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Liu F, Kong B, Zhang Z, Chen L, Li Y, Xiong J, Yao P, Li Y, Tang Y. Associations between adherence to 24-Hour Movement Guidelines with continuous metabolic syndrome score among Chinese children and adolescents. Public Health 2024; 236:274-280. [PMID: 39278070 DOI: 10.1016/j.puhe.2024.08.005] [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: 05/14/2024] [Revised: 07/21/2024] [Accepted: 08/08/2024] [Indexed: 09/17/2024]
Abstract
OBJECTIVES The objective of this study was to evaluate the associations between adherence to 24-Hour Movement Guidelines (24-HMG) with continuous metabolic syndrome score (cMetS) among Chinese children. STUDY DESIGN Cross-sectional study. METHODS We conducted a cross-sectional study among 4604 children aged 6-17 years from Shenzhen, China. The 24-HMG was constructed using the self-report information on moderate-to-vigorous physical activity (MVPA), screen time (ST), and sleep duration. The cMetS was calculated based on waist circumference, homoeostatic model assessment for insulin resistance, mean arterial blood pressure, high-density lipoprotein cholesterol, and triglyceride. Multivariate linear regression models were used to assess the associations between adherence to recommendations of 24-HMG and cMetS. RESULTS Among the participants, 563 (12.23%) students adhered to 3 recommendations of the 24-HMG. We found that adhering to more recommendations was negatively associated with cMetS (P for trend: <0.001). For specific combinations, meeting the ST + MVPA recommendations was negatively associated with cMetS (coefficients [β]: -0.686; 95% confidence interval [CI]: -1.148, -0.223). Individuals who adhered to all recommendations had a lower cMetS (β: -0.693; 95% CI: -1.147, -0.238) than those who met none of the recommendations. CONCLUSIONS Our study showed that adherence to more recommendations of the 24-HMG was associated with lower levels of cMetS in Chinese children and adolescents.
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Affiliation(s)
- Fangqu Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China; Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong, 518000, China
| | - Bingxuan Kong
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Zhuangyu Zhang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Li Chen
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Yan Li
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong, 518000, China
| | - Jingfan Xiong
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong, 518000, China
| | - Ping Yao
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Yanyan Li
- Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong, 518000, China.
| | - Yuhan Tang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.
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Valerio G, Di Bonito P, Calcaterra V, Cherubini V, Corica D, De Sanctis L, Di Sessa A, Faienza MF, Fornari E, Iughetti L, Licenziati MR, Manco M, Del Giudice EM, Morandi A, Salerno M, Street ME, Umano GR, Wasniewska M, Maffeis C. Cardiometabolic risk in children and adolescents with obesity: a position paper of the Italian Society for Pediatric Endocrinology and Diabetology. Ital J Pediatr 2024; 50:205. [PMID: 39380079 PMCID: PMC11463079 DOI: 10.1186/s13052-024-01767-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Accepted: 09/20/2024] [Indexed: 10/10/2024] Open
Abstract
Despite the implementation of preventive measures to counteract the obesity epidemics, the prevalence of childhood obesity is still alarming all over the world. Childhood obesity is the most common risk factor for both cardiovascular and metabolic diseases. In fact, an earlier onset of obesity can cause a greater risk of adiposity tracking across the lifespan and consequently a longer exposure to cardiometabolic risk factors. Accumulating evidence provided by prospective and intervention studies demonstrated the link between pediatric obesity and selected subclinical signs of cardiovascular damage (atherosclerosis and left ventricular hypertrophy), or fatal and not fatal cardiovascular events as early as 40 years of age.The numerous guidelines and scientific documents published in the last years demonstrate the relevance of assessing cardiometabolic risk factors in children and adolescents with OB.This Position paper, released by experts of the "Childhood Obesity study group" within the Italian Society for Pediatric Endocrinology and Diabetology, aims to review the assessment of cardiometabolic risk factors and comorbidities in children and adolescents with OW/OB on the light of the most recent scientific evidence.The main recommendations are: (a) early detection of comorbidities, including hypertension, dyslipidemia, prediabetes/type 2 diabetes, metabolic dysfunction-associated steatotic liver disease, polycystic ovary syndrome, inactivity, obstructive sleep apnea and decline in kidney function; (b) weight loss treatment, which is associated with a reduction of all cardiometabolic risk factors; (c) specific treatment of comorbidities, through lifestyle modifications or pharmacological treatment added to lifestyle for suitable individuals; d). monitoring comorbidities for mitigating future morbidity and mortality.
