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Ding N, Li S, Zhou H, Tang Z, Gao T, Tian M, Liu C, Luo X, Chen H, Yu L, Chen Y, Yang L, Zhu L. Exploring the complex dynamics of BMI, age, and physiological indicators in early adolescents. BMC Pediatr 2024; 24:222. [PMID: 38561702 PMCID: PMC10983764 DOI: 10.1186/s12887-024-04680-8] [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: 01/18/2024] [Accepted: 03/01/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND AND OBJECTIVES To investigate the relationship between body mass index (BMI) and blood biochemical indicators in early adolescence, and to provide ideas for early prevention of diseases and explore possible disease-related predictors. METHODS 3125 participants aged 10 ∼ 14 years were selected from China from the survey of "China Nutrition and Health Surveillance ( 2016 ∼ 2017 ) ". Employing advanced statistical methods, including generalized linear models, heatmaps, hierarchical clustering, and generalized additive models, the study delved into the associations between BMI and various biochemical indicators. RESULTS In early adolescence, indicators including systolic pressure, diastolic pressure, weight, height, BMI, hemoglobin, blood uric acid, serum creatinine, albumin, vitamin A presented increasing trends with the increase of age ( P < 0.05 ), whereas LDL-C, vitamin D, and ferritin showed decreasing trends with the increase of age ( P < 0.05 ). The increase in hemoglobin and blood uric acid levels with age was more pronounced in males compared to females ( P < 0.05 ). BMI was positively correlated with blood glucose, hemoglobin, triglyceride, LDL-C, blood uric acid, serum creatinine, ferritin, transferrin receptor, hs-CRP, total protein, vitamin A ( P < 0.05 ). There was a significant BMI × age interaction in the correlation analysis with LDL-C, transferrin receptor, serum creatinine, and hs-CRP ( P < 0.05 ). BMI was a risk factor for hypertension, hypertriglyceridemia, low high density lipoprotein cholesterolemia, and metabolic syndrome in all age groups ( OR > 1, P < 0.05 ). CONCLUSIONS High BMI was a risk factor for hypertension, hypertriglyceridemia, low high density lipoprotein cholesterolemia, and MetS in early adolescents. With the focus on energy intake beginning in early adolescence, the maintenance of a healthy weight warrants greater attention.
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Affiliation(s)
- Ning Ding
- Department of Pediatrics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Suyun Li
- Shandong Center for Disease Control and Prevention, Ji'nan, Jinan, Shandong, China
| | - Han Zhou
- Shandong Center for Disease Control and Prevention, Ji'nan, Jinan, Shandong, China
| | - Zhenchuang Tang
- Institute of Food and Nutrition Development, Ministry of Agriculture and Rural Affairs, Beijing, China
| | - Tianlin Gao
- School of Public Health, Qingdao University, Qingdao, China
| | - Meina Tian
- Hebei Center for Disease Control and Prevention, Shijiazhuang, Hebei, China
| | - Changqing Liu
- Hebei Center for Disease Control and Prevention, Shijiazhuang, Hebei, China
| | - Xiaoyan Luo
- Hebei Center for Disease Control and Prevention, Shijiazhuang, Hebei, China
| | - Hongtong Chen
- Department of cardiothoracic Surgery, Heart Center, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lianlong Yu
- Shandong Center for Disease Control and Prevention, Ji'nan, Jinan, Shandong, China.
| | - Yao Chen
- People's Hospital of Rizhao, Rizhao, Shandong, China.
| | - Li Yang
- Jinan Center for Disease Control and Prevention, Jinan, Shandong, China.
| | - Lichao Zhu
- Department of Pediatric Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
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Obita G, Alkhatib A. Disparities in the Prevalence of Childhood Obesity-Related Comorbidities: A Systematic Review. Front Public Health 2022; 10:923744. [PMID: 35874993 PMCID: PMC9298527 DOI: 10.3389/fpubh.2022.923744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 06/01/2022] [Indexed: 11/13/2022] Open
Abstract
Background Non-communicable diseases among children are serious consequences of childhood obesity. However, less is known about the disparities in childhood obesity comorbidities burden. This review describes the salient pattern of disparities in the prevalence of childhood obesity-related non-communicable diseases and relevant inequalities in both high- and low/medium-income countries. Method A systematic literature search was performed in MEDLINE, Embase, CINAHL, PsycInfo, Scopus, and Web of Science databases by two independent reviewers. Inclusion criteria were as follows: age 2–18 years; the prevalence or incidence of childhood obesity comorbidities reported; and studies published in English from January 2010 to date. No restrictions on the setting. The prevalence data were analyzed using range and median for subgroups based on the country's development status, gender, and geographical region. Results Our search identified 6,837 articles, out of which we examined 145 full-text articles and included 54 articles in the analysis. The median prevalence of childhood obesity-related hypertension was 35.6 vs. 12.7% among middle- and low-income countries compared with high-income countries; 37.7 vs. 32.9% among boys compared with girls; and 38.6, 25.3, and 20.1% in Asia, South America, and Europe, respectively. For metabolic syndrome, the median prevalence was 26.9 vs. 5.5% among middle- and low-income countries compared with high-income countries; 55.2 vs. 12.0% among boys compared with girls; and 40.3, 25.8, and 7.7% in South America, Asia, and Europe, respectively. The prevalence of childhood obesity-related non-alcoholic fatty liver disease was 47.5 vs. 23% among middle- and low-income countries compared with high-income countries; and 52.1, 39.7, and 23.0% in Asia, South America, and Europe, respectively. The median prevalence of dyslipidemia was 43.5 vs. 63% among middle- and low-income countries compared with high-income countries; 55.2 vs. 12.0% among boys compared to girls; and 73.7 and 49.2% in Australia and Europe, respectively. Conclusion There are disparities in the prevalence of childhood obesity-related hypertension, metabolic syndrome, and non-alcoholic fatty liver disease, with middle- and low-income countries, boys, and Asian region having higher prevalence. Implementing targeted interventions for childhood obesity comorbidities should consider socioeconomic disparities and strengthening of research surveillance methods for a better understanding of non-communicable disease burden in the pediatric population. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO, identifier: CRD42021288607.
