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Gastelum Guerrero C, Cháidez Fernández YL, Magaña Ordorica D, Berger H, Vazquez Landrove M, Guadrón Llanos A, Angulo Rojo C, Magaña Gómez J. A systematic review and meta-analysis of serum lipid concentrations in people with Down syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2024; 68:553-563. [PMID: 38404114 DOI: 10.1111/jir.13128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 01/24/2024] [Accepted: 01/31/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND Down syndrome (DS) is the most prevalent chromosomal disorder, being the leading cause of intellectual disability. The increased life expectancy of individuals with DS has led to a shift in the incidence of non-communicable chronic diseases, resulting in new concerns, particularly cardiovascular disease (CVD) and Alzheimer's disease. This study aimed to analyse the blood lipid profile of a large DS cohort to establish a baseline for evaluating health risk parameters. METHODS A comprehensive literature search was conducted on PubMed and Virtual Health Library databases to identify original articles published before July 2022. Selected studies were included in the meta-analysis. RESULTS Fifteen studies reporting serum lipid levels in individuals with DS were incorporated into the analysis. The meta-analysis used the means and standard deviations extracted from the selected studies. The analysis encompassed 671 participants in the DS group and 898 euploid controls. The results indicated significant differences in total cholesterol [C] (mean difference [MD]: -3.34; CI: 95%: -4.94 to -1.73; P < 0.0001), HDL-C (MD: -3.39; CI: 95%: -6.72 to -0.06; P = 0.05) and triglycerides (MD: 21.48; CI: 95%: 9.32 to 33.65; P = 0.0005) levels between individuals with DS and their control counterparts. CONCLUSIONS Individuals with DS have less favourable blood lipid concentrations than their controls, particularly HDL-C, triglycerides, and total-C, even when grouped by age. These findings underscore the importance of closer monitoring of lipid profiles in people with DS and the necessity for specific cut-offs for this population, considering the risk for ischemic heart and Alzheimer's diseases.
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Affiliation(s)
| | | | - Dalia Magaña Ordorica
- Facultad de Ciencias de la Nutrición y Gastronomía, Universidad Autónoma de Sinaloa, Culiacán, Mexico
| | - Heidi Berger
- Department of Mathematics, Simpson College, Indianola, Iowa, USA
| | | | | | - Carla Angulo Rojo
- Facultad de Medicina, Universidad Autónoma de Sinaloa, Culiacán, Mexico
| | - Javier Magaña Gómez
- Facultad de Ciencias de la Nutrición y Gastronomía, Universidad Autónoma de Sinaloa, Culiacán, Mexico
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Caldwell AR, Kim Y, Alshahwan N, Vellody K, Bendixen RM, Renz K, Duong T, Dodd J, Terhorst L, Must A. Parental perception of facilitators and barriers to health among young children with down syndrome: a qualitative study. Front Pediatr 2023; 11:1155850. [PMID: 37497298 PMCID: PMC10366365 DOI: 10.3389/fped.2023.1155850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/29/2023] [Indexed: 07/28/2023] Open
Abstract
Background Despite high rates of obesity and weight-related conditions observed in children with Down syndrome, little is known about how to prevent these conditions. Purpose The purpose of this study was to identify parent-perceived facilitators and barriers to health for toddlers (12-36 months old) with Down syndrome. Materials and methods We conducted in-depth, semi-structured interviews with the mothers of 25 toddlers with Down syndrome. All interviews were conducted using Zoom Video Technology, audio recorded and transcribed before being coded in NVivo software using a structured protocol. Thematic analysis was used to identify themes in perceived facilitators and barriers to health at the level of the child, family, and community. Data were triangulated using reflective journaling, video review of child meals, and member-checking techniques. Results We identified unique themes for facilitators (on the move and sound sleep) and barriers (co-occurring conditions and eating behaviors) at the level of the child. At the level of the family and community, overarching themes that were viewed as either a facilitator or barrier, depending on the context, were identified (role models matter, time is critical, the importance of place, and social support). Conclusion These themes can help clinicians and researchers tailor their health promotion interventions to meet the unique needs of children with Down syndrome by using strength-based approaches and providing families with the tools to overcome barriers.
