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Navarro P, Feo-Ortega S, Casabona-Francés S, Gutiérrez-Junquera C, Savarino EV, Amorena E, Fernández-Fernández S, Pérez-Martínez I, Oliva S, Barrio J, Masiques-Mas ML, Guardiola-Arévalo A, Guagnozzi D, Racca F, Betoré E, Votto M, Rodríguez-Sánchez A, Barrio ML, Blas-Jhon L, Sánchez-Vegazo CT, García-Morales N, Krarup AL, Dainese R, Martín-Dominguez V, García-Díaz A, Maniero D, Santander C, Arias Á, Laserna-Mendieta EJ, Lucendo AJ. Determinant factors for first-line treatment choice and effectiveness in pediatric eosinophilic esophagitis: an analysis of the EUREOS EoE CONNECT registry. Eur J Pediatr 2024:10.1007/s00431-024-05618-z. [PMID: 38819501 DOI: 10.1007/s00431-024-05618-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 05/03/2024] [Accepted: 05/17/2024] [Indexed: 06/01/2024]
Abstract
This study compared short-term effectiveness of proton pump inhibitors (PPI), swallowed topical corticosteroids (STC), and dietary therapies in reversing clinical and histological features in pediatric patients with eosinophilic esophagitits (EoE). Determinants for treatment choice and PPI therapy effectiveness were also assessed. A cross-sectional study analysis of patients under 18 years old recruited onto the multicenter EoE CONNECT registry was performed. Clinico-histological response was defined as symptomatic improvement plus a peak eosinophil count below 15 per high-power field after treatment. Effectiveness of first-line options used in monotherapy was compared. Overall, 393 patients (64% adolescents) receiving PPI, STC, or dietary monotherapy to induce EoE remission were identified. PPI was the preferred option (71.5%), despite STC providing the highest clinico-histological response rates (66%) compared to PPI (44%) and diet (42%). Logistic regression identified fibrotic features and recruitment at Italian sites independently associated to first-line STC treatment; age under 12 associated to dietary therapy over other options. Analysis of 262 patients in whom PPI effectiveness was evaluated after median (IQR) 96 (70-145) days showed that this effectiveness was significantly associated with management at pediatric facilities and use of high PPI doses. Among PPI responders, decrease in rings and structures in endoscopy from baseline was documented, with EREFS fibrotic subscore for rings also decreasing among responders (0.27 ± 0.63 vs. 0.05 ± 0.22, p < 0.001). Conclusion: Initial therapy choice for EoE depends on endoscopic phenotype, patient's age, and patients' origin. High PPI doses and treatment in pediatric facilities significantly determined effectiveness, and reversed fibrotic endoscopic features among responders. What is Known: • Proton pump inhibitors are widely used to induce and maintain remission in EoE in real practice, despite other first-line alternative therapies possibly providing higher effectiveness. What is New: • Proton pump inhibitors represent up to two-thirds of first-line monotherapies used to induce EoE remission in pediatric and adolescent patients with EoE. The choice of STC as first-line treatment for EoE was significantly associated with fibrotic features at baseline endoscopy and recruitment in Italian centers; age less than 12 years was associated with dietary therapy. • PPI effectiveness was found to be determined by use of high doses, attendance at pediatric facilities, presenting inflammatory instead of fibrotic or mixed phenotypes, and younger age. Among responders, PPI therapy reversed both inflammatory and fibrotic features of EoE after short-term treatment.
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Affiliation(s)
- Pilar Navarro
- Department of Gastroenterology, Hospital General de Tomelloso, Vereda de Socuéllamos s/n, 13700, Tomelloso, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Toledo, Spain
- Instituto de Investigación Sanitaria La Princesa, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, CIBERehd, Madrid, Spain
| | - Sara Feo-Ortega
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Toledo, Spain
- Department of Pediatrics, Hospital General de Tomelloso, Tomelloso, Spain
| | - Sergio Casabona-Francés
- Instituto de Investigación Sanitaria La Princesa, Madrid, Spain
- Department of Gastroenterology, Hospital Universitario de La Princesa, Madrid, Spain
| | - Carolina Gutiérrez-Junquera
- Pediatric Gastroenterology Unit, Hospital Universitario Puerta de Hierro, Majadahonda, Spain
- Universidad Autónoma de Madrid, Madrid, Spain
| | - Edoardo V Savarino
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
- Gastroenterology Unit, Azienza Ospedaliera di Padova, Padua, Italy
| | - Edurne Amorena
- Department of Gastroenterology, Hospital Universitario de Navarra, Pamplona, Spain
| | | | - Isabel Pérez-Martínez
- Department of Gastroenterology, Hospital Universitario Central de Asturias, Oviedo, Spain
- Diet, Microbiota and Health Group, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Salvatore Oliva
- Pediatric Gastroenterology and Liver Unit, Maternal and Child Health Department, Sapienza-University of Rome, Rome, Italy
| | - Jesús Barrio
- Department of Gastroenterology, Hospital Universitario Rio Hortega, Valladolid, Spain
| | | | | | - Danila Guagnozzi
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, CIBERehd, Madrid, Spain
- Department of Gastroenterology, Hospital Universitario Vall d'Hebrón, Barcelona, Spain
| | - Francesca Racca
- Personalized Medicine, Asthma and Allergy Clinic, IRCCS Humanitas Research Hospital, Rozzano - Milan, Italy
| | - Elena Betoré
- Department of Gastroenterology, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Martina Votto
- Pediatric Unit, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia; and Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | | | | | | | | | - Anne Lund Krarup
- Department of Emergency Medicine and Trauma Center, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Raffaella Dainese
- Department of Gastroenterology, Centre Hospitalier d'Antibes Juan-les Pins, Antibes, France
| | - Verónica Martín-Dominguez
- Instituto de Investigación Sanitaria La Princesa, Madrid, Spain
- Department of Gastroenterology, Hospital Universitario de La Princesa, Madrid, Spain
| | - Alejandro García-Díaz
- Pediatric Gastroenterology Unit, Hospital Universitario Puerta de Hierro, Majadahonda, Spain
| | - Daria Maniero
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Cecilio Santander
- Instituto de Investigación Sanitaria La Princesa, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, CIBERehd, Madrid, Spain
- Department of Gastroenterology, Hospital Universitario de La Princesa, Madrid, Spain
- Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | - Ángel Arias
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Toledo, Spain
- Instituto de Investigación Sanitaria La Princesa, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, CIBERehd, Madrid, Spain
- Research Unit, Hospital General Mancha-Centro, Alcázar de San Juan, Spain
| | - Emilio J Laserna-Mendieta
- Department of Gastroenterology, Hospital General de Tomelloso, Vereda de Socuéllamos s/n, 13700, Tomelloso, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Toledo, Spain
- Instituto de Investigación Sanitaria La Princesa, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, CIBERehd, Madrid, Spain
| | - Alfredo J Lucendo
- Department of Gastroenterology, Hospital General de Tomelloso, Vereda de Socuéllamos s/n, 13700, Tomelloso, Spain.
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Toledo, Spain.
- Instituto de Investigación Sanitaria La Princesa, Madrid, Spain.
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, CIBERehd, Madrid, Spain.
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Bertomeu-Gonzalez V, Sanchez-Ferrer F, Quesada JA, Nso-Roca AP, Lopez-Pineda A, Ruiz-Nodar JM. Prevalence of childhood obesity in Spain and its relation with socioeconomic status and health behaviors: Population-based cross-sectional study. Med Clin (Barc) 2024:S0025-7753(24)00199-4. [PMID: 38714468 DOI: 10.1016/j.medcli.2024.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/04/2024] [Accepted: 02/06/2024] [Indexed: 05/09/2024]
Abstract
OBJECTIVES This study aims to assess the current state of childhood overweight and obesity in Spain, and its relationship with socioeconomic status and health-related behaviors. METHODS Population-based cross-sectional observational study, based on the 2017 National Health Survey in minors in Spain. This study included all children surveyed who were aged 1-14 years. Childhood obesity was estimated from the z-score of the body mass index. RESULTS The study included 4882 children aged 1-14 years (mean 7.5). The prevalence of obesity was 18.6% (95% confidence interval [CI] 18.5-18.7), while 13.5% (95% CI 13.4-13.6) were overweight. These figures represent over a million children in Spain who are obese and nearly 750,000 who are overweight. A north-south geographic gradient was apparent, with higher prevalence of unhealthy body weight in southern Spain. Factors associated with childhood obesity were low socioeconomic status, poor diet and sedentarism, among others. CONCLUSIONS Childhood overweight in Spain is strongly associated with socioeconomic status and other factors such as diet and sedentarism. Multidisciplinary public health interventions are needed to reduce this serious health problem in children.
