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Zamora Auñón A, Guijo Alonso B, De Andrés Esteban EM, Argente J, Martos-Moreno GÁ. Predictors of adherence to follow-up and treatment success in childhood obesity. An Pediatr (Barc) 2024:S2341-2879(24)00146-7. [PMID: 38834436 DOI: 10.1016/j.anpede.2024.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 04/03/2024] [Indexed: 06/06/2024] Open
Abstract
INTRODUCTION Management of childhood obesity, based upon behavioural, physical activity and dietary guidance, usually achieves limited success and is hindered by a high attrition rate. The identification of potential predictors of either weight loss or early weight management attrition could help develop personalised management plans in order to improve patient outcomes. PATIENTS AND METHODS We conducted a retrospective study in a cohort of 1300 patients with obesity managed in speciality clinics for up to 5 years with outpatient conservative treatment. We studied the family background and personal characteristics (demographic, behavioural, psychosocial, anthropometric and metabolic) of patients who dropped out before completing the first year of the programme and patients who achieved significant weight loss, with a separate analysis of patients who achieved substantial reductions in weight compared to the rest of the cohort. RESULTS The mean age of the patients in the cohort was 10.46 years (SD, 3.48) the mean BMI z-score 4.01 (SD, 1.49); 52.8% of the patients were male, 53.3% were prepubertal, 75.8% were Caucasian and 19% Latin. We found a higher proportion of Latinla ethnicity and compulsive eating in the group of patients with early attrition from the weight management follow-up. In the group of patients with substantial weight loss, a greater proportion were male, there was a higher frequency of dietary intake control at home and obesity was more severe, and the latter factor was consistently observed in patients who achieved substantial weight loss at any point of the follow-up. CONCLUSIONS Some family and personal characteristics in childhood obesity are associated with an increased risk of early withdrawal from follow-up or a greater probability of successful outcomes; however, the predictive value of these variables is limited.
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Affiliation(s)
- Ana Zamora Auñón
- Servicio de Pediatría y Endocrinología, Hospital Infantil Universitario Niño Jesús, Instituto de Investigación La Princesa, Madrid, Spain
| | - Blanca Guijo Alonso
- Servicio de Pediatría y Endocrinología, Hospital Infantil Universitario Niño Jesús, Instituto de Investigación La Princesa, Madrid, Spain
| | - Eva María De Andrés Esteban
- Departamento de Economía de la Empresa, Facultad de Ciencias de la Economía y Empresa, Universidad Rey Juan Carlos, Madrid, Spain
| | - Jesús Argente
- Servicio de Pediatría y Endocrinología, Hospital Infantil Universitario Niño Jesús, Instituto de Investigación La Princesa, Madrid, Spain; Departamento de Pediatría, Universidad Autónoma de Madrid, Madrid, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Instituto de alimentación IMDEA, CEIUAM+CSIC, Madrid, Spain
| | - Gabriel Á Martos-Moreno
- Servicio de Pediatría y Endocrinología, Hospital Infantil Universitario Niño Jesús, Instituto de Investigación La Princesa, Madrid, Spain; Departamento de Pediatría, Universidad Autónoma de Madrid, Madrid, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.
