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Çelik N, Ünsal G, Taştanoğlu H. Predictive markers of metabolically healthy obesity in children and adolescents: can AST/ALT ratio serve as a simple and reliable diagnostic indicator? Eur J Pediatr 2024; 183:243-251. [PMID: 37870612 DOI: 10.1007/s00431-023-05296-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 10/06/2023] [Accepted: 10/17/2023] [Indexed: 10/24/2023]
Abstract
This study aimed to estimate the prevalence of metabolically healthy obesity (MHO) according to two different consensus-based criteria and to investigate simple, measurable predictive markers for the diagnosis of MHO. Five hundred and ninety-three obese children and adolescents aged 6-18 years were included in the study. The frequency of MHO was calculated. ROC analysis was used to estimate the predictive value of AST/ALT ratio, waist/hip ratio, MPV, TSH, and Ft4 cut-off value for the diagnosis of MHO. The prevalence of MHO was 21.9% and 10.2% according to 2018 and 2023 consensus-based MHO criteria, respectively. AST/ALT ratio cut-off value for the diagnosis of MHO was calculated as ≥ 1 with 77% sensitivity and 52% specificity using Damanhoury et al.'s criteria (AUC = 0.61, p = 0.02), and 90% sensitivity and 51% specificity using Abiri et al.'s criteria (AUC = 0.70, p = 0.01). Additionally, using binomial regression analysis, only the AST/ALT ratio is independently and significantly associated with the diagnosis of MHO (p = 0.03 for 2018 criteria and p = 0.04 for 2023 criteria). CONCLUSION The ALT/AST ratio may be a useful indicator of MHO in children and adolescents. WHAT IS KNOWN • Metabolically healthy obesity refers to people who are obese but do not have any of the standard cardio-metabolic risk factors. • Metabolically healthy obesity is not entirely harmless; the metabolic characteristics of individuals with this phenotype are less favorable than those of healthy lean groups. Moreover, it is not a constant state, and there may be a transition to metabolically unhealthy phenotypes over time. WHAT IS NEW • The prevalence of MHO is 21.9% and 10.2% according to 2018 and 2023 consensus-based metabolically healthy obesity criteria, respectively. • The ALT/AST ratio may be a useful indicator of metabolically healthy obesity in children and adolescents.
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Affiliation(s)
- Nurullah Çelik
- Division of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey.
| | - Gülşah Ünsal
- Department of Pediatrics, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey
| | - Hüseyin Taştanoğlu
- Department of Pediatrics, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey
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2
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Park J, Lee KE, Choi DH, Kim YK, Lee WH, Kim MS, Sung HWJ, Chang JW, Park YS. The association of tonsillar microbiota with biochemical indices based on obesity and tonsillar hypertrophy in children. Sci Rep 2023; 13:22716. [PMID: 38123635 PMCID: PMC10733282 DOI: 10.1038/s41598-023-49871-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 12/13/2023] [Indexed: 12/23/2023] Open
Abstract
The correlation between tonsil microbiome and tonsillar hypertrophy has not been well established. Given that oral dysbiosis is related to several metabolic diseases and that tonsillar hypertrophy leads to disordered breathing during sleep and obesity in children, it is necessary to investigate the relationship between the oral microbiome and tonsillar hypertrophy. After 16S rRNA amplicon sequencing of tonsillectomy samples, we evaluated the correlation between the tonsil microbiome and biochemical blood indices in pediatric patients who underwent tonsillectomy. Groups are classified into two categories: based on BMI, and grades 2, 3, and 4 based on tonsil size. Children with obesity and tonsillar hypertrophy have similar microbiome compositions and induce comparable changes in microbiome abundance and composition, confirming the association from a metagenomic perspective. In addition, obesity and tonsillar hypertrophy demonstrated a strong correlation with the Proteobacteria to Firmicutes (P/F) ratio, and among various biochemical indicators, alanine aminotransferase (ALT) levels increase with obesity and tonsillar hypertrophy, indicating a possible association of tonsil microbiome and liver metabolism. These novel findings demonstrate the significance of the tonsil microbiome and suggest the need for tonsil regulation, particularly during childhood.
