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Saintila J, Oblitas-Guerrero SM, Larrain-Tavara G, Lizarraga-De-Maguiña IG, Bernal-Corrales FDC, López-López E, Calizaya-Milla YE, Serpa-Barrientos A, Ramos-Vera C. Associations between social network addiction, anxiety symptoms, and risk of metabolic syndrome in Peruvian adolescents-a cross-sectional study. Front Public Health 2024; 12:1261133. [PMID: 38751589 PMCID: PMC11094343 DOI: 10.3389/fpubh.2024.1261133] [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: 07/18/2023] [Accepted: 04/16/2024] [Indexed: 05/18/2024] Open
Abstract
Background The link between physical and mental health and screen time in adolescents has been the subject of scientific scrutiny in recent years. However, there are few studies that have evaluated the association between social network addiction (SNA) and metabolic risk in this population. Objective This study determined the association between SNA and anxiety symptoms with the risk of metabolic syndrome (MetS) in adolescents. Methods A cross-sectional study was conducted in Peruvian adolescents aged 12 to 18 years, who completed a Social Network Addiction Questionnaire and the Generalized Anxiety Disorder 2-item scale (GAD-2), between September and November 2022. A total of 903 participants were included in the study using a non-probability convenience sample. Sociodemographic and anthropometric data were also collected. Binary logistic regression was used to explore the association between SNA and anxiety symptoms with MetS in a cross-sectional analysis. Results Males were more likely to have MetS than females (OR = 1.133, p = 0.028). Participants who were 16 years of age or older and those with excess body weight were 2.166, p = 0.013 and 19.414, p < 0.001 times more likely to have MetS, respectively. Additionally, SNA (OR = 1.517, p = 0.016) and the presence of anxiety symptoms (OR = 2.596, p < 0.001) were associated with MetS. Conclusion Our findings suggest associations between SNA, anxiety symptoms, and MetS among youth. However, more studies are needed to better understand this association and to deepen the possible clinical and public health implications.
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Affiliation(s)
| | | | | | | | | | - Elmer López-López
- Escuela de Medicina Humana, Universidad Señor de Sipán, Chiclayo, Peru
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Martin M, Condori AI, Davico B, Gómez Rosso L, Gaete L, Tetzlaff W, Chiappe EL, Sáez MS, Lorenzon González MV, Godoy MF, Osta V, Trifone L, Ballerini MG, Cherñavsky A, Boero L, Tonietti M, Feliu S, Brites F. Impaired Reverse Cholesterol Transport is Associated with Changes in Fatty Acid Profile in Children and Adolescents with Abdominal Obesity. J Nutr 2024; 154:12-25. [PMID: 37716606 DOI: 10.1016/j.tjnut.2023.08.037] [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: 07/14/2023] [Revised: 08/25/2023] [Accepted: 08/31/2023] [Indexed: 09/18/2023] Open
Abstract
BACKGROUND Abdominal obesity is an important cardiovascular disease risk factor. Plasma fatty acids display a complex network of both pro and antiatherogenic effects. High density lipoproteins (HDL) carry out the antiatherogenic pathway called reverse cholesterol transport (RCT), which involves cellular cholesterol efflux (CCE), and lecithin:cholesterol acyltransferase (LCAT) and cholesteryl ester transfer protein (CETP) activities. OBJECTIVES Our aim was to characterize RCT and its relation to fatty acids present in plasma in pediatric abdominal obesity. METHODS Seventeen children and adolescents with abdominal obesity and 17 healthy controls were studied. Anthropometric parameters were registered. Glucose, insulin, lipid levels, CCE employing THP-1 cells, LCAT and CETP activities, plus fatty acids in apo B-depleted plasma were measured. RESULTS The obese group showed a more atherogenic lipid profile, plus lower CCE (Mean±Standard Deviation) (6 ± 2 vs. 7 ± 2%; P < 0.05) and LCAT activity (11 ± 3 vs. 15 ±5 umol/dL.h; P < 0.05). With respect to fatty acids, the obese group showed higher myristic (1.1 ± 0.3 vs. 0.7 ± 0.3; P < 0.01) and palmitic acids (21.5 ± 2.8 vs. 19.6 ± 1.9; P < 0.05) in addition to lower linoleic acid (26.4 ± 3.3 vs. 29.9 ± 2.6; P < 0.01). Arachidonic acid correlated with CCE (r = 0.37; P < 0.05), myristic acid with LCAT (r = -0.37; P < 0.05), palmitioleic acid with CCE (r = -0.35; P < 0.05), linoleic acid with CCE (r = 0.37; P < 0.05), lauric acid with LCAT (r = 0.49; P < 0.05), myristic acid with LCAT (r = -0.37; P < 0.05) ecoisatrienoic acid with CCE (r = 0.40; P < 0.05) and lignoseric acid with LCAT (r = -0.5; P < 0.01). CONCLUSIONS Children and adolescents with abdominal obesity presented impaired RCT, which was associated with modifications in proinflammatory fatty acids, such as palmitoleic and myristic, thus contributing to increased cardiovascular disease risk.
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Affiliation(s)
- Maximiliano Martin
- Laboratorio de Lípidos y Aterosclerosis, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina.
| | - Anabel Impa Condori
- Departamento de Sanidad, Nutrición, Bromatología y Toxicología, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Belén Davico
- Laboratorio de Lípidos y Aterosclerosis, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Leonardo Gómez Rosso
- Laboratorio de Lípidos y Aterosclerosis, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Laura Gaete
- Hospital de Niños "Ricardo Gutiérrez", Buenos Aires, Argentina
| | - Walter Tetzlaff
- Laboratorio de Lípidos y Aterosclerosis, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Ezequiel Lozano Chiappe
- Laboratorio de Lípidos y Aterosclerosis, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina
| | | | | | - María Fernanda Godoy
- Departamento de Sanidad, Nutrición, Bromatología y Toxicología, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Viviana Osta
- Hospital de Niños "Ricardo Gutiérrez", Buenos Aires, Argentina
| | - Liliana Trifone
- Hospital de Niños "Ricardo Gutiérrez", Buenos Aires, Argentina
| | - María Gabriela Ballerini
- Laboratorio de Lípidos y Aterosclerosis, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Alejandra Cherñavsky
- Instituto de Inmunología, Genética y Metabolismo, Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
| | - Laura Boero
- Laboratorio de Lípidos y Aterosclerosis, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Miriam Tonietti
- Hospital de Niños "Ricardo Gutiérrez", Buenos Aires, Argentina
| | - Susana Feliu
- Departamento de Sanidad, Nutrición, Bromatología y Toxicología, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Fernando Brites
- Laboratorio de Lípidos y Aterosclerosis, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina
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Kim S, Song K, Lee M, Suh J, Chae HW, Kim HS, Kwon A. Trends in HOMA-IR values among South Korean adolescents from 2007-2010 to 2019-2020: a sex-, age-, and weight status-specific analysis. Int J Obes (Lond) 2023; 47:865-872. [PMID: 37443273 PMCID: PMC10439007 DOI: 10.1038/s41366-023-01340-2] [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: 11/01/2022] [Revised: 06/27/2023] [Accepted: 07/04/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND/OBJECTIVES An increase in obesity prevalence may lead to an increase in the HOMA-IR value. This study aimed to investigate changes in age- and sex-specific homeostasis model assessment of insulin resistance (HOMA-IR) values among South Korean adolescents, using data from the Korean National Health and Nutrition Examination Survey (KNHANES) IV, V, and VIII conducted between 2007-2010 and 2019-2020. SUBJECTS/METHODS Overall, 4621 adolescents aged 10-18 years were evaluated, including 3473 from the 2007-2010 dataset and 1148 from the 2019-2020 dataset. The mean HOMA-IR values and percentile curves were evaluated by age, sex, and weight status. RESULTS The mean HOMA-IR values peaked at puberty in both sexes and further increased during puberty in the 2019-2020 dataset (boys 5.21, 95% confidence interval [CI] 4.16-6.26; girls 5.21, 95% CI 3.09-7.33) compared with the 2007-2010 dataset (boys 3.25, 95% CI 3.04-3.47; girls 3.58, 95% CI 3.31-3.85). Both groups (with normal-weight and overweight/obesity) exhibited a peak HOMA-IR value during puberty in both sexes and both datasets, although the group with overweight/obesity had a higher and wider peak age range. While the mean HOMA-IR values did not change in adolescents with normal-weight, they increased during puberty and post-puberty in boys with overweight/obesity. CONCLUSIONS HOMA-IR values should be interpreted considering sex, weight status, and pubertal stages. In particular, during the pubertal period, insulin resistance (IR) can coexist not only due to weight-related factors but also as a result of the distinct hormonal changes characteristic of puberty. Over the 10-year period, the mean HOMA-IR values increased in the group with overweight/obesity during puberty and post-puberty, highlighting the need for active intervention to prevent metabolic complications in adolescents with overweight/obesity.
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Affiliation(s)
- Sujin Kim
- Department of Pediatrics, Severance Children's Hospital, Institute of Endocrinology, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Kyungchul Song
- Department of Pediatrics, Severance Children's Hospital, Institute of Endocrinology, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Myeongseob Lee
- Department of Pediatrics, Severance Children's Hospital, Institute of Endocrinology, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Junghwan Suh
- Department of Pediatrics, Severance Children's Hospital, Institute of Endocrinology, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Hyun Wook Chae
- Department of Pediatrics, Severance Children's Hospital, Institute of Endocrinology, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Ho-Seong Kim
- Department of Pediatrics, Severance Children's Hospital, Institute of Endocrinology, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Ahreum Kwon
- Department of Pediatrics, Severance Children's Hospital, Institute of Endocrinology, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea.
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Hassan AA, Elshall S, Erfan A, Hafez M, Salah W, Elrifaey S, El Amrousy D. Urinary C-peptide and urinary C-peptide creatinine ratio as markers for insulin resistance in obese children and adolescents. Pediatr Res 2022; 92:805-809. [PMID: 34775475 DOI: 10.1038/s41390-021-01847-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/20/2021] [Accepted: 10/28/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Obesity is associated with insulin resistance (IR). Identifying high-risk obese children affected with IR is crucial to apply preventive management. We aimed to assess the diagnostic value of urinary C-peptide (UCP) and urinary C-peptide creatinine ratio (UCPCR) to diagnose IR in obese children. METHODS This prospective cross-sectional study was performed on 60 children with obesity as the study group. Sixty healthy children of matched age and sex with normal body mass index (BMI) served as the control group. Hemostasis model for the assessment of IR (HOMA-IR), glycated hemoglobin (HbA1c), fasting blood glucose and insulin, UCP, and UCPCR were assessed in all included children. RESULTS UCP and UCPCR were significantly higher in children with obesity (2.075 ± 0.783) ng/ml, (0.200 ± 0.021) nmol/mmol compared to the control group (1.012 ± 0.465) ng/ml, (0.148 ± 0.016) nmol/mmol, respectively. Both UCP and UCPCR were positively correlated with each other and with HOMA-IR, HbA1c, acanthosis nigricans, waist circumference, and BMI. At cutoff ≥2.45, the sensitivity of UCP to diagnose IR in obese children was 71.4%. At cutoff ≥0.20, the sensitivity of UCPCR to diagnose IR in obese children was 87.6%. CONCLUSIONS UCP and UCPCR are promising surrogate markers of IR in children and adolescents with obesity. However, UCPCR is a better marker than UCP. IMPACT Obesity is associated with IR. Identifying high-risk obese children affected with IR is crucial to apply preventive management. We aimed to assess the diagnostic value of UCP and UCPCR to detect IR in obese children. To the best of our knowledge, we are the first to use UCP and UCPCR to assess IR in obese children. We found that UCP and UCPCR are practical, easy, dependable noninvasive markers to assess IR in children with obesity and could potentially be useful in epidemiological studies and clinical practice.
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Affiliation(s)
- Ahmed Arafa Hassan
- Pediatric Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Sara Elshall
- Pediatric Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Adel Erfan
- Pediatric Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Mona Hafez
- Pediatric Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Wesam Salah
- Clinical Pathology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Shaymaa Elrifaey
- Pediatric Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Doaa El Amrousy
- Pediatric Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
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Engwa GA, Schmid-Zalaudek K, Anye C, Letswalo BP, Anye PC, Mungamba MM, Sewani-Rusike CR, Goswami N, Nkeh-Chungag BN. Assessment of Anthropometric Indices for Optimal Cut-Offs for Obesity Screening in a South African Adolescent Population. BIOLOGY 2021; 10:biology10111118. [PMID: 34827111 PMCID: PMC8614919 DOI: 10.3390/biology10111118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/05/2021] [Accepted: 10/15/2021] [Indexed: 11/29/2022]
Abstract
Simple Summary The diagnosis of obesity in sub-Saharan African children relies on cut-off values for body mass index percentile (pBMI) and waist-to-height ratio (WtHR) established in western populations. Hence, this study assessed anthropometric indices to determine optimal cut-off values for obesity screening in the South African adolescent population. Findings from this study showed that the cut-off value for pBMI was p85.2th, which improved the sensitivity of the test by approximately 30% compared to the CDC recommended BMI percentile of p95.0th. Moreover, the optimal cut-off for WHtR was 0.481, which was close to the recommended cut-off value of 0.5. This study reveals a lower pBMI cut-off value, different from the CDC recommended cut-off, for screening obesity in a South African adolescent population and suggests that the optimal pBMI cut-off for obesity screening may be ethnic-specific. Abstract The assessment of obesity in sub-Saharan Africa relies on cut-offs established from western populations. This study assessed anthropometric indices to determine optimal cut-off values for obesity screening in the South African adolescent population. A cross-sectional study involving 1144 (796 females and 348 males) adolescents aged 11–17 years from the Eastern Cape Province of South African was conducted. Anthropometric parameters were measured. Receiver operating characteristic (ROC) analysis was performed to assess the sensitivity and specificity of obesity screening tools and establish cut-offs. The optimal cut-offs for obesity in the cohort using waist-to-height ratio (WHtR) as reference were: neck circumference (NC) = 30.6 cm, mid-upper arm circumference (MUAC) = 25.9 cm, waist circumference (WC) = 75.1 cm, hip circumference (HC) = 92.15 cm and body mass index percentile (pBMI) = p85.2th. The new pBMI cut-off value at p85.2th improved the sensitivity of the test by approximately 30% compared to the CDC recommended BMI percentile (pBMIr) of p95.0th. When pBMI was used as reference, the optimal cut-offs in the cohort were: WHtR = 0.481, NC = 30.95 cm, MUAC = 27.95 cm, WC = 76.1 cm and HC = 95.75 cm. The WHtR optimal cut-off of 0.481 was close to the recommended cut-off value of 0.5. The predicted prevalence of obesity obtained using cut-offs from ROC analysis was higher than those from recommended references. All cut-off values for the various anthropometric measures generally increased with age for all percentile ranges. This study reveals a lower pBMI cut-off value, different from the CDC recommended cut-off, for screening obesity in a South African adolescent population. The study has established that the optimal pBMI cut-off for obesity screening may be ethnic-specific.