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2
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Gersing S, Cagiada M, Gebbia M, Gjesing AP, Coté AG, Seesankar G, Li R, Tabet D, Weile J, Stein A, Gloyn AL, Hansen T, Roth FP, Lindorff-Larsen K, Hartmann-Petersen R. A comprehensive map of human glucokinase variant activity. Genome Biol 2023; 24:97. [PMID: 37101203 PMCID: PMC10131484 DOI: 10.1186/s13059-023-02935-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 04/10/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Glucokinase (GCK) regulates insulin secretion to maintain appropriate blood glucose levels. Sequence variants can alter GCK activity to cause hyperinsulinemic hypoglycemia or hyperglycemia associated with GCK-maturity-onset diabetes of the young (GCK-MODY), collectively affecting up to 10 million people worldwide. Patients with GCK-MODY are frequently misdiagnosed and treated unnecessarily. Genetic testing can prevent this but is hampered by the challenge of interpreting novel missense variants. RESULT Here, we exploit a multiplexed yeast complementation assay to measure both hyper- and hypoactive GCK variation, capturing 97% of all possible missense and nonsense variants. Activity scores correlate with in vitro catalytic efficiency, fasting glucose levels in carriers of GCK variants and with evolutionary conservation. Hypoactive variants are concentrated at buried positions, near the active site, and at a region of known importance for GCK conformational dynamics. Some hyperactive variants shift the conformational equilibrium towards the active state through a relative destabilization of the inactive conformation. CONCLUSION Our comprehensive assessment of GCK variant activity promises to facilitate variant interpretation and diagnosis, expand our mechanistic understanding of hyperactive variants, and inform development of therapeutics targeting GCK.
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Affiliation(s)
- Sarah Gersing
- The Linderstrøm-Lang Centre for Protein Science, Department of Biology, University of Copenhagen, Ole Maaløes Vej 5, 2200, Copenhagen, Denmark
| | - Matteo Cagiada
- The Linderstrøm-Lang Centre for Protein Science, Department of Biology, University of Copenhagen, Ole Maaløes Vej 5, 2200, Copenhagen, Denmark
| | - Marinella Gebbia
- Donnelly Centre, University of Toronto, Toronto, ON, M5S 3E1, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, ON, M5S 1A8, Canada
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, M5G 1X5, Canada
| | - Anette P Gjesing
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Atina G Coté
- Donnelly Centre, University of Toronto, Toronto, ON, M5S 3E1, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, ON, M5S 1A8, Canada
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, M5G 1X5, Canada
| | - Gireesh Seesankar
- Donnelly Centre, University of Toronto, Toronto, ON, M5S 3E1, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, ON, M5S 1A8, Canada
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, M5G 1X5, Canada
| | - Roujia Li
- Donnelly Centre, University of Toronto, Toronto, ON, M5S 3E1, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, ON, M5S 1A8, Canada
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, M5G 1X5, Canada
- Department of Computer Science, University of Toronto, Toronto, ON, M5T 3A1, Canada
| | - Daniel Tabet
- Donnelly Centre, University of Toronto, Toronto, ON, M5S 3E1, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, ON, M5S 1A8, Canada
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, M5G 1X5, Canada
- Department of Computer Science, University of Toronto, Toronto, ON, M5T 3A1, Canada
| | - Jochen Weile
- Donnelly Centre, University of Toronto, Toronto, ON, M5S 3E1, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, ON, M5S 1A8, Canada
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, M5G 1X5, Canada
- Department of Computer Science, University of Toronto, Toronto, ON, M5T 3A1, Canada
| | - Amelie Stein
- The Linderstrøm-Lang Centre for Protein Science, Department of Biology, University of Copenhagen, Ole Maaløes Vej 5, 2200, Copenhagen, Denmark
| | - Anna L Gloyn
- Division of Endocrinology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
- Stanford Diabetes Research Center, Stanford University, Stanford, CA, USA
| | - Torben Hansen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Frederick P Roth
- Donnelly Centre, University of Toronto, Toronto, ON, M5S 3E1, Canada.
- Department of Molecular Genetics, University of Toronto, Toronto, ON, M5S 1A8, Canada.
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, M5G 1X5, Canada.
- Department of Computer Science, University of Toronto, Toronto, ON, M5T 3A1, Canada.
| | - Kresten Lindorff-Larsen
- The Linderstrøm-Lang Centre for Protein Science, Department of Biology, University of Copenhagen, Ole Maaløes Vej 5, 2200, Copenhagen, Denmark.
| | - Rasmus Hartmann-Petersen
- The Linderstrøm-Lang Centre for Protein Science, Department of Biology, University of Copenhagen, Ole Maaløes Vej 5, 2200, Copenhagen, Denmark.
