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Singleton CMH, Brar S, Robertson N, DiTommaso L, Fuchs GJ, Schadler A, Radulescu A, Attia SL. Cardiometabolic risk factors in South American children: A systematic review and meta-analysis. PLoS One 2023; 18:e0293865. [PMID: 37992076 PMCID: PMC10664905 DOI: 10.1371/journal.pone.0293865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 10/20/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Cardiometabolic risk factors (impaired fasting glucose, abdominal obesity, high blood pressure, dyslipidemia) cluster in children, may predict adult disease burden, and are inadequately characterized in South American children. OBJECTIVES To quantify the burden of cardiometabolic risk factors in South American children (0-21 years) and identify knowledge gaps. METHODS We systematically searched PubMed, Google Scholar, and the Latin American and Caribbean Health Sciences Literature via Virtual Health Library from 2000-2021 in any language. Two independent reviewers screened and extracted all data. RESULTS 179 studies of 2,181 screened were included representing 10 countries (n = 2,975,261). 12.2% of South American children experienced obesity, 21.9% elevated waist circumference, 3.0% elevated fasting glucose, 18.1% high triglycerides, 29.6% low HDL cholesterol, and 8.6% high blood pressure. Cardiometabolic risk factor definitions varied widely. Chile exhibited the highest prevalence of obesity/overweight, low HDL, and impaired fasting glucose. Ecuador exhibited the highest prevalence of elevated blood pressure. Rural setting (vs. urban or mixed) and indigenous origin protected against most cardiometabolic risk factors. CONCLUSIONS South American children experience high rates of obesity, overweight, and dyslipidemia. International consensus on cardiometabolic risk factor definitions for children will lead to improved diagnosis of cardiometabolic risk factors in this population, and future research should ensure inclusion of unreported countries and increased representation of indigenous populations.
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Affiliation(s)
| | - Sumeer Brar
- University of Kentucky College of Medicine, Lexington, Kentucky, United States of America
| | - Nicole Robertson
- University of Kentucky College of Medicine, Lexington, Kentucky, United States of America
| | - Lauren DiTommaso
- University of Kentucky College of Medicine, Lexington, Kentucky, United States of America
| | - George J. Fuchs
- University of Kentucky College of Medicine Division of Pediatric Gastroenterology, Hepatology and Nutrition, Kentucky, United States of America
- University of Kentucky College of Public Health Department of Epidemiology, Kentucky, United States of America
| | - Aric Schadler
- University of Kentucky College of Medicine Department of Pediatrics, Kentucky, United States of America
| | - Aurelia Radulescu
- University of Kentucky College of Medicine Department of Pediatrics, Kentucky, United States of America
| | - Suzanna L. Attia
- University of Kentucky College of Medicine Division of Pediatric Gastroenterology, Hepatology and Nutrition, Kentucky, United States of America
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Díaz-Ortega JL, Yupari-Azabache IL, Caballero Vidal JA, Conde-Parada NE, Rojas Gamboa AF. Criteria in the Diagnosis of Metabolic Syndrome in Children: A Scoping Review. Diabetes Metab Syndr Obes 2023; 16:3489-3500. [PMID: 37942175 PMCID: PMC10629454 DOI: 10.2147/dmso.s430360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 10/10/2023] [Indexed: 11/10/2023] Open
Abstract
Currently, there is no consensus on the criteria for identifying metabolic syndrome in children, as observed in the diversity of research developed. For this reason, a scoping review was developed in this work, in order to compare the criteria for the diagnosis of metabolic syndrome (MetS) applied in children, described in observational, descriptive cross-sectional studies. The databases PubMed, Scopus, Web of Science and the search engine Google Scholar were used. The search terms "metabolic syndrome", "cardiometabolic syndrome", "child", "children" and "childhood" were considered, as well as the names of organizations or authors proposing identification criteria for MetS to establish search relationships using the Boolean connectors "AND" and "OR". Likewise, two reviewers carried out the evaluation and selection of articles, of which 26 articles were included in which children aged 6 to 12 participated. It was found that the most commonly used criteria for identifying MetS since 2015 are those of Cook et al, IDF, NCEP ATPIII, and De Ferranti et al, in that order. Specific criteria, such as those proposed by Cook et al, are being chosen to enhance the accuracy of identifying MetS in children. The most common risk factors in children with MetS are abdominal circumference and BMI, followed by triglycerides, HDL, blood pressure, and blood glucose. The prevalence of MetS in children varies according to the criteria used, being higher with De Ferranti et al.
