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de Castro Silveira JF, Sehn AP, da Silva L, Gaya AR, Lima RA, Burns RD, Andersen LB, Renner JDP, Reuter CP. The stability of cardiometabolic risk factors clustering in children and adolescents: a 2-year longitudinal study. J Diabetes Metab Disord 2023; 22:529-538. [PMID: 37255777 PMCID: PMC10225448 DOI: 10.1007/s40200-022-01174-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 12/14/2022] [Indexed: 06/01/2023]
Abstract
Objective The present study aims to verify the odds of remaining with the clustering of 3 or more, 4 or more, and 5 or more risk factors across a 2-year time span. Methods Observational longitudinal study that included 358 children and adolescents (10.96 ± 2.28 years of age at baseline). Cardiorespiratory fitness, glucose, systolic blood pressure, total cholesterol/high-density lipoprotein cholesterol ratio, triglycerides, and waist circumference were assessed. The number of children in whom the risk factors were not independently distributed was analyzed. Odds ratios of presenting n risk factors clustered at follow-up according to the number of risk factors observed at baseline were calculated. Results More participants than expected were found presenting clustering of 4 or more and 5 or more risk factors at both baseline (11.7% and 5.6%, respectively) and follow-up (9.5% and 5.6%, respectively). The odds ratios calculated demonstrated that the odds of presenting the same number of risk factors clustered or more at follow-up increased according to the number of risk factors clustered at baseline. Conclusion The higher the number of risk factors a child had at baseline, the higher the odds of presenting the same number of risk factors or more after two years of follow-up. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-022-01174-1.
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Affiliation(s)
| | - Ana Paula Sehn
- Graduation Program in Health Promotion, University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, RS Brazil
| | - Luiza da Silva
- Department of Health Sciences, University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, RS Brazil
| | - Anelise Reis Gaya
- Graduation Program in Human Movement Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS Brazil
| | - Rodrigo Antunes Lima
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain
- Research Group on Lifestyles and Health, University of Pernambuco, Recife, PE Brazil
| | - Ryan Donald Burns
- Department of Health, Kinesiology, and Recreation, University of Utah, Salt Lake City, UT USA
| | - Lars Bo Andersen
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Jane Dagmar Pollo Renner
- Graduation Program in Health Promotion, University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, RS Brazil
| | - Cézane Priscila Reuter
- Graduation Program in Health Promotion, University of Santa Cruz do Sul (UNISC), Santa Cruz do Sul, RS Brazil
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Nur Zati Iwani AK, Jalaludin MY, Roslan FA, Mansor F, Md Zain F, Hong JYH, Zin RMWM, Yahya A, Ishak Z, Selamat R, Mokhtar AH. Cardiometabolic risk factors among children who are affected by overweight, obesity and severe obesity. Front Public Health 2023; 11:1097675. [PMID: 37181686 PMCID: PMC10173091 DOI: 10.3389/fpubh.2023.1097675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 03/14/2023] [Indexed: 05/16/2023] Open
Abstract
Background The increasing severity of obesity is expected to lead to more serious health effects. However, there is limited information on the prevalence and clinical characteristics of cardiometabolic risk factors in severely children affected by obesity in Malaysia. This baseline study aimed to investigate the prevalence of these factors and their association with obesity status among young children. Methods In this study, a cross-sectional design was employed using the baseline data obtained from the My Body Is Fit and Fabulous at school (MyBFF@school) intervention program involving obese school children. Obesity status was defined using the body mass index (BMI) z-score from the World Health Organization (WHO) growth chart. Cardiometabolic risk factors presented in this study included fasting plasma glucose (FPG), triglycerides (TGs), total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), blood pressure, acanthosis nigricans, insulin resistance (IR), and MetS. MetS was defined using the International Diabetes Federation (IDF) 2007 criteria. Descriptive data were presented accordingly. The association between cardiometabolic risk factors, such as obesity status, and acanthosis nigricans with MetS was measured using multivariate logistic regression, which was adjusted for gender, ethnicity, and strata. Results Out of 924 children, 38.4% (n = 355) were overweight, 43.6% (n = 403) were obese, and 18% (n = 166) were severely obese. The overall mean age was 9.9 ± 0.8 years. The prevalence of hypertension, high FPG, hypertriglyceridemia, low HDL-C, and the presence of acanthosis nigricans among severely children affected by obesity