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3
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Weiland A, Nannette LK, Zipfel S, Ehehalt S, Ziser K, Junne F, Mack I. Predictors of Weight Loss and Weight Loss Maintenance in Children and Adolescents With Obesity After Behavioral Weight Loss Intervention. Front Public Health 2022; 10:813822. [PMID: 35400038 PMCID: PMC8989956 DOI: 10.3389/fpubh.2022.813822] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 03/02/2022] [Indexed: 12/12/2022] Open
Abstract
Objective Predictors of body weight loss (BWL) and body weight loss maintenance (BWLM) after behavioral weight loss intervention are well-investigated in adults. Less is known for children and adolescents and a systematic overview on the topic for this age group was aim of the review. Methods A systematic research according to PRISMA guidelines using several databases was performed. The outcome was the BMI z-Score of longitudinal studies. The extracted predictors were classified in clusters (Physiology, Behavior, Psychology, Environment) and compared with a theory-driven model based on international guidelines and known predictors for adults. Results Out of 2,623 articles 24 met the eligibility criteria, 23 investigating BWL and 8 BWLM. The expected key predictor in research for adults “Behavior” was hardly investigated in children. The most examined cluster was “Physiology” with the most significant predictors, in particular genetics (BWL) and blood parameters (BWLM). Factors in the cluster “Psychology” also predicted BWL and BWLM. The cluster “Environment,” which was highlighted in most intervention guidelines, was neglected in studies regarding BWLM and hardly investigated in studies with BWL. Conclusion The comparison with the theory-driven children model outlined research gaps and differences between predictors for adults and children providing further direction of research. Systematic Review Registration http://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42020200505.
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Affiliation(s)
- Alisa Weiland
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany
| | - Lena Kasemann Nannette
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany
| | - Stefan Ehehalt
- Public Health Department of Stuttgart, Stuttgart, Germany
| | - Katrin Ziser
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Magdeburg, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Isabelle Mack
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, Tübingen, Germany
- *Correspondence: Isabelle Mack
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Langkjær IOJ, Fonvig CE, Holm LA, Pihl AF, Holm JC. Longitudinal evaluation of an mHealth overweight and obesity management tool. Mhealth 2022; 8:2. [PMID: 35178433 PMCID: PMC8800205 DOI: 10.21037/mhealth-21-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 06/24/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Efficient obesity treatment protocols are lacking. This study reports treatment results from a web-based application, originally developed for use in an in-person healthcare setting providing health, overweight, and obesity management. METHODS The web application DrHolmApp (WADHA) was evaluated in adult users two years after it was launched. The WADHA provides a personal and tailored treatment plan comprising a series of detailed action advices on everyday life, constructed from the user's input to a thorough online questionnaire. Throughout the subscription period, the WADHA users have full access to online healthcare professional support. We conducted a longitudinal cohort study using self-reported data. RESULTS This study included 940 adult WADHA users (861 female). The median body mass index (BMI) change across all WADHA users was -0.63 BMI points (95% CI: -0.7 to -0.57, P<0.001). 665 (71%) of all WADHA users reduced their BMI (median reduction: 0.94, 95% CI: 0.88 to 1.02). In the subset with obesity (n=675), BMI was reduced in 72%. The median number of days per week with physical activity for at least one hour per day increased with 1.5 days per week (from 2 days per week at baseline, P<0.001). Subsequently, the WADHA users improved their mood, quality of life, and body image satisfaction and reduced their appetite, bullying, and wish for weight loss (all P<0.001). A higher number of consultations associated with greater weight loss (P<0.001) independent of age and degree of obesity at treatment initiation. CONCLUSIONS Seventy-one percent of the WADHA users experienced weight loss, concomitant to an increased level of physical activity, improved mood, quality of life, and body image satisfaction, and reduced appetite, degree of bullying, and wish for weight loss. KEYWORDS Body mass index (BMI); mobile health (mHealth); obesity; treatment; weight loss.