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Affiliation(s)
- Jorge Luis Díaz-Ortega
- Grupo de investigación en Síndrome Metabólico, Universidad César Vallejo, Trujillo, Perú
- Escuela Profesional de Nutrición, Universidad César Vallejo, Trujillo, Perú
| | | | - Joao Alonzo Caballero Vidal
- Grupo de investigación en Síndrome Metabólico, Universidad César Vallejo, Trujillo, Perú
- Escuela Profesional de Nutrición, Universidad César Vallejo, Trujillo, Perú
| | - Nelson Enrique Conde-Parada
- Grupo de investigación en Síndrome Metabólico, Universidad César Vallejo, Trujillo, Perú
- Programa de Nutrición y Dietética, Universidad Mariana, San Juan de Pasto, Colombia
| | - Abigail Fernanda Rojas Gamboa
- Grupo de investigación en Síndrome Metabólico, Universidad César Vallejo, Trujillo, Perú
- Escuela Profesional de Nutrición, Universidad César Vallejo, Trujillo, Perú
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Efficacy of vitamin D supplementation in reducing body mass index and lipid profile in healthy young adults in Colombia: a pilot randomised controlled clinical trial. J Nutr Sci 2023; 12:e29. [PMID: 36843975 PMCID: PMC9947753 DOI: 10.1017/jns.2022.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/16/2022] [Accepted: 11/17/2022] [Indexed: 02/24/2023] Open
Abstract
The objective of the present study was to evaluate the efficacy of oral administration of vitamin D supplementation in reducing BMI and lipid profile in adolescents and young adults from a cohort in Bucaramanga, Colombia. One hundred and one young adults were randomly assigned to one of two doses of vitamin D [1000 international units (IU) or 200 IU] administered daily for 15 weeks. The primary outcomes were serum 25(OH)D levels, BMI and lipid profile. The secondary outcomes were waist-hip ratio, skinfolds and fasting blood glucose. We found a mean ± sd plasma concentration of 25-hydroxyvitamin D [25(OH)D] was 25⋅0 ± 7⋅0 ng/ml at baseline, and after 15 weeks, it increased to 31⋅0 ± 10⋅0 ng/ml in the participants who received a daily dose of 1000 IU, (P < 0⋅0001). For the participants in the control group (200 IU), it went from 26⋅0 ± 8⋅0 ng/ml to 29⋅0 ± 8⋅0 ng/ml (P = 0⋅002). There were no differences between groups in body mass index. There was a statistically significant decrease in LDL-cholesterol between the intervention group v. the control group (mean difference -11⋅50 mg/dl (95 % CI -21⋅86 to -1⋅15; P = 0⋅030). The conclusions of the present study were two different doses of vitamin D supplementation (200 IU v. 1000 IU) produced changes in serum 25(OH)D levels over 15 weeks of administration in healthy young adults. No significant changes were found in the body mass index when the effect of the treatments was compared. A significant reduction in LDL-cholesterol was found when comparing the two intervention groups. Trial registration: NCT04377386.