was 1.8%, 5.4%, 10.2%, 42.8%, and 83.7%, respectively. The prevalence of children affected by obesity who were at risk of MetS in <10-year-old and MetS >10-year-old was observed to be similar at 4.8%. Severely children affected by obesity had higher odds of high FPG [odds ratio (OR) = 3.27; 95% confdence interval (CI) 1.12, 9.55], hypertriglyceridemia (OR = 3.50; 95%CI 1.61, 7.64), low HDL-C (OR = 2.65; 95%CI 1.77, 3.98), acanthosis nigricans (OR = 13.49; 95%CI 8.26, 22.04), IR (OR = 14.35; 95%CI 8.84, 23.30), and MetS (OR = 14.03; 95%CI 3.97, 49.54) compared to overweight and children affected by obesity. The BMI z-score, waist circumference (WC), and percentage body fat showed a significant correlation with triglycerides, HDL-C, the TG: HDL-C ratio, and the homeostatic model assessment for IR (HOMA-IR) index. Conclusions Severely children affected by obesity exhibit a higher prevalence of and are more likely to develop cardiometabolic risk factors compared to overweight and children affected by obesity. This group of children should be monitored closely and screened periodically for obesity-related health problems to institute early and comprehensive intervention.
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Affiliation(s)
- Ahmad Kamil Nur Zati Iwani
- Endocrine and Metabolic Unit, Institute for Medical Research, Ministry of Health Malaysia, Setia Alam, Malaysia
| | - Muhammad Yazid Jalaludin
- Department of Paediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
- *Correspondence: Muhammad Yazid Jalaludin
| | - Farah Aqilah Roslan
- Endocrine and Metabolic Unit, Institute for Medical Research, Ministry of Health Malaysia, Setia Alam, Malaysia
| | - Fazliana Mansor
- Endocrine and Metabolic Unit, Institute for Medical Research, Ministry of Health Malaysia, Setia Alam, Malaysia
| | - Fuziah Md Zain
- Department of Paediatrics, Hospital Putrajaya, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Janet Yeow Hua Hong
- Department of Paediatrics, Hospital Putrajaya, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Ruziana Mona Wan Mohd Zin
- Endocrine and Metabolic Unit, Institute for Medical Research, Ministry of Health Malaysia, Setia Alam, Malaysia
| | - Abqariyah Yahya
- Department of Social and Preventive Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Zahari Ishak
- Department of Educational Psychology and Counselling, Faculty of Education, University Malaya, Kuala Lumpur, Malaysia
| | - Rusidah Selamat
- Nutrition Division, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Abdul Halim Mokhtar
- Department of Sports Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
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Li LJ, Rifas-Shiman SL, Aris IM, Mantzoros C, Hivert MF, Oken E. Leptin trajectories from birth to mid-childhood and cardio-metabolic health in early adolescence. Metabolism 2019; 91:30-38. [PMID: 30412696 PMCID: PMC6366620 DOI: 10.1016/j.metabol.2018.11.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 11/01/2018] [Accepted: 11/03/2018] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Leptin is a hormone produced by adipose tissue that promotes satiety, and some evidence suggests that greater early life leptin exposure prevents excessive adiposity gain in later life. However, few studies have analyzed dynamic changes in leptin throughout childhood in relation to later cardio-metabolic health. Our study aims to identify distinct leptin trajectories in childhood, and to examine their associations with cardio-metabolic outcomes in adolescence. METHODS Among children in the Project Viva cohort born 1999-2002 in Massachusetts, we used latent class growth models to identify leptin trajectories independent of maternal BMI, child sex, race/ethnicity, size at birth and current age and size among 1360 children with leptin measured at least once at birth, early childhood (mean 3.3 ± SD 0.3 years), or mid-childhood (7.9 ± 0.8 years). At research visits in early adolescence (13.2 ± 0.9 years), we assessed cardio-metabolic outcomes including adiposity measures, fasting biomarkers, and blood pressure among 855 children. We then applied multiple regression models to examine associations of the leptin trajectories with these cardio-metabolic outcomes in early adolescence, adjusting for child age at outcome, maternal age, education, prenatal smoking and glucose, total gestational weight gain and paternal BMI. RESULTS The latent class growth model identified 3 distinct leptin trajectories: "low stable" (n = 1031, 75.8%), "high-decreasing" (n = 219, 16.1%) and "intermediate-increasing" (n = 110, 8.1%). In adjusted models, the intermediate-increasing leptin trajectory was associated with higher early adolescence adiposity measures (e.g. BMI z-score: 0.62 units; 95% confidence interval: 0.28, 0.96 and odds of obesity: 2.84: 1.17, 6.94), but lower systolic blood pressure (-0.46 z-score units; -0.74, -0.18), compared to the low-stable group. CONCLUSIONS Our findings on leptin trajectories in childhood suggest important differences and associations with later metabolic outcomes.