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Affiliation(s)
- Angela R. Caldwell
- Pediatric Health Promotion Laboratory, Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, United States
| | - Yeook Kim
- Families and Autism Research Lab, Department of Occupational Therapy, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA, United States
| | - Nada Alshahwan
- Pediatric Health Promotion Laboratory, Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, United States
| | - Kishore Vellody
- Department of Pediatrics, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Roxanna M. Bendixen
- Department of Rehabilitation Sciences, College of Health Professions, University of Pittsburgh, Pittsburgh, PA, United States
| | - Kayley Renz
- Pediatric Health Promotion Laboratory, Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, United States
| | - Tiffany Duong
- Pediatric Health Promotion Laboratory, Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, United States
| | - Judith Dodd
- Department of Sports Medicine and Nutrition, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, United States
| | - Lauren Terhorst
- Pediatric Health Promotion Laboratory, Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, United States
- SHRS Data Center, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, United States
| | - Aviva Must
- Department of Public Health and Community Medicine, School of Medicine, Tufts University, Boston, MA, United States
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Pérez-Villarreal JM, Aviña-Padilla K, Beltrán-López E, Guadrón-Llanos AM, López-Bayghen E, Magaña-Gómez J, Meraz-Ríos MA, Varela-Echavarría A, Angulo-Rojo C. Profiling of circulating chromosome 21-encoded microRNAs, miR-155, and let-7c, in down syndrome. Mol Genet Genomic Med 2022; 10:e1938. [PMID: 35411714 PMCID: PMC9184673 DOI: 10.1002/mgg3.1938] [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: 11/10/2021] [Revised: 03/02/2022] [Accepted: 03/14/2022] [Indexed: 11/18/2022] Open
Abstract
Background Down syndrome (DS) is the most common chromosomal survival aneuploidy. The increase in DS life expectancy further heightens the risk of dementia, principally early‐onset Alzheimer's disease (AD). AD risk in DS is higher, considering that this population may also develop metabolic diseases such as obesity, dyslipidemias, and diabetes mellitus. The extra genetic material that characterizes DS causes an imbalance in the genetic dosage, including over‐expression of AD's key pathophysiological molecules and the gene expression regulators, the microRNAs (miRNAs). Two miRNAs, chromosome 21‐encoded, miR‐155, and let‐7c, are associated with cognitive impairment and dementia in adults; but, expression dynamics and relationship with clinical variables during the DS's lifespan had remained hitherto unexplored. Methods The anthropometric, clinical, biochemical, and profile expression of circulating miR‐155 and let‐7c were analyzed in a population of 52 control and 50 DS subjects divided into the young group (Aged ≤20 years) and the adult group (Aged ≥21 years). Results The expression changes for miR‐155 were not significant; nevertheless, a negative correlation with HDL‐Cholesterol concentrations was observed. Notably, let‐7c was over‐expressed in DS from young and old ages. Conclusion Overall, our results suggest that let‐7c plays a role from the early stages of DS's cognitive impairment while overexpression of miR‐155 may be related to lipid metabolism changes. Further studies of both miRNAs will shed light on their potential as therapeutic targets to prevent or delay DS's cognitive impairment.
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Affiliation(s)
- Jesús Manuel Pérez-Villarreal
- Laboratorio de Neurociencias, Centro de Investigación Aplicada a la Salud Pública (CIASaP), Facultad de Medicina, Universidad Autónoma de Sinaloa, Culiacán, Mexico.,Maestría en Ciencias Biomédicas, Facultad de Ciencias Químico-Biológicas, Universidad Autónoma de Sinaloa, Culiacán, Mexico.,Laboratorio de Nutrición Molecular, Escuela de Nutrición y Gastronomía, Universidad Autónoma de Sinaloa, Culiacán, Mexico
| | - Katia Aviña-Padilla
- Instituto de Neurobiología, Universidad Nacional Autónoma de México, Querétaro, Mexico.,Laboratorio de Bioinformática y de Redes Complejas, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV-IRAPUATO), Mexico
| | - Evangelina Beltrán-López
- Laboratorio Edificio Central, Facultad de Ciencias Químico-Biológicas, Universidad Autónoma de Sinaloa, Culiacán, Mexico
| | - Alma Marlene Guadrón-Llanos
- Laboratorio de Diabetes y comorbilidades, Centro de Investigación Aplicada a la Salud Pública (CIASaP), Facultad de Medicina, Universidad Autónoma de Sinaloa, Culiacán, Mexico
| | - Esther López-Bayghen
- Departamento de Toxicología, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV-IPN), México City, Mexico
| | - Javier Magaña-Gómez
- Maestría en Ciencias Biomédicas, Facultad de Ciencias Químico-Biológicas, Universidad Autónoma de Sinaloa, Culiacán, Mexico.,Laboratorio de Nutrición Molecular, Escuela de Nutrición y Gastronomía, Universidad Autónoma de Sinaloa, Culiacán, Mexico