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Affiliation(s)
- Vicente Bertomeu-Gonzalez
- GRINCAVA Research Group, Clinical Medicine Department, Miguel Hernandez University, San Juan de Alicante, Alicante, Spain; Cardiology Section, University Hospital of San Juan de Alicante, San Juan de Alicante, Alicante, Spain; Center for Biomedical Research Network Cardiovascular Diseases (CIBERCV), Spain
| | - Francisco Sanchez-Ferrer
- GRINCAVA Research Group, Clinical Medicine Department, Miguel Hernandez University, San Juan de Alicante, Alicante, Spain; Pharmacology, Pediatrics and Organic Chemistry Department, Miguel Hernandez University, San Juan de Alicante, Alicante, Spain.
| | - Jose Antonio Quesada
- GRINCAVA Research Group, Clinical Medicine Department, Miguel Hernandez University, San Juan de Alicante, Alicante, Spain
| | - Ana Pilar Nso-Roca
- GRINCAVA Research Group, Clinical Medicine Department, Miguel Hernandez University, San Juan de Alicante, Alicante, Spain
| | - Adriana Lopez-Pineda
- GRINCAVA Research Group, Clinical Medicine Department, Miguel Hernandez University, San Juan de Alicante, Alicante, Spain
| | - Juan Miguel Ruiz-Nodar
- GRINCAVA Research Group, Clinical Medicine Department, Miguel Hernandez University, San Juan de Alicante, Alicante, Spain; Center for Biomedical Research Network Cardiovascular Diseases (CIBERCV), Spain; Cardiology Service, General University Hospital of Alicante, Alicante, Spain
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Özyildirim C, Unsal EN, Ayhan NY. Performance of triponderal mass index, body mass index z scores, and body mass index performance in the diagnosis of obesity in children and adolescents. Nutrition 2023; 114:112116. [PMID: 37406609 DOI: 10.1016/j.nut.2023.112116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 05/24/2023] [Accepted: 06/01/2023] [Indexed: 07/07/2023]
Abstract
OBJECTIVES Childhood obesity is a global health problem that affects millions of children and causes obesity-related adverse health outcomes in both childhood and adulthood. Although body mass index (BMI) z scores and percentiles are used in the diagnosis of obesity in children, it has been emphasized in recent years that the triponderal mass index (TMI) may be more accurate for this purpose. We aimed to compare TMI with BMI in the diagnosis of obesity in Turkish children and adolescents. METHODS The records of 3540 children who applied to Gülhane Training and Research Hospital were retrospectively scanned and the data of 1161 children were included in the study. The body fat percentage (BF%) was calculated by a formula, and children with body fat in the ≥95th percentile were classified as obese. Receiver study characteristics analysis was performed to compare the effectiveness of TMI and BMI in the diagnosis of obesity. RESULTS TMI correlated more with BF% (r = 0.863) than fat mass (r = 0.664); BMI correlated more with fat mass (r = 0.957) than BF% (r = 0.714) (P < 0.001). TMI had the highest area under the curve (AUC) in boys at diagnosis of obesity (6-11 y = 0.981; 12-15 y = 0.994). Girls ages 6 to 11 y had the same AUC for all 3 indexes (AUC = 0.977), whereas girls ages 12 to 15 y had the highest AUC for TMI (AUC = 0.967). However, the AUC values between all indices were very close. CONCLUSIONS TMI can be used to diagnose obesity in Turkish children and adolescents in both boys and girls similarly and with good performance. The correlation with BF% and stability of TMI makes this index more advantageous. However, it should be noted that the performance of each of the 3 indices is very close to that of the others, and adjustments should be made according to age and sex.
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Affiliation(s)
- Caner Özyildirim
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Akdeniz University, Antalya, Turkey; Ankara University Graduate School of Health Sciences.
| | | | - Nurcan Yabanci Ayhan
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Ankara University, Ankara, Turkey
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Palomo Atance E, Caballero Mora FJ, Espadas Maciá D, Marbán Calzón M, Sevilla Ramos P, García Villaescusa L, Dabad Moreno MJ, Muñoz-Rodríguez JR, Ruiz Cano R. Triponderal mass index and markers of metabolic risk in children and adolescents with obesity. Med Clin (Barc) 2023; 160:379-384. [PMID: 36631326 DOI: 10.1016/j.medcli.2022.09.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/19/2022] [Accepted: 09/22/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND OBJECTIVE Triponderal mass index (TMI) would estimate excess adiposity better than body mass index (BMI), maintaining stable values during childhood. This work aims to determine the correlation between TMI and markers of metabolic risk as well as set values of TMI that are related to an increase of metabolic risk. MATERIAL AND METHODS Multicenter, observational, cross-sectional and prospective study in children under 14 years of age with obesity. VARIABLES age, sex, pubertal stage, weight, height, abdominal circumference, BMI, TMI, basal glucose and insulin, HOMA index, blood pressure, lipoprotein profile, transaminases and uric acid. BMI and TMI were expressed according to the values of the Barcelona longitudinal study. Statistical analysis was performed with the SPSS* program. RESULTS One hundred and ninety-nine patients (50.3% male), age 11.08 (2.48) years, TMI 19.68 (2.36)kg/m3. Correlation between TMI and abdominal circumference (r=0.571; p=0), insulin (r=0.198; p=0.005), HOMA index (r=0.189; p=0.008) and HDL-c (r=-0.188; p=0.008) was observed. IMT>20.15kg/m3 was associated with insulin≥15mIU/ml (p=0.029) and IMT>20.36kg/m3 with HDL-c<40mg/dl (p=0.023). CONCLUSIONS TMI was correlated with increase of abdominal circumference, insulin and HOMA index and decrease of HDL-c. IMT>20kg/m3 can be associated with increased insulin and decreased HDL-c. Therefore, the IMT seems to be a useful parameter in the assessment of pediatric patients with obesity.
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Affiliation(s)
- Enrique Palomo Atance
- Endocrinología Pediátrica, Servicio de Pediatría, Hospital General Universitario de Ciudad Real, Grupo de Endocrinología Pediátrica de Castilla-La Mancha (GEPCAM), Ciudad Real, España.