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Affiliation(s)
- Godwill Azeh Engwa
- Department of Biological and Environmental Sciences, Faculty of Natural Sciences, Walter Sisulu University, Mthatha 5117, South Africa;
| | - Karin Schmid-Zalaudek
- Physiology Division, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Neue Stiftingtalstrasse 6, D-5 A 8036 Graz, Austria;
| | - Chungag Anye
- Dayenuel Consulting, Postnet Suites 092, Mthatha 5099, South Africa;
| | - Boitumelo P. Letswalo
- Department of Human Biology, Faculty of Natural Sciences, Walter Sisulu University, Mthatha 5177, South Africa; (B.P.L.); (M.M.M.); (C.R.S.-R.)
| | - Paul Chungag Anye
- MBCHB Programme, Faculty of Health Sciences, Walter Sisulu University PBX1, Mthatha 5117, South Africa;
| | - Muhau Muhulo Mungamba
- Department of Human Biology, Faculty of Natural Sciences, Walter Sisulu University, Mthatha 5177, South Africa; (B.P.L.); (M.M.M.); (C.R.S.-R.)
| | - Constance Rufaro Sewani-Rusike
- Department of Human Biology, Faculty of Natural Sciences, Walter Sisulu University, Mthatha 5177, South Africa; (B.P.L.); (M.M.M.); (C.R.S.-R.)
| | - Nandu Goswami
- Physiology Division, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Neue Stiftingtalstrasse 6, D-5 A 8036 Graz, Austria;
- Correspondence: (N.G.); (B.N.N.-C.)
| | - Benedicta Ngwenchi Nkeh-Chungag
- Department of Biological and Environmental Sciences, Faculty of Natural Sciences, Walter Sisulu University, Mthatha 5117, South Africa;
- Correspondence: (N.G.); (B.N.N.-C.)
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Zang XD, Hu QH, Liu XX, Da M, Yang ZC, Qi JR, Mo XM. Serum vitamin E concentration is negatively associated with body mass index change in girls not boys during adolescence. World J Pediatr 2021; 17:517-526. [PMID: 34468958 DOI: 10.1007/s12519-021-00454-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 08/11/2021] [Indexed: 01/16/2023]
Abstract
BACKGROUND Vitamin E is the most abundant lipid-soluble antioxidants present in plasma; however, the relationship between serum vitamin E and change in body mass index (BMI)-for-age Z scores in adolescents has not been well described. METHODS This study is a cross-sectional study. Data were analyzed from 4014 adolescents who participated in the National Health and Nutrition Examination Survey. The nutritional status was calculated by BMI Z scores and was classified into normal weight, overweight, and obese. Multivariable-adjusted logistic regression was used to examine the association between serum vitamin E levels with overweight/obesity. Besides, the interaction effects between potential confounders and vitamin E on obesity were further evaluated. RESULTS After adjusting potential confounders, serum vitamin E levels were negatively associated with overweight/obesity in girls but not in boys. Per standard deviation increment in vitamin E concentrations was associated with a 92% decreased risk of obesity in females. Besides, lower quartiles of serum vitamin E were associated with a higher risk of overweight/obesity in girls. Moreover, the inverse association between serum vitamin E levels and obesity was also found in most subgroups through subgroup analysis. CONCLUSIONS Our study supports the negative association between serum vitamin E levels and overweight/obesity in adolescents. A higher serum vitamin E level may be associated with a reduced probability of obesity in girls, but not in boys.
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Affiliation(s)
- Xiao-Dong Zang
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Jiangdong South No.8 Road, Nanjing, 210008, China.,The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, China
| | - Qing-Hui Hu
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Jiangdong South No.8 Road, Nanjing, 210008, China
| | - Xiao-Xu Liu
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Jiangdong South No.8 Road, Nanjing, 210008, China
| | - Min Da
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Jiangdong South No.8 Road, Nanjing, 210008, China
| | - Zhao-Cong Yang
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Jiangdong South No.8 Road, Nanjing, 210008, China
| | - Ji-Rong Qi
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Jiangdong South No.8 Road, Nanjing, 210008, China
| | - Xu-Ming Mo
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Jiangdong South No.8 Road, Nanjing, 210008, China.
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Diagnostic Performance and Appropriate Cut-Offs of Different Anthropometric Indicators for Detecting Children with Overweight and Obesity. BIOMED RESEARCH INTERNATIONAL 2021; 2021:1608760. [PMID: 34568486 PMCID: PMC8457951 DOI: 10.1155/2021/1608760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 07/29/2021] [Accepted: 08/07/2021] [Indexed: 12/12/2022]
Abstract
In the clinical settings, different anthropometric indicators like neck circumference (NC), waist circumference (WC), midupper arm circumference (MUAC), waist-to-height ratio (WHtR), and arm-to-height ratio (AHtR) have been suggested for evaluating overweight and obesity in children. The comparative ability of these indicators in Pakistan is yet unknown. This study is aimed at examining the validity of different anthropometric indicators of overweight and obesity simultaneously and at determining their superlative cut-off values that would correctly detect overweight and obesity in children. For this purpose, the dataset of anthropometric measurements height, weight, WC, MUAC, and NC of 5,964 Pakistani children, aged 5-12 years collected in a cross-sectional multiethnic anthropometric survey (MEAS), was used. Receiver operating characteristic (ROC) curve analysis was performed to assess the validity of different anthropometric indicators. The most sensitive and specific cut-off points, positive and negative predictive values of each indicator were also calculated. The results of the ROC curve indicated that all the studied indicators had a good performance but the indicators AHtR and WHtR had the highest value of the area under the curve (AUC) for the screening of children with overweight and obesity (AUC > 0.80). In the overall sample, AHtR, WHtR, MUAC, WC, and NC cut-off points indicative of overweight, in both boys and girls, were 0.14, 0.46, 18.41 cm, 62.86 cm, and 26.36 cm and 0.14, 0.47, 18.16 cm, 64.39 cm, and 26.54 cm, respectively; the corresponding values for obesity were 0.14, 0.47, 18.67 cm, 62.10 cm, and 26.36 cm and 0.14, 0.48, 20.19 cm, 64.39 cm, and 25.27 cm. We concluded that the sex-specific cut-off points for AHtR, WHtR, MUAC, WC, and NC can be used to diagnose overweight and obesity in Pakistani children.
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Hirschler V, Molinari C, Lapertosa S, Maccallini G, Gonzalez CD. Cardiometabolic markers among Argentinean normal weight and overweight children with and without central obesity. Endocr Connect 2021; 10:902-908. [PMID: 34261036 PMCID: PMC8346185 DOI: 10.1530/ec-21-0139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 07/14/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND The association between central obesity and cardiometabolic complications justifies exploring its association in normal-weight and overweight/obese (OW/OB) schoolchildren. OBJECTIVE To describe cardiometabolic markers in four groups according to BMI/WC categories: (i) normal weight with central OB; (ii) normal weight without central OB; (iii) OW/OB with central OB and (iv) OW/OB without central OB, in a sample of Argentinean schoolchildren. METHODS A cross-sectional study of 1264 Argentinean schoolchildren (624 F), aged 9.5 ± 2.2 years was performed between November 2013 and 2015. Children's anthropometric measures, blood pressure (BP), glucose, lipids, and insulin were measured. Children were divided into four groups: (i) normal weight with central OB; (ii) normal weight without central OB; (iii) OW/OB with central OB and (iv) OW/OB without central OB. RESULTS The prevalence of normal-weight children without central OB was 64.3% (796), normal weight with central OB 5% (66), OW/OB without central OB 11% (137), and OW/OB with central OB 21% (265). Normal weight with central OB had significantly higher triglycerides than normal-weight children without central OB (86 vs 70 mg/dL, respectively) and OW/OB children without central OB (81 vs 77 mg/dL). Multiple linear regression analyses showed that age, systolic BP, HDL-C, triglycerides, and maternal WC were significantly associated with children's WC; R2 = 0.50 as well as children's BMI; R2 = 0.37. CONCLUSION This study found that children with central OB might be at future higher cardiometabolic risk than those without central OB independently of the presence of OW/OB. However, future longitudinal studies should be performed to confirm these findings.
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Affiliation(s)
- Valeria Hirschler
- University of Buenos Aires, Buenos Aires, Argentina
- Correspondence should be addressed to V Hirschler:
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Rhee KE, Manzano M, Goffin S, Strong D, Boutelle KN. Exploring the relationship between appetitive behaviours, executive function, and weight status among preschool children. Pediatr Obes 2021; 16:e12774. [PMID: 33530135 PMCID: PMC9186098 DOI: 10.1111/ijpo.12774] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 12/15/2020] [Accepted: 01/15/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The goal was to conduct exploratory analysis to determine if executive functions (EFs) and food responsiveness/satiety responsiveness (appetitive behaviours that describe one's tendency to eat in the presence of food or food cues) interact to influence weight status among preschool children participating in a trial promoting self-regulation around energy-dense foods. METHODS At baseline, parents completed the Behaviour Rating Inventory of Executive Function-Preschool and the Child Eating Behaviour Questionnaire. Children completed anthropometric measurements at the preschool. Spearman's correlation, linear regression, and tests of interaction were conducted. The relationship between weight status and EFs among those who were high vs low in food responsiveness and satiety responsiveness was examined. RESULTS Children (n = 92) had a mean age of 5.1 years and body mass index (BMI) percentile of 57.6; half (54%) were male. There were significant correlations between food responsiveness and several EFs (emotional control, inhibitory control, working memory, and plan/organize). In the stratified analysis, children with high food responsiveness or low satiety responsiveness had higher BMI percentiles as emotional control skills worsened. BMI percentiles were not elevated among children with low food responsiveness and poor emotional control. CONCLUSION These results suggest that EFs may be more relevant to weight status if preschool children had high levels of food responsiveness or low levels of satiety responsiveness (ie, increased tendency to be influenced by environmental food cues). This analysis should be replicated with direct measures of executive function and appetitive behaviours in larger samples of young children to examine longitudinal impact on weight status.
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Affiliation(s)
- Kyung E. Rhee
- Department of Pediatrics, University of California, San Diego School of Medicine, 9500 Gilman Drive, La Jolla, CA 92093. USA
| | - Michael Manzano
- Department of Pediatrics, University of California, San Diego School of Medicine, 9500 Gilman Drive, La Jolla, CA 92093. USA.,San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Court, Suite 103, San Diego, CA 92120. USA
| | - Stanny Goffin
- Department of Pediatrics, University of California, San Diego School of Medicine, 9500 Gilman Drive, La Jolla, CA 92093. USA
| | - David Strong
- Department of Family Medicine and Public Health, University of California, San Diego School of Medicine, 9500 Gilman Drive, La Jolla, CA 92093. USA
| | - Kerri N. Boutelle
- Department of Pediatrics, University of California, San Diego School of Medicine, 9500 Gilman Drive, La Jolla, CA 92093. USA.,Department of Family Medicine and Public Health, University of California, San Diego School of Medicine, 9500 Gilman Drive, La Jolla, CA 92093. USA.,Department of Psychiatry, University of California, San Diego School of Medicine, 9500 Gilman Drive, La Jolla, CA 92093. USA
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10
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Geiger SD, Yao P, Vaughn MG, Qian Z. PFAS exposure and overweight/obesity among children in a nationally representative sample. CHEMOSPHERE 2021; 268:128852. [PMID: 33223205 DOI: 10.1016/j.chemosphere.2020.128852] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 10/29/2020] [Accepted: 10/31/2020] [Indexed: 05/22/2023]
Abstract
PURPOSE Perfluoroalkyl substances (PFASs) are a class of manmade chemicals commonly used in consumer product manufacturing. Perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) are two of the most highly studied PFASs. Both are present in the blood of the most Americans. PFASs are associated with intermediate cardiovascular disease (CVD) outcomes, but their relationship with obesity, a risk factor for intermediate and advanced CVD, remains largely unconfirmed. In this context, we aimed to explore the relationship between PFASs and both overweight/obesity and abdominal obesity among children. METHODS We examine associations between PFOA and PFOS levels, and Body Mass Index (BMI) and waist circumference (WC) in a representative sample (N = 2473) of US children, aged 12-18 years from the Centers for Disease Control and Prevention's National Health and Nutrition Examination Survey 1999-2012. Overweight/obesity is defined as age-, sex-specific BMI z-score ≥ 85th percentile; abdominal obesity is defined as age-, sex-specific waist circumference ≥90th percentile. RESULTS Associations between PFASs and anthropometric outcomes show a dose-response relationship overall. For overweight/obese BMI z-score, findings indicate OR = 1.42 and 95% CI: 0.85-2.38 for quartile 2 of PFOA exposure; OR = 2.22 (95% CI: 1.20-4.13) for quartile 3 of PFOA exposure; and OR = 2.73 (95% CI:1.10-6.74) for quartile 4 of PFOA exposure. DISCUSSION Findings indicate an association between elevated PFOA and overweight/obesity among children after multivariable adjustment.