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Affiliation(s)
- Jiwon Park
- Department of Biological Sciences and Biotechnology, School of Biological Sciences, College of Natural Sciences, Chungbuk National University, Cheongju, 28644, Republic of Korea
| | - Kyeong Eun Lee
- Department of Biological Sciences and Biotechnology, School of Biological Sciences, College of Natural Sciences, Chungbuk National University, Cheongju, 28644, Republic of Korea
| | - Da Hyeon Choi
- Department of Biological Sciences and Biotechnology, School of Biological Sciences, College of Natural Sciences, Chungbuk National University, Cheongju, 28644, Republic of Korea
| | - Yoon-Keun Kim
- Institute of MD Healthcare Inc., Seoul, 03923, Republic of Korea
| | - Won Hee Lee
- Institute of MD Healthcare Inc., Seoul, 03923, Republic of Korea
| | - Min Su Kim
- Department of Otolaryngology-Head and Neck Surgery, Chungnam National University College of Medicine, Daejeon, 35015, Republic of Korea
| | - Han Wool John Sung
- Department of Otolaryngology-Head and Neck Surgery, Chungnam National University College of Medicine, Daejeon, 35015, Republic of Korea
| | - Jae Won Chang
- Department of Otolaryngology-Head and Neck Surgery, Chungnam National University College of Medicine, Daejeon, 35015, Republic of Korea.
| | - Yoon Shin Park
- Department of Biological Sciences and Biotechnology, School of Biological Sciences, College of Natural Sciences, Chungbuk National University, Cheongju, 28644, Republic of Korea.
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3
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Lu CW, Lin MS, Lin YS, Chang IJ, Tsai MH, Wei KL, Chen MY. Aminotransferase Ratio Is a Useful Index for Hepatosteatosis in Children and Adolescents: A Cross-Sectional Observational Study. Gastroenterol Nurs 2020; 42:486-495. [PMID: 31770351 DOI: 10.1097/sga.0000000000000389] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) and childhood obesity are emerging global health issues. The aim of this study was to identify a simple predictor of NAFLD in children and adolescents. This community-based study was conducted from December 2012 to September 2013 in Taiwan and included 1,222 children between 10 and 19 years of age. After excluding alcohol consumption and hepatic-related lesions, NAFLD was diagnosed according to sonographic criteria. Potential confounding factors (including age, gender, and anthropometric and laboratory data) were tested by logistic regression analysis. The cutoff value was determined using receiver operating characteristic (ROC) curve analysis. In addition to older age, heavier weight, and wider waist, subjects with NAFLD had significantly higher blood pressure, lipid disturbances, and alanine aminotransferase/aspartate aminotransferase (ALT/AST) ratios. The correlation between NAFLD and ALT/AST ratio remained significant even after adjusting for confounders (adjusted odds ratio [OR], 2.19; 95% confidence interval [CI], 1.24-3.87; p = .007). The risk score of having a fatty liver, based on ALT/AST ratio, was greater than 0.981 according to ROC curve analysis (sensitivity, 60.5%; specificity, 80.3%; area under the curve, 0.756; CI, 0.71-0.80; p < .001). Therefore, ALT/AST ratio may represent a powerful index of hepatosteatosis in children and adolescents.