| | - Francisco Javier Caballero Mora
- Endocrinología Pediátrica, Servicio de Pediatría, Hospital Santa Bárbara, Grupo de Endocrinología Pediátrica de Castilla-La Mancha (GEPCAM), Puertollano, Ciudad Real, España
| | - David Espadas Maciá
- Endocrinología Pediátrica, Servicio de Pediatría, Hospital Virgen de la Luz, Grupo de Endocrinología Pediátrica de Castilla-La Mancha (GEPCAM), Cuenca, España
| | - Mercedes Marbán Calzón
- Endocrinología Pediátrica, Servicio de Pediatría, Hospital General La Mancha Centro, Grupo de Endocrinología Pediátrica de Castilla-La Mancha (GEPCAM), Alcázar de San Juan, Ciudad Real, España
| | - Pilar Sevilla Ramos
- Endocrinología Pediátrica, Servicio de Pediatría, Hospital Universitario de Guadalajara, Grupo de Endocrinología Pediátrica de Castilla-La Mancha (GEPCAM), Guadalajara, España
| | - Lourdes García Villaescusa
- Endocrinología Pediátrica, Servicio de Pediatría, Hospital General de Almansa, Grupo de Endocrinología Pediátrica de Castilla-La Mancha (GEPCAM), Almansa, Albacete, España
| | - María Jesús Dabad Moreno
- Endocrinología Pediátrica, Servicio de Pediatría, Hospital General Universitario de Albacete, Grupo de Endocrinología Pediátrica de Castilla-La Mancha (GEPCAM), Albacete, España
| | - José Ramón Muñoz-Rodríguez
- Unidad de Investigación Traslacional, Hospital General Universitario de Ciudad Real, Ciudad Real, España
| | - Rafael Ruiz Cano
- Endocrinología Pediátrica, Servicio de Pediatría, Hospital General Universitario de Albacete, Grupo de Endocrinología Pediátrica de Castilla-La Mancha (GEPCAM), Albacete, España
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Triponderal mass index is as strong as body mass index in the determination of obesity and adiposity. Nutrition 2023; 105:111846. [PMID: 36265325 DOI: 10.1016/j.nut.2022.111846] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 08/18/2022] [Accepted: 08/31/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE In determining obesity and body adiposity, triponderal mass index (TMI) is as strong an anthropometric measurement as body mass index (BMI). The aim of this study was to develop TMI reference values for Turkish children and adolescents and compare TMI with BMI according to body adiposity and obesity indices. METHODS Data from the DAMTCA-II (Determination of Anthropometric Measurements of Turkish Children and Adolescents II) study were used in this cross-sectional study. Data from 4330 children (1931 boys, 2399 girls) ages 6 to 17 y were evaluated, and the TMI percentile values were produced. The predictive power of TMI and BMI for obesity and overweight were done for waist circumference, waist/height ratio, body fat percentage, and upper arm fat area, which are different parameters used to determine body adiposity. RESULTS The 3rd, 5th, 10th, 25th, 50th, 75th, 85th, 90th, 95th, and 97th TMI percentiles and mean values were calculated for all children's age and sex. TMI cutoff values were calculated by receiver operating characteristic analysis regarding waist/height ratio 0.5, waist circumference ≥90 percentile, arm fat area ≥85 percentile, and body fat percentage ≥85. TMI and BMI area under the curve values were similar for each of these four measurements. TMI was as robust an index as BMI in demonstrating obesity and adiposity for all age groups in boys and girls. It was concluded that the values >90th percentile (median 15.8 kg/m3) in girls aged ≤10 y, 95th percentile (median 16.2 kg/m3) in girls aged >10 y, >85th percentile (median 14.9 kg/m3) in boys aged ≤12 y and 75th percentile (median value 14.5 kg/m3) in boys aged >12 y are critical values for TMI when evaluating adiposity and obesity. CONCLUSIONS We considered that TMI is as effective as BMI in terms of waist/height ratio, waist circumference, arm fat area, and body fat percentage in determining overweight and obesity in children. The ages at which TMI showed distinct variation were determined for both sexes.
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Myocardial tissue characterization by cardiovascular magnetic resonance T1 mapping and pericardial fat quantification in adolescents with morbid obesity. Cardiac dimorphism by gender. Int J Cardiovasc Imaging 2022; 39:781-792. [PMID: 36508057 DOI: 10.1007/s10554-022-02773-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 11/30/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE Changes in the myocardial extracellular matrix (ECM) identified using T1 mapping cardiovascular magnetic resonance (CMR) have been only reported in obese adults, but with opposite conclusions. The objectives are to assess the composition of the myocardial ECM in an obese pediatric population without type 2 diabetes by quantifying native T1 time, and to quantify the pericardial fat index (PFI) and their relationship with cardiovascular risk factors. METHODS Observational case-control research of 25 morbidly obese adolescents and 13 normal-weight adolescents. Native T1 and T2 times (ms), left ventricular (LV) geometry and function, PFI (g/ht3) and hepatic fat fraction (HFF, %) were calculated by 1.5-T CMR. RESULTS No differences were noticed in native T1 between obese and non-obese adolescents (1000.0 vs. 990.5 ms, p0.73), despite showing higher LV mass values (28.3 vs. 22.9 g/ht3, p0.01). However, the T1 mapping values were significantly higher in females (1012.7 vs. 980.7 ms, p < 0.01) while in males, native T1 was better correlated with obesity parameters, particularly with triponderal mass index (TMI) (r = 0.51), and inflammatory cells. Similarly, the PFI was correlated with insulin resistance (r = 0.56), highly sensitive C-reactive protein (r = 0.54) and TMI (r = 0.77). CONCLUSION Female adolescents possess myocardium peculiarities associated with higher mapping values. In males, who are commonly more exposed to future non-communicable diseases, TMI may serve as a useful predictor of native T1 and pericardial fat increases. Furthermore, HFF and PFI appear to be markers of adipose tissue infiltration closely related with hypertension, insulin resistance and inflammation.
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Siurana JM, Sabaté-Rotés A, Amigó N, Martínez-Micaelo N, Arciniegas L, Riaza L, Mogas E, Rosés-Noguer F, Ventura PS, Yeste D. Different profiles of lipoprotein particles associate various degrees of cardiac involvement in adolescents with morbid obesity. Front Pediatr 2022; 10:887771. [PMID: 36483472 PMCID: PMC9723388 DOI: 10.3389/fped.2022.887771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 11/02/2022] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Dyslipidemia secondary to obesity is a risk factor related to cardiovascular disease events, however a pathological conventional lipid profile (CLP) is infrequently found in obese children. The objective is to evaluate the advanced lipoprotein testing (ALT) and its relationship with cardiac changes, metabolic syndrome (MS) and inflammatory markers in a population of morbidly obese adolescents with normal CLP and without type 2 diabetes mellitus, the most common scenario in obese adolescents. METHODS Prospective case-control research of 42 morbidly obese adolescents and 25 normal-weight adolescents, whose left ventricle (LV) morphology and function had been assessed. The ALT was obtained by proton nuclear magnetic resonance spectroscopy, and the results were compared according to the degree of cardiac involvement - normal heart, mild LV changes, and severe LV changes (specifically LV remodeling and systolic dysfunction) - and related to inflammation markers [highly-sensitive C-reactive protein and glycoprotein A (GlycA)] and insulin-resistance [homeostatic model assessment for insulin-resistance (HOMA-IR)]. A second analysis was performed to compare our results with the predominant ALT when only body mass index and metabolic syndrome criteria were considered. RESULTS The three cardiac involvement groups showed significant increases in HOMA-IR, inflammatory markers and ALT ratio LDL-P/HDL-P (40.0 vs. 43.9 vs. 47.1, p 0.012). When only cardiac change groups were considered, differences in small LDL-P (565.0 vs. 625.1 nmol/L, p 0.070), VLDL size and GlycA demonstrated better utility than just traditional risk factors to predict which subjects could present severe LV changes [AUC: 0.79 (95% CI: 0.54-1)]. In the second analysis, an atherosclerotic ALT was detected in morbidly obese subjects, characterized by a significant increase in large VLDL-P, small LDL-P, ratio LDL-P/HDL-P and ratio HDL-TG/HDL-C. Subjects with criteria for MS presented overall worse ALT (specially in triglyceride-enriched particles) and remnant cholesterol values. CONCLUSIONS ALT parameters and GlycA appear to be more reliable indicators of cardiac change severity than traditional CV risk factors. Particularly, the overage of LDL-P compared to HDL-P and the increase in small LDL-P with cholesterol-depleted LDL particles appear to be the key ALT's parameters involved in LV changes. Morbidly obese adolescents show an atherosclerotic ALT and those with MS present worse ALT values.