| | - Marco Antonio Meraz-Ríos
- Departamento de Biomedicina Molecular, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV-IPN), México City, Mexico
| | | | - Carla Angulo-Rojo
- Laboratorio de Neurociencias, Centro de Investigación Aplicada a la Salud Pública (CIASaP), Facultad de Medicina, Universidad Autónoma de Sinaloa, Culiacán, Mexico.,Centro de Investigación y Docencia en Ciencias de la Salud (CIDOCS), Universidad Autónoma de Sinaloa, Culiacán, Mexico
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Yahia S, El-Farahaty R, El-Gilany AH, Shoaib R, Ramadan R, Salem N. Serum adiponectin, body adiposity and metabolic parameters in obese Egyptian children with Down syndrome. J Pediatr Endocrinol Metab 2021; 34:1401-1410. [PMID: 34348423 DOI: 10.1515/jpem-2021-0324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 07/19/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Children with Down syndrome (DS) have a higher risk for obesity. Adiponectin plays a crucial role in obesity-related cardiometabolic comorbidities. The study aimed to explore whether body adiposity indicators, the frequency of metabolic syndrome (MetS) and its components, serum adiponectin and insulin resistance indices as well as the validity of serum adiponectin as a biomarker for MetS are different in prepubertal obese-DS children compared to matched obese-controls. METHODS Cross-sectional study included 150 prepubertal children classfied into three groups; obese-DS (n=50), obese-control (n=50) and normal-weight-control (n=50). Participants were evaluated for waist-circumference (WC), body adiposity, serum triglycerides, HDL-C, adiponectin and Homeostasis-Model-Assessment of Insulin-Resistance (HOMA-IR). MetS was defined using modified Adult Treatment Panel III-criteria. RESULTS Obese-DS had significantly higher WC, %body fat, total-fat mass, trunk-fat mass, trunk/appendicular-fat mass ratio, triglycerides, insulin and HOMA-IR and significantly lower HDL-C values compared to obese-control. Higher prevalence of MetS and its components were observed in obese-DS that was evident at younger age. Adiponectin was significantly lower in obese-DS compared with obese-control and in obese-DS children with MetS compared to obesecontrol with MetS. The decrease in adiponectin with increasing grades of obesity was pronounced in obese-DS. Adiponectin exhibited strong correlations with body adiposity, several MetS components and HOMA-IR in obese-DS. Adiponectin performed better as a biomarker for MetS among obese-DS (AUC=0.808) than obese-control (AUC=0.674). CONCLUSIONS Prepubertal obese-DS displayed excess body adiposity with pronounced central fat distribution, atherogenic lipid profile and higher insulin resistance compared to matched obese-control. Adiponectin performed better as potential biomarker of MetS in obese-DS than obese-control.
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Affiliation(s)
- Sohier Yahia
- Department of Pediatrics, Genetics Unit, Faculty of Medicine, Mansoura, Egypt
| | - Reham El-Farahaty
- Clinical Pathology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Abdel-Hady El-Gilany
- Public Health Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Rasha Shoaib
- Biochemistry Department, Faculty of Science, Damietta University, New Damietta, Egypt
| | | | - Nanees Salem
- Department of Pediatrics, Endocrinology Unit, Faculty of Medicine, Mansoura, Egypt
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Alldred MJ, Lee SH, Ginsberg SD. Adiponectin Modulation by Genotype and Maternal Choline Supplementation in a Mouse Model of Down Syndrome and Alzheimer's Disease. J Clin Med 2021; 10:2994. [PMID: 34279477 PMCID: PMC8267749 DOI: 10.3390/jcm10132994] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/01/2021] [Accepted: 07/03/2021] [Indexed: 12/13/2022] Open
Abstract
Down syndrome (DS) is a genetic disorder caused by the triplication of human chromosome 21, which results in neurological and physiological pathologies. These deficits increase during aging and are exacerbated by cognitive decline and increase of Alzheimer's disease (AD) neuropathology. A nontoxic, noninvasive treatment, maternal choline supplementation (MCS) attenuates cognitive decline in mouse models of DS and AD. To evaluate potential underlying mechanisms, laser capture microdissection of individual neuronal populations of MCS offspring was performed, followed by RNA sequencing and bioinformatic inquiry. Results at ~6 months of age (MO) revealed DS mice (the well-established Ts65Dn model) have significant dysregulation of select genes within the Type 2 Diabetes Mellitus (T2DM) signaling pathway relative to normal disomic (2N) littermates. Accordingly, we interrogated key T2DM protein hormones by ELISA assay in addition to gene and encoded protein levels in the brain. We found dysregulation of adiponectin (APN) protein levels in the frontal cortex of ~6 MO trisomic mice, which was attenuated by MCS. APN receptors also displayed expression level changes in response to MCS. APN is a potential biomarker for AD pathology and may be relevant in DS. We posit that changes in APN signaling may be an early marker of cognitive decline and neurodegeneration.