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Affiliation(s)
- Sarah Dee Geiger
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, 61820, USA; Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, USA.
| | - Ping Yao
- School of Health Studies, Northern Illinois University, DeKalb, IL, USA.
| | - Michael G Vaughn
- School of Social Work, College for Public Health & Social Justice, Saint Louis University, Tegeler Hall, 3550 Lindell Boulevard, St. Louis, MO, 63103, USA.
| | - Zhengmin Qian
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, 3545 Lafayette Avenue, Saint Louis, MO, 63104, USA.
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11
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Integrative Analysis of Lipid Profiles in Plasma Allows Cardiometabolic Risk Factor Clustering in Children with Metabolically Unhealthy Obesity. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2020; 2020:2935278. [PMID: 33299523 PMCID: PMC7710435 DOI: 10.1155/2020/2935278] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 07/09/2020] [Accepted: 07/20/2020] [Indexed: 12/12/2022]
Abstract
Hypertension, central obesity, hyperglycemia, and dyslipidemia are key risk factors for cardiovascular disease. However, the specific factors contributing to the development of unfavorable cardiometabolic characteristics in children with obesity are unknown. In this study, we investigated the cross-sectional relationships between cytokines, irisin, and fatty acid (FA) composition in plasma in school-age children with metabolically healthy and unhealthy obesity (MHO and MUO, respectively) of the same age and body mass index and waist circumference percentiles. We compared the data with that of children with normal weight (NW). We found that inflammatory cytokines and low irisin plasma concentrations are associated with obesity but not with cardiometabolic risk (CMR). Lipid profiles showed that children with MUO have a distinctive FA profile compared with children with MHO and NW, whereas children with MHO shared 88% of the FA profile with the NW group. Among all FAs, concentration of myristic acid (14 : 0), arachidic acid (20 : 0), and n-3 polyunsaturated FAs (PUFAs) was higher in children with MHO, whereas n-6 PUFAs such as arachidonic acid (20 : 4n6) had a significant contribution in defining MUO. These data suggest that the plasma FA profile is not only a central link to obesity but also may act as an indicator of CMR presence.
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12
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Lee JS, Song YH. Relationship between Waist Circumference and Cardiovascular Risk Factors in Adolescents: Analysis of the Korea National Health and Nutrition Examination Survey Data. Korean Circ J 2020; 50:723-732. [PMID: 32725980 PMCID: PMC7390717 DOI: 10.4070/kcj.2019.0329] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 03/23/2020] [Accepted: 04/16/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND AND OBJECTIVES High waist circumference (WC) is associated with increased cardiovascular risk (CVR) in adulthood. We investigated this association in adolescents. METHODS We performed a cross-sectional analysis of data for 10-18-year-olds included in the Korea National Health and Nutrition Examination Survey (KNHANES) (2005-2014). The association between WC and CVR factors was evaluated. We analyzed this relationship according to age. RESULTS We analyzed 8,153 participants (4,319 boys and 3,834 girls) from the KNHANES. High WC was associated with increased incidence of CVR factors: hypertension (odds ratio [OR], 3.5 in boys, 1.9 in girls), high total cholesterol (OR, 3.9 in boys, 1.9 in girls), high triglycerides (OR, 4.9 in boys, 3.2 in girls), high low-density lipoprotein (LDL) cholesterol (OR, 5.0 in boys, 1.8 in girls), low high-density lipoprotein (HDL) cholesterol (OR, 2.6 in boys, 3.0 in girls), and hyperglycemia (OR, 2.8 in girls). In boys, the association between high WC and hypertension, high triglycerides, and low HDL cholesterol was noted in early adolescence. High WC was associated with high total cholesterol and high LDL cholesterol in middle adolescence. In girls, high WC was correlated with high total cholesterol, high triglycerides, and low HDL cholesterol in early adolescence. High WC was shown to be associated with hyperglycemia in middle adolescence, and with hypertension and high LDL cholesterol in late adolescence. CONCLUSIONS High WC in adolescents is associated with increased CVR. The timing of this association differs according to sex and CVR factors.
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Affiliation(s)
- Jue Seong Lee
- Department of Pediatrics, Korea University Medical Center, Korea University College of Medicine, Seoul, Korea
| | - Young Hwan Song
- Division of Pediatric Cardiology, Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.
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13
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Zhu Y, Lin Q, Zhang Y, Deng H, Hu X, Yang X, Yao B. Mid-upper arm circumference as a simple tool for identifying central obesity and insulin resistance in type 2 diabetes. PLoS One 2020; 15:e0231308. [PMID: 32437358 PMCID: PMC7241705 DOI: 10.1371/journal.pone.0231308] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 03/20/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Our research aimed to explore the correlation between mid-upper arm circumference (MUAC) and central obesity and insulin resistance (IR) in Chinese subjects with type 2 diabetes. MATERIALS A total of 103 participants (60 men) were recruited in our study. MUAC was measured around the mid-arm between the shoulder and elbow. Waist circumference (WC) was obtained as central obesity parameter, and the IR parameter of Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) was calculated. The subjects were divided into three groups according to the tertiles cut-points of MUAC level. RESULTS Body mass index (BMI), WC, the percentages of central obesity and HOMA-IR were significantly higher in the groups with higher MUAC than those in the group with lower MUAC (all P < 0.05). Pearson analysis showed that MUAC was correlated with BMI, WC, waist-to-hip ratio (WHR), logHOMA-IR, low density lipoprotein cholesterol (LDL-C), uric acid (UA) and high density lipoprotein cholesterol (HDL-C) in all subjects. Multivariate linear regression analysis revealed that MUAC was independently associated with logHOMA-IR (β = 0.036, P<0.001) after adjusting for age, gender, WHR, UA, TG, LDL-C and HDL-C. Binary logistic regression analysis revealed that MUAC was an independent predictor of central obesity (OR: 2.129, 95%CI: 1.311-3.457, P = 0.002). Furthermore, MUAC≥30.9cm for male and ≥30.0cm for female were the optimal cutoff values for identifying central obesity. CONCLUSIONS Our study indicated that among Chinese subjects with type 2 diabetes, MUAC is a simple and effective tool for the determination of central obesity and IR. Additionally, the larger MUAC is proved to be more associated with metabolic risk factors of higher UA and LDL-C and lowever HDL-C.
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Affiliation(s)
- Yanhua Zhu
- Department of Endocrinology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Qiongyan Lin
- Department of Endocrinology, Jieyang People’s Hospital (Jieyang Affiliated Hospital, Sun Yat-sen University), Jieyang, Guangdong, China
| | - Yao Zhang
- Department of Endocrinology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Hongrong Deng
- Department of Endocrinology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xiling Hu
- Department of Endocrinology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xubin Yang
- Department of Endocrinology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- * E-mail: (BY); (XY)
| | - Bin Yao
- Department of Endocrinology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- * E-mail: (BY); (XY)
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14
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Wang HH, Lee DK, Liu M, Portincasa P, Wang DQH. Novel Insights into the Pathogenesis and Management of the Metabolic Syndrome. Pediatr Gastroenterol Hepatol Nutr 2020; 23:189-230. [PMID: 32483543 PMCID: PMC7231748 DOI: 10.5223/pghn.2020.23.3.189] [Citation(s) in RCA: 116] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 04/17/2020] [Accepted: 04/21/2020] [Indexed: 02/06/2023] Open
Abstract
The metabolic syndrome, by definition, is not a disease but is a clustering of individual metabolic risk factors including abdominal obesity, hyperglycemia, hypertriglyceridemia, hypertension, and low high-density lipoprotein cholesterol levels. These risk factors could dramatically increase the prevalence of type 2 diabetes and cardiovascular disease. The reported prevalence of the metabolic syndrome varies, greatly depending on the definition used, gender, age, socioeconomic status, and the ethnic background of study cohorts. Clinical and epidemiological studies have clearly demonstrated that the metabolic syndrome starts with central obesity. Because the prevalence of obesity has doubly increased worldwide over the past 30 years, the prevalence of the metabolic syndrome has markedly boosted in parallel. Therefore, obesity has been recognized as the leading cause for the metabolic syndrome since it is strongly associated with all metabolic risk factors. High prevalence of the metabolic syndrome is not unique to the USA and Europe and it is also increasing in most Asian countries. Insulin resistance has elucidated most, if not all, of the pathophysiology of the metabolic syndrome because it contributes to hyperglycemia. Furthermore, a major contributor to the development of insulin resistance is an overabundance of circulating fatty acids. Plasma fatty acids are derived mainly from the triglycerides stored in adipose tissues, which are released through the action of the cyclic AMP-dependent enzyme, hormone sensitive lipase. This review summarizes the latest concepts in the definition, pathogenesis, pathophysiology, and diagnosis of the metabolic syndrome, as well as its preventive measures and therapeutic strategies in children and adolescents.
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Affiliation(s)
- Helen H. Wang
- Department of Medicine and Genetics, Division of Gastroenterology and Liver Diseases, Marion Bessin Liver Research Center, Einstein-Mount Sinai Diabetes Research Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Dong Ki Lee
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Min Liu
- Department of Pathology and Laboratory Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Piero Portincasa
- Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari Medical School, Bari, Italy
| | - David Q.-H. Wang
- Department of Medicine and Genetics, Division of Gastroenterology and Liver Diseases, Marion Bessin Liver Research Center, Einstein-Mount Sinai Diabetes Research Center, Albert Einstein College of Medicine, Bronx, NY, USA
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Predictive Ability of Waist Circumference and Waist-to-Height Ratio for Cardiometabolic Risk Screening among Spanish Children. Nutrients 2020; 12:nu12020415. [PMID: 32033484 PMCID: PMC7071136 DOI: 10.3390/nu12020415] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 01/16/2020] [Accepted: 02/02/2020] [Indexed: 11/17/2022] Open
Abstract
An excess of fat mass has been associated with adverse cardiometabolic risk factors. Different anthropometric measures have been proposed as alternative non-invasive measures for obesity-related cardiometabolic risk. To evaluate the magnitude of association between waist circumference (WC) and waist-to-height ratio (WtHR) with cardiometabolic risk factors and metabolic syndrome and to determine the WtHR cutoff associated with a more favorable cardiometabolic risk profile in Spanish children, data were taken from a cross-sectional survey conducted in 2010 among 848 schoolchildren aged 8–11 years from 20 public schools in the province of Cuenca (Spain). Anthropometric variables, glucose, insulin, triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), systolic (SBP) and diastolic blood pressure (DBP) and metabolic syndrome (MetS) were also analyzed. WtHR and WC had a good accuracy for TG, insulin, and MetS. The diagnostic odds ratio ranged from 2.95 to 9.07 for WtHR and from 5.30 to 27.40 for WC. The main result of the present study suggests that both WtHR and WC could be used as a screening tool to identify children with cardiometabolic abnormalities.
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16
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Radetti G, Fanolla A, Grugni G, Lupi F, Sartorio A. Indexes of adiposity and body composition in the prediction of metabolic syndrome in obese children and adolescents: Which is the best? Nutr Metab Cardiovasc Dis 2019; 29:1189-1196. [PMID: 31378631 DOI: 10.1016/j.numecd.2019.06.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 06/13/2019] [Accepted: 06/13/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND AIM There is no agreement about which index of adiposity and/or body composition is the most accurate in identifying the metabolic syndrome (METS). The aim of our study was to compare the accuracy of the different indexes in order to recognize the most reliable. METHODS AND RESULTS We evaluated 1332 obese children and adolescents (778 females and 554 males), aged 14.4 ± 1.8 yrs, Body Mass Index (BMI) standard deviation scores (SDS) 2.99 ± 0.55, followed at the Istituto Auxologico Italiano, a tertiary center for childhood obesity. For each subject the following indexes were assessed: BMI, BMI SDS, Fat-Free Mass Index (FFMI), Fat Mass Index (FMI), Tri-Ponderal Mass Index (TMI), Waist-to-Height ratio (WtHR) and a new one, the Body Mass Fat Index (BMFI), which normalizes the BMI for percentage of body fat and the waist circumference. Thereafter we calculated for each index a threshold value for age and sex, in order to compare their accuracy, sensitivity and specificity in identifying the METS. There was a good correlation among indexes (p < 0.0001 for all). However, when the area under the curve (AUC) was compared, some of them, in particular the BMFI and the BMI, performed better than the other ones, although the differences were small. CONCLUSIONS BMI, which neither considers body composition nor fat distribution, performs as good as other indexes, and should therefore be the preferred one, also because of the easiness of its calculation.
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Affiliation(s)
| | - Antonio Fanolla
- Observatory for Health Provincial Government South Tyrol, Italy
| | - Graziano Grugni
- Istituto Auxologico Italiano, Experimental Laboratory for Auxo-endocrinological Research & Division of Auxology, Verbania, Italy
| | - Fiorenzo Lupi
- Department of Pediatrics, Regional Hospital of Bolzano, Italy
| | - Alessandro Sartorio
- Istituto Auxologico Italiano, Experimental Laboratory for Auxo-endocrinological Research & Division of Auxology, Verbania, Italy
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17
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Cruz NRC, Cardoso PC, Frossard TNSV, Ferreira FDO, Brener S, Gomides AFDF, Valente MAS, Velloso-Rodrigues C. Waist circumference as high blood pressure predictor in school age children. CIENCIA & SAUDE COLETIVA 2019; 24:1885-1893. [PMID: 31166521 DOI: 10.1590/1413-81232018245.18012017] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 08/16/2017] [Indexed: 11/22/2022] Open
Abstract
Childhood hypertension is becoming more common with the increasing numbers of child obesity, which has encouraged new studies to identify a good anthropometric marker for high blood pressure levels. The objective this study was to identify the best anthropometric predictor of risk of hypertension in children between 8-10 years of age. The Children were evaluated for socioeconomic status and their blood pressure (BP), weight, height, waist circumference (WC) and percentage of body fat (PBF) were measured. The study included 445 children, of which 50.1% were females. The prevalence of obesity defined by body mass index (BMI) was 14.6%. Increased BP was found in 3.4% and 2.2% of the children, considering the pre-hypertension and hypertension classifications respectively. The arithmetic mean of BP value correlated significantly with BMI, WC and PBF. After height control, the correlations that were maintained significant were between WC and systolic blood pressure (SBP) and between WC and diastolic blood pressure (DBP). The variable with the highest predictive power of the occurrence of hypertension was WC. The results indicate that, in this population of children between 8 and 10 years old, WC is a measurement of higher value in predicting increased BP.