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de Paiva MHP, Miranda VA, de Oliveira ARS, Cruz KJC, de Araújo RMS, de Oliveira KA. Prevalence of metabolic syndrome and its components in Brazilian adolescents: a systematic review and meta-analysis. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2022; 41:e2021145. [PMID: 35830158 PMCID: PMC9273121 DOI: 10.1590/1984-0462/2023/41/2021145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 11/14/2021] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To determine the prevalence of metabolic syndrome (MS) and its components among Brazilian adolescents. DATA SOURCE Databases, such as LILACS, MEDLINE, and SciELO, were searched for original cross-sectional studies published between 2010 and 2021. The inclusion criteria were determined based on the mnemonic CoCoPop - Condition, Context, and Population: studies determining the prevalence of MS and its components (condition) in the general population of Brazilian adolescents, female and male (population), enrolled in public or private schools in rural or urban areas (context). Reviews, editorials, and articles that did not directly relate to the prevalence of MS or that included non-adolescent age groups or groups with specific health conditions (obesity/overweight and others) were excluded. DATA SYNTHESIS A total of 15 studies, including 43,227 adolescents, were identified. MS prevalence (95% confidence interval [95%CI]) was 2.9% (2.65-3.18) and 2.4% (1.90-2.90) (p<0.001) in males and females, respectively, by using the International Diabetes Federation (IDF) criteria. There was a significant difference in MS prevalence among Brazilian regions (Q=24.7; p<0.001). The lowest MS prevalence (95%CI) was determined for North Region of Brazil, 1.8% (1.52-2.13), and the highest for Northeast Region of Brazil, 2.9% (2.62-3.23). Regarding MS components, a higher prevalence (95%CI) was found for low high-density lipoprotein (HDL), 22.1% (12.49-36.17), followed by abdominal obesity, 11.0% (8.05-14.94), and arterial hypertension, 10.3% (7.84-13.48). CONCLUSIONS This study allowed the determination of the prevalence of MS and the MS components in Brazilian adolescents, highlighting relevant aspects to be addressed on public health management.
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Rojas LZ, Quintero-Lesmes DC, Gamboa-Delgado EM, Guio E, Serrano NC. Prevalence of vitamin D status and its association with overweight or obesity in a population of Colombian children and adolescents. J Nutr Sci 2020; 9:e55. [PMID: 33354326 PMCID: PMC7737171 DOI: 10.1017/jns.2020.47] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/27/2020] [Accepted: 10/14/2020] [Indexed: 12/02/2022] Open
Abstract
The present study aimed to estimate the prevalence of 25-OH-D status (insufficiency and deficiency) in children and adolescents residing in Bucaramanga, Colombia and to determine its association with excess weight. A case-control study was nested in the SIMBA II cohort in children and adolescents between the ages of 11 and 20 years old. Cases were defined as those children and adolescents with overweight or obesity. The control group was composed of children and adolescents from the same population sample with similar sociodemographic and economic characteristics but without overweight or obesity diagnosis. 25-hydroxyvitamin D (25-OH-D) was quantified in serum using a chemiluminescent microparticle immunoassay. Logistic regression models were used to assess the association between vitamin D status and overweight or obesity adjusted for the main confounding variables. A total of 494 children and adolescents cases were 138 (52⋅17% boys and 47⋅83% girls; median age 16⋅0 [Q1 15; Q3 18]). The median BMI S-Score minors age in the cases was 1⋅36 [Q1 1⋅06; Q3 2⋅00] and BMI (kg/m2) 28⋅0 [Q1 26⋅2; Q3 30⋅8]. The prevalence of vitamin D in the cases was deficiency 16⋅67%, insufficiency 57⋅25%, sufficiency 26⋅09. 25-OH-D insufficiency was associated with overweight or obesity after adjusting for the main confounding variables (OR 1⋅73; 95% CI 1⋅05-2⋅84). Our study concludes that the 25-OH-D insufficiency is common in children and adolescents in Bucaramanga, Colombia, and it was associated with overweight or obesity.