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Affiliation(s)
| | - Cilius Esmann Fonvig
- Faculty of Health and Medical Sciences, Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
- Dr Holm App Aps., Holbæk, Denmark
| | - Louise Aas Holm
- Faculty of Health and Medical Sciences, Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Andreas Friis Pihl
- Research Unit of General Practice, University of Southern Denmark, Odense, Denmark
- Roche Diagnostics Denmark, Hvidovre, Denmark
| | - Jens-Christian Holm
- University of Copenhagen, Faculty of Health and Medical Sciences, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
- Dr Holm App Aps., Holbæk, Denmark
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Frithioff-Bøjsøe C, Lund MAV, Lausten-Thomsen U, Hedley PL, Pedersen O, Christiansen M, Baker JL, Hansen T, Holm JC. Leptin, adiponectin, and their ratio as markers of insulin resistance and cardiometabolic risk in childhood obesity. Pediatr Diabetes 2020; 21:194-202. [PMID: 31845423 DOI: 10.1111/pedi.12964] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 10/13/2019] [Accepted: 12/04/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND It is imperative to develop markers for risk stratification and detection of cardiometabolic comorbidities in children with obesity. The adipokines leptin and adiponectin are both involved in fat mass regulation and the development of obesity-related disorders; furthermore, their ratio (leptin/adiponectin ratio) is suggested to be associated with insulin resistance and cardiometabolic risk. OBJECTIVE To evaluate associations between fasting serum concentrations of the adipokines (total leptin and adiponectin as well as the L/A ratio) and cardiometabolic comorbidities in children with overweight/obesity. METHODS A total of 2258 children with overweight/obesity or normal weight aged 6 to 18 years were studied. Differences in anthropometrics and adipokine concentrations were tested using Wilcoxon rank-sum test. Associations between the adipokines and cardiometabolic risk were tested using Spearman's correlation and logistic regression, adjusted for age and body mass index SD score (BMI-SDS). RESULTS Compared to normal weight children; children with overweight/obesity exhibited higher leptin concentrations, lower adiponectin concentrations, and higher L/A ratios. After adjusting for age and degree of obesity, girls with overweight/obesity in the upper quartile range for the L/A ratio, when compared with girls in the lower quartile range, were more likely to have insulin resistance (odds ratio [OR]: 7.78 [95% confidence interval [CI], 3.78-16.65]), dysglycemia (OR: 3.08 [95% CI, 1.35-7.31]), and dyslipidemia (OR: 2.53 [95% CI, 1.18-5.59]); while boys were more likely to have insulin resistance (OR: 4.45 [95% CI, 2.03-10.10]). CONCLUSIONS Independent of the degree of obesity, leptin, adiponectin, and the L/A ratio were associated with insulin resistance and other cardiometabolic comorbidities in children with overweight/obesity, but the L/A ratio exhibited stronger associations than the respective adipokines.