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Affiliation(s)
- George Obita
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
| | - Ahmad Alkhatib
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
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Akcan N, Bundak R. Accuracy of Tri-ponderal Mass Index and Body Mass Index in Estimating Insulin Resistance, Hyperlipidemia, Impaired Liver Enzymes or Thyroid Hormone Function and Vitamin D Levels in Children and Adolescents. J Clin Res Pediatr Endocrinol 2019; 11:366-373. [PMID: 30991791 PMCID: PMC6878335 DOI: 10.4274/jcrpe.galenos.2019.2018.0279] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Tri-ponderal mass index (TMI) has been reported to estimate body fat more accurately than body mass index (BMI). This study aimed to compare the efficacy of TMI and BMI in predicting insulin resistance (IR), hyperlipidemia, impaired liver enzymes or thyroid hormone function and vitamin D concentration. METHODS One hundred and forty-three overweight or obese children, based on BMI-standard deviation (SD) scoring (BMI-SDS) were studied retrospectively. TMI thresholds for overweight status were 16.0 kg/m3 for boys and 16.8 kg/m3 for girls and 18.8 kg/m3 for boys and 19.7 kg/m3 for girls for obese status. RESULTS Twenty-two overweight and eight obese children by BMI-SDS were classified as normal by TMI. Of the overweight children 22 (22.7%) had IR and IR was detected in 2 of 8 obese children with normal TMI. There was no increase in liver enzymes in any of the children with normal TMI. Forty-four obese children were overweight according to TMI and IR was detected in 40.9%. Thyroid stimulating hormone levels were significantly higher in BMI-based obese children. Vitamin D levels were similar in all groups of both classifications. CONCLUSION When TMI was used there may be a risk of overlooking IR. However, if it is assumed that liver enzymes are elevated as a result of visceral adiposity, TMI can be used as an auxiliary parameter to show visceral effects of adiposity. Normal TMI may indicate that visceral organ functions have not deteriorated yet. More studies are needed to evaluate TMI as a clinical tool.
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Affiliation(s)
- Neşe Akcan
- Near East University Faculty of Medicine, Department of Pediatric Endocrinology, Nicosia, Cyprus,* Address for Correspondence: Near East University Faculty of Medicine, Department of Pediatric Endocrinology, Nicosia, Cyprus Phone: +90 392 675 10 00 (1388) E-mail:
| | - Rüveyde Bundak
- Kyrenia University Faculty of Medicine, Department of Pediatric Endocrinology, Kyrenia, Cyprus
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Zhao Q, Jiang Y, Zhang M, Chu Y, Ji B, Pan H, Ban B. Low-density lipoprotein cholesterol levels are associated with insulin-like growth factor-1 in short-stature children and adolescents: a cross-sectional study. Lipids Health Dis 2019; 18:120. [PMID: 31122262 PMCID: PMC6533685 DOI: 10.1186/s12944-019-1062-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 04/29/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Elevated low-density lipoprotein cholesterol (LDL-C) levels in childhood have recently been found to be the strongest predictive risk factor for coronary artery disease in adulthood. There is an increased level of LDL-C in children and adolescents with short stature. However, the underlying factors associated with increased LDL-C levels in children and adolescents with short stature are unknown. In addition, the insulin-like growth factor 1 (IGF-1) level in the short-stature population is usually below the normal reference range. The aim of this study was to investigate the relationship between IGF-1 standard deviation score (IGF-1 SDS) and LDL-C level in children and adolescents with short stature. METHODS A cross-sectional study was conducted in a single centre of China, 557 short-stature children and adolescents whose height SDS was lower than - 2 SD after adjustment for age and gender were included. The related clinical and laboratory examinations, including anthropometric parameters, lipid profiles, IGF-1 levels and the levels of other cofactors, were assessed in all participants. RESULTS The univariate analysis results showed a significant negative correlation between IGF-1 SDS and LDL-C levels (P = 0.006). Furthermore, a nonlinear relationship was observed between IGF-1 SDS and LDL-C by smooth curve fitting after adjusting for possible confounders. A multivariate piecewise linear regression model revealed a significant negative correlation between IGF-1 SDS and LDL-C when the IGF-1 level was greater than - 2 SDS (β - 0.07, 95% CI -0.12, - 0.02; P = 0.006). However, we did not observe a significant relationship between IGF-1 SDS and LDL-C when the IGF-1 level was lower than - 2 SDS (β 0.08, 95% CI -0.02, 0.17; P = 0.119). CONCLUSION This study demonstrated a nonlinear relationship between IGF-1 and LDL-C independent of other potential confounding factors, suggesting that circulating IGF-1 may contribute to the regulation of LDL-C levels, thus meriting further investigation.