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Affiliation(s)
- Cheng-Wei Lu
- Cheng-Wei Lu, MD, Department of Family Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan. Ming-Shyan Lin, MD, Department of Cardiology, Chang Gung Memorial Hospital, Yunlin, Taiwan. Yu-Sheng Lin, MD, Department of Cardiology, Chang Gung Memorial Hospital, Chiayi, Taiwan. I-Jen Chang, MD, Department of Family Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan. Ming-Horng Tsai, MD, Department of Pediatrics, Chang Gung Memorial Hospital, Yunlin, Taiwan. Kuo-Liang Wei, MD, Department of Hepato-Gastroenterology, Chang Gung Memorial Hospital, Chiayi, Taiwan. Mei-Yen Chen, PhD, Department of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan; Research Fellow, Department of Cardiology, Chang Gung Memorial Hospital, Yunlin, Taiwan; and Department of Nursing, Chang Gung University, Taoyuan, Taiwan
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4
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Serafim V, Chirita-Emandi A, Andreescu N, Tiugan DA, Tutac P, Paul C, Velea I, Mihailescu A, Șerban CL, Zimbru CG, Puiu M, Niculescu MD. Single Nucleotide Polymorphisms in PEMT and MTHFR Genes are Associated with Omega 3 and 6 Fatty Acid Levels in the Red Blood Cells of Children with Obesity. Nutrients 2019; 11:nu11112600. [PMID: 31671528 PMCID: PMC6893426 DOI: 10.3390/nu11112600] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 10/24/2019] [Accepted: 10/25/2019] [Indexed: 01/17/2023] Open
Abstract
Polyunsaturated fatty acids (PUFAs) play important roles in health and disease. PUFA levels are influenced by nutrition and genetic factors. The relationship between PUFA composition in red blood cells (RBCs) and genetic variations involved in PUFA metabolism has not been investigated in children with obesity. This study evaluated the association between several genetic variations and PUFA levels in RBCs in children with obesity. One hundred ninety-six children with obesity (101 females, 95 males) were evaluated using anthropometric measurements, dietary intakes, plasma and RBC PUFA quantification, blood biochemistry, and 55 single nucleotide polymorphisms within 14 genes. phosphatidylethanolamine N-methyltransferase (PEMT) rs1109859 and methylenetetrahydrofolate reductase gene (MTHFR) rs4846052 genotypes were associated with PUFA levels in RBCs. PUFA intake did not influence the RBC eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) levels. Higher RBC DHA and EPA levels were observed for PEMT rs1109859 GG and GA genotypes versus the AA genotype. Higher levels of RBC DHA, EPA, arachidonic acid (ARA), and linoleic acid (LA) and were observed for MTHFR rs4846052 TT genotype versus TC and CC genotypes. Genetic variations in PEMT rs1109859 and MTHFR rs4846052 were associated with different PUFA levels in RBC membranes and are estimators for PUFA species in RBCs. Further research is needed to establish whether these genotype-specific alterations are specific to overweight children.
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Affiliation(s)
- Vlad Serafim
- Centre of Genomic Medicine, Genetics Discipline, "Victor Babes" University of Medicine and Pharmacy, Timisoara 300041, Romania.
- The National Institute of Research and Development for Biological Sciences, Bucharest 060031, Romania.
| | - Adela Chirita-Emandi
- Centre of Genomic Medicine, Genetics Discipline, "Victor Babes" University of Medicine and Pharmacy, Timisoara 300041, Romania.
- "Louis Turcanu" Clinical Emergency Hospital for Children, Timisoara 300011, Romania.
| | - Nicoleta Andreescu
- Centre of Genomic Medicine, Genetics Discipline, "Victor Babes" University of Medicine and Pharmacy, Timisoara 300041, Romania.
- "Louis Turcanu" Clinical Emergency Hospital for Children, Timisoara 300011, Romania.
| | - Diana-Andreea Tiugan
- Centre of Genomic Medicine, Genetics Discipline, "Victor Babes" University of Medicine and Pharmacy, Timisoara 300041, Romania.
- "Louis Turcanu" Clinical Emergency Hospital for Children, Timisoara 300011, Romania.
| | - Paul Tutac
- Centre of Genomic Medicine, Genetics Discipline, "Victor Babes" University of Medicine and Pharmacy, Timisoara 300041, Romania.
- "Louis Turcanu" Clinical Emergency Hospital for Children, Timisoara 300011, Romania.
| | - Corina Paul
- Paediatrics Department, "Victor Babes" University of Medicine and Pharmacy, Timisoara 300041, Romania.