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Affiliation(s)
- José M Siurana
- Department of Pediatric Cardiology, Hospital HM Nens, HM Hospitales, Barcelona, Spain.,Autonomous University of Barcelona, Barcelona, Spain
| | - Anna Sabaté-Rotés
- Autonomous University of Barcelona, Barcelona, Spain.,Department of Pediatric Cardiology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Núria Amigó
- Biosfer Teslab, Reus, Spain.,Department of Basic Medical Sciences, Universitat Rovira I Virgili, Institut D'Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Neus Martínez-Micaelo
- Biosfer Teslab, Reus, Spain.,Department of Basic Medical Sciences, Universitat Rovira I Virgili, Institut D'Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain
| | - Larry Arciniegas
- Department of Pediatric Endocrinology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Lucia Riaza
- Department of Pediatric Radiology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Eduard Mogas
- Department of Pediatric Endocrinology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Ferran Rosés-Noguer
- Autonomous University of Barcelona, Barcelona, Spain.,Department of Pediatric Cardiology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Paula S Ventura
- Department of Pediatric Endocrinology, Hospital HM Nens, HM Hospitales, Barcelona, Spain.,Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain
| | - Diego Yeste
- Autonomous University of Barcelona, Barcelona, Spain.,Department of Pediatric Endocrinology, Vall d'Hebron University Hospital, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
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Gómez-Campos R, Vidal-Espinoza R, Marques de Moraes A, Lázari E, Andruske CL, Castelli Correia de Campos L, Urzua-Alul L, Cossio-Bolaños W, Cossio-Bolanõs MA. Comparison of Anthropometric Indicators That Assess Nutritional Status From Infancy to Old Age and Proposal of Percentiles for a Regional Sample of Chile. Front Nutr 2021; 8:657491. [PMID: 35004795 PMCID: PMC8740328 DOI: 10.3389/fnut.2021.657491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 12/01/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: Anthropometric variables are used to evaluate health, dietary status, disease risks, and changes in body composition. The purpose of this study was to compare weight, height, and Body Mass Index (BMI) with American references from the National Center for Health Statistics (NCHS-2012), using BMI and Tri-Ponderal Mass Index (TMI) to propose percentiles for evaluating nutritional status of children, adolescents, and adults, ages 5-80 years old. Methods: A descriptive cross-sectional study was conducted in 15,436 (8,070 males and 7,366 females) children, youths and adults in the Maule region (Chile). The age range ranged from 5.0 to ~80 years of age. Weight and height were assessed. Body mass index BMI and tri-ponderal mass index (TMI) were calculated. The LMS method was used to generate percentiles. Results: The results illustrated that children were heavier and had more BMI during childhood compared to the NCHS references. During adolescence, reference values were greater until approximately ages 70-79. For height, children were relatively similar to those of the NCHS references, but during adolescence, differences became evident. Adolescence until approximately age 80, the population showed lower values for height. Percentiles were calculated using BMI and TMI by age range and sex. Differences occurred between the American NCHS references and the population with regard to the anthropometric variables of weight, height, and in BMI. Conclusion: Discrepancies with the American NCHS reference were verified in the anthropometric variables of weight, height and BMI. Reference percentiles of BMI and TMI were developed for the evaluation of the nutritional status of the regional population of Maule (Chile). Its use is suggested in clinical and epidemiological contexts.
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Affiliation(s)
- Rossana Gómez-Campos
- Departamento de Diversidad e Inclusividad Educativa, Universidad Católica del Maule, Talca, Chile
| | | | | | | | | | | | - Luis Urzua-Alul
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Viña del Mar, Chile
| | | | - Marco A. Cossio-Bolanõs
- Departamento de Ciencias de la Actividad Física, Universidad Católica del Maule, Talca, Chile
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9
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Siurana JM, Ventura PS, Yeste D, Riaza-Martin L, Arciniegas L, Clemente M, Torres M, Amigó N, Giralt G, Roses-Noguer F, Sabate-Rotes A. Myocardial Geometry and Dysfunction in Morbidly Obese Adolescents (BMI 35-40 kg/m 2). Am J Cardiol 2021; 157:128-134. [PMID: 34392890 DOI: 10.1016/j.amjcard.2021.07.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/27/2021] [Accepted: 07/01/2021] [Indexed: 11/30/2022]
Abstract
This study evaluated the preclinical effect of obesity on the ventricular remodeling in adolescents with morbid obesity, and determined if subjects labelled as metabolically healthy obesity (MHO) presented better heart index than those with metabolically unhealthy obesity (MUO). Prospective case-control research of 45 adolescents (14-year-old) with morbid obesity and 25 normal weight adolescents' gender- and age-matched with Tanner stage 4-5. Left ventricle (LV) was evaluated by conventional Doppler echocardiography, tissue Doppler imaging and two-dimensional speckle tracking echocardiography. Compared to normal-weight subjects, adolescents with morbid obesity presented a high percentage of pathological LV geometry (87%; p<0.01), and systolic and diastolic dysfunctions only detected by E/A ratio (2.0 vs 1.7, p<0.01), global longitudinal strain (-21.0% vs -16.5%, p<0.01), and early diastolic strain rate (3.2 vs 2.2, p<0.01). A correlation was found between impaired cardiac index and body mass index (BMI), high blood pressure, hyperglycemia, low HDL-cholesterol and hypertriglyceridemia. BMI and HDL-cholesterol were the most significant independent variables. No significant differences were found in structural and functional cardiac index when MHO and MUO subjects were compared (global longitudinal strain: -17.0% vs -16.4%, p0.79). Morbidly obese adolescents have an abnormal LV geometry, closely related to BMI, and systolic and diastolic LV dysfunctions. Adolescents labelled as MHO, despite exhibiting better BMI and insulin-resistance values, present the same pathological heart changes as MUO.
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Affiliation(s)
- Jose M Siurana
- Hospital HM Nens. HM Hospitales, Barcelona, Spain; Autonomous University of Barcelona, Spain.
| | - Paula S Ventura
- Hospital HM Nens. HM Hospitales, Barcelona, Spain; Autonomous University of Barcelona, Spain
| | - Diego Yeste
- Autonomous University of Barcelona, Spain; Vall d'Hebron University Hospital, Barcelona, Spain; CIBER of Rare Diseases (CIBERER) ISCIII, Spain
| | | | | | - Maria Clemente
- Autonomous University of Barcelona, Spain; Vall d'Hebron University Hospital, Barcelona, Spain; CIBER of Rare Diseases (CIBERER) ISCIII, Spain
| | | | - Núria Amigó
- Biosfer Teslab - Metabolomics Platform, Rovira i Virgili University, Tarragona, Spain
| | - Gemma Giralt
- Autonomous University of Barcelona, Spain; Vall d'Hebron University Hospital, Barcelona, Spain
| | - Ferran Roses-Noguer
- Autonomous University of Barcelona, Spain; Vall d'Hebron University Hospital, Barcelona, Spain
| | - Anna Sabate-Rotes
- Autonomous University of Barcelona, Spain; Vall d'Hebron University Hospital, Barcelona, Spain
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10
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Anthropometric and fitness normative values for young karatekas. Biol Sport 2021; 38:351-357. [PMID: 34475618 PMCID: PMC8329972 DOI: 10.5114/biolsport.2021.99324] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 07/06/2020] [Accepted: 08/31/2020] [Indexed: 11/17/2022] Open
Abstract
To provide information regarding the anthropometric and fitness profile of young karatekas and to study its evolution with age. Data from top-level karatekas were included in the analysis: 97 athletes in the U14 category (12–13 years old), 238 in cadet (14–15 years old), 261 in junior (16–17 years old) and 177 in U21 (18–20 years old), which makes a total of 773 athlete data sets. Karatekas underwent anthropometric (weight, height, body mass index and body fat percentage) and fitness (sit and reach, 20-m shuttle run, standing long jump, overhead 3-kg ball throw, 10x5-m shuttle run, and plate-tapping) assessments during the training camps organized by the Spanish National Karate Federation between 1999 and 2016. Male karatekas were taller and heavier, and performed better than females in all the fitness dimensions assessed, except for flexibility and speed of upper limb movements. The obtained cardiovascular and lower-body muscular values indicated that karatekas in this study were placed between the 80th and the 90th percentile when compared with the general population. The results of the agility, coordination and speed of upper limb movements, and flexibility tests showed that the karatekas obtained much higher scores than those observed in age-matched populations. Young karatekas show a high fitness level in comparison with the general population, especially with regards to aerobic performance, lower-body muscular power and upper-limb movement speed. Reference values of anthropometric and fitness dimensions are provided in order to be used by coaches, conditioning trainers and sport scientists when testing young male and female karatekas.