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Affiliation(s)
- Giuliana Valerio
- Department of Medical, Movement and Wellbeing Sciences, University of Napoli "Parthenope", Napoli, 80133, Italy.
| | - Procolo Di Bonito
- Department of Internal Medicine, "S. Maria delle Grazie" Hospital, Pozzuoli, 80078, Italy
| | - Valeria Calcaterra
- Pediatric Department, "V. Buzzi" Children's Hospital, 20154, Milano, Italy
- Department of Internal Medicine, University of Pavia, Pavia, 27100, Italy
| | - Valentino Cherubini
- Department of Women's and Children's Health, Azienda Ospedaliero-Universitaria delle Marche, Ospedali Riuniti di Ancona, "G. Salesi Hospital,", Ancona, Italy
| | - Domenico Corica
- Department of Human Pathology in Adulthood and Childhood, University of Messina, Messina, 98122, Italy
| | - Luisa De Sanctis
- Department of Public Health and Pediatric Sciences, University of Turin, Turin, 10126, Italy
| | - Anna Di Sessa
- Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli", Napoli, 80138, Italy
| | - Maria Felicia Faienza
- Pediatric Unit, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari "Aldo Moro", Bari, 70124, Italy
| | - Elena Fornari
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, 37126, Italy
| | - Lorenzo Iughetti
- Paediatric Unit Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, 41121, Italy
| | - Maria Rosaria Licenziati
- Neuro-Endocrine Diseases and Obesity Unit, Department of Neurosciences, Santobono- Pausilipon Children's Hospital, Naples, 80129, Italy
| | - Melania Manco
- Preventive and Predictive Medicine Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, 00165, Italy
| | - Emanuele Miraglia Del Giudice
- Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli", Napoli, 80138, Italy
| | - Anita Morandi
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, 37126, Italy
| | - Mariacarolina Salerno
- Department of Translational Medical Science, University of Naples "Federico II", Napoli, 80131, Italy
| | | | - Giuseppina Rosaria Umano
- Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli", Napoli, 80138, Italy
| | - Malgorzata Wasniewska
- Department of Human Pathology in Adulthood and Childhood, University of Messina, Messina, 98122, Italy
| | - Claudio Maffeis
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, 37126, Italy
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Lefebvre L, Grunemwald T, Hamrene K, Roda C, Momas I. Unsupervised identification of cardiometabolic profiles among adolescents: findings from the PARIS birth cohort study. Eur J Pediatr 2024; 183:715-725. [PMID: 37979049 PMCID: PMC10912260 DOI: 10.1007/s00431-023-05311-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/11/2023] [Accepted: 10/25/2023] [Indexed: 11/19/2023]
Abstract
Metabolic syndrome (MetS) is known as a risk factor in cardiometabolic morbidity but there is no consensus on its definition for teenagers. We aimed to identify cardiometabolic health profiles and which parameters best discriminate them. K-means partitioning identified cardiometabolic profiles by sex using data on health measurements of 530 adolescents from the PARIS birth cohort. A discriminant analysis was performed. Cardiometabolic risk score and handgrip strength were also measured. Depending on definitions, MetS prevalence ranged from 0.2% to 1.3%. Two profiles were identified for the entire group and by sex: "healthy" and "at cardiometabolic risk." Weight and waist-to-height ratio or waist circumference explained more than 87% of the variance in the profile differentiation. The "at cardiometabolic risk" profiles included adolescents with overweight, a waist-to-height ratio over 0.5, and prehypertension. They had higher cardiometabolic risk scores and parents who were more likely to be overweight and have cardiometabolic diseases themselves. They also had higher birthweights, earlier adiposity-rebound and puberty ages, and lower relative handgrip strength. Conclusion: The two profiles identified, based on cardiometabolic health, were associated with early indicators and handgrip strength. Results suggest that the waist-to-height ratio is a useful clinical tool for screening individuals at cardiometabolic risk and who therefore require clinical follow-up. What is Known: • Although there is a need for tools to assess cardiometabolic health during adolescence, there is no consensus on the definition of metabolic syndrome for this age group. What is Knew: • The findings suggest that waist-to-height ratio can serve as a simple and valuable clinical tool for screening individuals at cardiometabolic risk who may require clinical monitoring for early prevention of cardiovascular diseases.