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Affiliation(s)
- Melissa J. Alldred
- Center for Dementia Research, Nathan Kline Institute, Orangeburg, NY 10962, USA
- Departments of Psychiatry, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Sang Han Lee
- Center for Biomedical Imaging and Neuromodulation, Nathan Kline Institute, Orangeburg, NY 10962, USA;
- Child & Adolescent Psychiatry, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Stephen D. Ginsberg
- Center for Dementia Research, Nathan Kline Institute, Orangeburg, NY 10962, USA
- Departments of Psychiatry, New York University Grossman School of Medicine, New York, NY 10016, USA
- Neuroscience & Physiology, New York University Grossman School of Medicine, New York, NY 10016, USA
- NYU Neuroscience Institute, New York University Grossman School of Medicine, New York, NY 10016, USA
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Hendrix JA, Amon A, Abbeduto L, Agiovlasitis S, Alsaied T, Anderson HA, Bain LJ, Baumer N, Bhattacharyya A, Bogunovic D, Botteron KN, Capone G, Chandan P, Chase I, Chicoine B, Cieuta-Walti C, DeRuisseau LR, Durand S, Esbensen A, Fortea J, Giménez S, Granholm AC, Hahn LJ, Head E, Hillerstrom H, Jacola LM, Janicki MP, Jasien JM, Kamer AR, Kent RD, Khor B, Lawrence JB, Lemonnier C, Lewanda AF, Mobley W, Moore PE, Nelson LP, Oreskovic NM, Osorio RS, Patterson D, Rasmussen SA, Reeves RH, Roizen N, Santoro S, Sherman SL, Talib N, Tapia IE, Walsh KM, Warren SF, White AN, Wong GW, Yi JS. Opportunities, barriers, and recommendations in down syndrome research. TRANSLATIONAL SCIENCE OF RARE DISEASES 2021; 5:99-129. [PMID: 34268067 PMCID: PMC8279178 DOI: 10.3233/trd-200090] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Recent advances in medical care have increased life expectancy and improved the quality of life for people with Down syndrome (DS). These advances are the result of both pre-clinical and clinical research but much about DS is still poorly understood. In 2020, the NIH announced their plan to update their DS research plan and requested input from the scientific and advocacy community. OBJECTIVE The National Down Syndrome Society (NDSS) and the LuMind IDSC Foundation worked together with scientific and medical experts to develop recommendations for the NIH research plan. METHODS NDSS and LuMind IDSC assembled over 50 experts across multiple disciplines and organized them in eleven working groups focused on specific issues for people with DS. RESULTS This review article summarizes the research gaps and recommendations that have the potential to improve the health and quality of life for people with DS within the next decade. CONCLUSIONS This review highlights many of the scientific gaps that exist in DS research. Based on these gaps, a multidisciplinary group of DS experts has made recommendations to advance DS research. This paper may also aid policymakers and the DS community to build a comprehensive national DS research strategy.
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Affiliation(s)
| | - Angelika Amon
- Deceased. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA; Department of Biology, Massachusetts Institute of Technology, Cambridge, MA, USA; Howard Hughes Medical Institute, Chevy Chase, MD, USA
| | - Leonard Abbeduto
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA; MIND Institute, University of California, Davis, CA, USA
| | | | - Tarek Alsaied
- Heart Institute Department of Pediatrics Cincinnati Children’s Hospital Medical Center University of Cincinnati, Cincinnati, OH, USA
| | | | | | - Nicole Baumer
- Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA; Down Syndrome Program, Developmental Medicine Center, Boston Children’s Hospital, Boston, MA, USA
| | - Anita Bhattacharyya
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
- Department of Cell and Regenerative Biology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Dusan Bogunovic
- Department of Microbiology, Icahn School of Medicine at Mt. Sinai, New York, NY, USA; Department of Pediatrics, Icahn School of Medicine at Mt. Sinai, New York, NY; Precision Immunology Institute, Icahn School of Medicine at Mt. Sinai, New York, NY, USA; Mindich Child Health and Development Institute, Icahn School of Medicine at Mt. Sinai, New York, NY, USA
| | - Kelly N. Botteron
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | | | - Priya Chandan
- Department of Neurosurgery, Division of Physical Medicine and Rehabilitation, University of Louisville School of Medicine, Louisville, KY, USA
| | - Isabelle Chase
- Department of Pediatric Dentistry, Boston Children’s Hospital, Boston, MA, USA
| | - Brian Chicoine
- Advocate Medical Group Adult Down Syndrome Center, Park Ridge, IL, USA
| | | | | | | | - Anna Esbensen
- Department of Pediatrics, University of Cincinnati College of Medicine & Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Juan Fortea
- Barcelona Down Medical Center, Fundació Catalana de Síndrome de Down, Barcelona, Spain; Sant Pau Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain; Center of Biomedical Investigation Network for Neurodegenerative Diseases, Madrid, Spain
| | - Sandra Giménez
- Multidisciplinary Sleep Unit, Respiratory Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Ann-Charlotte Granholm
- Knoebel Institute for Healthy Aging, University of Denver, Denver, CO, USA
- Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
| | - Laura J. Hahn
- Department of Speech and Hearing Science, University of Illinois Urbana Champaign, Champaign, IL, USA
| | - Elizabeth Head
- Department of Pathology and Laboratory Medicine, UC Irvine School of Medicine, Orange, CA, USA
| | | | - Lisa M. Jacola
- Department of Psychology, St Jude Children’s Research Hospital, Memphis, TN, USA
| | | | - Joan M. Jasien
- Division of Pediatric Neurology, Duke University Health System, Durham, NC, USA
| | - Angela R. Kamer
- Department of Periodontology and Implant Dentistry, New York University, College of Dentistry, New York, NY, USA
| | - Raymond D. Kent