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11
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Effects of Cardiopulmonary Rehabilitation on the Muscle Function of Children with Congenital Heart Disease: A Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115870. [PMID: 34070726 PMCID: PMC8199033 DOI: 10.3390/ijerph18115870] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/23/2021] [Accepted: 05/24/2021] [Indexed: 02/07/2023]
Abstract
Critical medical and surgical advances have led to a shift in the care and management of children with congenital heart disease (CHD). These patients present with muscle deconditioning, which negatively influences their response to exercise, functional capacities, and quality of life. This study evaluates the influence of a cardiopulmonary rehabilitation program (CPRP) on the function of peripheral musculature of children with CHD. A single-center prospective cohort study was designed. Fifteen CHD subjects, between 12 and 16 years of age, with reduced aerobic capacity on a cardiopulmonary exercise test, were included in a three-month, 24-session CPRP. Measurements of the subjects’ handgrip strength, biceps brachii and quadriceps femoris strength, and triceps surae fatigue process were collected at the beginning of the program, after completion, and six months after the end of the intervention. A substantial and statistically significant improvement was observed in the subjects’ handgrip strength (kg) (p < 0.001), biceps brachii and quadriceps femoris strength (N) (p < 0.001), as well as triceps surae fatigue process (repetitions) (p = 0.018), with a maintenance of the results six months after the intervention. These results suggest that a CPRP could potentially improve the peripheral muscle function of children with CHD. Additional research is needed to confirm and expand on this hypothesis.
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12
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The Tri-ponderal Mass Index is associated with adiposity in adolescent type 2 diabetes mellitus: a cross-sectional analysis. Sci Rep 2021; 11:9111. [PMID: 33907287 PMCID: PMC8079364 DOI: 10.1038/s41598-021-88705-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 04/05/2021] [Indexed: 12/26/2022] Open
Abstract
Pediatric type 2 diabetes mellitus (T2DM) patients are often overweight or obese, yet there are no validated clinical measures of adiposity to stratify cardiometabolic risk in this population. The tri-ponderal mass index (TMI, kg/m3) has recently been reported as a measure of adiposity in children, but there has been no validation of the association of TMI with adiposity in pediatric T2DM. We hypothesized that in children with T2DM, the TMI can serve as a more accurate measure of adiposity when compared to BMI z-score, and that it is associated with components of the metabolic syndrome. This is a cross-sectional secondary data analysis from the Improving Renal Complications in Adolescents with Type 2 Diabetes Through REsearch (iCARE) study (n = 116, age 10.20–17.90 years). Spearman’s correlations and multivariable regression were used in the analyses. When compared to DXA, TMI demonstrated significant correlation with total adiposity versus BMI z-score (TMI r = 0.74, p-value < 0.0001; BMI z-score r = − 0.08, p-value 0.403). In regression analyses, TMI was associated with WHtR (B = 35.54, 95% CI 28.81, 42.27, p-value < 0.0001), MAP dipping (B = 1.73, 95% CI 0.12, 3.33, p-value = 0.035), and HDL (B = − 5.83, 95% CI − 10.13, − 1.54, p-value = 0.008). In conclusion, TMI is associated with adiposity and components of the metabolic syndrome in pediatric T2DM patients.
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13
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Empringham B, Jennings WJ, Rajan R, Fleming AJ, Portwine C, Johnston DL, Zelcer SM, Rassekh SR, Tran V, Burrow S, Thabane L, Samaan MC. Leptin is Associated with the Tri-Ponderal Mass Index in Children: A Cross-Sectional Study. ADOLESCENT HEALTH MEDICINE AND THERAPEUTICS 2021; 12:9-15. [PMID: 33727877 PMCID: PMC7955735 DOI: 10.2147/ahmt.s289973] [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] [Received: 11/10/2020] [Accepted: 02/05/2021] [Indexed: 11/23/2022]
Abstract
Background Obesity is characterized by the disproportionate expansion of the fat mass and is most commonly diagnosed using the Body Mass Index (BMI) z-score or percentile in children. However, these measures associate poorly with the fat mass. This is important, as adiposity is a more robust predictor of cardiometabolic risk than BMI-based measures, but there are limited clinical measures of adiposity in children. A new measure, the Tri-ponderal Mass Index (TMI, kg/m3) has recently demonstrated robust prediction of adiposity in children. The aim of this study is to explore the association of leptin, a validated biomarker of the fat mass, with TMI. Methods One hundred and eight children and adolescents were included in this cross-sectional study. Height and weight were used to calculate TMI. Plasma leptin was measured using ELISA. Multivariable regression analysis was applied to determine the predictors of TMI. Results The age range of participants included in this study was 8.00-16.90 years (female n=48, 44%). Leptin correlated with BMI percentile (r=0.64, p-value <0.0001) and TMI (r=0.71, p-value <0.0001). The multivariable regression analysis revealed that BMI percentile (Estimated Beta-coefficient 0.002, 95% CI 0.002-0.003, p-value <0.0001) and Leptin (Estimated Beta-coefficient 0.05, 95% CI 0.02-0.07, p-value 0.013) were associated with TMI. Conclusion Leptin is associated with TMI in healthy children. The TMI is a feasible clinical measure of adiposity that may be used to stratify children and adolescents for further assessments and interventions to manage and attempt to prevent cardiometabolic comorbidities.
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Affiliation(s)
- Brianna Empringham
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.,Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - William J Jennings
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.,Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Raeesha Rajan
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.,Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada.,Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Adam J Fleming
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.,Division of Pediatric Hematology/Oncology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Carol Portwine
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.,Division of Pediatric Hematology/Oncology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Donna L Johnston
- Division of Pediatric Hematology/Oncology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Shayna M Zelcer
- Pediatric Hematology Oncology, Children's Hospital, London Health Sciences Center, London, Ontario, Canada
| | - Shahrad Rod Rassekh
- Division of Pediatric Hematology/Oncology/BMT, Department of Pediatrics, British Columbia's Children's Hospital, Vancouver, BC, Canada
| | - Victoria Tran
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.,Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Sarah Burrow
- Division of Orthopedic Surgery, Department of Surgery, McMaster University Medical Centre, Hamilton, Ontario, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.,Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada.,Centre for Evaluation of Medicines, St. Joseph's Health Care, Hamilton, Ontario, Canada.,Biostatistics Unit, St Joseph's Healthcare-Hamilton, Hamilton, Ontario, Canada
| | - M Constantine Samaan
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.,Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada.,Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
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14
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Yeste D, Clemente M, Campos A, Fábregas A, Mogas E, Soler L, Carrascosa A. Diagnostic accuracy of the tri-ponderal mass index in identifying the unhealthy metabolic obese phenotype in obese patients. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2021. [DOI: 10.1016/j.anpede.2020.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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15
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Eiholzer U, Fritz C, Stephan A. The increase in child obesity in Switzerland is mainly due to migration from Southern Europe - a cross-sectional study. BMC Public Health 2021; 21:243. [PMID: 33514341 PMCID: PMC7845097 DOI: 10.1186/s12889-021-10213-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 01/10/2021] [Indexed: 11/16/2022] Open
Abstract
Background Novel height, weight and body mass index (BMI) references for children in Switzerland reveal an increase in BMI compared to former percentile curves. This trend may be the result of children with parents originating from Southern European countries having a higher risk of being overweight compared to their peers with parents of Swiss origin. We examined the association of generational, migration-related and socioeconomic factors on BMI in Switzerland and expect the results to lead to more targeted prevention programs. Methods From contemporary cross-sectional data, we calculated subgroup-specific BMI percentiles for origin. Results for children of Swiss origin were compared with historical BMI data from Zurich. We tested for the association of overweight and obesity with origin and compared the distributions of BMI percentile ranks. Logistic regression analyses were applied to predict probabilities of being overweight or obese by origin and the Swiss neighborhood index of socioeconomic position (SSEP). Results Compared to the BMI from two generations ago, the newly calculated BMI increased only slightly for children with both parents from Switzerland; 1.2% of these girls and 1.6% of these boys are obese. In the Swiss population, 13% of the children have parents from Southern Europe and the proportion of obesity is 57 and 42% in these boys and girls, respectively. Their BMI medians correspond to those of their parents’ countries of origin. For the probability of being overweight or obese, the SSEP differences are less important than the status of origin. Conclusion We identified children with both parents from Southern Europe as the main influence driving the increase in BMI in Switzerland over the past 50 years. A differentiated consideration of the proportions of various migrant groups within cross-sectional samples is essential when monitoring BMI. Ignoring fluctuations can lead to false conclusions.