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Affiliation(s)
| | - Pollyanna Costa Cardoso
- Universidade Federal de Juiz de Fora. R. José de Tassis 350, Vila Bretas. 35030-250 Governador Valadares MG Brasil.
| | | | | | - Stela Brener
- Fundação e Centro de Hemoterapia e Hematologia de Minas Gerais. Belo Horizonte MG Brasil
| | | | - Maria Anete Santana Valente
- Universidade Federal de Juiz de Fora. R. José de Tassis 350, Vila Bretas. 35030-250 Governador Valadares MG Brasil.
| | - Cibele Velloso-Rodrigues
- Universidade Federal de Juiz de Fora. R. José de Tassis 350, Vila Bretas. 35030-250 Governador Valadares MG Brasil.
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18
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Fazeli M, Mohammad-Zadeh M, Darroudi S, Meshkat Z, Moslem A, Ghazizadeh H, Kargozar S, Ferns G, Bahrami-Taghanaki H, Ghayour-Mobarhan M. New anthropometric indices in the definition of metabolic syndrome in pediatrics. Diabetes Metab Syndr 2019; 13:1779-1784. [PMID: 31235094 DOI: 10.1016/j.dsx.2019.03.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 03/14/2019] [Indexed: 02/02/2023]
Abstract
Pediatrics metabolic syndrome (MetS) may be associated with the risk of development of chronic diseases in adulthood; however, the definition of pediatric MetS is unclear, and may vary with ethnicity. The primary goal of this study was to determine the best anthropometric predictors for pediatric MetS. For this purpose, 988 high school girls were recruited. Anthropometric indices and biochemical parameters were measured using standard procedures. The adapted MetS for pediatrics, including the IDF, NCEP, and two modified-NCEPs (Cook's and DeFerranti's) were used to establish a diagnosis of MetS. Statistical analysis was performed using SPSS and MedCalc softwares. Except for body frame size (r), the values for anthropometric indices were significantly lower in an individual without MetS. Waist to height (WHtR), BMI and hip circumference (HiC) showed the strongest association with the different MetS definitions. For the IDF definition, the highest sensitivity and specificity were observed for HiC (100.0, 85.2) and WHtR (100.0, 84.7); while for the NCEP definition, the r index showed the highest sensitivity (85.0); but low specificity made it inapplicable. For the Cook's definition of MetS, wrist circumference (WrC), HiC, WHtR, BMI and SR had similar sensitivity values with WC (92.9%), and HiC (85.3%) have the highest specificity. WHtR (86.05, 80.5), SR (86.05, 82.7) and HiC (76.7, 87.0) sensitivity and specificity were the best indexes for DeFerranti's criteria. Based on this date, we concluded that HiC and WHtR might be helpful as auxiliary indexes for pediatric MetS definition; however, further studies are required in both genders.
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Affiliation(s)
- Mostafa Fazeli
- Molecular Medicine Group, Department of Modern Sciences and Technologies, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Mohammad-Zadeh
- Department of Physiology & Pharmacology, Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Susan Darroudi
- Molecular Medicine Group, Department of Modern Sciences and Technologies, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Meshkat
- Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Moslem
- Department of Anesthesiology, Faculty of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Hamideh Ghazizadeh
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saeid Kargozar
- Tissue Engineering Research Group (TERG), Department of Anatomy and Cell Biology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon Ferns
- Division of Medical Education, Brighton & Sussex Medical School, Falmer, Brighton, Sussex, BN1 9PH, UK
| | | | - Majid Ghayour-Mobarhan
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
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Pozuelo-Carrascosa DP, Cavero-Redondo I, Herráiz-Adillo Á, Díez-Fernández A, Sánchez-López M, Martínez-Vizcaíno V. School-Based Exercise Programs and Cardiometabolic Risk Factors: A Meta-analysis. Pediatrics 2018; 142:peds.2018-1033. [PMID: 30337478 DOI: 10.1542/peds.2018-1033] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/30/2018] [Indexed: 11/24/2022] Open
Abstract
CONTEXT The effects of school-based physical activity (PA) programs on different cardiometabolic risk factors and the most appropriate features of PA programs to achieve maximum effectiveness are unclear. OBJECTIVE To provide a comprehensive synthesis of the effectiveness of school-based PA interventions on cardiometabolic risk factors in children. DATA SOURCES We identified studies from database inception to February 22, 2018. STUDY SELECTION We selected studies that were focused on examining the effect of school-based PA interventions on cardiometabolic risk factors in children. DATA EXTRACTION Random-effects models were used to calculate the pooled effect size (ES) for the included cardiometabolic risk factors (waist circumference [WC], triglycerides, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, systolic blood pressure and diastolic blood pressure (DBP), and fasting insulin and glucose). RESULTS Nineteen randomized controlled trials (which included 11 988 children aged 3-12 years) were included in the meta-analysis. School-based PA programs were associated with a significant small improvement in WC (ES = -0.14; 95% confidence interval [CI]: -0.22 to -0.07; P < .001), DBP (ES = -0.21; 95% CI: -0.42 to -0.01; P = .040), and fasting insulin (ES = -0.12; 95% CI: -0.20 to -0.04; P = .003). LIMITATIONS Authors of few studies described the implementation conditions of their interventions in detail, and compliance rates were lacking in most studies. In addition, results by sex were provided in a small number of studies. CONCLUSIONS School-based PA interventions improve some cardiometabolic risk factors in children, such as WC, DBP, and fasting insulin.
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Affiliation(s)
| | | | - Ángel Herráiz-Adillo
- Social and Health Care Research Center and.,Department of Primary Care, Health Service of Castilla-La Mancha, Tragacete, Cuenca, Spain
| | - Ana Díez-Fernández
- Social and Health Care Research Center and.,Faculty of Nursing, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Mairena Sánchez-López
- Social and Health Care Research Center and.,Faculty of Education, Universidad de Castilla-La Mancha, Ciudad Real, Spain; and
| | - Vicente Martínez-Vizcaíno
- Social and Health Care Research Center and.,Faculty of Health Science, Universidad Autónoma de Chile, Talca, Chile
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20
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Andaki ACR, Mendes EL, Santos A, Brito CJ, Tinôco ALA, Mota J. Waist circumference percentile curves as a screening tool to predict cardiovascular risk factors and metabolic syndrome risk in Brazilian children. CAD SAUDE PUBLICA 2018; 34:e00105317. [PMID: 30208174 DOI: 10.1590/0102-311x00105317] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 04/06/2018] [Indexed: 01/19/2023] Open
Abstract
The goals of this study were to develop reference values for waist circumference (WC) in Brazilian children between 6-10 years old and to evaluate the WC performance in predicting cardiovascular risk factors and metabolic syndrome (MetS) in children. This is a population-based epidemiological cross-sectional study, in which 1,397 children participated, with a 6-10 years old probability sampling and from public and private schools in the city of Uberaba, Minas Gerais State, Brazil. WC was measured at the waist narrowest point (WC1) and at the umbilicus level (WC2). Blood samples and blood pressure were collected to determine the MetS diagnosis. There was a significant effect of age (p = 0.001), anatomical point (WC1 vs. WC2, p = 0.001) and sex-anatomical point interaction (p = 0.016) for WC. Smoothed sex- and age-specific 5th, 10th, 25th, 50th, 75th, 90th and 95th percentile curves of WC1 and WC2 were designed by the LMS method. WC was accurate to predict MetS, for all ages [area under the ROC curve (AUC) > 0.79 and p < 0.05], regardless of sex. This study presented percentile curves for WC at two anatomical points in a representative sample of Brazilian children. Furthermore, WC was shown to be a strong predictor of cardiovascular risk factors and MetS in children.
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Affiliation(s)
| | - Edmar Lacerda Mendes
- Departamento de Ciências do Esporte, Universidade Federal do Triângulo Mineiro, Uberaba, Brasil
| | - Amanda Santos
- Centro de Investigação em Actividade Física, Saúde e Lazer, Universidade do Porto, Porto, Portugal
| | - Ciro Jose Brito
- Faculdade de Educação Física, Universidade Federal de Juiz de Fora, Juiz de Fora, Brasil
| | | | - Jorge Mota
- Centro de Investigação em Actividade Física, Saúde e Lazer, Universidade do Porto, Porto, Portugal
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Mamen A, Fredriksen PM. Anthropometric measures as fitness indicators in primary school children: The Health Oriented Pedagogical Project (HOPP). Scand J Public Health 2018; 46:48-53. [DOI: 10.1177/1403494818770129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims: As children’s fitness continues to decline, frequent and systematic monitoring of fitness is important. Easy-to-use and low-cost methods with acceptable accuracy are essential in screening situations. This study aimed to investigate how the measurements of body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR) relate to selected measurements of fitness in children. Methods: A total of 1731 children from grades 1 to 6 were selected who had a complete set of height, body mass, running performance, handgrip strength and muscle mass measurements. A composite fitness score was established from the sum of sex- and age-specific z-scores for the variables running performance, handgrip strength and muscle mass. This fitness z-score was compared to z-scores and quartiles of BMI, WC and WHtR using analysis of variance, linear regression and receiver operator characteristic analysis. Results: The regression analysis showed that z-scores for BMI, WC and WHtR all were linearly related to the composite fitness score, with WHtR having the highest R2 at 0.80. The correct classification of fit and unfit was relatively high for all three measurements. WHtR had the best prediction of fitness of the three with an area under the curve of 0.92 ( p < 0.001). Conclusions: BMI, WC and WHtR were all found to be feasible measurements, but WHtR had a higher precision in its classification into fit and unfit in this population.
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Affiliation(s)
- Asgeir Mamen
- Kristiania University College, Department of Health Sciences, Oslo, Norway
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Mahbuba S, Mohsin F, Rahat F, Nahar J, Begum T, Nahar N. Descriptive epidemiology of metabolic syndrome among obese adolescent population. Diabetes Metab Syndr 2018; 12:369-374. [PMID: 29358036 DOI: 10.1016/j.dsx.2017.12.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 12/21/2017] [Indexed: 01/19/2023]
Abstract
AIMS The study was done to assess the magnitude of problems of metabolic syndrome among obese adolescents. MATERIALS AND METHOD It was a cross-sectional study done from January 2013 to June 2014 in paediatric endocrine outpatient department in BIRDEM General Hospital, Dhaka, Bangladesh. Total 172 adolescents having exogenous obesity aged 10-18 years were included. Impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and type 2 diabetes mellitus (DM) were defined as per WHO criteria.The adolescents having Body Mass Index (BMI) ≥95th centile were classified as obese.Waist circumference was measured at the level midway between the lower rib margin & the iliac crest, at the level of umbilicus with the person breathing out gently in centimeter. Hip circumference was measured at the maximum width over the buttocks at the level of the greater trochanters in centimeter. RESULT Among 172 obese adolescents, metabolic syndrome was found in 66 patients (38.4%). The commonest metabolic abnormality among those having metabolic syndrome was low HDL level (77.3%) followed by high triglyceride level(71.2%). Glucose intolerance (IFG and/or IGT) was found in 16.7%, Type 2 DM in 10.6%, systolic hypertension in 10.7% and diastolic hypertension in 12.1%. Triglyceride (p = 0.042) and Cholesterol level (p = 0.016) were significantly higher and HDL-cholesterol level (p = 0.000) was significantly lower among obese adolescents having metabolic syndrome. Less physical activity (p = 0.04) was significantly related to the development of metabolic syndrome. On logistic regression analysis male sex, family history of obesity and low HDL-cholesterol correlated to metabolic syndrome. CONCLUSION The High rate of metabolic syndrome among obese adolescents is alarming.
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Affiliation(s)
| | | | - Farhana Rahat
- Shishu Shashthyo Foundation Hospital and Institute of Child Health, Dhaka, Bangladesh
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Wrist circumference is associated with increased systolic blood pressure in children with overweight/obesity. Hypertens Res 2018; 41:193-197. [PMID: 29335612 DOI: 10.1038/s41440-017-0006-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 08/10/2017] [Accepted: 08/29/2017] [Indexed: 01/25/2023]
Abstract
Wrist circumference is a clinical marker for insulin-resistance in overweight/obese children and adolescents. Insulin resistance is considered a major determinant of increased vascular resistance and hypertension. The aim of the study was to investigate the association between wrist circumference and systolic (S) and diastolic (D) blood pressure (BP) in a population of overweight/obese children and adolescents. A population of 1133 overweight/obese children and adolescents (n = 1133) were consecutively enrolled. Multivariate regression analyses were used to investigate the influence of independent variables on the variance of BP. The prevalence of hypertension was 21.74% in males and 28.95% in females (p = 0.048). The results showed that SBP was significantly associated with wrist circumference in both genders (p < 0.0001 for both comparisons). We found no association between DBP and wrist circumference in either gender. Wrist circumference accounted for 17% of the total variance of SBP in males and 14% in females. Wrist circumference, a marker of insulin resistance, is associated with increased SBP in overweight/obese children and adolescents, suggesting a role of insulin resistance in the pathogenesis and development of hypertension.