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Bernard Khor
- Benaroy Research Institute at Virginia Mason, Seattle, WA, USA
| | - Jeanne B. Lawrence
- Department of Neurology, University of Massachusetts Medical School, Worcester, MA, USA; Department of Pediatrics, University of Massachusetts Medical School, Worcester, MA, USA
| | | | - Amy Feldman Lewanda
- Children s National Rare Disease Institute, Children’s National Health System, Washington, DC., USA
| | - William Mobley
- Department of Neurosciences, University of California, San Diego, CA, USA
| | - Paul E. Moore
- Division of Allergy, Immunology, and Pulmonology, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Nicolas M. Oreskovic
- Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA; Department of Internal Medicine, Massachusetts General Hospital, Boston, Mass
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Ricardo S. Osorio
- Center for Brain Health, Department of Psychiatry, NYU Langone Medical Center, New York, NY, USA
| | - David Patterson
- Knoebel Institute for Healthy Aging, University of Denver, Denver, CO, USA
- Eleanor Roosevelt Institute, University of Denver, Denver, CO, USA; Department of Biological Sciences, University of Denver, Denver, CO, USA; Molecular and Cellular Biophysics Program, University of Denver, Denver, CO, USA
| | - Sonja A. Rasmussen
- Department of Pediatrics, University of Florida College of Medicine, Gainesville, FL; Department of Epidemiology, University of Florida College of Public Health and Health Professions and College of Medicine, Gainesville, FL
| | - Roger H. Reeves
- Department of Physiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nancy Roizen
- Department of Pediatrics, UH/Rainbow Babies and Children’s Hospital and Department of Pediatrics, Case Western Reserve University, Cleveland, OH, USA
| | - Stephanie Santoro
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
- Down Syndrome Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA
| | - Stephanie L. Sherman
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA
| | - Nasreen Talib
- Division of General Pediatrics, Children’s Mercy Kansas City, 2401 Gillham Road, Kansas City, MO, USA
| | - Ignacio E. Tapia
- Sleep Center, Division of Pulmonary Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Kyle M. Walsh
- Division of Neuro-epidemiology, Department of Neurosurgery, Duke University, Durham, NC, USA
| | - Steven F. Warren
- Institute for Life Span Studies, University of Kansas, Lawrence, KS, USA
| | - A. Nicole White
- Research Foundation, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Guang William Wong
- Department of Physiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Center for Metabolism and Obesity Research, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - John S. Yi
- Division of Surgical Sciences, Department of Surgery, Duke University Medical Center, Durham, NC, USA
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Moreau M, Benhaddou S, Dard R, Tolu S, Hamzé R, Vialard F, Movassat J, Janel N. Metabolic Diseases and Down Syndrome: How Are They Linked Together? Biomedicines 2021; 9:biomedicines9020221. [PMID: 33671490 PMCID: PMC7926648 DOI: 10.3390/biomedicines9020221] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 02/15/2021] [Accepted: 02/17/2021] [Indexed: 12/13/2022] Open
Abstract
Down syndrome is a genetic disorder caused by the presence of a third copy of chromosome 21, associated with intellectual disabilities. Down syndrome is associated with anomalies of both the nervous and endocrine systems. Over the past decades, dramatic advances in Down syndrome research and treatment have helped to extend the life expectancy of these patients. Improved life expectancy is obviously a positive outcome, but it is accompanied with the need to address previously overlooked complications and comorbidities of Down syndrome, including obesity and diabetes, in order to improve the quality of life of Down syndrome patients. In this focused review, we describe the associations between Down syndrome and comorbidities, obesity and diabetes, and we discuss the understanding of proposed mechanisms for the association of Down syndrome with metabolic disorders. Drawing molecular mechanisms through which Type 1 diabetes and Type 2 diabetes could be linked to Down syndrome could allow identification of novel drug targets and provide therapeutic solutions to limit the development of metabolic and cognitive disorders.
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Affiliation(s)
- Manon Moreau
- Laboratoire Processus Dégénératifs, Université de Paris, BFA, UMR 8251, CNRS, Stress et Vieillissemen, F-75013 Paris, France; (M.M.); (S.B.); (R.D.)
| | - Soukaina Benhaddou
- Laboratoire Processus Dégénératifs, Université de Paris, BFA, UMR 8251, CNRS, Stress et Vieillissemen, F-75013 Paris, France; (M.M.); (S.B.); (R.D.)
| | - Rodolphe Dard
- Laboratoire Processus Dégénératifs, Université de Paris, BFA, UMR 8251, CNRS, Stress et Vieillissemen, F-75013 Paris, France; (M.M.); (S.B.); (R.D.)
- Genetics Deptartment, CHI Poissy St Germain-en-Laye, F-78300 Poissy, France;
- Université Paris-Saclay, UVSQ, INRAE, ENVA, BREED, F-78350 Jouy-en-Josas, France
| | - Stefania Tolu
- Laboratoire de Biologie et Pathologie du Pancréas Endocrine, Université de Paris, BFA, UMR 8251, CNRS, F-75013 Paris, France; (S.T.); (R.H.); (J.M.)
| | - Rim Hamzé
- Laboratoire de Biologie et Pathologie du Pancréas Endocrine, Université de Paris, BFA, UMR 8251, CNRS, F-75013 Paris, France; (S.T.); (R.H.); (J.M.)
| | - François Vialard
- Genetics Deptartment, CHI Poissy St Germain-en-Laye, F-78300 Poissy, France;
- Université Paris-Saclay, UVSQ, INRAE, ENVA, BREED, F-78350 Jouy-en-Josas, France
| | - Jamileh Movassat
- Laboratoire de Biologie et Pathologie du Pancréas Endocrine, Université de Paris, BFA, UMR 8251, CNRS, F-75013 Paris, France; (S.T.); (R.H.); (J.M.)
| | - Nathalie Janel
- Laboratoire Processus Dégénératifs, Université de Paris, BFA, UMR 8251, CNRS, Stress et Vieillissemen, F-75013 Paris, France; (M.M.); (S.B.); (R.D.)