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Affiliation(s)
- Qianqian Zhao
- Department of Clinical Medicine, Jining Medical University, 16 Hehua Road, Beihu New District, Jining, Shandong 272067 People’s Republic of China
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, 89 Guhuai Road, Jining, Shandong 272029 People’s Republic of China
- Chinese Research Center for Behavior Medicine in Growth and Development, 89 Guhuai Road, Jining, 272029 Shandong People’s Republic of China
| | - Yingzhe Jiang
- Department of Clinical Medicine, Jining Medical University, 16 Hehua Road, Beihu New District, Jining, Shandong 272067 People’s Republic of China
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, 89 Guhuai Road, Jining, Shandong 272029 People’s Republic of China
- Chinese Research Center for Behavior Medicine in Growth and Development, 89 Guhuai Road, Jining, 272029 Shandong People’s Republic of China
| | - Mei Zhang
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, 89 Guhuai Road, Jining, Shandong 272029 People’s Republic of China
- Chinese Research Center for Behavior Medicine in Growth and Development, 89 Guhuai Road, Jining, 272029 Shandong People’s Republic of China
| | - Yuntian Chu
- School of Health Management and Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030 People’s Republic of China
- Chinese Research Center for Behavior Medicine in Growth and Development, 89 Guhuai Road, Jining, 272029 Shandong People’s Republic of China
| | - Baolan Ji
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, 89 Guhuai Road, Jining, Shandong 272029 People’s Republic of China
- Chinese Research Center for Behavior Medicine in Growth and Development, 89 Guhuai Road, Jining, 272029 Shandong People’s Republic of China
| | - Hui Pan
- Key Laboratory of Endocrinology of National Health and Family Planning Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730 People’s Republic of China
- Chinese Research Center for Behavior Medicine in Growth and Development, 89 Guhuai Road, Jining, 272029 Shandong People’s Republic of China
| | - Bo Ban
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, 89 Guhuai Road, Jining, Shandong 272029 People’s Republic of China
- Chinese Research Center for Behavior Medicine in Growth and Development, 89 Guhuai Road, Jining, 272029 Shandong People’s Republic of China
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Effectiveness of early identification and electronic interventions for teens with risk factors for the development of heart disease and diabetes: Phase II findings. J Am Assoc Nurse Pract 2018; 31:17-23. [PMID: 30095669 DOI: 10.1097/jxx.0000000000000087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE Serum and physical risk factors for the development of heart disease and diabetes are detectable long before adulthood. The purpose of this two-part study was to assess the prevalence and associations of these risk factors in teens and determine the effectiveness of a customizable two-part electronic education program on minimizing identified risks. METHODS Data were collected from teens (n = 168) from two high schools (one urban and one rural) in the mid-Atlantic region. After baseline data were collected, the two-part electronic education program was initiated. Serum and physical risk factors were rechecked at 12-week intervals, and results were analyzed. CONCLUSIONS Significant serum and physical risk factor associations were identified and remained present among teens over the course of the study. High-density lipoproteins showed significant, steady improvement. Low-density lipoproteins were positively associated with body mass index, diastolic blood pressure, and thyroid-stimulating hormone level. IMPLICATIONS FOR PRACTICE Although serum and physical risk factors are identifiable in teens, routine screening of this age group and younger is not an established standard of care. Health care providers need effective, innovative methods to counteract these risks. Through increased awareness of the presence of risk factors in young patients, advanced nurse practitioners may implement earlier interventions to counteract these risks.