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Featherston EL, Dihigo S, Gilder RE. Improving Adherence to Atypical Antipsychotic Agent Screening Guidelines in Pediatric Patients: A Quality Improvement Project Within an Integrated Community Mental Health Setting. J Am Psychiatr Nurses Assoc 2018; 24:352-359. [PMID: 29357722 DOI: 10.1177/1078390317752444] [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] [Indexed: 12/17/2022]
Abstract
BACKGROUND Approximately 14% to 20% of children and adolescents have a mental health problem. Atypical antipsychotic agents are used to treat behavioral, emotional, and mental health problems in children and adolescents. A discrepancy between best practices and actual practices exists. OBJECTIVE The purpose of this quality improvement project was to increase adherence above baseline, through implementation of a checklist, to recommended screening guidelines in children, ages 4 to 18, prescribed atypical antipsychotic agents over 12 weeks. Design/Results: Aggregate comparison of the mean ranks of scores were tested with the Mann-Whitney U test, U = 1,087.5, n1 = n2 = 70, total N =140, p < .001. Variables of body mass index, blood pressure, waist circumference, fasting glucose, fasting lipids, personal history, and family history were observed and tested using the chi-square with Fisher's exact tests and are significant at or above 99% confidence level ( p < .01). CONCLUSION Educating mental health providers, child and adolescent psychiatrists, and psychiatric mental health nurse practitioners on recommended screening guidelines and implementing a checklist had a measurable effect on increasing adherence to the recommended screening guidelines in a community mental health setting.
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Affiliation(s)
- Elishia L Featherston
- 1 Elishia L. Featherston, DNP, RN, CPNP-PC, PMHS, University of Texas Arlington, Arlington, TX, USA
| | - Sharolyn Dihigo
- 2 Sharolyn Dihigo, DNP, RN, CPNP-PC, University of Texas Arlington, Arlington, TX, USA
| | - Richard E Gilder
- 3 Richard E. Gilder, MS, BSN, RN-C, Baylor Health Care System Dallas, Dallas, TX, USA
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25
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Silverstein DM. Growth and Nutrition in Pediatric Chronic Kidney Disease. Front Pediatr 2018; 6:205. [PMID: 30155452 PMCID: PMC6103270 DOI: 10.3389/fped.2018.00205] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 06/28/2018] [Indexed: 12/14/2022] Open
Abstract
Children with chronic kidney disease (CKD) feature significant challenges to the maintenance of adequate nutrition and linear growth. Moreover, the impaired nutritional state contributes directly to poor growth. Therefore, it is necessary to consider nutritional status in the assessment of etiology and treatment of sub-optimal linear growth. The major causes of poor linear growth including dysregulation of the growth hormone/insulin-like growth factor-I (IGF-I) axis, nutritional deficiency, metabolic acidosis, anemia, renal osteodystrophy/bone mineral disease, and inflammation. This review summarizes the causes and assessment tools of growth and nutrition while providing a summary of state of the art therapies for these co-morbidities of pediatric CKD.
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Affiliation(s)
- Douglas M Silverstein
- Division of Reproductive, Gastrorenal, and Urology Devices, Office of Device Evaluation, Center for Devices and Radiological Health, United States Food and Drug Administration, Silver Spring, MD, United States
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26
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Grummon AH, Vaughn A, Jones DJ, Ward DS. Cumulative Risk Exposure and Waist Circumference in Preschool-Aged Children: the Mediating Role of Television and Moderating Role of Sex. Ann Behav Med 2017; 51:489-499. [PMID: 28097514 PMCID: PMC5513794 DOI: 10.1007/s12160-016-9872-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Children exposed to multiple stressors are more likely to be overweight, but little is known about the mechanisms explaining this association. PURPOSE This cross-sectional study examined whether children exposed to multiple stressors had higher waist circumference, and whether this association was mediated through children's television time. METHODS Participants were 319 parent-child dyads. Children were 2-5 years old and had at least one overweight parent (BMI ≥ 25 kg/m2). Data were collected at baseline of a larger childhood obesity prevention study and included information on psychosocial stressors (e.g., parenting stress), demographic stressors (e.g., low income), children's television time, and children's waist circumference. Two cumulative risk scores were created by summing stressors in each domain (demographic and psychosocial). Mediation and moderated mediation analyses were conducted. RESULTS Indirect effects of both cumulative risk scores on waist circumference through television time were not significant; however, moderated mediation analyses found significant moderation by gender. The indirect effects of both risk scores on waist circumference through television time were significant and positive for girls, but near-zero for boys. CONCLUSIONS Reducing television time should be explored as a strategy for buffering against the negative health effects of exposure to multiple stressors among girls. Longitudinal and intervention research is needed to confirm these results and to identify mediating factors between cumulative risk and body weight among boys.
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Affiliation(s)
- Anna H Grummon
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Amber Vaughn
- Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA
| | - Deborah J Jones
- Department of Psychology, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA
| | - Dianne S Ward
- Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA.
- Department of Nutrition, Gillings School of Global Public Health, and Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, 135 Dauer Drive, 2200 McGavran-Greenberg Hall, CB no. 7461, Chapel Hill, NC, 27599-7461, USA.
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Bravo J, Raimundo AM, Santos DA, Timón R, Sardinha LB. Abdominal obesity in adolescents: Development of age‐specific waist circumference cut‐offs linked to adult IDF criteria. Am J Hum Biol 2017; 29. [DOI: 10.1002/ajhb.23036] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 03/30/2017] [Accepted: 06/13/2017] [Indexed: 11/10/2022] Open
Affiliation(s)
- Jorge Bravo
- Department of Sport and Health, Research Center in Sports, Health Sciences and Human Development, Science and Technology SchoolUniversity of ÉvoraÉvora Portugal
| | - Armando M. Raimundo
- Department of Sport and Health, Research Center in Sports, Health Sciences and Human Development, Science and Technology SchoolUniversity of ÉvoraÉvora Portugal
| | - Diana A. Santos
- Exercise and Health LaboratoryCIPER, Faculdade de Motricidade Humana, Universidade de Lisboa Portugal
| | - Rafael Timón
- Department of Didactics of Music, Plastic and Corporal Expression, Sports Science SchoolUniversity of ExtremaduraCáceres Spain
| | - Luís B. Sardinha
- Exercise and Health LaboratoryCIPER, Faculdade de Motricidade Humana, Universidade de Lisboa Portugal
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Chew WF, Leong PP, Yap SF, Yasmin AM, Choo KB, Low GKK, Boo NY. Risk factors associated with abdominal obesity in suburban adolescents from a Malaysian district. Singapore Med J 2017; 59:104-111. [PMID: 28210748 DOI: 10.11622/smedj.2017013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
INTRODUCTION We aimed to determine the risk factors associated with abdominal obesity (AO) in suburban adolescents. METHODS This cross-sectional study included adolescents aged 15-17 years from five randomly selected secondary schools in the Hulu Langat district of Selangor state, Malaysia. Waist circumference (WC) was measured at the midpoint between the lower margin of the last palpable rib and the top of the iliac crest. Information on sociodemographic data, dietary habits, physical activity levels and duration of sleep was obtained via interviewer-administered questionnaires. Participants' habitual food intake was determined using a 73-item Food Frequency Questionnaire. RESULTS Among 832 participants, 56.0% were girls; 48.4% were Malay, 40.5% Chinese, 10.2% Indian and 0.8% of other ethnic groups. Median age and WC were 16 (interquartile range [IQR] 15-16) years and 67.9 (IQR 63.0-74.6) cm, respectively. Overall prevalence of AO (> 90th percentile on the WC chart) was 11.3%. A higher proportion (22.4%) of Indian adolescents were found to have AO compared with Malay and Chinese adolescents. Logistic regression analysis showed that female gender (adjusted odds ratio [OR] 7.064, 95% confidence interval [CI] 2.087-23.913; p = 0.002), Indian ethnicity (adjusted OR 10.164, 95% CI 2.182-47.346; p = 0.003), irregular meals (adjusted OR 3.193, 95% CI 1.043-9.774; p = 0.042) and increasing body mass index (BMI) (adjusted OR 2.867, 95% CI 2.216-3.710; p < 0.001) were significantly associated with AO. CONCLUSION AO was common among Malaysian adolescents. Female gender, Indian ethnicity, irregular meals and increasing BMI were significant risk factors.
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Affiliation(s)
- Wai Fong Chew
- Department of Pre-Clinical Sciences, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Selangor, Malaysia
| | - Pooi Pooi Leong
- Department of Pre-Clinical Sciences, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Selangor, Malaysia
| | - Sook Fan Yap
- Department of Pre-Clinical Sciences, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Selangor, Malaysia
| | - A Malik Yasmin
- Department of Pre-Clinical Sciences, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Selangor, Malaysia
| | - Kong Bung Choo
- Department of Pre-Clinical Sciences, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Selangor, Malaysia
| | - Gary Kim Kuan Low
- Department of Population Medicine, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Selangor, Malaysia
| | - Nem Yun Boo
- Department of Population Medicine, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Selangor, Malaysia
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Mainguy C, Bellon G, Delaup V, Ginoux T, Kassai-Koupai B, Mazur S, Rabilloud M, Remontet L, Reix P. Sensitivity and specificity of different methods for cystic fibrosis-related diabetes screening: is the oral glucose tolerance test still the standard? J Pediatr Endocrinol Metab 2017; 30:27-35. [PMID: 27977404 DOI: 10.1515/jpem-2016-0184] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 11/11/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND Cystic fibrosis-related diabetes (CFRD) is a late cystic fibrosis (CF)-associated comorbidity whose prevalence is increasing sharply lifelong. Guidelines for glucose metabolism (GM) monitoring rely on the oral glucose tolerance test (OGTT). However, this test is neither sensitive nor specific. The aim of this study was to compare sensitivity and specificity of different methods for GM monitoring in children and adolescents with CF. METHODS Continuous glucose monitoring system (CGMS), used as the reference method, was compared with the OGTT, intravenous glucose tolerance test (IGTT), homeostasis model assessment index of insulin resistance (HOMA-IR), homeostasis model assessment index of β-cell function (HOMA-%B) and glycated haemoglobin A1C. Patients were classified into three groups according to CGMS: normal glucose tolerance (NGT), impaired glucose tolerance (IGT) and diabetes mellitus (DM). RESULTS Twenty-nine patients (median age: 13.1 years) were recruited. According to CGMS, 11 had DM, 12 IGT and six NGT, whereas OGTT identified three patients with DM and five with IGT. While 13 of 27 had insulin deficiency according to IGTT, there was 19 of 28 according to HOMA-%B. According to HOMA-IR, 12 of 28 had insulin resistance. HOMA-%B was the most sensitive method for CFRD screening [sensitivity 91% (95% CI), specificity 47% (95% CI) and negative predictive value 89% (95% CI)]. CONCLUSIONS OGTT showed the weak capacity to diagnose DM in CF and should no longer be considered as the reference method for CFRD screening in patients with CF. In our study, HOMA-%B showed promising metrics for CFRD screening. Finally, CGMS revealed that pathological glucose excursions were frequent even early in life.
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da Silva CDC, Zambon MP, Vasques ACJ, Rodrigues AMDB, Camilo DF, Antonio MÂRDGM, Cassani RSL, Geloneze B. Neck circumference as a new anthropometric indicator for prediction of insulin resistance and components of metabolic syndrome in adolescents: Brazilian Metabolic Syndrome Study. ACTA ACUST UNITED AC 2016; 32:221-9. [PMID: 25119754 PMCID: PMC4183009 DOI: 10.1590/0103-0582201432210713] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Accepted: 10/28/2013] [Indexed: 12/19/2022]
Abstract
OBJECTIVE: To evaluate the correlation between neck circumference and insulin resistance and
components of metabolic syndrome in adolescents with different adiposity levels
and pubertal stages, as well as to determine the usefulness of neck circumference
to predict insulin resistance in adolescents. METHODS: Cross-sectional study with 388 adolescents of both genders from ten to 19 years
old. The adolescents underwent anthropometric and body composition assessment,
including neck and waist circumferences, and biochemical evaluation. The pubertal
stage was obtained by self-assessment, and the blood pressure, by auscultation.
Insulin resistance was evaluated by the Homeostasis Model Assessment-Insulin
Resistance. The correlation between two variables was evaluated by partial
correlation coefficient adjusted for the percentage of body fat and pubertal
stage. The performance of neck circumference to identify insulin resistance was
tested by Receiver Operating Characteristic Curve. RESULTS: After the adjustment for percentage body fat and pubertal stage, neck
circumference correlated with waist circumference, blood pressure, triglycerides
and markers of insulin resistance in both genders. CONCLUSIONS: The results showed that the neck circumference is a useful tool for the detection
of insulin resistance and changes in the indicators of metabolic syndrome in
adolescents. The easiness of application and low cost of this measure may allow
its use in Public Health services.
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Affiliation(s)
| | | | | | | | | | | | | | - Bruno Geloneze
- Faculdade de Ciências Médicas, Unicamp, Campinas, SP, Brasil
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Abstract
RESUMO Objetivo: caracterizar o perfil miofuncional orofacial de crianças e adolescentes com obesidade comparados a um grupo de eutróficos e verificar quais aspectos influenciam as funções de mastigação e deglutição. Métodos: foram avaliados os órgãos do sistema estomatognático, a mastigação e a deglutição aplicando o protocolo de Avaliação Miofuncional Orofacial com Escores Expandidos (AMIOFE-E) em 50 indivíduos do sexo feminino e masculino, com idades entre 9 e 18 anos, atendidos em um ambulatório de Nutrologia. Eles foram divididos em dois grupos, o grupo pesquisa, de obesos, e o grupo controle, de eutróficos. Os testes estatísticos utilizados foram: análise de variância (ANOVA), Teste Exato de Fisher, Intervalo de Confiança para Média e Coeficiente da Variação. Resultados: os obesos, quando comparados aos eutróficos, apresentaram pior desempenho nos aspectos de tonicidade e mobilidade de bochechas e na deglutição (p<0,05), sendo que 71% dos indivíduos com redução da tonicidade apresentaram deglutições múltiplas contra 25% dos indivíduos eutróficos. Além disso, 68% das crianças e adolescentes obesos dessa pesquisa apresentaram mastigação bilateral alternada. Conclusão: as crianças e adolescentes obesos estudados nessa pesquisa apresentaram maior ocorrência de alterações miofuncionais orofaciais quando comparados aos eutróficos em relação à tonicidade e mobilidade de bochechas e na deglutição. Nesta pesquisa também houve associação estatística entre a redução da tonicidade de bochechas das crianças e adolescentes obesos e a presença de deglutições múltiplas durante a deglutição.