- Correspondence: ; Tel.: +33-1-57-27-83-60; Fax: +33-1-57-27-83-54
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Valentini D, Mosca A, Di Camillo C, Crudele A, Sartorelli MR, Scoppola V, Tarani L, Villani A, Raponi M, Novelli A, Alisi A. PNPLA3 gene polymorphism is associated with liver steatosis in children with Down syndrome. Nutr Metab Cardiovasc Dis 2020; 30:1564-1572. [PMID: 32636123 DOI: 10.1016/j.numecd.2020.05.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 05/18/2020] [Accepted: 05/18/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND AIMS We previously demonstrated that children with Down syndrome (DS) exhibited a greater risk of steatosis than the general pediatric population. This trend was independent of obese phenotype, thus suggesting a role of genetic predisposition. Therefore, we investigated the prevalence of non-alcoholic fatty liver disease (NAFLD) and metabolic syndrome (MetS) in function of genetic susceptibility and adipocytokine levels in children with DS. METHODS AND RESULTS A total of 84 Caucasian children with DS (age range 5-17 years), were included in this study. For all children, we collected data on anthropometric and biochemical parameters, and liver ultrasound (US). We also measured adipocytokines circulating levels and specific polymorphisms closed to NAFLD. We found a prevalence of 64.3% of liver steatosis at US, with a severe steatosis of about 4% in children with DS. The presence of steatosis in children with DS was associated with the presence of patatin-like phospholipase domain-containing 3 (PNPLA3) rs738409 variant, which also correlated with interleukin (IL)-6 levels. Moreover, we found that the 52.4% had a waist circumference > 90th percentile, 21.4% were hypertensive, 7.14% had hyperglycemia, 9.5% had hypertriglyceridemia, and 17.9% showed high-density lipoprotein cholesterol ≤ 40 mg/dl. Finally, the IL-6 and adiponectin levels correlated with steatosis, and several adipocytokines correlated with single MetS traits in children with DS. CONCLUSION The present study explores for the first time potential pathomechanisms connecting pediatric NAFLD and MetS in DS. We found that the PNPLA3 variant is associated with steatosis, but not with MetS, in children with DS.
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Affiliation(s)
- Diletta Valentini
- Pediatric and Infectious Disease Unit, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy.
| | - Antonella Mosca
- Hepato-Metabolic Disease Unit, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - Chiara Di Camillo
- Pediatric and Infectious Disease Unit, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - Annalisa Crudele
- Molecular Genetics of Complex Phenotypes Research Unit, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | | | - Vittorio Scoppola
- Pediatric and Infectious Disease Unit, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - Luigi Tarani
- Department of Pediatrics, Sapienza University of Rome, Rome, Italy
| | - Alberto Villani
- Pediatric and Infectious Disease Unit, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | | | - Antonio Novelli
- Laboratory of Medical Genetics, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - Anna Alisi
- Molecular Genetics of Complex Phenotypes Research Unit, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy.
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9
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Dierssen M, Fructuoso M, Martínez de Lagrán M, Perluigi M, Barone E. Down Syndrome Is a Metabolic Disease: Altered Insulin Signaling Mediates Peripheral and Brain Dysfunctions. Front Neurosci 2020; 14:670. [PMID: 32733190 PMCID: PMC7360727 DOI: 10.3389/fnins.2020.00670] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 06/02/2020] [Indexed: 12/19/2022] Open
Abstract
Down syndrome (DS) is the most frequent chromosomal abnormality that causes intellectual disability, resulting from the presence of an extra complete or segment of chromosome 21 (HSA21). In addition, trisomy of HSA21 contributes to altered energy metabolism that appears to be a strong determinant in the development of pathological phenotypes associated with DS. Alterations include, among others, mitochondrial defects, increased oxidative stress levels, impaired glucose, and lipid metabolism, finally resulting in reduced energy production and cellular dysfunctions. These molecular defects seem to account for a high incidence of metabolic disorders, i.e., diabetes and/or obesity, as well as a higher risk of developing Alzheimer’s disease (AD) in DS. A dysregulation of the insulin signaling with reduced downstream pathways represents a common pathophysiological aspect in the development of both peripheral and central alterations leading to diabetes/obesity and AD. This is further strengthened by evidence showing that the molecular mechanisms responsible for such alterations appear to be similar between peripheral organs and brain. Considering that DS subjects are at high risk to develop either peripheral or brain metabolic defects, this review will discuss current knowledge about the link between trisomy of HSA21 and defects of insulin and insulin-related pathways in DS. Drawing the molecular signature underlying these processes in DS is a key challenge to identify novel drug targets and set up new prevention strategies aimed to reduce the impact of metabolic disorders and cognitive decline.