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Affiliation(s)
- Urs Eiholzer
- Center for Paediatric Endocrinology Zurich (PEZZ), Moehrlistrasse 69, CH-8006, Zurich, Switzerland.
| | - Chris Fritz
- Center for Paediatric Endocrinology Zurich (PEZZ), Moehrlistrasse 69, CH-8006, Zurich, Switzerland
| | - Anika Stephan
- Center for Paediatric Endocrinology Zurich (PEZZ), Moehrlistrasse 69, CH-8006, Zurich, Switzerland
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16
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Guolla L, Morrison KM, Barr RD. Adiposity in Survivors of Cancer in Childhood: How is it Measured and Why Does it Matter? J Pediatr Hematol Oncol 2021; 43:1-11. [PMID: 33122586 DOI: 10.1097/mph.0000000000001988] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Survival of cancer in childhood is increasingly common with modern therapeutic protocols but leads frequently to adverse long-term impacts on health, including metabolic and cardiovascular disease. Changes in body composition, especially an increase in fat mass and a decrease in muscle mass, are found early in patients with pediatric cancer, persist long after treatment has been completed and seem to contribute to the development of chronic disease. This review details the effects of such changes in body composition and reviews the underlying pathophysiology of the development of sarcopenic obesity and its adverse metabolic impact. The authors discuss the particular challenges in identifying obesity accurately in survivors of pediatric cancer using available measurement techniques, given that common measures, such as body mass index, do not distinguish between muscle and adipose tissue or assess their distribution. The authors highlight the importance of a harmonized approach to the assessment of body composition in pediatric cancer survivors and early identification of risk using "gold-standard" measurements. This will improve our understanding of the significance of adiposity and sarcopenia in this population, help identify thresholds predictive of metabolic risk, and ultimately prevent or ameliorate the long-term metabolic and cardiovascular impacts on health experienced by survivors of cancer in childhood.
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Affiliation(s)
| | - Katherine M Morrison
- Department of Pediatrics, McMaster University
- McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Ronald D Barr
- Department of Pediatrics, McMaster University
- McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, ON, Canada
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17
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Pérez-Bermejo M, Alcalá-Dávalos L, Pérez-Murillo J, Legidos-García ME, Murillo-Llorente MT. Are the Growth Standards of the World Health Organization Valid for Spanish Children? The SONEV Study. Front Pediatr 2021; 9:700748. [PMID: 34490160 PMCID: PMC8418137 DOI: 10.3389/fped.2021.700748] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 07/23/2021] [Indexed: 12/02/2022] Open
Abstract
Background: The use of different growth tables to assess the population's nutritional status has given rise to a series of limitations arising from the lack of consensus and uniform methodological criteria. This leads to a disparity of results that prevent an accurate and reliable diagnosis of whether a child is overweight or obese. Objective: The purpose of this study was to develop growth references for weight, height, and body mass index for Eastern-Spanish children from 6 to 16 years of age. Methods: The final sample used to fit the growth curves was made up of 1,102 observations. The 2007 WHO curves are currently used for Child Health Service Cards. Therefore, to make the comparison of the internal values obtained as realistic as possible, the same construction method has been used for the internal curves, modeling age as a continuous variable and simultaneously adjusting the curves, smoothing them using cubic splines and further smoothing the edge effects by means of data extending above or below the upper and lower age limits. Results: Growth curves for percentiles were constructed for both sexes and higher values were noticeably found to set as growth-standard compared to WHO-standards. Conclusion: Our analysis shows that the WHO 2007 standard references are not suitable for Eastern-Spanish children. The standards shown in this study are much more realistic and current, and we believe that their use will help healthcare professionals more effectively combat the current epidemic of overweight and obesity.
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Affiliation(s)
- Marcelino Pérez-Bermejo
- SONEV Research Group (Overweight, Obesity, Nutrition and Lifestyles), School of Medicine and Health Sciences, Catholic University of Valencia San Vicente Mártir, Valencia, Spain
| | - Luisa Alcalá-Dávalos
- SONEV Research Group (Overweight, Obesity, Nutrition and Lifestyles), School of Medicine and Health Sciences, Catholic University of Valencia San Vicente Mártir, Valencia, Spain
| | - Javier Pérez-Murillo
- SONEV Research Group (Overweight, Obesity, Nutrition and Lifestyles), School of Medicine and Health Sciences, Catholic University of Valencia San Vicente Mártir, Valencia, Spain
| | - Maria Ester Legidos-García
- SONEV Research Group (Overweight, Obesity, Nutrition and Lifestyles), School of Medicine and Health Sciences, Catholic University of Valencia San Vicente Mártir, Valencia, Spain
| | - Maria Teresa Murillo-Llorente
- SONEV Research Group (Overweight, Obesity, Nutrition and Lifestyles), School of Medicine and Health Sciences, Catholic University of Valencia San Vicente Mártir, Valencia, Spain
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Rodríguez-Rubio PR, Bagur-Calafat C, López-de-Celis C, Bueno-Gracía E, Cabanas-Valdés R, Herrera-Pedroviejo E, Girabent-Farrés M. Validity and Reliability of the Satel 40 Hz Stabilometric Force Platform for Measuring Quiet Stance and Dynamic Standing Balance in Healthy Subjects. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217733. [PMID: 33105835 PMCID: PMC7660083 DOI: 10.3390/ijerph17217733] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/18/2020] [Accepted: 10/20/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND A force platform must have validity and reliability for optimal use. The objective of this study was to analyze the validity and the reliability of the Satel 40 Hz stabilometric force platform. METHODS A study of instrumental validity and reliability, involving a cross-sectional correlational and comparative analysis was performed. To determine the validity, four certified weights located on three axes were used and the ability of the stabilometric force platform to detect changes in the position of the different axes was observed. A test-retest was performed to analyze the reliability. Forty-two symptom-free volunteers participated in the study. Assessments were taken in a standing static position and in a dynamic position, with the eyes open and closed. Three measurements were taken and the intra-class correlation coefficient (ICC) was calculated. RESULTS The validity increased as the weight increased for all the variables measured in the stabilometric parameters (p < 0.05). The reliability was shown to be good to excellent for the two visual conditions. The positional variables obtained a higher ICC. The variable with the best ICC was the Y mean in OE (ICC 0.874 and a p < 0.001). All the values showed an increase in a dynamic situation. CONCLUSION The findings support the reliability and validity of the Satel 40 Hz stabilometric force platform. The platform could be recommended to evaluate static and dynamic standing balance in healthy adult individuals. Guidelines for treatment and the level of quality of stabilometry could be obtained from its use.
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Affiliation(s)
- Pere Ramón Rodríguez-Rubio
- Department of Physiotherapy, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, UIC Barcelona, Sant Cugat del Vallès, 08195 Barcelona, Spain; (P.R.R.-R.); (C.B.-C.); (C.L.-d.-C.); (E.H.-P.)
| | - Caritat Bagur-Calafat
- Department of Physiotherapy, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, UIC Barcelona, Sant Cugat del Vallès, 08195 Barcelona, Spain; (P.R.R.-R.); (C.B.-C.); (C.L.-d.-C.); (E.H.-P.)
| | - Carlos López-de-Celis
- Department of Physiotherapy, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, UIC Barcelona, Sant Cugat del Vallès, 08195 Barcelona, Spain; (P.R.R.-R.); (C.B.-C.); (C.L.-d.-C.); (E.H.-P.)
- Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain
| | - Elena Bueno-Gracía
- Department of Physiatrist and Nursery, Faculty of Heath Sciences, University of Zaragoza, 50009 Zaragoza, Spain;
| | - Rosa Cabanas-Valdés
- Department of Physiotherapy, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, UIC Barcelona, Sant Cugat del Vallès, 08195 Barcelona, Spain; (P.R.R.-R.); (C.B.-C.); (C.L.-d.-C.); (E.H.-P.)