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Albaum JM, Carsley S, Chen Y, Dai DWH, Lebovic G, McCrindle BW, Maguire JL, Parkin PC, Birken CS. Persistent High Non-High-Density Lipoprotein Cholesterol in Early Childhood: A Latent Class Growth Model Analysis. J Pediatr 2017; 191:152-157. [PMID: 29173300 DOI: 10.1016/j.jpeds.2017.08.079] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 08/05/2017] [Accepted: 08/30/2017] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To examine patterns of non-high-density lipoprotein (HDL) cholesterol in early childhood and identify factors associated with persistent high non-HDL cholesterol in healthy urban children. STUDY DESIGN We identified all children enrolled in a primary care practice-based research network called TARGet Kids! (The Applied Research Group for Kids) with ≥3 laboratory measurements of non-HDL cholesterol. Latent class growth model analysis was performed to identify distinct trajectory groups for non-HDL cholesterol. Trajectory groups were then categorized into "normal" vs "persistent-high" non-HDL cholesterol based on guideline cut-off values and logistic regression was completed to examine the association between trajectory group and the presence of anthropometric and cardiometabolic risk factors. RESULTS A total of 608 children met inclusion criteria for the trajectory analysis (median age at enrolment = 18.3, IQR = 27.9 months). Four trajectory groups were identified with 2 groups (n = 451) categorized as normal non-HDL cholesterol and 2 groups (n = 157) as persistent high non-HDL cholesterol. Family history of high cholesterol (OR 2.04, 95% CI 1.27-3.28) was associated significantly with persistent high non-HDL cholesterol, whereas East/Southeast Asian vs European ethnicity (OR 0.33, 95% CI 0.14-0.78), longer breastfeeding duration (OR 0.96, 95% CI 0.93-1.00), and greater birth weight (OR 0.69, 95% CI 0.48-1.00) were associated with lower odds of persistent high non-HDL cholesterol. CONCLUSIONS Patterns of non-HDL cholesterol are identified during early childhood, and family history of high cholesterol was associated most strongly with persistent high non-HDL cholesterol. Future research should inform the development of a clinical prediction tool for lipids in early childhood to identify children who may benefit from interventions to promote cardiovascular health.
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Affiliation(s)
- Jordan M Albaum
- Pediatrics Outcomes Research Team (PORT), The Hospital for Sick Children, Toronto, Ontario; Faculty of Medicine, University of Toronto, Toronto, Ontario; Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario
| | - Sarah Carsley
- Pediatrics Outcomes Research Team (PORT), The Hospital for Sick Children, Toronto, Ontario; Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario
| | - Yang Chen
- The Applied Health Research Centre of the Li Ka Shing Knowledge Institute, Toronto, Ontario
| | - David W H Dai
- The Applied Health Research Centre of the Li Ka Shing Knowledge Institute, Toronto, Ontario
| | - Gerald Lebovic
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario; The Applied Health Research Centre of the Li Ka Shing Knowledge Institute, Toronto, Ontario
| | - Brian W McCrindle
- Faculty of Medicine, University of Toronto, Toronto, Ontario; Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario
| | - Jonathon L Maguire
- Faculty of Medicine, University of Toronto, Toronto, Ontario; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario; The Applied Health Research Centre of the Li Ka Shing Knowledge Institute, Toronto, Ontario
| | - Patricia C Parkin
- Faculty of Medicine, University of Toronto, Toronto, Ontario; Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario; Division of Pediatric Medicine, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario
| | - Catherine S Birken
- Pediatrics Outcomes Research Team (PORT), The Hospital for Sick Children, Toronto, Ontario; Faculty of Medicine, University of Toronto, Toronto, Ontario; Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario; Division of Pediatric Medicine, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario.
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Kaushal A, Zhang H, Karmaus WJJ, Everson TM, Marsit CJ, Karagas MR, Tsai SF, Wen HJ, Wang SL. Genome-wide DNA methylation at birth in relation to in utero arsenic exposure and the associated health in later life. Environ Health 2017; 16:50. [PMID: 28558807 PMCID: PMC5450181 DOI: 10.1186/s12940-017-0262-0] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 05/22/2017] [Indexed: 05/19/2023]
Abstract
BACKGROUND In utero arsenic exposure may alter fetal developmental programming by altering DNA methylation, which may result in a higher risk of disease in later life. We evaluated the association between in utero arsenic exposure and DNA methylation (DNAm) in cord blood and its influence in later life. METHODS Genome-wide DNA methylation in cord blood from 64 subjects in the Taiwanese maternal infant and birth cohort was analyzed. Robust regressions were applied to assess the association of DNA methylation with in utero arsenic exposure. Multiple testing was adjusted by controlling false discovery rate (FDR) of 0.05. The DAVID bioinformatics tool was implemented for functional annotation analyses on the detected CpGs. The identified CpGs were further tested in an independent cohort. For the CpGs replicated in the independent cohort, linear mixed models were applied to assess the association of DNA methylation with low-density lipoprotein (LDL) at different ages (2, 5, 8, 11 and 14 years). RESULTS In total, 579 out of 385,183 CpGs were identified after adjusting for multiple testing (FDR = 0.05), of which ~60% were positively associated with arsenic exposure. Functional annotation analysis on these CpGs detected 17 KEGG pathways (FDR = 0.05) including pathways for cardiovascular diseases (CVD) and diabetes mellitus. In the independent cohort, about 46% (252 out of 553 CpGs) of the identified CpGs showed associations consistent with those in the study cohort. In total, 11 CpGs replicated in the independent cohort were in the pathways related to CVD and diabetes mellitus. Via longitudinal analyses, we found at 5 out of the 11 CpGs methylation was associated with LDL over time and interactions between DNA methylation and time were observed at 4 of the 5 CpGs, cg25189764 (coeff = 0.157, p-value = 0.047), cg04986899 (coeff. For interaction [coeff.int] = 0.030, p-value = 0.024), cg04903360 (coeff.int = 0.026, p-value = 0.032), cg08198265 (coeff.int = -0.063, p-value = 0.0021), cg10473311 (coeff.int = -0.021, p-value = 0.027). CONCLUSION In utero arsenic exposure was associated with cord blood DNA methylation at various CpGs. The identified CpGs may help determine pathological epigenetic mechanisms linked to in utero arsenic exposure. Five CpGs (cg25189764, cg04986899, cg04903360, cg08198265 and cg10473311) may serve as epigenetic markers for changes in LDL later in life.