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Affiliation(s)
- Mara Dierssen
- Centre for Genomic Regulation (CRG), Barcelona Institute of Science and Technology, Barcelona, Spain.,Universitat Pompeu Fabra, Barcelona, Spain.,Human Pharmacology and Clinical Neurosciences Research Group, Neurosciences Research Program, Hospital Del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Madrid, Spain
| | - Marta Fructuoso
- Centre for Genomic Regulation (CRG), Barcelona Institute of Science and Technology, Barcelona, Spain
| | - María Martínez de Lagrán
- Centre for Genomic Regulation (CRG), Barcelona Institute of Science and Technology, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Madrid, Spain
| | - Marzia Perluigi
- Department of Biochemical Sciences "A. Rossi-Fanelli", Sapienza University of Rome, Rome, Italy
| | - Eugenio Barone
- Department of Biochemical Sciences "A. Rossi-Fanelli", Sapienza University of Rome, Rome, Italy
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10
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Capone G, Stephens M, Santoro S, Chicoine B, Bulova P, Peterson M, Jasien J, Smith AJ. Co-occurring medical conditions in adults with Down syndrome: A systematic review toward the development of health care guidelines. Part II. Am J Med Genet A 2020; 182:1832-1845. [PMID: 32338447 DOI: 10.1002/ajmg.a.61604] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 03/27/2020] [Accepted: 04/06/2020] [Indexed: 12/12/2022]
Abstract
Adults with Down syndrome (DS) represent a unique population who are in need of clinical guidelines to address their medical care. Many of these conditions are of public health importance with the potential to develop screening recommendations to improve clinical care for this population. Our workgroup previously identified and prioritized co-occurring medical conditions in adults with DS. In this study, we again performed detailed literature searches on an additional six medical conditions of clinical importance. A series of key questions (KQ) were formulated a priori to guide the literature search strategy. Our KQs focused on disease prevalence, severity, risk-factors, methodologies for screening/evaluation, impact on morbidity, and potential costs/benefits. The available evidence was extracted, evaluated and graded on quality. The number of participants and the design of clinical studies varied by condition and were often inadequate for answering most of the KQ. Based upon our review, we provide a summary of the findings on hip dysplasia, menopause, acquired cardiac valve disease, type 2 diabetes mellitus, hematologic disorders, and dysphagia. Minimal evidence demonstrates significant gaps in our clinical knowledge that compromises clinical decision-making and management of these medically complex individuals. The creation of evidence-based clinical guidance for this population will not be possible until these gaps are addressed.
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Affiliation(s)
- George Capone
- Down Syndrome Clinic and Research Center, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Mary Stephens
- Adult Down Syndrome Clinic, Christiana Care Health System, Wilmington, Delaware, USA
| | | | - Brian Chicoine
- Lutheran General Hospital, Advocate Adult Down Syndrome Center, Park Ridge, Illinois, USA
| | - Peter Bulova
- Adult Down Syndrome Clinic, Montefiore Hospital, Pittsburgh, Pennsylvania, USA
| | - Moya Peterson
- Adults with Down Syndrome Specialty Clinic, University of Kansas Medical Center, Kansas City, Missouri, USA
| | - Joan Jasien
- Department of Pediatrics and Child Neurology, Lenox Baker Children's Hospital, Durham, North Carolina, USA
| | - Anna Jo Smith
- Department of Gynecology and Obstetrics, Johns Hopkins Hospital, Baltimore, Maryland, USA
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11
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Gutierrez-Hervas A, Gómez-Martínez S, Izquierdo-Gómez R, Veiga OL, Perez-Bey A, Castro-Piñero J, Marcos A. Inflammation and fatness in adolescents with and without Down syndrome: UP & DOWN study. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2020; 64:170-179. [PMID: 31858639 DOI: 10.1111/jir.12697] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 10/08/2019] [Accepted: 10/09/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND The main objective of this study was to describe the inflammatory status of adolescents with Down syndrome (DS) and their relationship with adiposity. METHODS Ninety-five adolescents with DS (44.2% girls) and a control group of 113 adolescents (47.8% girls), aged between 11 and 18 years old, from the UP & DOWN study were included in this substudy. Serum C-reactive protein, C3 and C4 complement factors, total proteins, interleukin-6, tumour necrosis factor-α, insulin, cortisol, leptin, adiponectin, galactin-3 and visfatin were analysed; homeostatic model assessment index was calculated. In order to evaluate adiposity, we measured the following body fat variables: weight, height, waist circumference and skinfold thicknesses. Birth weight was obtained by questionnaire. In addition, body mass index, waist-to-height ratio (WHtR) and body fat percentage (BF%) were calculated. RESULTS Down syndrome group showed higher levels of body mass index, WHtR, waist circumference, BF% and lower birth weight than controls (P < 0.001). In the general linear model in the total sample, WHtR was positively associated with C3 and C4 (P < 0.001) as well as with leptin levels (P = 0.015). BF% was positively associated with total proteins (P = 0.093) and leptin levels (P < 0.001). DS was positively associated with total proteins (P < 0.001), C3 (P = 0.047) and C4 (P = 0.019). Despite the higher levels of adiposity found in DS group, no direct association was found between BF% and leptin levels, comparing with the control group. CONCLUSIONS These findings suggest that abdominal obesity should be controlled in adolescents because of its relationship with acute phase-inflammatory biomarkers but especially in DS adolescents who may show a peculiar metabolic status according to their relationship between adiposity and inflammatory biomarkers.