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Affiliation(s)
- Léa Lefebvre
- Université Paris Cité, Sorbonne Paris-Nord, INRAe, INSERM, UMR 1153-CRESS, HERA Team, Paris, France
- ADEME - Agence de la transition écologique, Angers, France
| | - Thomas Grunemwald
- Centre d'Examens de Santé de la Caisse Primaire d'Assurance Maladie, Paris, France
| | - Karima Hamrene
- Centre d'Examens de Santé de la Caisse Primaire d'Assurance Maladie, Paris, France
| | - Céline Roda
- Université Paris Cité, Sorbonne Paris-Nord, INRAe, INSERM, UMR 1153-CRESS, HERA Team, Paris, France.
- Faculté de Pharmacie, 4 Avenue de l'Observatoire, 75006, Paris, France.
| | - Isabelle Momas
- Université Paris Cité, Sorbonne Paris-Nord, INRAe, INSERM, UMR 1153-CRESS, HERA Team, Paris, France
- Faculté de Pharmacie, 4 Avenue de l'Observatoire, 75006, Paris, France
- Cellule Cohorte, Mairie de Paris, Direction de la Santé Publique, Paris, France
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Halvorson BD, Bao Y, Singh KK, Frisbee SJ, Hachinski V, Whitehead SN, Melling CWJ, Chantler PD, Goldman D, Frisbee JC. Thromboxane-induced cerebral microvascular rarefaction predicts depressive symptom emergence in metabolic disease. J Appl Physiol (1985) 2024; 136:122-140. [PMID: 37969083 PMCID: PMC11551004 DOI: 10.1152/japplphysiol.00410.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 11/14/2023] [Accepted: 11/14/2023] [Indexed: 11/17/2023] Open
Abstract
Previous studies have suggested that the loss of microvessel density in the peripheral circulation with evolving metabolic disease severity represents a significant contributor to impaired skeletal muscle oxygenation and fatigue-resistance. Based on this and our recent work, we hypothesized that cerebral microvascular rarefaction was initiated from the increased prooxidant and proinflammatory environment with metabolic disease and is predictive of the severity of the emergence of depressive symptoms in obese Zucker rats (OZRs). In male OZR, cerebrovascular rarefaction followed the emergence of elevated oxidant and inflammatory environments characterized by increased vascular production of thromboxane A2 (TxA2). The subsequent emergence of depressive symptoms in OZR was associated with the timing and severity of the rarefaction. Chronic intervention with antioxidant (TEMPOL) or anti-inflammation (pentoxifylline) therapy blunted the severity of rarefaction and depressive symptoms, although the effectiveness was limited. Blockade of TxA2 production (dazmegrel) or action (SQ-29548) resulted in a stronger therapeutic effect, suggesting that vascular production and action represent a significant contributor to rarefaction and the emergence of depressive symptoms with chronic metabolic disease (although other pathways clearly contribute as well). A de novo biosimulation of cerebrovascular oxygenation in the face of progressive rarefaction demonstrates the increased probability of generating hypoxic regions within the microvascular networks, which could contribute to impaired neuronal metabolism and the emergence of depressive symptoms. The results of the present study also implicate the potential importance of aggressive prodromic intervention in reducing the severity of chronic complications arising from metabolic disease.NEW & NOTEWORTHY With clinical studies linking vascular disease risk to depressive symptom emergence, we used obese Zucker rats, a model of chronic metabolic disease, to identify potential mechanistic links between these two negative outcomes. Depressive symptom severity correlated with the extent of cerebrovascular rarefaction, after increased vascular oxidant stress/inflammation and TxA2 production. Anti-TxA2 interventions prevasculopathy blunted rarefaction and depressive symptoms, while biosimulation indicated that cerebrovascular rarefaction increased hypoxia within capillary networks as a potential contributing mechanism.
