlation with body mass index, fasting blood sugar, and blood lipids (low density lipoproteins and cholesterol) but negative correlation with high density lipoproteins. Blood pressure did not correlate with SGA-duration in the studied patients. Indices which showed correlation could be predictors of the metabolic syndrome developments. Although the correlation and regression model showed moderate degree of association, this is considered important issue for the young patients.

Conclusion

SGA treatment in children and adolescence confers a significantly increased risk for metabolic syndrome and SGA-treatment duration is important for MtS development.

Factors Associated with Undertaking Health-Promoting Activities by Older Women at High Risk of Metabolic Syndrome

BACKGROUND

The complexity of health problems concerning women aged ≥60 years makes it necessary to develop effective, low-cost strategies involving biopsychosocial interventions. The aim of this study is to identify the factors associated with undertaking health-promoting activities by older women at high risk of metabolic syndrome (MetS) with or without depressive symptoms.

METHODS

The study group consisted of 70 older women (62-84 years old) undertaking regular physical activity. A self-developed questionnaire (used to determine the living situation, selected lifestyle components and health problems), the Perceived Stress Questionnaire (PSQ) and the Geriatric Depression Scale (GDS) were used.

RESULTS

In the study group undertaking regular physical activity, 40% had increased symptoms of depression (D group), and 60% were classified as non-depressed (ND group). The D group had a higher general stress level (t = -6.18, p = 0.001). Improving and/or maintaining physical fitness was identified as the greatest motivation in both groups. Willingness to spend time with other people significantly differed between the two groups (χ² = 4.148, p = 0.042). The sole factor significantly differentiating between both groups was lack of time (χ² = 8.777, p = 0.003).

CONCLUSIONS

Motivations and barriers to undertaking health-promoting activities and levels of perceived stress were significantly different between the depressed and non-depressed groups. It is important to encourage primary care physicians to perform screening tests for late-life depression and to provide information on where therapeutic interventions are available for patients with symptoms of MetS and coexisting depressive symptoms.

A, Bhardwaj S, Yadav NK, Patel A, Patel A. Gut Microbiota Interventions for the Management of Obesity: A Literature Review

The gut microbiota (GM) has been recognized as an important factor in the development of metabolic diseases such as obesity; it has been reported that the composition of the GM differs in obese and lean subjects, suggesting that microbiota dysbiosis can contribute to changes in body weight. Dysbiosis occurs due to an imbalance in the composition of gut bacteria, changes in the metabolic process, or changes in the distribution of microbiota within the gut. Dysbiosis can change the functioning of the intestinal barrier and the gut-associated lymphoid tissues (GALT). Microbial manipulation may help with preventing or treating weight gain and associated comorbidities. Approaches to this may range from dietary manipulation, which is suitable to treat the individual’s microflora, to probiotics, prebiotics, synbiotics, and fecal microbiota transplant (FMT).

From pregnancy to breastfeeding: adequate maternal body mass index is essential to prevent a high body mass index in your children

OBJECTIVES

To verify the associations between prenatal and perinatal factors with offspring body mass index (BMI) and the moderator role of maternal BMI in this relationship.

METHODS

Cross-sectional study developed with 1,562 children and adolescents aged between 6 and 17 years, as well as their mothers, from southern Brazil. The prenatal and perinatal factors, weight, and height for the calculation of maternal BMI were self-reported. For the calculation of BMI, weight and height of the child/adolescent were measured on an anthropometric scale with a coupled stadiometer. Linear regression models were used for the moderation analysis. All analyzes were adjusted for the mother's and child's age, sex, sexual maturation, skin color/race, and educational level.

RESULTS

cesarean as type of delivery (β=0.66; 95% CI=0.22 1.04; p=0.002) and pregnancy complications (β=0.60; 95% CI=0.15 1.04; p=0.002) were positively associated with offspring BMI. Schoolchildren who were breastfed for 4-6 months showed -0.56 kg/m² of BMI (95% CI=-1.06-0.06; p=0.02). Birth weight was also associated with BMI, with low weight being inversely (β=-0.59; 95% CI=-1.03-0.15; p=0.008), while overweight was positively related (β=0.84; 95% CI=0.08 1.60; p=0.02). The moderation analysis indicated a positive interaction between the mother's BMI and cesarean, pregnancy complications, and smoking with the offspring's BMI. On the other hand, there was an inverse association between breastfeeding from 7 to 12 months and the offspring BMI, only in mothers with high BMI.