- 2nd Paediatrics Clinic, Clinical Emergency County Hospital, Timisoara 300041, Romania.
| | - Iulian Velea
- Paediatrics Department, "Victor Babes" University of Medicine and Pharmacy, Timisoara 300041, Romania.
- 2nd Paediatrics Clinic, Clinical Emergency County Hospital, Timisoara 300041, Romania.
| | - Alexandra Mihailescu
- Centre of Genomic Medicine, Genetics Discipline, "Victor Babes" University of Medicine and Pharmacy, Timisoara 300041, Romania.
| | - Costela Lăcrimioara Șerban
- Department of Functional Sciences, "Victor Babes" University of Medicine and Pharmacy, Timișoara 300041, Romania.
| | - Cristian G Zimbru
- Centre of Genomic Medicine, Genetics Discipline, "Victor Babes" University of Medicine and Pharmacy, Timisoara 300041, Romania.
- Faculty of Automation and Computer Science, Politehnica University of Timisoara, Timisoara 300223, Romania.
| | - Maria Puiu
- Centre of Genomic Medicine, Genetics Discipline, "Victor Babes" University of Medicine and Pharmacy, Timisoara 300041, Romania.
- "Louis Turcanu" Clinical Emergency Hospital for Children, Timisoara 300011, Romania.
| | - Mihai Dinu Niculescu
- Centre of Genomic Medicine, Genetics Discipline, "Victor Babes" University of Medicine and Pharmacy, Timisoara 300041, Romania.
- Advanced Nutrigenomics, 130 Rainbow Ct, Cary, NC 27511, USA.
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Zaman A, Arif Z, Moinuddin, Akhtar K, Ali WM, Alam K. A study on hepatopathic, dyslipidemic and immunogenic properties of fructosylated-HSA-AGE and binding of autoantibodies in sera of obese and overweight patients with fructosylated-HSA-AGE. PLoS One 2019; 14:e0216736. [PMID: 31116779 PMCID: PMC6530853 DOI: 10.1371/journal.pone.0216736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 04/26/2019] [Indexed: 11/29/2022] Open
Abstract
Over consumption of fructose may lead to obesity and dyslipidemia and cause fructosylation-induced alterations in the structure and function of proteins. The aim of this study was to investigate the role of fructosylated-HSA-AGE in the pathogenesis of fatty liver (NAFLD and NASH) by biochemical, immunological and histological studies. Immunogenicity of fructosylated-HSA-AGE was probed by inducing antibodies in rabbits. Fructosylated-HSA-AGE was found to be highly immunogenic. Furthermore, fructosylated-HSA-AGE caused mild fibrosis with steatosis and portal inflammation of hepatocytes in experimental animals. Liver function test and dyslipidemic parameters in immunized animals were also found to be raised. Ultrasonography, which should form part of the assessment of chronically raised transaminases, shows fatty infiltration. Interestingly, alanine aminotransferase (ALT), aspartate aminotransferase (AST), bilirubin, total cholesterol (TC) and triglyceride (TG) profiles confirms USG images of overweight, obese patients. Thus, present study demonstrates that fructosylated-HSA-AGE is hepatotoxic, immunologically active and may cause dyslipidemia.