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Affiliation(s)
- Ling-Jun Li
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA; Duke-NUS Medical School, Singapore; Division of Obstetrics & Gynaecology, KK Women's and Children's Hospital, Singapore; Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Sheryl L Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Izzuddin M Aris
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA; Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore
| | | | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA; Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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Nappo A, González-Gil EM, Ahrens W, Bammann K, Michels N, Moreno LA, Kourides Y, Iacoviello L, Mårild S, Fraterman A, Molnàr D, Veidebaum T, Siani A, Russo P. Analysis of the association of leptin and adiponectin concentrations with metabolic syndrome in children: Results from the IDEFICS study. Nutr Metab Cardiovasc Dis 2017; 27:543-551. [PMID: 28511904 DOI: 10.1016/j.numecd.2017.04.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 03/20/2017] [Accepted: 04/08/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND AIMS Adipokines may play a role in the pathogenesis of the metabolic syndrome (MetS) in children. We aimed to evaluate the association of leptin, adiponectin, and its ratio (L/A ratio) with the metabolic syndrome (MetS) in a subsample of the IDEFICS (Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS) cohort. METHODS AND RESULTS Leptin, adiponectin and MetS parameters were measured in a subsample of 1253 children (3-9.9 years) participating to the IDEFICS study, grouped as: Non-OW (underweight/normal weight) and OW/Ob (overweight/obese). MetS was defined using the sex- and age-specific cut-offs based on the distribution of MetS components in the IDEFICS cohort. The prevalence of the MetS among OW/Ob was 24.8% and 27.1% in boys and girls respectively, whereas ≤2% among Non-OW. OW/Ob had significantly higher leptin and L/A ratio as compared to Non-OW. Significantly higher leptin was found in OW/Ob with MetS as compared with OW/Ob without MetS. Significantly lower adiponectin was observed only in OW/Ob girls as compared to Non-OW. A 1SD increase in leptin and L/A ratio z-scores or a 1SD decrease in adiponectin z-score were significantly associated with higher risk of MetS. After adjustment for BMI or body fat mass (BFM) the association remained significant only for leptin. CONCLUSION We showed that in European children, higher leptin concentration is associated with MetS, even after adjusting for BMI or BFM, confirming an early role of leptin in MetS, while the association of adiponectin with MetS seems be mediated by body fat in this age range.
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Affiliation(s)
- A Nappo
- Institute of Food Sciences, National Research Council, Avellino, Italy
| | - E M González-Gil
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
| | - W Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany; Institute of Statistics, Faculty of Mathematics and Computer Science, Bremen University, Bremen, Germany
| | - K Bammann
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany; Institute for Public Health and Nursing Research (IPP), University of Bremen, Bremen, Germany
| | - N Michels
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - L A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
| | - Y Kourides
- Research and Education Institute of Child Health, Strovolos, Cyprus
| | - L Iacoviello
- Department of Epidemiology and Prevention, Unit of Molecular and Nutritional Epidemiology, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli, Italy
| | - S Mårild
- Department of Paediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - A Fraterman
- Laboratoriumsmedizin Dortmund, Eberhard & Partner Dortmund, Germany
| | - D Molnàr
- Department of Paediatrics, Medical Faculty, University of Pécs, Pécs, Hungary
| | - T Veidebaum
- National Institute for Health Development, Tallinn, Estonia
| | - A Siani
- Institute of Food Sciences, National Research Council, Avellino, Italy.
| | - P Russo
- Institute of Food Sciences, National Research Council, Avellino, Italy
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