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Affiliation(s)
- Lyda Z. Rojas
- Fundación Cardiovascular de Colombia, Dirección de Investigaciones, Calle 155A No. 23–58, Urbanización el Bosque, Floridablanca, Colombia
| | - Doris C. Quintero-Lesmes
- Fundación Cardiovascular de Colombia, Dirección de Investigaciones, Calle 155A No. 23–58, Urbanización el Bosque, Floridablanca, Colombia
| | - Edna M. Gamboa-Delgado
- Universidad Industrial de Santander, Escuela de Nutrición y Dietética, carrera 32 No. 29–32, Bucaramanga, Santander, Colombia
| | - Elizabeth Guio
- Fundación Cardiovascular de Colombia, Dirección de Investigaciones, Calle 155A No. 23–58, Urbanización el Bosque, Floridablanca, Colombia
| | - Norma C. Serrano
- Fundación Cardiovascular de Colombia, Dirección de Investigaciones, Calle 155A No. 23–58, Urbanización el Bosque, Floridablanca, Colombia
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Du J, Zang L, Li Y, Liu J, Wang L, Duan Y, Guo G, Li Y, Zhang Y, Wang G, Mu Y. A multi-center randomized controlled trial of the LenoMed ATA-I-1-0 insulin pump for the intensive treatment of diabetic patients. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:1485. [PMID: 33313230 PMCID: PMC7729342 DOI: 10.21037/atm-20-6024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Continuous subcutaneous insulin infusion (CSII) is an effective method for managing diabetes. The aim of this study was to evaluate the efficacy and safety of the LenoMed ATA-I-1-0 insulin pump for the treatment of patients with type 1 and type 2 diabetes, compared to the Medtronic MMT-712 insulin pump. Methods A total of 120 subjects with diabetes needing insulin treatment were recruited, and 104 completed the trial. The intervention and control group used the LenoMed and Medtronic insulin pump, respectively. The primary outcome was a reduction in fasting plasma glucose. Secondary outcomes included blood glucose control at 7 time points (before and after each meal, and before sleep), hemoglobin A1c (HbA1c) levels at 1 time point, and accuracy and safety of the pumps. Results In the per protocol set of 104 subjects, a significant drop in fasting plasma glucose levels was observed for 98.0% subjects in the intervention group and 92.7% in the control group. There was no statistically significant difference between groups [5.23%; 95% confidence interval (CI): −2.69% –13.2%]. Compared to baseline, levels of blood glucose and HbA1c dropped (P<0.001) at a similar magnitude in both groups. The accuracy and alarm effectiveness was 100%. No adverse event or severe adverse event related to the medication occurred in the study. Conclusions The novel injection equipment, the LenoMed ATA-I-1-0 insulin pump, demonstrated efficacy and a good safety profile, and was not inferior to the widely used Medtronic MMT-712 insulin pump. Thus, our study suggests that the LenoMed ATA-I-1-0 insulin pump can be widely used in clinical practice.
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Affiliation(s)
- Jin Du
- Department of Endocrinology, The First Medical Center of PLA General Hospital, Beijing, China
| | - Li Zang
- Department of Endocrinology, The First Medical Center of PLA General Hospital, Beijing, China
| | - Yufeng Li
- Department of Endocrinology, Beijing Pinggu Hospital, Beijing, China
| | - Jia Liu
- Department of Endocrinology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Lijuan Wang
- Department of Endocrinology, Beijing Pinggu Hospital, Beijing, China
| | - Yan Duan
- Department of Endocrinology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Guangxia Guo
- Department of Endocrinology, Beijing Pinggu Hospital, Beijing, China
| | - Yijun Li
- Department of Endocrinology, The First Medical Center of PLA General Hospital, Beijing, China
| | - Yajing Zhang
- Department of Endocrinology, Beijing Pinggu Hospital, Beijing, China
| | - Guang Wang
- Department of Endocrinology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Yiming Mu
- Department of Endocrinology, The First Medical Center of PLA General Hospital, Beijing, China
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Serrano NC, Romero SL, Suárez DP, Rojas LZ, Gamboa-Delgado EM, Forero M, Guio E, Quintero-Lesmes DC. Efficacy of oral Vitamin D supplementation in reducing body mass index and lipid profile in adolescents and young adults in Colombia: A pilot clinical trial protocol nested in the SIMBA cohort. Medicine (Baltimore) 2020; 99:e21722. [PMID: 32871891 PMCID: PMC7458167 DOI: 10.1097/md.0000000000021722] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
Abstract
BACKGROUND In recent years, the role of vitamin D (VD) as a protective factor in cardiovascular disease has been recognized. Thus, there is a need to study the effect of vitamin D supplementation in the control of different cardiovascular risk factors and metabolic syndrome, especially in young populations where few studies have been conducted. METHODS Pilot study of a randomized, parallel two-arm, triple-blind clinical controlled trial in 150 adolescents and young adults in the city of Bucaramanga-Colombia. The intervention group will receive 1000 IU of VD and the control group 200 IU of VD daily for 15 weeks. The main outcomes are: serum calcifediol levels (25(OH) D), body mass index and lipid profile; secondary outcomes are complementary to the previous ones (skin folds, waist-hip ratio). Other variables will be analyzed such as assessment of dietary intake, physical activity, sun exposure, cigarette and tobacco consumption and compliance with VD supplementation. DISCUSSION This study is innovative since there is little evidence from clinical trials in adolescents and young adults; similar studies are not known in our context. The results of this study may facilitate the recommendation of oral vitamin D supplementation in the population of interest. In addition, it is a low-cost and easy-to-apply intervention that could contribute to the formulation and implementation of health policies. TRIAL REGISTRATION NCT04377386.