CONCLUSIONS

Adequate maternal BMI is essential to prevent a high BMI in their children, especially when considering the influence of prenatal and perinatal risk factors.

Impact of risk factors related to metabolic syndrome on acute myocardial infarction in younger patients

Despite diagnostic and therapeutic advancements in cardiovascular medicine, myocardial infarction (MI) remains a major cause of adverse outcomes in younger MI patients, i.e., those who are aged 55 years or younger. Traditional cardiovascular risk factors have not often been emphasized in the management of younger MI patients. However, plaque rupture or erosion, which is deeply related to cardiovascular risk factors, remains the most common etiology of MI even in younger patients. The global increase in the prevalence of obesity underscores the clinical importance of metabolic syndrome (MetS), i.e., obesity-associated cardiovascular risk factors, dyslipidemia, diabetes mellitus and particularly hypertension, in younger people. The concept of "lifetime risk" of cardiovascular disease reinforces the need for prevention or treatment of MetS. This review focuses on the risk factors related to MetS and an overall understanding of recent profiles of younger MI patients. We hope that this review will aid in the primary prevention of MetS-related risk factors and the prevention of cardiovascular disease, particularly MI, in younger patients.

Integrated role of lifestyle habits in cardiometabolic risk factors according to sex in adolescents

Background: A healthy lifestyle should be adopted by young people to maintain cardiometabolic health. Aim: To verify the prevalence and the integrated role of lifestyle habits in cardiometabolic risk factors according to sex in adolescents. Subjects and methods: Cross-sectional study developed with 1,502 adolescents, aged 10 to 17 years. Lifestyle habits included physical activity, screen time and sleep duration evaluated through a questionnaire. Cardiometabolic risk score (CMRS) was calculated by summing z-scores, divided by six. For statistical analyses, multivariable binary and multinomial logistic regression models were used. Results: 80.7% of the boys classified with adverse CMRS presented physical inactivity, compared to normal CMRS. In girls, 42.6% showed inadequate sleep compared to normal CMRS. Boys classified as inactive showed higher odds for obesity, as well as altered triglycerides, and systolic blood pressure, risk for cardiorespiratory fitness (CRF), high waist circumference, and CMRS, compared to the active. A prolonged screen time increased the odds for altered glucose and decreased the odds for altered triglycerides. In girls, inadequate sleep duration presented higher odds for overweight, obesity, risk for CRF, and high CMRS, compared to adequate sleep. Conclusions: Physical activity for boys and sleep duration for girls are important to maintain healthy metabolic health among youth.

Inflammatory Biomarkers and Components of Metabolic Syndrome in Adolescents: a Systematic Review

Metabolic syndrome (MetS) has been prevalent among adolescents. The association between the concentration of inflammatory markers and the individual components of the metabolic syndrome indicates that inflammation, when there is no recent or ongoing disease, mediated by an inflammatory process, is an event that may precede the development of metabolic disorders in teenagers. The objective of this study is to verify the association of inflammatory biomarkers with the components of metabolic syndrome in adolescents. From a search of 3 databases, 13 articles met the study inclusion criteria. Two investigators independently extracted data from included studies. The evaluated inflammatory biomarkers are related to the components of MetS (insulin resistance, central and visceral obesity, arterial hypertension, dyslipidemia), which may increase the risk of developing the syndrome in adolescents. The results of this review are of clinical relevance, since the evaluation of inflammatory biomarkers in the presence of metabolic alterations can help to identify the risk factors that lead to the progression of MetS in adolescents.

Prevalence of Metabolic Syndrome among Children and Adolescents in High-Income Countries: A Systematic Review and Meta-Analysis of Observational Studies