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Affiliation(s)
- Akhilesh Kaushal
- Division of Epidemiology, Biostatistics, and Environmental Health, University of Memphis, Memphis, TN 38152 USA
| | - Hongmei Zhang
- Division of Epidemiology, Biostatistics, and Environmental Health, University of Memphis, Memphis, TN 38152 USA
| | - Wilfried J. J. Karmaus
- Division of Epidemiology, Biostatistics, and Environmental Health, University of Memphis, Memphis, TN 38152 USA
| | - Todd M. Everson
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA USA
| | - Carmen J. Marsit
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA USA
| | - Margaret R. Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, NH USA
- Children’s Environmental Health & Disease Prevention Research Center at Dartmouth, Hanover, NH USA
| | - Shih-Fen Tsai
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Hui-Ju Wen
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Shu-Li Wang
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
- Department of Public Health, China Medical University, Taichung, Taiwan
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Zaid M, Ameer F, Munir R, Rashid R, Farooq N, Hasnain S, Zaidi N. Anthropometric and metabolic indices in assessment of type and severity of dyslipidemia. J Physiol Anthropol 2017; 36:19. [PMID: 28241855 PMCID: PMC5330152 DOI: 10.1186/s40101-017-0134-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 02/15/2017] [Indexed: 01/01/2023] Open
Abstract
Background It has been shown that obesity is associated with increased rates of dyslipidemia. The present work revisits the association between plasma lipid levels and classical indicators of obesity including body mass index (BMI). The significance of various anthropometric/metabolic variables in clinical assessment of type and severity of dyslipidemia was also determined. Recently described body indices, a body shape index (ABSI) and body roundness index (BRI), were also assessed in this context. Methods For the present cross-sectional analytical study, the participants (n = 275) were recruited from the patients visiting different health camps. Participants were anthropometrically measured and interviewed, and their fasting intravenous blood was collected. Plasma lipid levels were accordingly determined. Results The values for different anthropometric parameters are significantly different between dyslipidemic and non-dyslipidemic participants. Receiver operating characteristics curve analyses revealed that all the tested variables gave the highest area under the curve (AUC) values for predicting hypertriglyceridemia in comparison to other plasma lipid abnormalities. BRI gave slightly higher AUC values in predicting different forms of dyslipidemia in comparison to BMI, whereas ABSI gave very low values. Conclusions Several anthropometric/metabolic indices display increased predictive capabilities for detecting hypertriglyceridemia in comparison to any other form of plasma lipid disorders. The capacity of BRI to predict dyslipidemia was comparable but not superior to the classical indicators of obesity, whereas ABSI could not detect dyslipidemia. Electronic supplementary material The online version of this article (doi:10.1186/s40101-017-0134-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Muhammad Zaid
- Microbiology and Molecular Genetics, University of the Punjab, Lahore, 54590, Pakistan
| | - Fatima Ameer
- Microbiology and Molecular Genetics, University of the Punjab, Lahore, 54590, Pakistan
| | - Rimsha Munir
- Microbiology and Molecular Genetics, University of the Punjab, Lahore, 54590, Pakistan
| | - Rida Rashid
- Microbiology and Molecular Genetics, University of the Punjab, Lahore, 54590, Pakistan
| | - Nimrah Farooq
- Microbiology and Molecular Genetics, University of the Punjab, Lahore, 54590, Pakistan
| | - Shahida Hasnain
- Microbiology and Molecular Genetics, University of the Punjab, Lahore, 54590, Pakistan
| | - Nousheen Zaidi
- Microbiology and Molecular Genetics, University of the Punjab, Lahore, 54590, Pakistan.