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Lee JJ, Ho C, Chen HJ, Huang N, Yeh JC, deFerranti S. Is the 90th Percentile Adequate? The Optimal Waist Circumference Cutoff Points for Predicting Cardiovascular Risks in 124,643 15-Year-Old Taiwanese Adolescents. PLoS One 2016; 11:e0158818. [PMID: 27389572 PMCID: PMC4936838 DOI: 10.1371/journal.pone.0158818] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 06/22/2016] [Indexed: 01/19/2023] Open
Abstract
Adolescent obesity has increased to alarming proportions globally. However, few studies have investigated the optimal waist circumference (WC) of Asian adolescents. This study sought to establish the optimal WC cutoff points that identify a cluster of cardiovascular risk factors (CVRFs) among 15-year-old ethnically Chinese adolescents. This study was a regional population-based study on the CVRFs among adolescents who enrolled in all the senior high schools in Taipei City, Taiwan, between 2011 and 2014. Four cross-sectional health examinations of first-year senior high school (grade 10) students were conducted from September to December of each year. A total of 124,643 adolescents aged 15 (boys: 63,654; girls: 60,989) were recruited. Participants who had at least three of five CVRFs were classified as the high-risk group. We used receiver-operating characteristic curves and the area under the curve (AUC) to determine the optimal WC cutoff points and the accuracy of WC in predicting high cardiovascular risk. WC was a good predictor for high cardiovascular risk for both boys (AUC: 0.845, 95% confidence interval [CI]: 0.833–0.857) and girls (AUC: 0.763, 95% CI: 0.731–0.795). The optimal WC cutoff points were ≥78.9 cm for boys (77th percentile) and ≥70.7 cm for girls (77th percentile). Adolescents with normal weight and an abnormal WC were more likely to be in the high cardiovascular risk group (odds ratio: 3.70, 95% CI: 2.65–5.17) compared to their peers with normal weight and normal WC. The optimal WC cutoff point of 15-year-old Taiwanese adolescents for identifying CVRFs should be the 77th percentile; the 90th percentile of the WC might be inadequate. The high WC criteria can help health professionals identify higher proportion of the adolescents with cardiovascular risks and refer them for further evaluations and interventions. Adolescents’ height, weight and WC should be measured as a standard practice in routine health checkups.
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Affiliation(s)
- Jason Jiunshiou Lee
- Department of Family Medicine, Yangming Branch, Taipei City Hospital, Taipei City, Taiwan
- Department of Public Health, School of Medicine, National Yang-Ming University, Taipei City, Taiwan
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan
| | - ChinYu Ho
- Department of Family Medicine, Yangming Branch, Taipei City Hospital, Taipei City, Taiwan
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei City, Taiwan
- Department of Leisure Industry and Health Promotion, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan
- * E-mail: ;
| | - Hsin-Jen Chen
- Department of Public Health, School of Medicine, National Yang-Ming University, Taipei City, Taiwan
| | - Nicole Huang
- Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei City, Taiwan
| | - Jade Chienyu Yeh
- Department of Family Medicine, Lo-Sheng Sanatorium and Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan
| | - Sarah deFerranti
- Department of Cardiology, Boston Children's Hospital, Boston, United States of America
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Campagna G, Zampetti S, Gallozzi A, Giansanti S, Chiesa C, Pacifico L, Buzzetti R. Excellent Intra and Inter-Observer Reproducibility of Wrist Circumference Measurements in Obese Children and Adolescents. PLoS One 2016; 11:e0156646. [PMID: 27294398 PMCID: PMC4905645 DOI: 10.1371/journal.pone.0156646] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 05/17/2016] [Indexed: 12/27/2022] Open
Abstract
In a previous study, we found that wrist circumference, in particular its bone component, was associated with insulin resistance in a population of overweight/obese children. The aim of the present study was to evaluate the intra- and inter-operator variability in wrist circumference measurement in a population of obese children and adolescents. One hundred and two (54 male and 48 female) obese children and adolescents were consecutively enrolled. In all subjects wrist circumferences were measured by two different operators two times to assess intra- and inter-operator variability. Statistical analysis was performed using SAS v.9.4 and JMP v.12. Measurements of wrist circumference showed excellent inter-operator reliability with Intra class Correlation Coefficients (ICC) of 0.96 and ICC of 0.97 for the first and the second measurement, respectively. The intra-operator reliability was, also, very strong with a Concordance Correlation Coefficient (CCC) of 0.98 for both operators. The high reproducibility demonstrated in our results suggests that wrist circumference measurement, being safe, non-invasive and repeatable can be easily used in out-patient settings to identify youths with increased risk of insulin-resistance. This can avoid testing the entire population of overweight/obese children for insulin resistance parameters.
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Affiliation(s)
- Giuseppe Campagna
- Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - Simona Zampetti
- Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - Alessia Gallozzi
- Policlinico Umberto I Hospital, Sapienza University, Rome, Italy
| | - Sara Giansanti
- Policlinico Umberto I Hospital, Sapienza University, Rome, Italy
| | - Claudio Chiesa
- Institute of Translational Pharmacology, National Research Council, Rome, Italy
| | - Lucia Pacifico
- Policlinico Umberto I Hospital, Sapienza University, Rome, Italy
| | - Raffaella Buzzetti
- Department of Experimental Medicine, Sapienza University, Rome, Italy
- * E-mail:
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González-Jiménez E, Schmidt-RioValle J, Montero-Alonso MA, Padez C, García-García CJ, Perona JS. Influence of Biochemical and Anthropometric Factors on the Presence of Insulin Resistance in Adolescents. Biol Res Nurs 2016; 18:541-8. [PMID: 27194780 DOI: 10.1177/1099800416648207] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Insulin resistance plays a determinant role in the development of metabolic syndrome in adolescents. The objective of the present study was to determine the influence of factors commonly associated with insulin resistance in a sample of adolescents. METHODS This cross-sectional study included 976 adolescents from southeast Spain. Anthropometric and biochemical measurements were performed, and insulin resistance was assessed using the homeostasis model assessment-insulin resistance (HOMA-IR). RESULTS Subjects with abnormal HOMA-IR values had significantly higher body mass index (BMI), body fat content, waist circumference, and systolic blood pressure (BP) than those with normal values. Furthermore, levels of glucose, insulin, glycosylated hemoglobin, total cholesterol, triglycerides, low-density lipoprotein-cholesterol, homocysteine, nonesterified fatty acids, and ceruloplasmin were higher in subjects with abnormal HOMA-IR values. Multivariate logistic regression analysis showed the highest odds ratio (OR) for BMI and that combinations of BMI with body fat content or systolic BP can increase the risk of insulin resistance 7-fold. DISCUSSION Anthropometric indicators have different levels of influence on the risk of insulin resistance in adolescents, and a combination of two of these indicators is enough to increase the risk 7-fold. Since the highest OR was observed for BMI, the greatest effort should be directed to reducing this parameter in adolescents. An adequate understanding by nursing personnel of factors associated with insulin resistance is a key factor in the prevention of this pathophysiological condition and its complications in adolescents.
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Affiliation(s)
| | | | | | - Cristina Padez
- Department of Life Sciences, University of Coimbra, Coimbra, Portugal
| | - Carmen J García-García
- Department of Forensic Medicine, Toxicology and Physical Anthropology, University of Granada, Granada, Spain
| | - Javier S Perona
- Department of Food and Health, Instituto de la Grasa (CSIC), Seville, Spain
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Caicedo-Álvarez JC, Correa-Bautista JE, González-Jiménez E, Schmidt-RioValle J, Ramírez-Vélez R. Waist circumference distribution in Colombian schoolchildren and adolescents: The FUPRECOL Study. ACTA ACUST UNITED AC 2016; 63:265-73. [PMID: 27048873 DOI: 10.1016/j.endonu.2016.01.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 01/13/2016] [Accepted: 01/24/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This study was intended to establish the percentile distribution of waist circumference in schoolchildren from Bogota, Colombia, participating in the FUPRECOL Study. METHODS A cross-sectional study conducted in 3,005 children and 2,916 adolescents aged 9 to 17.9 years. Height, weight, waist circumference, hip circumference, and self-assessed sexual maturity status were recorded. Percentiles (3(rd), 10(th), 25(th), 50(th), 75(th), 90(th), and 97(th)) and smoothed sex- and age-specific curves were calculated, and the waist circumference values found were compared to international references from other ethnic populations. RESULTS Fifty-seven percent of the overall population (n=5,921) were females (mean age, 12.7±2.3 years). In most age groups, waist circumference was greater in boys as compared to girls. The increase between the 50(th) and 97(th) percentiles by age was 15.7cm in boys aged 9 to 9.9 years and 16.0cm in girls aged 11-11.9 years. Comparison of our study results, by age group and sex, to international references showed that our 50(th) percentile was lower than reported in Peru and the UK except for studies in India, Venezuela (Merida), US, and Spain was higher. CONCLUSIONS Age- and sex-specific percentiles of waist circumference obtained from children and adolescents from Bogota, Colombia, are reported. They may be used as a reference both for nutritional assessment and for predicting cardiovascular risks at early ages.
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Affiliation(s)
- Juan Carlos Caicedo-Álvarez
- Centro de Estudios en Medición de la Actividad Física (CEMA), Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, D.C, Colombia
| | - Jorge Enrique Correa-Bautista
- Centro de Estudios en Medición de la Actividad Física (CEMA), Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, D.C, Colombia
| | - Emilio González-Jiménez
- Departamento de Enfermería, Facultad de Ciencias de la Salud, Granada, España; Grupo CTS-436, adscrito al Centro de Investigación Mente, Cerebro y Comportamiento (CIMCYC, Departamento de Enfermería, Facultad de Ciencias de la Salud, Granada, España
| | - Jacqueline Schmidt-RioValle
- Departamento de Enfermería, Facultad de Ciencias de la Salud, Granada, España; Grupo CTS-436, adscrito al Centro de Investigación Mente, Cerebro y Comportamiento (CIMCYC, Departamento de Enfermería, Facultad de Ciencias de la Salud, Granada, España
| | - Robinson Ramírez-Vélez
- Centro de Estudios en Medición de la Actividad Física (CEMA), Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, D.C, Colombia.
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So HK, Yip GWK, Choi KC, Li AM, Leung LCK, Wong SN, Sung RYT. Association between waist circumference and childhood-masked hypertension: A community-based study. J Paediatr Child Health 2016; 52:385-90. [PMID: 27145500 DOI: 10.1111/jpc.13121] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 10/02/2015] [Accepted: 10/19/2015] [Indexed: 11/30/2022]
Abstract
AIM The aim of this study is to determine the association between waist circumference (WC) and childhood-masked hypertension. METHODS A territory-wide, school-based cohort of 1385 Hong Kong students (672 boys and 713 girls) aged 8-17 years was analysed. The ambulatory blood pressure-monitoring assessment was performed using validated oscillometric recorders (A&D TM-2430 (A&D Inc., Tokyo, Japan)) following American Heart Association's recommendations. Subjects were considered normotensive if their casual blood pressure, 24-h daytime and night-time average systolic blood pressure and diastolic blood pressure (DBP) were <95th percentile. If one or more of the ambulatory blood pressure parameters was ≥95th percentile, subjects would be considered suffering from masked hypertension (MH). Subjects who had three successive casual blood pressure measurements above the 95th percentile were excluded. RESULTS By body mass index, 148 (10.7%) subjects were obese, 182 (13.1%) overweight and 359 (25.9%) having larger WC (≥85th percentiles). MH was diagnosed in 217 subjects (15.7%). Subjects with larger WC or obesity were significantly associated with higher 24-h daytime and night-time systolic blood pressure (≥95th percentile) (odds ratios from 1.84 to 2.09 and from 2.07 to 3.54 for larger WC and obese respectively, all P < 0.05) as well as 24-h DBP for larger WC (odds ratio = 2, P = 0.015) than normal subjects adjusted by sex, age and height. CONCLUSION Waist circumference and body mass index are independent risk factors of childhood and adolescent MH. WC appears a significant associated factor of elevated 24-h DBP in children aged 8-17 years.
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Affiliation(s)
- Hung-Kwan So
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong, China
| | | | - Kai-Chow Choi
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
| | - Albert M Li
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong, China
| | | | - Sik-Nin Wong
- Paediatrics, Tuen Mun Hospital, Hong Kong, China
| | - Rita Yn-Tz Sung
- Clinical Skill Lab, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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Davis CL, Tingen MS, Jia J, Sherman F, Williams CF, Bhavsar K, Wood N, Kobleur J, Waller JL. Passive Smoke Exposure and Its Effects on Cognition, Sleep, and Health Outcomes in Overweight and Obese Children. Child Obes 2016; 12:119-25. [PMID: 26812049 PMCID: PMC4817566 DOI: 10.1089/chi.2015.0083] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Passive smoke exposure (PSE) may be a risk factor for childhood overweight and obesity and is associated with worse neurocognitive development, cognition, and sleep in children. The purpose of the study is to examine the effects of PSE on adiposity, cognition, and sleep in overweight and obese children using an objective measure of PSE. METHODS Overweight or obese children (n = 222) aged 7-11 (9.4 ± 1.1 years; 58% black; 58% female; 85% obese) were recruited from schools near Augusta, Georgia, over the course of the school year from 2003-2006 for a clinical trial, with data analyzed in 2009-2010. Passive smoke exposure was measured with plasma cotinine. Health, cognitive, and sleep measures and parent report of smoke exposure were obtained. RESULTS Overweight and obese children with PSE had greater overall and central adiposity than nonexposed overweight and obese children (p < 0.03). However, PSE was unrelated to prediabetes, insulin resistance, or visceral fat. PSE was linked to poorer cognitive scores (p < 0.04) independent of adiposity, but was not related to sleep-disordered breathing. CONCLUSIONS PSE is associated with fatness and poorer cognition in children. Tailored interventions that target multiple health risk factors including nutrition, physical activity, and tobacco use in children and families are needed to prevent adverse health outcomes related to tobacco use and obesity.