Introduction. Metabolic syndrome (MetS) is an assemblage of interconnected cardiovascular risk factors that are prevalent among children and adolescents in high-income countries (HICs). Despite the presence of several studies on the issue, the study findings are incongruent due to the absence of a gold standard diagnostic method of MetS in children. Thus, the findings of the original studies are inconclusive for policy makers and other stakeholders. This systematic review and meta-analysis is aimed at giving conclusive evidence about MetS among children and adolescents in HICs. Methods. We conducted searches using electronic databases (PubMed, Scopus, Web of Science, CINAHL (EBSCOhost), EMBASE (Elsevier), and Medline (EBSCOhost)) and other sources (Google Scholar and Google) up to September 2020. Observational studies reporting the prevalence of MetS were eligible in this study. The pooled estimates were computed in fixed and random effect models using six diagnostic methods (IDF, ATP III, de Ferranti et al., WHO, Weiss et al., and Cruz and Goran). Publication bias was verified using funnel plots and Egger’s regression tests. Subgroup and sensitivity analysis were performed in case of higher heterogeneities among the included studies. Result. In this study, 77 studies with a total population of 125,445 children and adolescents were used in the final analysis. Metabolic syndrome among the overweight and obese population was computed from 28 studies with the pooled prevalence of 25.25%, 24.47%, 39.41%, 29.52%, and 33.36% in IDF, ATP III, de Ferranti et al., WHO, and Weiss et al. criteria, respectively. Likewise, 49 studies were eligible to compute the pooled prevalence of MetS in the general population of children and adolescents. Hence, MetS was found in 3.70% (IDF), 5.40% (ATP III), 14.78% (de Ferranti et al.), 3.90% (WHO), and, 4.66% (Cruz and Goran) of study participants. Regarding the components of MetS, abdominal obesity in the overweight and obese population, and low HDL-C in the general population were the most common components. Besides, the prevalence of Mets among males was higher than females. Conclusion. This study demonstrates that MetS among children and adolescents is undoubtedly high in HICs. The prevalence of MetS is higher among males than females. Community-based social and behavioral change communications need to be designed to promote healthy eating behaviors and physical activities. Prospective cohort studies could also help to explore all possible risk factors of MetS and to design specific interventions accordingly.

The dynamics of metabolic syndrome development from its isolated components among iranian children and adolescents: Findings from 17 Years of the Tehran Lipid and Glucose Study (TLGS)

BACKGROUND

Careful evaluation of the progression trend of the metabolic syndrome (MetS) in children and adolescents (C&A) is one of the important methods of studying the natural history of MetS in them. This study was performed to determine the trend of changes in the progression of MetS from its components.

METHODS

This was a longitudinal study which was performed on data from 4 follow-up periods of Tehran Lipid and Glucose Study (TLGS) between 1999 and 2015. The research population consisted of 6-18-year-old children and adolescents creating 3895-person population. The criteria for the diagnosis of MetS was joint interim statement (JIS). The considered components were central adiposity, high blood pressure, insulin resistance, and dyslipidemia.

RESULTS

In this study, in the long term, the highest increase in the MetS' incidence in boys occurred in obesity and in girls in dyslipidemia and in total mode, in obesity. But in the short term (3.6 year follow-up periods) in the first to fourth periods, in total mode, the highest incidence occurred in dyslipidemia, hyperglycemia, dyslipidemia, and obesity. In terms of trend, in total mode, the highest increase in MetS incidence was related to the obesity component. Also, the incidence of MetS from all components was declining in overall mode. Also, the most common components at the beginning and end of the study in all groups were dyslipidemia with a decreasing and obesity with an increasing trend, respectively.

CONCLUSION

It seems that in Iranian C&As, obesity and dyslipidemia components play a more important role in the further development of the MetS than other components. This matter requires careful and serious attention in preventive and control planning.

Diet-induced rodent models of obesity-related metabolic disorders-A guide to a translational perspective

Diet is a critical element determining human health and diseases, and unbalanced food habits are major risk factors for the development of obesity and related metabolic disorders. Despite technological and pharmacological advances, as well as intensification of awareness campaigns, the prevalence of metabolic disorders worldwide is still increasing. Thus, novel therapeutic approaches with increased efficacy are urgently required, which often depends on cellular and molecular investigations using robust animal models. In the absence of perfect rodent models, those induced by excessive consumption of fat and sugars better replicate the key aspects that are the root causes of human metabolic diseases. However, the results obtained using these models cannot be directly compared, particularly because of the use of different dietary protocols, and animal species and strains, among other confounding factors. This review article revisits diet-induced models of obesity and related metabolic disorders, namely, metabolic syndrome, prediabetes, diabetes and nonalcoholic fatty liver disease. A critical analysis focused on the main pathophysiological features of rodent models, as opposed to the criteria defined for humans, is provided as a practical guide with a translational perspective for the establishment of animal models of obesity-related metabolic diseases.

Multiple-element exposure and metabolic syndrome in Chinese adults: A case-control study based on the Beijing population health cohort

BACKGROUND

Metabolic syndrome (MetS) patients have a considerably increased risk for noncommunicable diseases, which poses a serious burden on public health. The effects of different elements on MetS have received increasing attention in the field of noncommunicable diseases over the past decade. These elements can exert adverse or favourable effects on human health by synergistic or antagonistic actions. Nevertheless, few studies have explored the relationship between multiple-element exposure and MetS.