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Affiliation(s)
- Christine Frithioff-Bøjsøe
- The Children's Obesity Clinic, European Centre of Management (EASO), Department of Pediatrics, Copenhagen University Hospital Holbaek, Holbaek, Denmark.,The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, University of Copenhagen, Copenhagen, Denmark
| | - Morten A V Lund
- The Children's Obesity Clinic, European Centre of Management (EASO), Department of Pediatrics, Copenhagen University Hospital Holbaek, Holbaek, Denmark.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ulrik Lausten-Thomsen
- Department of Neonatology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Paula L Hedley
- Department for Congenital Disorders, Danish National Biobank and Biomarkers, Statens Serum Institut, Copenhagen, Denmark
| | - Oluf Pedersen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, University of Copenhagen, Copenhagen, Denmark
| | - Michael Christiansen
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department for Congenital Disorders, Danish National Biobank and Biomarkers, Statens Serum Institut, Copenhagen, Denmark
| | - Jennifer L Baker
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, University of Copenhagen, Copenhagen, Denmark.,Center for Clinical Research and Disease Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Torben Hansen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, University of Copenhagen, Copenhagen, Denmark.,Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Jens-Christian Holm
- The Children's Obesity Clinic, European Centre of Management (EASO), Department of Pediatrics, Copenhagen University Hospital Holbaek, Holbaek, Denmark.,The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, University of Copenhagen, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Caprio S, Santoro N, Weiss R. Childhood obesity and the associated rise in cardiometabolic complications. Nat Metab 2020; 2:223-232. [PMID: 32694781 PMCID: PMC9425367 DOI: 10.1038/s42255-020-0183-z] [Citation(s) in RCA: 79] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 02/17/2020] [Indexed: 02/06/2023]
Abstract
Childhood obesity is one of the most serious global public-health challenges of the twenty-first century. Over the past four decades, the number of children and adolescents with obesity has risen more than tenfold. Worldwide, an increasing number of youth are facing greater exposure to obesity throughout their lives, and this increase will contribute to the early development of type 2 diabetes, fatty liver and cardiovascular complications. Herein, we provide a brief overview of trends in the global shifts in, and environmental and genetic determinants of, childhood obesity. We then discuss recent progress in the elucidation of the central role of insulin resistance, the key element linking obesity and cardiovascular-risk-factor clustering, and the potential mechanisms through which ectopic lipid accumulation leads to insulin resistance and its associated cardiometabolic complications in obese adolescents. In the absence of effective prevention and intervention programs, childhood obesity will have severe public-health consequences for decades to come.
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Affiliation(s)
- Sonia Caprio
- Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA.
| | - Nicola Santoro
- Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA.
| | - Ram Weiss
- Department of Pediatrics, Ruth Rappaport Children's Hospital, Rambam Medical Center, Technion School of Medicine, Haifa, Israel.
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7
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Frithioff-Bøjsøe C, Lund MAV, Kloppenborg JT, Nielsen TTH, Fonvig CE, Lausten-Thomsen U, Hedley PL, Hansen T, Pedersen OB, Christiansen M, Baker JL, Hansen T, Holm JC. Glucose metabolism in children and adolescents: Population-based reference values and comparisons to children and adolescents enrolled in obesity treatment. Pediatr Diabetes 2019; 20:538-548. [PMID: 31074070 DOI: 10.1111/pedi.12859] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 03/03/2019] [Accepted: 04/15/2019] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Alterations in glucose metabolism that lead to the development of metabolic and cardiovascular disease may begin already in childhood. OBJECTIVE This study aims to generate pediatric age and sex-specific reference values for fasting concentrations of glucose, hemoglobin A1c (HbA1c), insulin, C-peptide, and homeostasis model assessment: insulin resistance (HOMA-IR) in Danish/North-European white children and adolescents from a population-based cohort and to compare values from children and adolescents with overweight/obesity with this reference. METHODS The population- and obesity clinic-based cohorts consisted of 2451 and 1935 children and adolescents between 6 and 18 years of age. Anthropometric measurements and blood samples were obtained and percentile curves were calculated. RESULTS In the population-based cohort, glucose, insulin, and HOMA-IR values increased before the expected onset of puberty (P < .05). Thereafter, all variables decreased in girls (P < .05) and HbA1c decreased in boys (P < .05). Concentrations of all measured markers of glucose metabolism were higher in the obesity clinic-based cohort than the population-based cohort (both sexes P < .001). Specifically, insulin and HOMA-IR continued to increase to 18 years in the clinic-based cohort, particularly among boys. CONCLUSIONS Fasting glucose, insulin, and HOMA-IR change during childhood, making pediatric reference values essential for timely identification of derangements in glucose metabolism. Children and adolescents with obesity exhibit increased concentrations of these biomarkers.
