[Waist-to-height ratio is an indicator of metabolic risk in children]

Telehealth Secure Solution to Provide Childhood Obesity Monitoring

Childhood obesity causes not only medical and psychosocial problems, it also reduces the life expectancy of the adults that they will become. On a large scale, obese adults adversely affect labor markets and the gross domestic product of countries. Monitoring the growth charts of children helps to maintain their body weight within healthy parameters according to the World Health Organization. Modern technologies allow the use of telehealth to carry out weight control programs and monitoring to verify children's compliance with the daily recommendations for risk factors that can be promoters of obesity, such as insufficient physical activity and insufficient sleep hours. In this work, we propose a secure remote monitoring and supervision scheme of physical activity and sleep hours for the children based on telehealth, multi-user networks, chaotic encryption, and spread spectrum, which, to our knowledge, is the first attempt to consider this service for safe pediatric telemedicine. In experimental results, we adapted a recent encryption algorithm in the literature for the proposed monitoring scheme using the assessment of childhood obesity as an application case in a multi-user network to securely send and receive fictitious parameters on childhood obesity of five users through the Internet by using just one communication channel. The results show that all the monitored parameters can be transmitted securely, achieving high sensitivity against secret key, enough secret key space, high resistance against noise interference, and 4.99 Mb/sec in computational simulations. The proposed scheme can be used to monitor childhood obesity in secure telehealth application.

Adiponectin and Leptin Adipocytokines in Metabolic Syndrome: What Is Its Importance?

The global obesity epidemic has motivated a large number of investigations related to adipose tissue. Within the advances in this area, a variety of factors secreted by adipose tissue and with regulatory activity on caloric intake, energy expenditure, reproduction, locomotor activity, glycidic and lipid metabolism, immune response, and bone physiology have been described. Among these adipocyte hormones, collectively called “adipokines” or “adipocytokines,” leptin (LEP) and adiponectin are addressed in this review. The regulation of adipocytokines is altered in diseases such as obesity, atherosclerosis, type 2 diabetes mellitus, and metabolic syndrome (MS) due to the increase in the mass of white adipose tissue. LEP and adiponectin have a broad spectrum of functions in regulating metabolism and are an important link between obesity and MS. Because these adipocytokines have opposite effects on subclinical inflammation and insulin resistance, it has been suggested that the combined use of these 2 adipocytokines may work as a better biomarker in the diagnosis of MS than using them individually. In this review, we address the characteristics and main functions of adipocytokines derived from adipose tissue such as adiponectin and LEP, which in the Colombian context could give good guidance for the management of MS, especially in populations of children and adolescents.

Overweight Proxies Are Associated with Atopic Asthma: A Matched Case-Control Study

BACKGROUND

Many studies have documented a link between overweight and asthma in children with contradictory results regarding the best way to measure overweight. Moreover, often, the dynamic development of atopy, overweight, and asthma is controlled for age dependency insufficiently.

OBJECTIVE

This study assesses and compares the associations of overweight measured as waist circumference, waist to height ratio (WHtR), neck circumference, and body mass index with the occurrence of asthma - best possibly controlling for age-dependencies of these parameters.

METHODS

From a sample of 2,511 children aged 6-17 years, we matched 157 children with asthma with 2 controls (n = 471) according to age and atopy status and performed conditional logistic regression analyses. We further investigated the role of known influencing factors of asthma occurrence.

RESULTS

In children with atopy, all overweight proxies were consistently positively associated with asthma. Statistical significance was reached for WHtR-SD score (OR 1.26, 95% CI 1.03-1.54, p = 0.025) and persisted when further covariates, such as birth weight or social status, were added to the model. Groups of atopic versus nonatopic participants do not differ in levels of interleukin-6 or high-sensitivity C-reactive protein.

CONCLUSION

In our cohort, overweight seems to carry a risk for asthma only if accompanied with atopy. We call for more strict age matching in pediatric cohort studies and longitudinal studies for a better understanding for causal links of overweight, atopy, and asthma.

Physical Exercise and Grip Strength in Patients Intervened through Bariatric Surgery

Objective: This work sought to evaluate a physical exercise program of moderate intensity in patients operated of bariatric surgery and its influence on muscle strength. Method: Randomized clinical trial, with an intervention group and a control group. Forty-three patients were operated of bariatric surgery. The intervention group was applied a program of moderate physical activity during six months. Grip strength and bioimpedance were measured at their baseline form, at one month, and six months after surgery. A bivariate study was conducted to observe variable changes. Results: Upon conducting Student´s t for independent samples in all the variables (weight, body mass index, grip strength, lean mass, fat mass, and metabolism), the result is that no significant differences exist between the intervention group and the control group with p > 0.05. Conclusion: A program of moderate physical activity lasting six months in patients intervened of bariatric surgery has no significant result in the development of muscle mass evaluated through manual dynamometry and bioimpedance.

Probability and Body Composition of Metabolic Syndrome in Young Adults: Use of the Bayes Theorem as Diagnostic Evidence of the Waist-to-Height Ratio

Metabolic syndrome (MS) directly increases the risk of cardiovascular diseases. Childhood and adulthood have been the most studied in MS, leaving aside the young adult population. This study aimed to compare the epidemiological probabilities between MS and different anthropometric parameters of body composition. Using a cross-sectional study with the sample of 1351 young adults, different body composition parameters were obtained such as Waist Circumference (WC), Body Mass Index (BMI), Body Fat% (BF%), Waist-to-Height Ratio (WHtR), and Waist-Hip Ratio. The Bayes Theorem was applied to estimate the conditional probability that any subject developed MS with an altered anthropometric parameter of body composition. Areas under receiver operating characteristic curves (AUCs) and adjusted odds ratios of the five parameters were analyzed in their optimal cutoffs. The conditional probability of developing MS with an altered anthropometric parameter was 17% in WHtR, WC, and Waist-hip R. Furthermore, body composition parameters were adjusted by age, BMI, and gender. Only WHtR (OR = 9.43, CI = 3.4–26.13, p < 0.0001), and BF% (OR = 3.18, CI = 1.42–7.13, p = 0.005) were significant, and the sensitivity (84%) and the AUCs (86%) was higher in WHtR than other parameters. In young adults, the WHtR was the best predictor of metabolic syndrome.

[Active form of vitamin D in overweight and obese pediatric patients in northwest Mexico]

BACKGROUND

Low levels of vitamin D have been associated with a range of clinical conditions such as obesity, insulin resistance, and diabetes mellitus, among others. There are few studies that measure the active form of vitamin D (1,25 (OH)₂ vitamin D) in obese children. However, published data are inconclusive. The aim of this study was to determine the active levels of vitamin D in obese and overweight children and to find an association between low levels of vitamin D, obesity and impaired glucose metabolism.

METHODS

A cross-sectional, analytical study was conducted in 6 to 12-year-old children with excess adiposity determined by waist-stature index and body mass index. Levels of glucose, insulin, complete lipid profile, homeostatic model assessment and the active form of vitamin D were measured in each patient. Levels < 30 pg/ml were considered as low levels of vitamin D.

RESULTS

The prevalence of low levels of active vitamin D was 36%. A significant association between low levels of active vitamin D and high levels of insulin was found. No significant association was found between vitamin levels and adiposity measures.

CONCLUSIONS

Low levels of active vitamin D were found in 36% of the population studied. A significant association with insulin resistance and hyperinsulinemia was demonstrated.