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Wang CJ, Wang YL, Li ZX, Wang YJ. The Management of LDL Cholesterol and Predictors of Goal Achievement in Stroke Patients in China: A Cross-Sectional Study. CNS Neurosci Ther 2016; 22:577-83. [PMID: 27297687 DOI: 10.1111/cns.12543] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 03/01/2016] [Accepted: 03/02/2016] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To assess the management of low-density lipoprotein cholesterol (LDL-C) in patients suffering from ischemic stroke within 6-12 months and explore the predictors of the achievement of LDL-C target. METHODS This study was a nation-wide, multicenter, cross-sectional study conducted from July 2013 to August 2013 in mainland China. Patients who had an ischemic stroke within 6-12 months and were more than 18 year old were consecutively included into this study. All data referred to personal information, medical history, medication and results from laboratory tests were collected by face-to-face questionnaires, physical examination and blood tests. The predictors for the achievement of LDL-C target (<1.8 mmol/L or <70 mg/dL) were analyzed by the multivariate analysis. RESULTS A total of 3956 cases from 56 centers who suffered from ischemic stroke within 6-12 months were finally included into this study. The average serum level of LDL-C in all patients was 2.42 ± 0.91 mmol/L with a median of 2.30 mmol/L and the total LDL-C goal achievement rate was 27.4% (95% CI: 26.0%-28.8%). Lipid-lowering therapy (odds ratio [OR] = 3.54, 95% CI: 2.879-4.388) was the most significant predictor for LDL-C target achievement and female (OR = 0.64, 95% CI: 0.526-0.777), current smoking (OR = 0.714, 95% CI: 0.571-0.892), and the history of dyslipidemia (OR = 0.577, 95% CI: 0.497-0.668) were other three important negative factors for the LDL-C goal achievement. CONCLUSION Although lipid modulation is recommended as an important intervention for stroke patients in the international guidelines, the goal achievement of LDL-C is still very low in this population in mainland China. The modifiable predictors including the use of lipid-lowering medication and smoking cessation should be improved in secondary prevention of stroke.
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Affiliation(s)
- Chun-Juan Wang
- Tiantan Clinical Trial and Research Center for Stroke, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Yi-Long Wang
- Tiantan Clinical Trial and Research Center for Stroke, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Zi-Xiao Li
- Tiantan Clinical Trial and Research Center for Stroke, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Yong-Jun Wang
- Tiantan Clinical Trial and Research Center for Stroke, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
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Ochiai H, Shirasawa T, Nanri H, Nishimura R, Matoba M, Hoshino H, Kokaze A. Eating quickly is associated with waist-to-height ratio among Japanese adolescents: a cross-sectional survey. ACTA ACUST UNITED AC 2016; 74:18. [PMID: 27162638 PMCID: PMC4860764 DOI: 10.1186/s13690-016-0130-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 03/02/2016] [Indexed: 01/04/2023]
Abstract
Background Central obesity, based on waist circumference (WC), has more adverse effects on health than general obesity, determined by body mass index. To date, eating quickly has been reported to be risk factors for overweight/obesity among children, adolescents, and adults. In contrast, there are few studies on the relationship between fast eating and central obesity among adolescents, particularly in Japan, where WC is not commonly measured in junior high schools. The aim of the present study was to investigate the relationship between eating quickly and waist-to-height ratio (WHtR), an index of central obesity, among adolescents in Japan. Methods Study subjects were 2136 seventh-grade school children (12 or 13 years of age) from Ina town junior high schools in Japan, between 2004 and 2009. Measurements of height, weight, and WC were performed, and information about eating habits was collected using a self-administered questionnaire. A logistic regression model was used to calculate the odds ratio (OR) and 95 % confidence interval (95 % CI) for WHtR ≥ 0.5. Results Eating quickly significantly increased the OR for WHtR ≥ 0.5 in boys (OR: 2.05, 95 % CI: 1.31–3.23) and girls (2.09, 1.15–3.81). When compared with the “not eating quickly and not eating until full” group, the OR for WHtR ≥ 0.5 in the “eating quickly and eating until full” group was 2.67 (95 % CI: 1.50–4.73) in boys and 2.59 (1.17–5.73) in girls, whereas that in the “eating quickly and not eating until full” group or the “not eating quickly and eating until full” group was not statistically significant regardless of sex. Conclusions The present study showed that eating quickly was associated with WHtR ≥ 0.5, and “eating quickly and eating until full” had a substantial impact on WHtR ≥ 0.5 among adolescents. This study suggests that modifying fast eating to a slower pace may help prevent central obesity among adolescents.