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Affiliation(s)
- Asif Zaman
- Department of Biochemistry, J.N. Medical College, Faculty of Medicine, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Zarina Arif
- Department of Biochemistry, J.N. Medical College, Faculty of Medicine, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Moinuddin
- Department of Biochemistry, J.N. Medical College, Faculty of Medicine, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Kafil Akhtar
- Department of Pathology, J.N. Medical College, Faculty of Medicine, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Wasif Mohammad Ali
- Department of Surgery, J.N. Medical College, Faculty of Medicine, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Khursheed Alam
- Department of Biochemistry, J.N. Medical College, Faculty of Medicine, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
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6
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Pîrsean C, Neguț C, Stefan-van Staden RI, Dinu-Pirvu CE, Armean P, Udeanu DI. The salivary levels of leptin and interleukin-6 as potential inflammatory markers in children obesity. PLoS One 2019; 14:e0210288. [PMID: 30605486 PMCID: PMC6317816 DOI: 10.1371/journal.pone.0210288] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 12/19/2018] [Indexed: 01/04/2023] Open
Abstract
Background Obesity among children is an alarming issue due to an increased incidence over the last years with devastating physiological and psychological consequences. Current available medical diagnostic tools use invasive methods to evaluate and monitor the lipid profile, glycaemia or liver status for determining the overweight/ obesity complications. The standard methods proposed for the assay of IL6 and leptin from saliva cannot detect these two biomarkers in children saliva; the levels of IL6 and leptin in children’s saliva are lower than the limit of determination of the standard methods. Therefore, we proposed a method based on utilization of stochastic sensors, able to simultaneously perform a qualitative and quantitative determination of these two biomarkers within minutes, in the range able to cover healthy and obese children. Methods Children from the urban area monitored for annual standard analyses and health status assessment at National Institute of Endocrinology C.I. Parhon within University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania were included in the study. In the same day, for all participants of the study, blood analyses were performed and saliva samples were collected for the determination of the IL-6 and leptin levels. Findings/ Results The children diagnosed with overweight/ obesity presented not significantly different blood lipid profile and glycaemia comparing to the control group. Only few cases of the children presented high levels of cholesterol, low level of HDL-cholesterol, a slightly increased level of triglycerides and transaminases. No correlation with the body mass index could be established with the blood analyses results. In case of the overweight/obese children, the salivary level of the proinflammatory citokynes IL-6 (41ng/mL±21) and leptin (40.4ng/mL±28.8), were significantly increased comparing to normal weight children (IL-6 8.1±4.6, leptin 9.58±3.1). Moreover, the saliva level of the IL-6 was positively correlated with the body mass index. Salivary leptin level was highly variable in case of obese children, 6 patients presenting similar levels with the control group. Conclusions Increased levels of salivary IL-6 and leptin sustain a systemic inflammation status despite normal range of standard blood analyses. The results were positively correlated in case of IL-6 with the body mass index the general accepted method used for the assessment of the obesity or overweight degree The determination of these markers in saliva samples by a stochastic method proved the utility within the medical examination for a better evaluation of the health status in obesity. The method has some advantages like: easy collection of the biological sample, fast determination of low concentrations and could be promising in case of no associated oral cavity infections or inflammations which could interfere the results.
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Affiliation(s)
- Corina Pîrsean
- School of Midwifery and Nursing, University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
| | - Cătălina Neguț
- Laboratory of Electrochemistry and PATLAB Bucharest, National Institute of Research for Electrochemistry and Condensed Matter, Bucharest, Romania
| | - Raluca-Ioana Stefan-van Staden
- Laboratory of Electrochemistry and PATLAB Bucharest, National Institute of Research for Electrochemistry and Condensed Matter, Bucharest, Romania
- * E-mail:
| | - Cristina Elena Dinu-Pirvu
- Department of Physical and Colloidal Chemistry, Faculty of Pharmacy, University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
| | - Petru Armean
- School of Midwifery and Nursing, University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
| | - Denisa Ioana Udeanu
- Department of Clinical Laboratory. Food Safety, Faculty of Pharmacy, University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
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Hampe CS, Shaffer ML, Roth CL. Associations between Liver Enzyme Levels and Parameters of the Metabolic Syndrome in Obese Children. Horm Res Paediatr 2018; 88:265-273. [PMID: 28898874 DOI: 10.1159/000479868] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 07/24/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Obesity is strongly associated with insulin resistance, hypertension, dyslipidemia, and therefore risk for metabolic syndrome (MetS), which is an increasing problem in youth. The potential role of elevated liver enzyme levels in this context needs to be further investigated. METHODS This paper provides a post hoc analysis of a cross-sectional study of 77 obese nondiabetic children (51% female; median age 11.7 years; BMI >97th percentile) enrolled at the University of Bonn, Bonn, Germany. Anthropometric parameters, lipid profiles, glycemic control, and liver enzyme levels were evaluated. Glucose and insulin levels were determined during an oral glucose tolerance test (OGTT). Gender- and age-specific cutoff values were used to assess MetS. RESULTS A high prevalence of hypertension (51%), dyslipidemia (52%), elevated liver enzyme levels (51%), and hyperglycemia (24%) was found. There was considerable overlap between the presence of different MetS risk factors in individuals, and 40% of the participants had ≥3 of a maximum of 5 MetS risk factors. Elevated liver enzyme levels were significantly associated with reduced insulin sensitivity, as the OGTT-insulin response was significantly higher in participants with elevated transaminases (p = 0.01). This association was independent of hyperglycemia and dyslipidemia (p = 0.03). CONCLUSIONS We conclude that liver enzyme levels are related to insulin sensitivity in obese children and could therefore be an indirect indicator for MetS. Testing for disturbed glucose metabolism should be considered for obese children with elevated liver enzymes.