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Affiliation(s)
- Catherine L. Davis
- Georgia Prevention Institute, Department of Pediatrics, Augusta University, Augusta, GA
| | - Martha S. Tingen
- Georgia Prevention Institute, Department of Pediatrics, Augusta University, Augusta, GA
| | - Jenny Jia
- Georgia Prevention Institute, Department of Pediatrics, Augusta University, Augusta, GA
| | - Forrest Sherman
- Georgia Prevention Institute, Department of Pediatrics, Augusta University, Augusta, GA
| | - Celestine F. Williams
- Georgia Prevention Institute, Department of Pediatrics, Augusta University, Augusta, GA
| | - Kruti Bhavsar
- Georgia Prevention Institute, Department of Pediatrics, Augusta University, Augusta, GA
| | - Nancy Wood
- Georgia Prevention Institute, Department of Pediatrics, Augusta University, Augusta, GA.,Pediatric Associates of Mobile, Mobile, AL
| | - Jessica Kobleur
- Georgia Prevention Institute, Department of Pediatrics, Augusta University, Augusta, GA.,University Pediatrics, Memorial University Medical Center, Savannah, GA
| | - Jennifer L. Waller
- Department of Biostatistics and Epidemiology, Medical College of Georgia, Augusta University, Augusta, GA
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Shashaj B, Luciano R, Contoli B, Morino GS, Spreghini MR, Rustico C, Sforza RW, Dallapiccola B, Manco M. Reference ranges of HOMA-IR in normal-weight and obese young Caucasians. Acta Diabetol 2016; 53:251-60. [PMID: 26070771 DOI: 10.1007/s00592-015-0782-4] [Citation(s) in RCA: 145] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 05/31/2015] [Indexed: 12/25/2022]
Abstract
AIMS Insulin resistance (IR) may develop very early in life being associated with occurrence of cardiometabolic risk factors (CMRFs). Aim of the present study was to identify in young Caucasians normative values of IR as estimated by the homeostasis model assessment (HOMA-IR) and cutoffs diagnostic of CMRFs. METHODS Anthropometrics and biochemical parameters were assessed in 2753 Caucasians (age 2-17.8 years; 1204 F). Reference ranges of HOMA-IR were defined for the whole population and for samples of normal-weight and overweight/obese individuals. The receiver operator characteristic analysis was used to find cutoffs of HOMA-IR accurately identifying individuals with any CMRF among total cholesterol and/or triglycerides higher than the 95th percentile and/or HDL cholesterol lower than the 5th for age and sex, impaired glucose tolerance, and alanine aminotransferase levels ≥40 U/l. RESULTS Overweight/obese individuals had higher HOMA-IR levels compared with normal-weight peers (p < 0.0001) at any age. HOMA-IR index rose progressively with age, plateaued between age 13 and 15 years and started decreasing afterward. HOMA-IR peaked at age 13 years in girls and at 15 years in boys. The 75th percentile of HOMA-IR in the whole population (3.02; AUROC = 0.73, 95 % CI = 0.70-0.75), in normal-weight (1.68; AUROC = 0.76, 95 % CI = 0.74-0.79), and obese (3.42; AUROC = 0.71, 95 % CI = 0.69-0.72) individuals identified the cutoffs best classifying individuals with any CMRF. CONCLUSIONS Percentiles of HOMA-IR varied significantly in young Caucasians depending on sex, age, and BMI category. The 75th percentile may represent an accurate cutoff point to suspect the occurrence of one or more CMRFs among high total cholesterol and triglycerides, low HDL cholesterol, and ALT ≥ 40 UI/l.
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Affiliation(s)
- Blegina Shashaj
- Research Unit for Multifactorial Diseases, Scientific Directorate, Bambino Gesù Children Hospital, Rome, Italy
| | - Rosa Luciano
- Department of Laboratory Medicine, Bambino Gesù Children Hospital, Rome, Italy
| | - Benedetta Contoli
- Research Unit for Multifactorial Diseases, Scientific Directorate, Bambino Gesù Children Hospital, Rome, Italy
| | | | | | - Carmela Rustico
- Unit for Clinical Nutrition, Bambino Gesù Children Hospital, Rome, Italy
| | | | - Bruno Dallapiccola
- Research Unit for Multifactorial Diseases, Scientific Directorate, Bambino Gesù Children Hospital, Rome, Italy
| | - Melania Manco
- Research Unit for Multifactorial Diseases, Scientific Directorate, Bambino Gesù Children Hospital, Rome, Italy.
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Hirschler V, Molinari C, Maccallini G, Hidalgo M, Gonzalez C. Waist Circumference Percentiles in Indigenous Argentinean School Children Living at High Altitudes. Child Obes 2016; 12:77-85. [PMID: 26699094 PMCID: PMC4753629 DOI: 10.1089/chi.2015.0058] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Central obesity is associated with increased risk of type 2 diabetes. OBJECTIVES The study objectives were to develop waist circumference (WC) percentiles, to determine if WC is associated with metabolic risk, and to compare our WC percentiles with those reported in the 2007-2010 National Health and Nutrition Examination Survey (NHANES). METHODS A cross-sectional study of 1232 children (606 boys ) 5-14 years was performed from 2011 to 2014 in indigenous Koya children from northwestern Argentina. Anthropometric characteristics, glucose, lipids, and insulin levels were measured. Sex-specific reference percentiles were computed using the Lambda-Mu-Sigma (LMS) method. We obtained 2007-2010 NHANES data for comparison with our results. RESULTS Compared with the NHANES 90th percentile, WC values for children in this study were lower by an average of 11.05 cm for girls and 12.66 cm for boys. The prevalence of low high-density lipoprotein cholesterol (HDL-C) was 11.8% in children with WC ≤50th percentile, 10.3% in children with WC >50th-70th percentile, 17.5% in children with WC >70th-90th percentile, and 21.3% in children with WC >90th percentile. The prevalence of high triglycerides (TG) was 19.5% in children with WC ≤50th percentile, 19.9% in children with WC >50th-70th percentile, 28.8% in children with WC >70th-90th percentile, and 39.7% in children with WC >90th percentile. Multiple logistic regression analyses showed that high TG values (>150 mg/dL) were significantly associated with WC [odds ratio (OR)] 1.05; 95% confidence interval (CI) 1.03-1.08; and low HDL-C values (<35 mg/dL) were significantly associated with WC (OR 1.04; 95% CI 1.01-1.06), adjusted for age and gender. CONCLUSION We present for the first time WC reference data for indigenous Koya children ages 5-14 years. There was a significant association between WC and dyslipidemia in this community. Compared with the NHANES WC percentiles, our WC values were lower. These differences possibly reflect ethnicity or the lower prevalence of obesity.
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Affiliation(s)
- Valeria Hirschler
- Department of Pharmacology, University of Buenos Aires, Buenos Aires, Argentina
| | - Claudia Molinari
- Department of Pharmacology, University of Buenos Aires, Buenos Aires, Argentina
| | | | | | - Claudio Gonzalez
- Department of Pharmacology, University of Buenos Aires, Buenos Aires, Argentina
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Childhood adiposity: being male is a potential cardiovascular risk factor. Eur J Pediatr 2016; 175:63-9. [PMID: 26226893 DOI: 10.1007/s00431-015-2599-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2015] [Revised: 06/23/2015] [Accepted: 07/16/2015] [Indexed: 01/11/2023]
Abstract
UNLABELLED As the earliest atherosclerotic lesions begin during childhood, our aim was to correlate gender-related adiposity to classical cardiovascular risk factors in a group of children.An observational and transversal analysis was carried out in a cohort consisting of 161 children of both sexes, aged 6 to 17 years of age. Waist circumference was correlated to leptin, high-sensitivity C-reactive protein, systolic and diastolic blood pressure, plasma lipids, homeostasis model assessment-insulin resistance, and the left ventricular mass index. After adjusting for age, waist circumference in boys, compared to girls, correlated more strongly and directly to systolic (r = 0.538; p < 0.001) and diastolic blood pressure (ρ = 0.401; p < 0.01), ApoB/ApoA ratio (ρ = 0.515; p < 0.01), high-density lipoprotein cholesterol (r = -0.441; p < 0.001), low-density lipoprotein cholesterol (ρ = 0.280; p < 0.01), triglycerides (ρ = 0.420; p < 0.001), homeostasis model assessment-insulin resistance (ρ = 0.463; p < 0.001), and the left ventricular mass index (ρ = 0.286; p < 0.01). A similar pattern was observed regarding the correlations between leptin, high-sensitivity C-reactive protein, and the above parameters (except between high-sensitivity C-reactive protein and diastolic blood pressure), and also, particularly in boys. CONCLUSION Although increased childhood adiposity is related to a more adverse metabolic and clinical profile in both genders, males appear to have a potentially greater cardiovascular risk. WHAT IS KNOWN Obesity is characterized by a chronic low-grade inflammatory process. WHAT IS NEW Increased adiposity is related to a more pronounced pro-inflammatory response in boys. Childhood male adiposity is a potentially greater cardiovascular risk factor. Arterial hypertension, insulin resistance, and dyslipidemia is more strongly correlated to waist circumference in boys.
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Hingle MD, Turner T, Kutob R, Merchant N, Roe DJ, Stump C, Going SB. The EPIC Kids Study: a randomized family-focused YMCA-based intervention to prevent type 2 diabetes in at-risk youth. BMC Public Health 2015; 15:1253. [PMID: 26679186 PMCID: PMC4683710 DOI: 10.1186/s12889-015-2595-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 12/10/2015] [Indexed: 11/25/2022] Open
Abstract
Background It is well established that behavioral lifestyle interventions resulting in modest weight reduction in adults can prevent or delay type 2 diabetes mellitus; however in children, successful weight management interventions are rarely found outside of controlled clinical settings. The lack of effective community-based programs is a barrier to reducing obesity prevalence and diabetes risk in children. The objective of our study is to develop and test a group-randomized family-centered community-based type 2 diabetes prevention intervention targeting at-risk children, 9- to 12-years-old. Methods/Design Using participatory methods, the adult-focused YMCA Diabetes Prevention Program was adapted for families, creating a novel lifestyle behavior change program focused on healthy eating, physical activity, and a supportive home environment. The program will be tested in sixty 9- to 12-year-old children at risk of diabetes and sixty parents over 12 consecutive weeks with two intervention formats randomized by location: a face-to-face instructor-led program, or a hybrid program with alternating face-to-face and mobile technology-delivered content. Anthropometric, behavioral, psychosocial and physiological outcomes will be assessed at baseline, post-intervention (12 weeks), and follow-up (24 weeks). Secondary outcomes are participant acceptability, feasibility, and adherence. The RE-AIM framework (reach, efficacy, adoption, implementation, and maintenance) will guide intervention implementation and evaluation. Changes at 12 weeks will be assessed using a paired t-test combining both delivery formats. Exploratory models using linear regression analysis will estimate the magnitude of the difference between the face-to-face and hybrid format. The sample size of 60 children, informed by a previous YMCA intervention in which −4.3 % change in overweight (SE = 1.1) was observed over 6 months, will give us 80 % power to detect an effect size of this magnitude, assuming a one-sided test at alpha = 0.05. Discussion The proposed study capitalizes on a partnership with the YMCA, a popular and widespread community organization, and uses mobile technologies to extend program reach while potentially reducing burden associated with weekly attendance. The long-term goal is to create a scalable, replicable, and sustainable pediatric “diabesity” prevention program that overcomes existing barriers to the translation of efficacious interventions into effective community programs. Trial registration ClinicalTrials.gov, NCT02421198 on April 15, 2015
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Affiliation(s)
- Melanie D Hingle
- Department of Nutritional Sciences, The University of Arizona, 1177 E 4th St, Shantz Bldg, Room 328, Tucson, AZ, 85721, USA.
| | - Tami Turner
- Department of Nutritional Sciences, The University of Arizona, 1177 E 4th St, Shantz Bldg, Room 328, Tucson, AZ, 85721, USA.
| | - Randa Kutob
- Department of Family & Community Medicine, The University of Arizona, Faculty Office Building #220, Tucson, AZ, USA.
| | - Nirav Merchant
- Arizona Research Laboratories, The University of Arizona, TW Keating Bioresearch Bldg. #240, Tucson, AZ, USA.
| | - Denise J Roe
- Mel & Enid Zuckerman College of Public Health, The University of Arizona, Leon Levy Cancer Center #222, Tucson, AZ, USA.
| | - Craig Stump
- Department of Medicine, The University of Arizona, AHSC #05099, Tucson, AZ, USA. .,Southern Arizona VA Health Care System, Tucson, AZ, USA.
| | - Scott B Going
- Department of Nutritional Sciences, The University of Arizona, 1177 E 4th St, Shantz Bldg, Room 328, Tucson, AZ, 85721, USA.