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Affiliation(s)
- Brayden D Halvorson
- Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada
| | - Yuki Bao
- Department of Biomedical Engineering, University of Western Ontario, London, Ontario, Canada
| | - Krishna K Singh
- Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada
| | - Stephanie J Frisbee
- Department of Pathology and Laboratory Medicine, University of Western Ontario, London, Ontario, Canada
| | - Vladimir Hachinski
- Department of Anatomy and Cell Biology, University of Western Ontario, London, Ontario, Canada
| | - Shawn N Whitehead
- Department of Anatomy and Cell Biology, University of Western Ontario, London, Ontario, Canada
| | - C W James Melling
- Department of Kinesiology, University of Western Ontario, London, Ontario, Canada
| | - Paul D Chantler
- Division of Exercise Physiology, West Virginia University, Morgantown, West Virginia, United States
| | - Daniel Goldman
- Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada
| | - Jefferson C Frisbee
- Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada
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Olorunmoteni OE, Gómez-Olivé FX, Popoola BO, Fatusi AO, Scheuermaier K. Adolescent sleep health in Africa: a scoping review protocol. BMJ Open 2023; 13:e067373. [PMID: 37591652 PMCID: PMC10441092 DOI: 10.1136/bmjopen-2022-067373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 07/10/2023] [Indexed: 08/19/2023] Open
Abstract
INTRODUCTION Problematic sleep is a major threat to health and quality of life among adolescents. Hence, to provide directions for research and interventions, there is a need to examine the literature on adolescent sleep health in Africa. However, available studies on adolescent sleep health in Africa have not been properly mapped. Thus, this scoping review aims to investigate the extent and type of available evidence concerning sleep health among adolescents in Africa and to highlight the relationship of adolescent sleep health with adverse mental health outcomes and cardiometabolic risk factors. The review will further highlight areas of agreement and controversies on adolescent sleep health, and identify evidence gaps that require research attention across the continent. METHODS AND ANALYSIS This scoping review will be conducted using Arksey and O'Malley's six-step procedure. Thus, we have prepared this protocol according to the framework for scoping reviews developed by the Joanna Briggs Institute. To identify eligible studies, we will search MEDLINE, Scopus, PsycINFO, AJOL, JSTOR, HINARI and Google Scholar. The review will include all published articles in English, French, Spanish, Portuguese and Italian languages on adolescent sleep health in Africa from the inception of the databases, while relevant information will be extracted from included studies using an adapted data extraction tool. The results will be presented using tables and charts as appropriate. ETHICS AND DISSEMINATION The scoping review does not require ethical approval because the publications to be used for the review are publicly available and the study does not involve contact with humans or other animals as research participants. Furthermore, clinical records will not be used for the study. Upon completion, findings from the study will be disseminated through presentations at scientific meetings and publication in a relevant peer-reviewed journal. SCOPING REVIEW REGISTRATION Open Science Framework (https://osf.io/5sjwq/).
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Affiliation(s)
- Oluwatosin Eunice Olorunmoteni
- Department of Paediatrics and Child Health, Obafemi Awolowo University, Ile-Ife, Nigeria
- School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - F Xavier Gómez-Olivé
- Medical Research Council/Wits Rural Health and Health Transitions Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Adesegun Olayiwola Fatusi
- Department of Community Medicine, University of Medical Sciences, Ondo, Nigeria
- Department of Community Health, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Karine Scheuermaier
- School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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