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Affiliation(s)
- Christiane S Hampe
- Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Michele L Shaffer
- Seattle Children's Research Institute, Center for Clinical and Translational Research, Seattle, Washington, USA.,Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - Christian L Roth
- Center for Integrative Brain Research, Seattle Children's Hospital and Research Institute, Seattle, Washington, USA.,Pediatric Endocrinology, Seattle Children's Hospital and Research Institute, Seattle, Washington, USA
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8
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Liu C, Chu C, Zhang J, Wu D, Xu D, Li P, Chen Y, Liu B, Pei L, Zhang L, Liu S, Qi T, Lou XY, Li L. IRX3 is a genetic modifier for birth weight, adolescent obesity and transaminase metabolism. Pediatr Obes 2018; 13:141-148. [PMID: 28316138 DOI: 10.1111/ijpo.12214] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 01/20/2017] [Indexed: 01/29/2023]
Abstract
OBJECTIVE IRX3 expression has been functionally associated in obesity-associated long-distance susceptibility loci, but the effect of the IRX3 genetic variants on human obesity and obesity-related metabolism remains uncertain. METHODS To determine the genetic role of IRX3, we conducted a molecular epidemiological analysis using three haplotype tagging single nucleotide polymorphisms (SNPs; rs8053360, rs3751723 and rs12445085) and one nonsynonymous SNP (rs1126960) at the IRX3 locus in 333 junior and senior high school students from a northeast Chinese population. RESULTS We identified significant associations between IRX3 SNPs and birth weight, body mass index (BMI), aspartate aminotransferase (AST), alanine aminotransferase (ALT) and AST/ALT ratio. The rs8053360 CC and rs1126960 GG genotypes were associated with increased birth weight and BMI, especially in females. Individuals with the rs12445085 TT genotype had significantly higher levels of AST and ALT, whereas individuals with the rs1126960 GG genotype had a significantly lower AST/ALT ratio than did individuals with other genotypes. However, no significant relationships were found between any of the IRX3 SNPs and metabolic syndrome or diabetes. CONCLUSIONS IRX3 genetic variants associate with birth weight, BMI and AST/ALT-related transaminase metabolism, supporting the role of IRX3 as an obesity-associated susceptibility gene.