- Correspondence:
| | - Ernesto Herrera-Pedroviejo
- Department of Physiotherapy, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, UIC Barcelona, Sant Cugat del Vallès, 08195 Barcelona, Spain; (P.R.R.-R.); (C.B.-C.); (C.L.-d.-C.); (E.H.-P.)
- Department of Physiotherapy, Blanquerna School of Health Sciences, Ramon Llull University, 08025 Barcelona, Spain
| | - Montserrat Girabent-Farrés
- Department of Physiotherapy, School of health Sciencies, Tecnocampus-pompeu Fabra University, Mataró, 08302 Barcelona, Spain;
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19
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Yeste D, Clemente M, Campos A, Fábregas A, Mogas E, Soler L, Carrascosa A. [Diagnostic accuracy of the tri-ponderal mass index in identifying the unhealthy metabolic obese phenotype in obese patients]. An Pediatr (Barc) 2020; 94:68-74. [PMID: 32446672 DOI: 10.1016/j.anpedi.2020.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 03/25/2020] [Accepted: 04/02/2020] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The metabolically healthy obese (MHO) phenotype defines obese patients who have preserved insulin sensitivity and absence of metabolic complications. This phenotype is associated with a lower risk of cardiovascular disease and type2 diabetes in adulthood. OBJECTIVES To determine the prevalence of MHO and the metabolically unhealthy obesity (MUO) phenotype in a cohort of obese children and adolescents and to establish the predictive capacity of the tri-ponderal mass index (TMI) and other anthropometric parameters in order to identify these patients. PATIENTS AND METHODS A cross-sectional study was conducted on 239 obese patients (125males) from 8 to 18years of age. Grade3 obesity was present in 45.9% of the patients. ROC curves were used to find the best cut-off point for: TMI, body mass index (BMI), BMI z-score (BMIzs), and waist/height index (WHI). MHO components: plasma blood glucose, plasma triglycerides, HDL-cholesterol, and blood pressure. RESULTS The prevalence of MUO in the study cohort was 62.4%. No differences between genders were observed, and it was increasing with the age and obesity degree. The TMI has a sensitivity of 75.8 and a specificity of 42.2 to identify the MUO patients. The best cut-off point for TMI is 18.7kg/m3, for BMI it was 30.4kg/m2, for BMIzs +3.5SD, and 0.62 for WHI. CONCLUSIONS The diagnostic accuracy of TMI in identifying obese adolescents with metabolic risk was similar to BMI and WHI. However, the TMI is much simpler to use and simplifies the categorization of the obesity in both genders.
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Affiliation(s)
- Diego Yeste
- Sección de Endocrinología Pediátrica, Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona. CIBER de Enfermedades Raras (CIBERER) ISCIII, Barcelona, España.
| | - María Clemente
- Sección de Endocrinología Pediátrica, Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona. CIBER de Enfermedades Raras (CIBERER) ISCIII, Barcelona, España
| | - Ariadna Campos
- Sección de Endocrinología Pediátrica, Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona. CIBER de Enfermedades Raras (CIBERER) ISCIII, Barcelona, España
| | - Anna Fábregas
- Sección de Endocrinología Pediátrica, Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona. CIBER de Enfermedades Raras (CIBERER) ISCIII, Barcelona, España
| | - Eduard Mogas
- Sección de Endocrinología Pediátrica, Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona. CIBER de Enfermedades Raras (CIBERER) ISCIII, Barcelona, España
| | - Laura Soler
- Sección de Endocrinología Pediátrica, Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona. CIBER de Enfermedades Raras (CIBERER) ISCIII, Barcelona, España
| | - Antonio Carrascosa
- Sección de Endocrinología Pediátrica, Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona. CIBER de Enfermedades Raras (CIBERER) ISCIII, Barcelona, España
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Khoshhali M, Heidari-Beni M, Qorbani M, Motlagh ME, Ziaodini H, Heshmat R, Kelishadi R. Tri-ponderal mass index and body mass index in prediction of pediatric metabolic syndrome: the CASPIAN-V study. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2020; 64:171-178. [PMID: 32236304 PMCID: PMC10118948 DOI: 10.20945/2359-3997000000206] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 03/29/2019] [Indexed: 11/23/2022]
Abstract
Objective Body mass index (BMI) and tri-ponderal mass index (TMI) are anthropometric measures to evaluate body adiposity in the various age groups. The present study aims to compare the predictive value of TMI and BMI for metabolic syndrome (Mets) in children and adolescents of both genders. Subjects and methods A cross-sectional study conducted on 3731 Iranian children and adolescents aged 7-18 years obtained from the fifth survey of 'Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable Disease' (CASPIAN-V) study. The predictive value of BMI and TMI for MetS were determined using Receiver-operator curves. Logistic regression analysis was used to assess the relationship between these indices with MetS. Results 52.6% of participants were boys. The mean (standard deviations) age for boys and girls were 12.62 (3.02) and 12.25 (3.05) years, respectively. In boys, the area under the curve (AUC) of TMI was greater than BMI for all age groups. AUC of TMI was also greater than BMI for age group of 11-14 years (AUC = 0.74; 95% CI (0.67, 0.81)) in girls. Furthermore, our findings showed that odds ratio of Mets for TMI was greater than BMI in age groups of 11-14 years (OR = 1.33 vs 1.22) and 15-18 years (1.16 vs 1.15) in girls and boys, respectively. Conclusion TMI and BMI had moderate predictive value for identifying MetS. However, TMI was a better predictor of MetS than BMI in both genders, especially in age groups of 11-14 and 15-19 years for girls and boys.
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Affiliation(s)
- Mehri Khoshhali
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Motahar Heidari-Beni
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | | | - Hasan Ziaodini
- Health Psychology Research Center, Education Ministry, Tehran, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Kelishadi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
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Matsuo AR, Lopes WA, Locatelli JC, Simões CF, de Oliveira GH, Nardo N. Tri-ponderal mass index as a tool for insulin resistance prediction in overweight adolescents: A cross-sectional study. Nutrition 2020; 74:110744. [PMID: 32217458 DOI: 10.1016/j.nut.2020.110744] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 12/30/2019] [Accepted: 01/01/2020] [Indexed: 01/14/2023]
Abstract
OBJECTIVE The aims of this study were to assess the capacity of tri-ponderal mass index (TMI) to screen and predict insulin resistance (IR) in overweight Brazilian adolescents, comparing it with body mass index (BMI) predictive capacity; and to verify the IR predictive capacity of other assessment tools such as waist circumference (WC), and waist-to-height ratio (WHR). METHODS A cross-sectional study was carried out with 217 overweight adolescents, from both sexes, between 12 and 18 y of age. The participants were classified as having IR according to a previous established cutoff point of ≤3.16. IR was determined by the homeostasis model assessment of insulin resistance. The other assessment tools were measured with standard protocols. RESULTS There was no difference between TMI and BMI to explain the presence of IR. In girls, BMI presented a slightly better predictive capacity to explain IR than TMI. Moreover, WC was reported to be the most effective IR screening methods for girls. Receiver operating characteristic curves showed that TMI and BMI presented similar values of sensibility and specificity for boys. Nevertheless, BMI had a better sensibility and TMI had a better specificity for girls. Interestingly, WC demonstrated a strong sensibility for both sexes. CONCLUSIONS TMI did not present a superior predictive accuracy for IR screening in overweight Brazilian adolescents when compared with BMI. TMI and BMI presented similar values of sensitivity and specificity for boys and WC a slightly superior IR predictive capacity for girls.