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Affiliation(s)
- Hirotaka Ochiai
- Department of Public Health, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555 Japan
| | - Takako Shirasawa
- Department of Public Health, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555 Japan
| | - Hinako Nanri
- Department of Public Health, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555 Japan
| | - Rimei Nishimura
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi Minato-ku, Tokyo, 105-8461 Japan
| | - Masaaki Matoba
- Department of Public Health, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555 Japan
| | - Hiromi Hoshino
- Department of Public Health, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555 Japan
| | - Akatsuki Kokaze
- Department of Public Health, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555 Japan
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11
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Fujita Y, Kouda K, Nakamura H, Iki M. Inverse association between height increase and LDL cholesterol during puberty: A 3-year follow-up study of the Fukuroi City. Am J Hum Biol 2015; 28:330-4. [PMID: 26345694 DOI: 10.1002/ajhb.22784] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 06/17/2015] [Accepted: 08/12/2015] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Few studies have reported on the association between changes in serum low-density lipoprotein cholesterol (LDL-C) and height increase. We investigated the association between LDL-C change and height increase during puberty in a 3-year follow-up study in Fukuroi City, Japan. METHODS The source population was all fifth grade 2,515 students enrolled in any public school in Fukuroi, Japan in 2008, 2009, and 2010. The follow-up survey was conducted in eighth grade students in 2011, 2012, and 2013. In total, 2,225 adolescents were followed. To evaluate the relationships between height increases and changes in LDL-C, a regression analysis was conducted after stratification by tertiles of weight change (LW: lowest group, MW: middle group, and HW: highest group). RESULTS In each weight change tertile, serum LDL-C significantly decreased from the lowest to highest tertiles of height change (LW: regression coefficient (B) = -0.12, MW: B = -0.07, HW: B = -0.08 in males; MW: B = -0.17, HW: B = -0.14 in females). The association between height increases and LDL-C was significantly stronger than that between weight increases and LDL-C (male: B = -0.609 and 95% CI -0.836 to -0.382 in height, B = 0.008 and 95% CI -0.193 to 0.209 in weight; female: B = -0.963 and 95% CI -1.301 to -0.624 in height, B = 0.366 and 95% CI 0.058-0.675 in weight). CONCLUSIONS Serum LDL-C decreased with increasing height, independent of increases in weight. The association between LDL-C and height is stronger than that between LDL-C and weight. Am. J. Hum. Biol. 28:330-334, 2016. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Yuki Fujita
- Department of Public Health, Kinki University Faculty of Medicine, Osaka-Sayama, Osaka, 589-8511, Japan
| | - Katsuyasu Kouda
- Department of Public Health, Kinki University Faculty of Medicine, Osaka-Sayama, Osaka, 589-8511, Japan
| | - Harunobu Nakamura
- Department of Health Promotion and Education, Graduate School of Human Development and Environment, Kobe University, Kobe, 657-8501, Japan
| | - Masayuki Iki
- Department of Public Health, Kinki University Faculty of Medicine, Osaka-Sayama, Osaka, 589-8511, Japan
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12
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Ochiai H, Shirasawa T, Nishimura R, Nanri H, Ohtsu T, Hoshino H, Tajima N, Kokaze A. Waist-to-height ratio is more closely associated with alanine aminotransferase levels than body mass index and waist circumference among population-based children: a cross-sectional study in Japan. BMC Pediatr 2015; 15:59. [PMID: 25980380 PMCID: PMC4477294 DOI: 10.1186/s12887-015-0378-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 05/08/2015] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND An association between anthropometric measurements, including waist circumference (WC), and alanine aminotransferase (ALT) levels has been reported among adults. However, studies conducted among population-based elementary schoolchildren to date have been limited, especially in Japan, where the measurement of WC and blood collection are not usually performed in the annual health examination at elementary schools. The present study investigated the association between anthropometric measurements and ALT levels among population-based elementary schoolchildren in Japan. METHODS Subjects were fourth-grade schoolchildren (aged 9 or 10) from the town of Ina in Saitama Prefecture, Japan during 2004-2009. The height, weight, and WC of each subject were measured, and blood samples were drawn to measure ALT levels. Childhood overweight or obesity was defined according to the age- and sex-specific cut-off points proposed by the International Obesity Task Force. Spearman's correlation coefficients between anthropometric measurements (body mass index (BMI), WC, and waist-to-height ratio (WHtR)) and ALT levels were calculated. RESULTS Data from 2499 subjects (1293 boys and 1206 girls) were analyzed. BMI, WC, and WHtR were significantly positively correlated with ALT levels; the correlation coefficient of ALT levels with WHtR was higher than that with BMI and WC in boys and girls. In the analysis stratified by physique (non-overweight/obesity, overweight, or obesity), all anthropometric measurements were significantly positively correlated with ALT levels among boys, while only WHtR was significantly positively correlated with ALT levels among girls. Moreover, the correlation coefficient of ALT levels with WHtR was more pronounced than that with BMI and WC in the non-overweight/obesity group, in the overweight group, and in the obesity group for each sex. CONCLUSIONS The present study showed that WHtR was more closely associated with ALT levels than BMI and WC. Furthermore, only WHtR was significantly positively associated with ALT levels regardless of sex and physique. This study suggests that it is more useful to monitor WHtR than BMI and WC as a surrogate for ALT levels among population-based elementary schoolchildren.