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Affiliation(s)
- C Liu
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China
| | - C Chu
- Department of Applied Psychology, Humanities and Management Colleges, Guangdong Medical University, Guangdong, China
| | - J Zhang
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China
| | - D Wu
- No. 2 Department of Rheumatology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - D Xu
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China
| | - P Li
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Y Chen
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China
| | - B Liu
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China
| | - L Pei
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China
| | - L Zhang
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China
| | - S Liu
- Institute of Bioinformatics, Zhejiang University, Hangzhou, China
| | - T Qi
- Institute of Bioinformatics, Zhejiang University, Hangzhou, China
| | - X-Y Lou
- Biostatistics Program, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.,Arkansas Children's Research Institute, Little Rock, AR, USA
| | - L Li
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China
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9
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Gorginzadeh M, Safari S, Alavian SM. Acute Fatty Liver of Pregnancy: A Life-Threatening Condition Requiring a Life-Saving Approach. HEPATITIS MONTHLY 2016; 16:e35256. [PMID: 27630721 PMCID: PMC5010886 DOI: 10.5812/hepatmon.35256] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Revised: 04/09/2016] [Accepted: 05/14/2016] [Indexed: 12/11/2022]
Affiliation(s)
- Mansoureh Gorginzadeh
- Department of Obstetrics and Gynecology, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Saeid Safari
- Department of Anesthesiology and Critical Care, Iran University of Medical Sciences, Tehran, IR Iran
| | - Seyed Moayed Alavian
- Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
- Tehran Hepatitis Center, Tehran, IR Iran
- Corresponding Author: Seyed Moayed Alavian, Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, IR Iran. Tel: +98-2188945186, Fax: +98-2188945188, E-mail:
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10
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Alterio A, Alisi A, Liccardo D, Nobili V. Non-alcoholic fatty liver and metabolic syndrome in children: a vicious circle. Horm Res Paediatr 2015; 82:283-9. [PMID: 25324136 DOI: 10.1159/000365192] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Accepted: 06/10/2014] [Indexed: 11/19/2022] Open
Abstract
During the last decade, paediatricians have observed a dramatic increase of non-alcoholic fatty liver disease (NAFLD) and metabolic syndrome (MS) in children. Furthermore, several lines of evidence have reported that a large part of children with NAFLD presents one or more traits of MS making plausible that, in the coming years, these subjects may present a rapid course of disease towards more severe cirrhosis and cardiovascular disease. Genetic susceptibility and the pressure of intrauterine environment and lifestyle are all crucial to activate molecular machinery that leads to development of NAFLD and MS in childhood. In this scenario, central obesity and consequent adipose tissue inflammation are critical to promote both MS-associated metabolic dysfunctions and NAFLD-related hepatic damage. An excessive dietary intake may in fact cause a specific lipid partitioning and induce metabolic stressors, which in turn promote insulin resistance and the release of several circulating factors. These molecules, on the one hand, trigger steatosis and the inflammatory response that characterize liver damage in NAFLD, and on the other hand contribute to the onset of other features of MS. This review provides an overview of current genetic, pathogenetic and clinical evidence of the vicious circle created by NAFLD and MS in children.
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Affiliation(s)
- Arianna Alterio
- Hepato-Metabolic Disease Unit and Liver Research Unit, 'Bambino Gesù' Children's Hospital, IRCCS, Rome, Italy
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11
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Mann JP, Goonetilleke R, McKiernan P. Paediatric non-alcoholic fatty liver disease: a practical overview for non-specialists. Arch Dis Child 2015; 100:673-7. [PMID: 25633064 DOI: 10.1136/archdischild-2014-307985] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2014] [Accepted: 01/07/2015] [Indexed: 02/06/2023]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the most common paediatric liver disease with a prevalence of almost 10%; therefore, the majority of affected patients are under the care of general practitioners and non-specialists. The condition is caused by central obesity with insulin resistance with additional factors influencing inflammatory activity (steatohepatitis). Ongoing inflammation leads to fibrosis and end-stage liver disease, though this will usually occur after children have transitioned into adult care. However, their main morbidity and mortality is from type 2 diabetes and complications of atherosclerosis. The minority of children undergo biopsy but currently there is no other method to accurately assess the stage of disease. Management is focused at weight loss through a combination of diet and exercise. Here, we present a current review of paediatric NAFLD aimed at non-specialists, with practice points for implementation.