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Minghelli B, Oliveira R, Nunes C. Association of obesity with chronic disease and musculoskeletal factors. Rev Assoc Med Bras (1992) 2015; 61:347-54. [DOI: 10.1590/1806-9282.61.04.347] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Accepted: 09/16/2014] [Indexed: 03/14/2023] Open
Abstract
SummaryIntroduction:overweight and obesity in adolescents are major public health problems with particular interest, because of their potential association with risk factors for development of diseases. The study aimed to determine the prevalence of overweight and obesity in adolescents in southern Portugal and investigate the association with risk factors for development of cardiovascular, respiratory and musculoskeletal diseases.Methods:the sample consisted of 966 adolescents aged 10 to 16 years. The calculation of body mass index (BMI), evaluation of blood glucose, total cholesterol and triglycerides, blood pressure, spirometry and application of low back pain (LBP) questionnaire were performed.Results:178 (18.4%) adolescents were overweight and 52 (5.4%) obese. None of the variables revealed a statistically significant association with overweight and obesity. The presence of high blood pressure was observed in 200 (20.7%) individuals and hypertension in 158 (16.4%) adolescents. Overweight and obese adolescents are 2.3 times more likely to develop signs of pre-hypertension and hypertension. 559 (57.9%) students had restrictive respiratory disorders and 23 (2.4%) had obstructive disorders. Those who were overweight and obese had 0.64 probability of having restrictive respiratory disorders.Conclusion:there was a high prevalence of overweight and obesity in Portuguese adolescents and these showed a statistically significant relationship with the development of pre-hypertension and hypertension, and restrictive respiratory disorders.
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Pagani LS, Nguyen AKD, Fitzpatrick C. Prospective Associations Between Early Long-Term Household Tobacco Smoke Exposure and Subsequent Indicators of Metabolic Risk at Age 10. Nicotine Tob Res 2015; 18:1250-7. [PMID: 26069035 DOI: 10.1093/ntr/ntv128] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Accepted: 06/03/2015] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Although there are established risks associated with gestational tobacco smoke exposure, few studies have addressed the metabolic hazards of domestic exposure in early childhood. This study prospectively examines the long-term relationship between early childhood exposure to household smoke and two adiposity-related measures at age 10. METHODS Participants from the Quebec Longitudinal Study of Child Development birth cohort were categorized into one of three groups of early childhood household exposure to tobacco smoke over four time points (from ages 1 to 7 years): never-exposed; transient exposure; and continuous exposure. Follow-up measures of body mass index and waist circumference were independently assessed at age 10. RESULTS Compared to being never exposed, transient and continuous household smoke exposure predicted increases of 0.93 cm (95% confidence interval [CI] between 0.05 and 1.82 cm; P = .03) and 1.56 cm (95% CI between 0.07 and 3.05 cm; P = .04) in children's waist circumference, respectively. Children exposed to transient and continuous household smoke, compared to unexposed children, also showed 0.48 and 0.81 point increases in their body mass index, respectively, both Ps = .005. Once adjusted, for confounding variables, only transient household smoke remained associated with 43% greater odds of belonging to the overweight/obese category (95% CI between 1.12 and 1.81 cm; P < .01). CONCLUSIONS We found significant long-term prospective associations between home-based secondhand smoke exposure and unhealthy body fat distribution. Waist circumference in youth has become an important risk factor for obesity-related diseases in adulthood. Our findings emphasize the importance public health initiatives and parental sensitization aimed at domestic exposure reductions during the critical early childhood years.
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Affiliation(s)
- Linda S Pagani
- Centre de Recherche de l'Hôpital Sainte-Justine, Université de Montréal, Montréal, QC, Canada; École de psychoéducation, Université de Montréal, Montréal, QC, Canada;
| | - A K Danny Nguyen
- École de psychoéducation, Université de Montréal, Montréal, QC, Canada
| | - Caroline Fitzpatrick
- Department of Exercise Science, PERFORM Centre, Concordia University, Montréal, QC, Canada
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Coutinho CA, Longui CA, Monte O, Conde W, Kochi C. Measurement of neck circumference and its correlation with body composition in a sample of students in São Paulo, Brazil. Horm Res Paediatr 2015; 82:179-86. [PMID: 25138376 DOI: 10.1159/000364823] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 05/26/2014] [Indexed: 11/19/2022] Open
Abstract
PURPOSE The purpose of this study was to verify the correlation between neck circumference (NC) and body mass index (BMI) in children, and to determine NC percentiles for Brazilian children. METHODS The subjects of this cross-sectional study were students between the ages of 6 and 19 years from five schools in São Paulo, Brazil. Clinical and anthropometric data were collected from the students from April 2011 to June 2012. NC was measured at the level of the cricoid cartilage. We calculated Pearson correlation coefficients between NC and other indices of obesity with Sigma Stat 3.5. NC percentiles were produced using the LMS (lambda, mu, and sigma) method (STATA 12.0). RESULTS Among 2,794 students, 49.9% were male. NC was significantly correlated with age, BMI, waist circumference (WC), and body fat percentage (%BF). The NC of boys was greater than that of girls. The NC curves of smoothed 3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentiles were constructed by age and sex. CONCLUSIONS NC can be used in the assessment of obesity in childhood. There was a positive correlation between NC and BMI, WC and %BF. This study was the first to provide NC percentiles for children in Brazil.
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Affiliation(s)
- Claudia Andrade Coutinho
- Pediatric Endocrinology Unit, Irmandade da Santa Casa de Misericórdia de São Paulo, Santa Casa de São Paulo Faculty of Medical Sciences, São Paulo, Brazil
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Simental-Mendía LE, Castañeda-Chacón A, Rodriguez-Morán M, Aradillas-García C, Guerrero-Romero F. Relationship between elevated triglyceride levels with the increase of HOMA-IR and HOMA-β in healthy children and adolescents with normal weight. Eur J Pediatr 2015; 174:597-605. [PMID: 25339422 DOI: 10.1007/s00431-014-2426-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Revised: 09/10/2014] [Accepted: 09/15/2014] [Indexed: 11/26/2022]
Abstract
UNLABELLED To test the hypothesis that mildly elevated triglyceride levels are associated with the increase of homeostasis model assessment of insulin resistance (HOMA-IR) and β-cell function (HOMA-β) indices in healthy children and adolescents with normal weight, we conducted a cross-sectional population study. Based on fasting triglyceride levels, participants were allocated into groups with and without triglyceride levels ≥1.2 mmol/L. Normal weight was defined by body mass index between the 15th and 85th percentiles, for age and gender. Insulin resistance and insulin secretion were estimated using HOMA-IR and HOMA-β indices. A total of 1660 children and adolescents were enrolled, of them 327 (19.7%) with mildly elevated triglycerides. The multivariate linear regression analysis showed that mildly elevated triglyceride levels in children were associated with HOMA-IR (β = 0.214, p < 0.001), HOMA-β (β = 0.139, p = 0.001), systolic (β = 0.094, p = 0.01), and diastolic blood pressure (β = 0.102, p = 0.007), whereas in adolescents, HOMA-IR (β = 0.267, p < 0.001) and HOMA-β (β = 0.154, p < 0.001), but not systolic (β = 0.029, p = 0.38) and diastolic blood pressure (β = 0.015, p = 0.642), showed association with mildly elevated triglycerides. CONCLUSION Mildly elevated triglyceride levels are associated with increased HOMA-IR and HOMA-β indices in healthy children and adolescents with normal weight.
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Affiliation(s)
- Luis E Simental-Mendía
- Biomedical Research Unit of the Mexican Social Security Institute, Siqueiros 225 esq/Castañeda, 34000, Durango, DGO, Mexico,
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An examination of eating behaviors, physical activity, and obesity in african american adolescents: gender, socioeconomic status, and residential status differences. J Pediatr Health Care 2015; 29:243-54. [PMID: 25582548 DOI: 10.1016/j.pedhc.2014.11.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 10/29/2014] [Accepted: 11/08/2014] [Indexed: 11/23/2022]
Abstract
BACKGROUND African American adolescents experience higher rates of obesity and have an increased risk of obesity-related diseases than do White American adolescents. Despite culturally sensitive obesity preventive interventions, obesity rates are increasing within the African American adolescent population. Current obesity interventions do not usually address the heterogeneity (e.g., socioeconomic status [SES], gender, and residential status differences) within the African American adolescent community that can affect the efficacy of these interventions. PURPOSE To examine the gender, SES, and residential status differences related to obesity and weight behaviors in African American adolescents. METHODS A descriptive correlational study was conducted with 15- to 17-year-old African American adolescents (n = 145) from community clinics, youth organizations, churches, and social networks in metropolitan and inner-city Detroit. Data were collected through use of survey methods and analyzed with use of descriptive statistics, independent sample t tests, and multiple regression equations. RESULTS Female adolescents consumed foods higher in fat and calories (t = -2.36, p = .019) and had more body fat (t = -9.37, p = .000) than did males. Adolescents of lower SES consumed food higher in fat and calories (t = -2.23, p = .027) and had higher body mass (t = -2.57, p = .011) than did adolescents of higher SES. Inner-city African American adolescents had higher levels of physical activity (t = -2.39, p = .018) and higher body mass (t = 2.24, p = .027) than did suburban African American adolescent counterparts. Gender, SES, and residential status were statistically significant predictors of eating behaviors, physical activity, body mass index, and body fat. CONCLUSIONS The initial findings from the study will assist in better understanding the obesity epidemic that affects African American adolescents in disparate proportions. IMPLICATIONS Further examination of the study variables is essential to serve as a basis for developmentally appropriate and culturally relevant targeted interventions with this population. Health care providers and obesity researchers who work with youth can use the initial findings from this study to advocate for healthy lifestyles while reducing the obesity disparity within the African American adolescent population.
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González-Zavala M, Velasco-Morales A, Terrazas-Flores J, de la Cruz-Galicia M, Cepeda-Nieto A, Hernández-del Río A. Levels of insulin and HOMA-IR in adolescents in Saltillo, Coahuila, Mexico. MEDICINA UNIVERSITARIA 2015. [DOI: 10.1016/j.rmu.2015.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
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Romualdo MCDS, de Nóbrega FJ, Escrivão MAMS. Insulin resistance in obese children and adolescents. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2014. [DOI: 10.1016/j.jpedp.2014.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Romualdo MCDS, Nóbrega FJD, Escrivão MAMS. Insulin resistance in obese children and adolescents. J Pediatr (Rio J) 2014; 90:600-7. [PMID: 25019650 DOI: 10.1016/j.jped.2014.03.005] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 03/21/2014] [Accepted: 03/28/2014] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE To evaluate the presence of insulin resistance and its association with other metabolic abnormalities in obese children and adolescents. METHODS Retrospective study of 220 children and adolescents aged 5-14 years. Anthropometric measurements were performed (weight, height, and waist circumference) and clinical (gender, age, pubertal stage, and degree of obesity) and biochemical (glucose, insulin, total cholesterol, and fractions, triglycerides) data were analyzed. Insulin resistance was identified by the homeostasis model assessment for insulin resistance (HOMA-IR) index. The analysis of the differences between the variables of interest and the HOMA-IR quartiles was performed by ANOVA or Kruskal-Wallis tests. RESULTS Insulin resistance was diagnosed in 33.20% of the sample. It was associated with low levels of high-density lipoprotein cholesterol (HDL-C; p=0.044), waist circumference measurement (p=0.030), and the set of clinical and metabolic (p=0.000) alterations. Insulin-resistant individuals had higher mean age (p=0.000), body mass index (BMI; p=0.000), abdominal circumference (p=0.000), median triglycerides (p=0.001), total cholesterol (p≤0.042), and low-density lipoprotein cholesterol (LDL-C; p≤0.027); and lower HDL-C levels (p=0.005). There was an increase in mean BMI (p=0.000), abdominal circumference (p=0.000), and median triglycerides (p=0.002) as the values of HOMA -IR increased, with the exception of HDL-C, which decreased (p=0.001). Those with the highest number of simultaneous alterations were between the second and third quartiles of the HOMA-IR index (p=0.000). CONCLUSION The results confirmed that insulin resistance is present in many obese children and adolescents, and that this condition is associated with alterations that represent an increased risk for developing metabolic disorders in adulthood.
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Affiliation(s)
| | - Fernando José de Nóbrega
- Department of Pediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Maria Arlete Meil Schimith Escrivão
- Department of Pediatrics, Discipline of Nutrology, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
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Andaki ACR, Tinôco ALA, Mendes EL, Andaki Júnior R, Hills AP, Amorim PRS. Anthropometry and physical activity level in the prediction of metabolic syndrome in children. Public Health Nutr 2014; 17:2287-94. [PMID: 24063585 PMCID: PMC10282609 DOI: 10.1017/s136898001300253x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Revised: 07/23/2013] [Accepted: 08/14/2013] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of anthropometric measures and physical activity level in the prediction of metabolic syndrome (MetS) in children. DESIGN Cross-sectional study with children from public and private schools. Children underwent an anthropometric assessment, blood pressure measurement and biochemical evaluation of serum for determination of TAG, HDL-cholesterol and glucose. Physical activity level was calculated and number of steps per day obtained using a pedometer for seven consecutive days. SETTING Viçosa, south-eastern Brazil. SUBJECTS Boys and girls (n 187), mean age 9·90 (SD 0·7) years. RESULTS Conicity index, sum of four skinfolds, physical activity level and number of steps per day were accurate in predicting MetS in boys. Anthropometric indicators were accurate in predicting MetS for girls, specifically BMI, waist circumference measured at the narrowest point and at the level of the umbilicus, four skinfold thickness measures evaluated separately, the sum of subscapular and triceps skinfold thickness, the sum of four skinfolds and body fat percentage. CONCLUSIONS The sum of four skinfolds was the most accurate method in predicting MetS in both genders.
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Affiliation(s)
- Alynne Christian Ribeiro Andaki
- Nutrition and Health Department, Viçosa Federal University, DNS – Prédio CCBII, Sexto andar, Lab. 47 – Campus UFV, Viçosa, MG, 36570-000 Brazil
| | - Adelson Luiz Araújo Tinôco
- Nutrition and Health Department, Viçosa Federal University, DNS – Prédio CCBII, Sexto andar, Lab. 47 – Campus UFV, Viçosa, MG, 36570-000 Brazil
| | - Edmar Lacerda Mendes
- Sport Science Department, Triângulo Mineiro Federal University, Uberaba, MG, Brazil
| | | | - Andrew P Hills
- Mater Mother's Hospital, Mater Medical Research Institute and Griffith Health Institute, Griffith University, Brisbane, Australia
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