METHOD

A total of 2095 MetS patients and 2039 controls free of major cardiovascular disease at baseline and follow-up visits were frequency matched for age (±5 years) and sex. The internal exposure levels of 15 elements in serum were investigated. Logistic regression models were employed to estimate odds ratios (ORs) of MetS for element concentrations categorized according to quartiles in the controls.

RESULT

Magnesium (Mg), selenium (Se), barium (Ba) and mercury (Hg) were significantly associated with MetS in the multi-element exposure model. The ORs for the extreme quartiles of Mg, Se, Ba, and Hg were 0.29 (95% CI: 0.23-0.37, P-trend < 0.001), 0.52 (95% CI: 0.42-0.65, P-trend < 0.001), 1.86 (95% CI: 1.51-2.28, P-trend < 0.001), and 2.61 (95% CI: 2.11-3.22, P-trend < 0.001), respectively. Ba may be antagonistic to Mg and Se in the human body.

CONCLUSIONS

Our study suggested that MetS was negatively associated with Mg and Se and positively associated with Ba and Hg. There were significant dose-response relationships between Mg, Se, Ba and Hg and the prevalence of MetS, suggesting that multiple elements may be involved in MetS.

Adherence to Mediterranean Diet among Students from Primary and Middle School in the Province of Taranto, 2016-2018

The Mediterranean diet represents one of the healthiest dietary patterns, but nowadays it is increasingly being ignored in schools and by families. The aim of this study is to assess the adherence to the Mediterranean diet by pupils living in a small Southern Italian municipality, and whether it is a predictor of nutritional status.The degree of adherence to the Mediterranean diet, the socio-economic status and the nutritional status of 314 students (6–14 years) were tested during the 2016/2017 and 2017/2018 school years with the help of a questionnaire comprising the Mediterranean Diet Quality Index for Children and Adolescents (KIDMED) test. Multivariate logistic regression analysis was used to assess the predictive role of the KIDMED score and the other variables with respect to nutritional status. Adherence to the Mediterranean diet is high, medium and poor in, respectively, 24.8, 56.4 and 18.8% of students; it varies depending on gender and age, with females and older students showing higher values. In the multivariate logistic regression model, sex and KIDMED level are become significant predictors of nutritional status. This study highlights the need for intervention in the form of school projects—also involving families—to promote healthier eating habits in younger generations.

Metabolic syndrome among children and adolescents in low and middle income countries: a systematic review and meta-analysis

BACKGROUND

Metabolic syndrome (MetS) is a clustering of cardiovascular risk factors, which is rising in the low and middle income countries (LMICs). There are various studies with inconsistent findings that are inconclusive for policy makers and program planners. Thus, this systematic review and meta-analysis aimed at estimating the pooled prevalence of MetS and its components in LMICs.

METHODS

Electronic searches were conducted in international databases including PubMed, Web of Science, EMBASE (Elsevier), Scopus, CINAHL (EBSCOhost), Science direct (Elsevier), Food Science and Technology Abstracts (FSTA), Global Health and Medline, and other sources (World Cat, Google Scholar, and Google). The pooled estimates were computed in the random effect model. The pooled prevalence was computed using the three diagnostic methods (IDF, ATP III and de Ferranti). Publication bias was verified using funnel plot and Egger's regression test. Subgroup and sensitivity analysis were performed to identify the possible sources of heterogeneity among the included studies.

RESULT

In this study, 142,142 children and adolescents from 76 eligible articles were included to compute the pooled prevalence of MetS and its components in LMCIs. MeTs among overweight and obese population was computed from 20 articles with the pooled prevalence of 24.09%, 36.5%, and 56.32% in IDF, ATP III and de Ferranti criteria, respectively. Similarly, a total of 56 articles were eligible to compute the pooled prevalence of MetS in the general population of children and adolescents. Hence, Mets was found in 3.98% (IDF), 6.71% (ATP III) and 8.91% (de Ferranti) of study subjects. Regarding the components of MetS, abdominal obesity was the major component in overweight and obese population and low HDL-C was the most common component in the general population. This study also revealed that males were highly affected by MetS than females.

CONCLUSION

This study illustrates that MetS among children and adolescents is an emerging public health challenge in LMICs, where the prevalence of obesity is on the move. Preventive strategies such as community and school based intervention need to be designed. Promoting physical activities and healthy eating behaviors could avert this problem.