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Affiliation(s)
| | | | | | | | | | - Mario Forero
- Hospital Internacional de Colombia, Piedecuesta, Colombia
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Higuita-Gutiérrez LF, Martínez Quiroz WDJ, Cardona-Arias JA. Prevalence of Metabolic Syndrome and Its Association with Sociodemographic Characteristics in Participants of a Public Chronic Disease Control Program in Medellin, Colombia, in 2018. Diabetes Metab Syndr Obes 2020; 13:1161-1169. [PMID: 32346303 PMCID: PMC7169935 DOI: 10.2147/dmso.s242826] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 03/03/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Metabolic syndrome has increased to epidemic levels in low- and middle-income countries. The knowledge on metabolic syndrome and its related diseases constitutes a clinical, epidemiological, and economic challenge of great relevance. The frequency of metabolic syndrome may vary between populations depending on age, sex, lifestyle, and culture; however, in Colombia, there is only little research, and the available studies focus on small populations that do not allow estimating their prevalence and distribution in different sociodemographic groups. We aimed to estimate the prevalence of metabolic syndrome and its association with sociodemographic characteristics in participants attending public chronic disease control programs in Medellin, Colombia, in the year 2018. METHODS We conducted a cross-sectional study in all patients who participated in a public chronic disease control program. Involved in this study were 68,288 individuals who attended at 10 hospital units and were strategically distributed in the city. The diagnostic criteria of the metabolic syndrome and its components were based on the consensus of the Latin American Diabetes Association. The data on age, sex, blood pressure, weight, height, physical activity, medications, lipid profile, and glycemic and glycosylated hemoglobin levels were obtained for clinical records. The prevalence, Pearson's chi-square test, prevalence ratios (Kato-Katz method), and odds ratios (Woolf method) were estimated with 95% confidence intervals. A multivariate adjustment model was used with a logistic regression model to identify potential confounders using Epidat 4.2 and SPSS® 25.0. RESULTS The prevalence of the syndrome was 35.4%, with abdominal obesity in 82.3% individuals, hypertension in 48.6%, glucose intolerance in 25.5%, and hypertriglyceridemia in 22%. The prevalence of the syndrome exhibited statistical differences according to the area of residence. It was 15% higher in women; 31% and 59% higher in young and older adults, respectively, than in individuals aged <25 years; 11% and 13% higher in the illiterate population and population with primary studies than in individuals with higher education; and approximately 200 times higher than those who are sedentary. CONCLUSION A high prevalence of the syndrome and its constitutive factors in the study population demonstrated the importance of controlling it and increasing community-based prevention strategies, prioritizing the identified groups that are at the highest risk.
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Affiliation(s)
- Luis Felipe Higuita-Gutiérrez
- Cooperative University of Colombia, University of Antioquia, Medellín, Colombia
- Correspondence: Luis Felipe Higuita-GutiérrezCalle 70 Número 52 – 51, Medellín, ColombiaTel +5742198486Fax +5742195486 Email
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