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Affiliation(s)
- Jake P Mann
- Department of paediatrics, University of Cambridge, Cambridge, UK
| | | | - Pat McKiernan
- Liver unit, Birmingham Children's Hospital, Birmingham, UK
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Dietary blueberry and bifidobacteria attenuate nonalcoholic fatty liver disease in rats by affecting SIRT1-mediated signaling pathway. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2014; 2014:469059. [PMID: 25544867 PMCID: PMC4265704 DOI: 10.1155/2014/469059] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 11/01/2014] [Accepted: 11/03/2014] [Indexed: 02/07/2023]
Abstract
NAFLD model rats were established and divided into NAFLD model (MG group), SIRT1 RNAi (SI group), blueberry juice (BJ group), blueberry juice + bifidobacteria (BJB group), blueberry juice + SIRT1 RNAi (BJSI group), and blueberry juice + bifidobacteria + SIRT1 RNAi groups (BJBSI group). A group with normal rats was a control group (CG). BJB group ameliorated NAFLD, which was better than BJ group (P < 0.05). The lipid accumulation was lower in CG, BJ, and BJB groups than that in MG, SI, BJSI, and BJBSI groups (P < 0.05). The levels of SIRT1 and PPAR-α were higher in CG, BJ, and BJB groups than those in MG, SI, BJSI, and BJBSI groups (P < 0.05). The levels of SREBP-1c were lower in CG, BJ, and BJB groups than those in MG, SI, BJSI, and BJBSI groups (P < 0.05). The biochemical indexes SOD, GSH, and HDL-c were improved from CG to BJB group (P < 0.05). Inversely, the levels of AST and ALT, TG, TC, LDL-c, and MDA were decreased from CG to BJB group (P < 0.05). These changes enhance antioxidative capability and biochemical index of rats. Blueberry juice and bifidobacteria improve NAFLD by activating SIRTI-mediating signaling pathway.
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Beacher DR, Ariza AJ, Fishbein MH, Binns HJ. Screening for elevated risk of liver disease in preschool children (aged 2-5 years) being seen for obesity management. SAGE Open Med 2014; 2:2050312114555211. [PMID: 26770745 PMCID: PMC4607231 DOI: 10.1177/2050312114555211] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 09/12/2014] [Indexed: 12/19/2022] Open
Abstract
Objectives: Elevated alanine aminotransferase can heighten concern for the presence of nonalcoholic fatty liver disease in obese children. Guidelines recommend alanine aminotransferase screening of obese children start at the age of 10 years. We examined alanine aminotransferase values routinely obtained for tertiary obesity care among preschool (2–5 years) and school-age children. Methods: Medical records of children attending a tertiary obesity clinic and with alanine aminotransferase measured within 6 months of the initial visit were reviewed. Children with known genetic abnormalities were excluded. Children were grouped by age to focus attention on groups not covered by screening guidelines. Associations with elevated alanine aminotransferase (>30 IU/L) were examined. Results: A total of 284 records were analyzed (73 preschool, 143 young school-age (6–9 years), 68 older school-age (10–11 years)). Children were primarily Hispanic and had body mass index ≥ 99th percentile (preschool children 92%, young school-age 73%, older school-age 59%). In all, 26% of preschool children had elevated alanine aminotransferase (young school-age 30%, older school-age 44%). Preschool children with elevated alanine aminotransferase had higher body mass index compared to preschool children with alanine aminotransferase ≤ 30 IU/L (median body mass index 27.8 kg/m2 vs 24.0 kg/m2; Mann–Whitney U test, p = 0.003), but there was no disparity for elevated alanine aminotransferase related to Hispanic ethnicity. For older children, Hispanic ethnicity, not body mass index, predicted elevated alanine aminotransferase. Conclusion: Alanine aminotransferase elevation was common in these preschool children. Screening severely obese children for elevated alanine aminotransferase should begin at the age of 2 years.
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Affiliation(s)
- Daniel R Beacher
- University of Minnesota Medical School, Minneapolis, MN, USA; Mary Ann & J. Milburn Smith Child Health Research Program, Stanley Manne Children's Research Institute, Chicago, IL, USA; Children's Hospital of Wisconsin Pediatric Residency Program, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Adolfo J Ariza
- Mary Ann & J. Milburn Smith Child Health Research Program, Stanley Manne Children's Research Institute, Chicago, IL, USA; Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA; Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Mark H Fishbein
- Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA; Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Helen J Binns
- Mary Ann & J. Milburn Smith Child Health Research Program, Stanley Manne Children's Research Institute, Chicago, IL, USA; Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA; Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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