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Affiliation(s)
- A Gutierrez-Hervas
- Nursing Department, University of Alicante, Alicante, Spain
- Department of Nutrition and Metabolism (DMN), Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
| | - S Gómez-Martínez
- Department of Nutrition and Metabolism (DMN), Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
| | - R Izquierdo-Gómez
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Puerto Real, Spain
- Department of Physical Education, Faculty of Education, Universidad Central de Chile, Santiago, Chile
| | - O L Veiga
- Department of Physical Education, Sport and Human Movement, Faculty of Education, Autonomous University of Madrid, Ciudad Universitaria de Cantoblanco, Madrid, Spain
| | - A Perez-Bey
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Puerto Real, Spain
| | - J Castro-Piñero
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Puerto Real, Spain
| | - A Marcos
- Department of Nutrition and Metabolism (DMN), Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
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12
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Dumortier L, Bricout VA. Obstructive sleep apnea syndrome in adults with down syndrome: Causes and consequences. Is it a "chicken and egg" question? Neurosci Biobehav Rev 2020; 108:124-138. [DOI: 10.1016/j.neubiorev.2019.10.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 10/11/2019] [Accepted: 10/26/2019] [Indexed: 12/31/2022]
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13
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Dayal D, Seetharaman K, Panigrahi I, Muthuvel B, Agarwal A. Severe Early Onset Obesity due to a Novel Missense Mutation in Exon 3 of the Leptin Gene in an Infant from Northwest India. J Clin Res Pediatr Endocrinol 2018; 10:274-278. [PMID: 29217499 PMCID: PMC6083471 DOI: 10.4274/jcrpe.5501] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Monogenic obesity, caused by mutations in one of the genes involved in the control of hunger and satiety, is a rare cause of early onset obesity (EOO). The most common of the single gene alterations affect the leptin gene (LEP), resulting in congenital leptin deficiency that manifests as intense hyperphagia, EOO and severe obesity associated with hormonal and metabolic alterations. Only eight mutations of (LEP associated with congenital leptin deficiency have been described in humans to date. In this study, we report a novel, homozygous, missense mutation in exon 3 of the (LEP gene (chr7:127894610;c.298G>A) resulting in the amino acid substitution of asparagine for aspartic acid at codon 100 (p.Asp100Asn) in a 10-month-old infant who presented to us with severe hyperphagia and EOO. She was subsequently found to have low serum leptin concentrations. Additionally, a homozygous missense variation of unknown significance in exon 11 of Bardet-Biedl syndrome-1 gene (chr11:66291279; G>A; Depth 168x) was detected. Significant abnormalities of lipid parameters were also present in our patient. Both parents were thin but there was a family history suggestive of EOO in a paternal uncle and a cousin. In conclusion, we report the second patient from India with a novel mutation of the (LEP gene associated with severe obesity.
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Affiliation(s)
- Devi Dayal
- Postgraduate Institute of Medical Education and Research, Department of Pediatrics, Division of Pediatric Endocrinology, Chandigarh, India,* Address for Correspondence: Postgraduate Institute of Medical Education and Research, Department of Pediatrics, Division of Pediatric Endocrinology, Chandigarh, India Phone: +91-172-2755657 E-mail:
| | - Keerthivasan Seetharaman
- Postgraduate Institute of Medical Education and Research, Department of Pediatrics, Division of Pediatric Endocrinology, Chandigarh, India
| | - Inusha Panigrahi
- Postgraduate Institute of Medical Education and Research, Department of Pediatrics, Division of Genetic-Metabolic, Chandigarh, India
| | - Balasubramaniyan Muthuvel
- Postgraduate Institute of Medical Education and Research, Department of Pediatrics, Division of Pediatric Endocrinology, Chandigarh, India
| | - Ashish Agarwal
- Postgraduate Institute of Medical Education and Research, Department of Pediatrics, Division of Pediatric Endocrinology, Chandigarh, India
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14
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Down Syndrome, Obesity, Alzheimer's Disease, and Cancer: A Brief Review and Hypothesis. Brain Sci 2018; 8:brainsci8040053. [PMID: 29587359 PMCID: PMC5924389 DOI: 10.3390/brainsci8040053] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 03/15/2018] [Accepted: 03/22/2018] [Indexed: 12/19/2022] Open
Abstract
Down syndrome (trisomy 21), a complex mix of physical, mental, and biochemical issues, includes an increased risk of Alzheimer’s disease and childhood leukemia, a decreased risk of other tumors, and a high frequency of overweight/obesity. Certain features related to the third copy of chromosome 21 (which carries the APP gene and several anti-angiogenesis genes) create an environment favorable for Alzheimer’s disease and unfavorable for cancer. This environment may be enhanced by two bioactive compounds from fat cells, leptin, and adiponectin. This paper outlines these fat-related disease mechanisms and suggests new avenues of research to reduce disease risk in Down syndrome.
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