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Affiliation(s)
- Christine Frithioff-Bøjsøe
- The Children's Obesity Clinic, Department of Pediatrics, Copenhagen University Hospital Holbaek, Holbaek, Denmark.,The Novo Nordisk Foundation Center for Basic Metabolic Research, Section for Metabolic Genetics, University of Copenhagen, Copenhagen, Denmark
| | - Morten A V Lund
- The Children's Obesity Clinic, Department of Pediatrics, Copenhagen University Hospital Holbaek, Holbaek, Denmark.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Julie T Kloppenborg
- The Children's Obesity Clinic, Department of Pediatrics, Copenhagen University Hospital Holbaek, Holbaek, Denmark.,Department of Pediatrics, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Tenna T H Nielsen
- The Children's Obesity Clinic, Department of Pediatrics, Copenhagen University Hospital Holbaek, Holbaek, Denmark.,Department of Pediatrics, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Cilius E Fonvig
- The Children's Obesity Clinic, Department of Pediatrics, Copenhagen University Hospital Holbaek, Holbaek, Denmark.,The Novo Nordisk Foundation Center for Basic Metabolic Research, Section for Metabolic Genetics, University of Copenhagen, Copenhagen, Denmark.,Department of Pediatrics, Kolding Hospital a part of Lillebaelt Hospital, Kolding, Denmark
| | - Ulrik Lausten-Thomsen
- The Children's Obesity Clinic, Department of Pediatrics, Copenhagen University Hospital Holbaek, Holbaek, Denmark.,Department of Neonatology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Paula L Hedley
- Department for Congenital Disorders, Danish National Biobank and Biomarkers, Statens Serum Institut, Copenhagen, Denmark
| | - Tina Hansen
- Department of Dental Care, Holbaek Municipality, Holbaek, Denmark
| | - Oluf B Pedersen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section for Metabolic Genetics, University of Copenhagen, Copenhagen, Denmark
| | - Michael Christiansen
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department for Congenital Disorders, Danish National Biobank and Biomarkers, Statens Serum Institut, Copenhagen, Denmark
| | - Jennifer L Baker
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section for Metabolic Genetics, University of Copenhagen, Copenhagen, Denmark.,Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Torben Hansen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section for Metabolic Genetics, University of Copenhagen, Copenhagen, Denmark.,University of Southern Denmark, Faculty of Health Sciences, Odense, Denmark
| | - Jens-Christian Holm
- The Children's Obesity Clinic, Department of Pediatrics, Copenhagen University Hospital Holbaek, Holbaek, Denmark.,The Novo Nordisk Foundation Center for Basic Metabolic Research, Section for Metabolic Genetics, University of Copenhagen, Copenhagen, Denmark.,Department of Dental Care, Holbaek Municipality, Holbaek, Denmark.,University of Copenhagen, Faculty of Health and Medical Sciences, Copenhagen, Denmark
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8
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Gepstein V, Weiss R. Obesity as the Main Risk Factor for Metabolic Syndrome in Children. Front Endocrinol (Lausanne) 2019; 10:568. [PMID: 31474943 PMCID: PMC6706788 DOI: 10.3389/fendo.2019.00568] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 08/02/2019] [Indexed: 02/06/2023] Open
Abstract
Obesity in childhood is the main determinant of whole body reduced insulin sensitivity. This association has been demonstrated in multiple adult and pediatric cohorts. The mechanistic link explaining this association is the pattern of lipid partitioning in the face of excess calories and energy surplus. A tight relation exists between typical lipid deposition patterns, specifically within the skeletal muscle and liver, as well as the intra-abdominal compartment and whole body insulin sensitivity. The impact of lipid deposition within insulin responsive tissues such as the liver and skeletal muscle relates to the ability of fatty acid derivates to inhibit elements of the insulin signal transduction pathway. Strengthening the relation of obesity and reduced insulin sensitivity are the observations that weight gain reduces insulin sensitivity while weight loss increases it. This manifests as the appearance of cardiovascular risk factor clustering with weight gain and its recovery in the face of weight loss. Both obesity per se, via the adipocytokine profile it induces, and low insulin sensitivity, are independent determinants of the adverse metabolic phenotype characteristic of the metabolic syndrome.
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