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Affiliation(s)
- Hirotaka Ochiai
- Department of Public Health, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan.
| | - Takako Shirasawa
- Department of Public Health, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan.
| | - Rimei Nishimura
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan.
| | - Hinako Nanri
- Department of Public Health, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan.
| | - Tadahiro Ohtsu
- Department of Public Health, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan.
| | - Hiromi Hoshino
- Department of Public Health, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan.
| | - Naoko Tajima
- Jikei University School of Medicine, Tokyo, Japan.
| | - Akatsuki Kokaze
- Department of Public Health, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan.
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Moschonis G, Georgiou A, Sarapi K, Manios Y. Association of distorted eating behaviors with cardiometabolic risk indices in preadolescents. The Healthy Growth Study. Appetite 2015; 91:35-40. [PMID: 25819605 DOI: 10.1016/j.appet.2015.03.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 02/06/2015] [Accepted: 03/20/2015] [Indexed: 10/23/2022]
Abstract
The association between distorted eating behavior (DEB) with cardiometabolic risk (CMR) in children has been poorly investigated. The aim of the study was to examine the association between DEB with certain CMR indices in 9- to 13-year-old children in Greece. A cross-sectional epidemiological study was conducted among 1803 schoolchildren from 77 primary schools in 4 counties of Greece with full data on DEBQ and ChEAT questionnaires and CMR indices. Children underwent anthropometric measurements and Tanner stage, serum lipid, glucose, insulin and HOMA-IR levels assessments. Univariate and multivariate linear regression analyses were performed to test for the association between components of DEBQ and ChEAT with CMR indices. Several significant associations between components of DEBQ and ChEAT with CMR indices were observed when tested at univariate regression models in both boys and girls. However, after adjusting for several possible confounders, including Tanner stage, all significant associations were lost in girls while only a few remained in boys. Thus, DEB might have an unfavorable effect also in certain CMR indices, besides nourishment status. This is more pronounced in preadolescent boys for whom hormonal changes due to the transition to adolescence have not yet been established compared to girls. Still further research is needed to shed more light on these associations.
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Affiliation(s)
- George Moschonis
- Department of Nutrition and Dietetics, Harokopio University of Athens, 70 El. Venizelou Avenue, 17671 Kallithea, Athens, Greece
| | - Alexandra Georgiou
- Department of Nutrition and Dietetics, Harokopio University of Athens, 70 El. Venizelou Avenue, 17671 Kallithea, Athens, Greece
| | - Katerina Sarapi
- Department of Nutrition and Dietetics, Harokopio University of Athens, 70 El. Venizelou Avenue, 17671 Kallithea, Athens, Greece
| | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University of Athens, 70 El. Venizelou Avenue, 17671 Kallithea, Athens, Greece.
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Prevalence of dyslipidaemia and associated risk factors among Balearic Islands adolescents, a Mediterranean region. Eur J Clin Nutr 2014; 69:722-8. [PMID: 25351644 DOI: 10.1038/ejcn.2014.236] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Revised: 09/16/2014] [Accepted: 09/24/2014] [Indexed: 01/22/2023]
Abstract
BACKGROUND/OBJECTIVES The increase in overweight and obese children and adolescents may be linked to increased rates of dyslipidaemia. The aim was to assess the prevalence of dyslipidaemia and associated risk factors among the Balearic Islands' adolescent population. SUBJECTS/METHODS A random sample (n=362, 143 boys and 219 girls, aged 12-17 years) was interviewed, anthropometrically measured and fasting blood samples taken. According to the 2011 Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents, dyslipidaemia was defined as the presence of one or more of the following levels (mg/dl): total cholesterol (TChol)⩾200, low-density lipoprotein cholesterol (LDL-chol)⩾130, non-high-density lipoprotein cholesterol (non-HDL-chol)⩾145, high-density lipoprotein cholesterol (HDL-chol)<40 and tryglicerides (TG)⩾130. RESULTS The overall prevalence of borderline-high+high TChol, LDL-chol, non-HDL-chol and TG was 24.3, 10.4, 13.3 and 14.9%, respectively. The TChol prevalence was higher among girls (27.8%) than the boys (19.1%). The overall prevalence of borderline-low+low HDL-chol was 12.2% (boys 20.7%; girls 6.3%). The overall prevalence of dyslipidaemia was 13.7% (boys 14.9%; girls 12.9%). Low HDL-chol levels were the most prevalent dyslipidaemia in boys (6.4%) and high TChol in girls (9.1%). Overweight/obese subjects were more likely to have at least one abnormal lipid concentration (odds ratio (OR): 2.10; 95% confidence interval (CI): 1.06-4.15) and subjects with abdominal obesity were more likely to have at least one abnormal lipid level (OR: 3.17; 95% CI: 1.04-9.66). CONCLUSIONS One in ten Balearic Islands' adolescents has at least one abnormal lipid concentration. Body mass index status and waist-to-height ratio were associated with the prevalence of at least one abnormal lipid level.
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