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Affiliation(s)
- Adriano Ruy Matsuo
- Department of Physical Education, Center of Health Sciences, State University of Maringa-UEM, Maringa, Brazil; Multidisciplinary Centre of Obesity Studies-NEMO, State University of Maringa, Maringa, Brazil
| | - Wendell Arthur Lopes
- Department of Physical Education, Center of Health Sciences, State University of Maringa-UEM, Maringa, Brazil; Research Group on Systemic Arterial Hypertension, Arterial Stiffness and Vascular Aging-GPHARV, State University of Maringa-UEM, Maringa, Brazil
| | - João Carlos Locatelli
- Department of Physical Education, Center of Health Sciences, State University of Maringa-UEM, Maringa, Brazil; Research Group on Systemic Arterial Hypertension, Arterial Stiffness and Vascular Aging-GPHARV, State University of Maringa-UEM, Maringa, Brazil.
| | - Caroline Ferraz Simões
- Department of Physical Education, Center of Health Sciences, State University of Maringa-UEM, Maringa, Brazil; Research Group on Systemic Arterial Hypertension, Arterial Stiffness and Vascular Aging-GPHARV, State University of Maringa-UEM, Maringa, Brazil
| | - Gustavo Henrique de Oliveira
- Department of Physical Education, Center of Health Sciences, State University of Maringa-UEM, Maringa, Brazil; Research Group on Systemic Arterial Hypertension, Arterial Stiffness and Vascular Aging-GPHARV, State University of Maringa-UEM, Maringa, Brazil
| | - Nelson Nardo
- Department of Physical Education, Center of Health Sciences, State University of Maringa-UEM, Maringa, Brazil; Multidisciplinary Centre of Obesity Studies-NEMO, State University of Maringa, Maringa, Brazil
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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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The Relationship Between Tri-ponderal Mass Index and Metabolic Syndrome and Its Components in Youth Aged 10-20 Years. Sci Rep 2019; 9:14462. [PMID: 31594996 PMCID: PMC6783432 DOI: 10.1038/s41598-019-50987-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 09/23/2019] [Indexed: 12/11/2022] Open
Abstract
The current study aimed to evaluate the distribution of the tri-ponderal mass index (TMI) according to sex and age and the relationship of obesity groups according to sex- and age-specific TMI with metabolic syndrome (MetS) and its components. A total of 8,464 subjects aged 10–20 years were classified into 4 groups according to sex- and age-specific TMI: (i) underweight, (ii) normal weight, (iii) overweight, and (iv) obese. The range of the 50th percentiles of TMI was from 13.24 kg/m3 at 10 years to 12.94 kg/m3 at 20 years among males and from 12.19 kg/m3 to 12.84 kg/m3 among females. In the analysis of covariance, obesity groups according to sex- and age-specific TMI were positively correlated with waist circumference (WC) standard deviation score; systolic blood pressure (BP); diastolic BP; and levels of glucose, total cholesterol, triglycerides (TGs), and low-density lipoprotein cholesterol, but for both sexes, the obesity groups were negatively related to high-density lipoprotein cholesterol (HDL-C). In the multiple logistic regression, subjects in the overweight group had higher odds ratios (ORs) for elevated WC (29.18), elevated BP (1.33), elevated TGs (2.55), reduced HDL-C (2.31), and MetS (8.93) than those with normal weight. Participants in the obesity group had increased ORs for elevated WC (154.67), elevated BP (2.22), elevated glucose (3.54), elevated TGs (4.12), reduced HDL-C (3.69), and MetS (25.57) compared to participants with normal weight after adjustment for confounders. Our results suggest that sex- and age-specific TMI may be applicable in the clinical setting as a useful screening tool.
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Nascimento VG, Bertoli CJ, Gallo PR, Abreu LCD, Leone C. Tri-Ponderal Mass Index: A Screening Tool for Risk of Central Fat Accumulation in Brazilian Preschool Children. ACTA ACUST UNITED AC 2019; 55:medicina55090577. [PMID: 31500381 PMCID: PMC6780244 DOI: 10.3390/medicina55090577] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 08/29/2019] [Accepted: 09/05/2019] [Indexed: 12/11/2022]
Abstract
Background and Objectives: To verify the use of the tri-ponderalmass index (TMI) as a screening tool for risk of central fat accumulation in preschool children. Materials and Methods: An observational, analytical study was carried out on samples from children 2 to 5 years of age. The body mass index (BMI) and the tri-ponderalmass index (TMI: Weight/height3) were calculated. The waist circumference-to-height ratio (WHtR) was used to classify central fat accumulation risk. Preschoolers whose WHtRwas in the upper tertile of the sample were classified as at risk for central fat accumulation. A comparison of the two indicators (BMI and TMI) was made from the area under the receiver operator characteristics (ROC) curve (AUC) in the discrimination of the WHtR. Results: The sample used for analysis was 919 preschoolers. The mean age of the children was 3.9 years (SD = 0.7). The difference in AUC was 5% higher for TMI (p < 0.0001). In the individual analysis of the ROC curve of the TMI, favoring a higher sensitivity, the cutoff point of 14.0 kg/m3 showed a sensitivity of 99.3% (95% CI: 97.6-99.9). Conclusion: Considering WHtR as a marker of possible future metabolic risk among preschool children, TMI proved to be a useful tool, superior to BMI, in screening for risk of central fat accumulation in preschool children.
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Affiliation(s)
| | - Ciro João Bertoli
- Departmento de Saúde, Ciclos de Vida e Sociedade, Faculdade de Saúde Pública da Universidade de São Paulo, São Paulo 0146-904, Brazil
| | - Paulo Rogerio Gallo
- Departmento de Saúde, Ciclos de Vida e Sociedade, Faculdade de Saúde Pública da Universidade de São Paulo, São Paulo 0146-904, Brazil
| | - Luiz Carlos de Abreu
- Laboratório de Delineamento de Estudos e Escrita Científica, Centro Universitário Saúde ABC, Santo André 09060-870, Brazil.
- Programa de Mestrado em Políticas Públicas e Desenvolvimento Local da Escola Superior de Ciências da Santa Casa de Misericórdia, Vitória 29045-402, Brazil.
- Graduate Entry Medical School, University of Limerick, V94 T9PX Limerick, Ireland.
| | - Claudio Leone
- Departmento de Saúde, Ciclos de Vida e Sociedade, Faculdade de Saúde Pública da Universidade de São Paulo, São Paulo 0146-904, Brazil
- Laboratório de Delineamento de Estudos e Escrita Científica, Centro Universitário Saúde ABC, Santo André 09060-870, Brazil
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De Lorenzo A, Romano L, Di Renzo L, Gualtieri P, Salimei C, Carrano E, Rampello T, de Miranda RC. Triponderal mass index rather than body mass index: An indicator of high adiposity in Italian children and adolescents. Nutrition 2018; 60:41-47. [PMID: 30529185 DOI: 10.1016/j.nut.2018.09.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 08/08/2018] [Accepted: 09/15/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aims of this study were to compare body mass index (BMI) and triponderal mass index (TMI) as predictors of fat mass percentage (FM%) and to develop TMI cutoffs for screening high adiposity. Therefore, TMI- and BMI-based references against FM% criterion for indicating adiposity in Italian children and adolescents were compared. METHODS This was a cross-sectional study conducted at the University of Rome Tor Vergata, Human Nutrition Unit, from 2008 to 2015. The sample included 485 children and adolescents from 8 to 17 y of age from central-southern Italy. Body weight (kg) and height (m) were assessed to calculate BMI and TMI. FM% was assessed by dual-energy x-ray absorptiometry. The prevalence of high adiposity was based on the 75th percentile of FM%, according to Ogden et al. curves. Statistical tests such as Mann-Whitney, Kruskal-Wallis, polynomial regression, receiver operating characteristics curve, and Cohen's κ, were performed using SPSS version 24 and MedCalc version 18. RESULTS Prevalence of high adiposity according to FM% was 50.2% (95% confidence interval [CI], 43.2-57.2) in boys and 43.2% (95% CI, 37.3-49.2) in girls. TMI rather than BMI could better predict FM% for both sexes (boys R2 = 0.67 and girls R2 = 0.79 versus boys R2 = 0.44 and girls R2 = 0.74, respectively). TMI was found to present a significantly higher area under the curve than BMI for indicating high adiposity in children and adolescents. TMI sex- and age-specific cutoffs were responsible by better classification of adiposity, followed by the International Obesity Task Force, World Health Organization, and Cacciari reference curves. CONCLUSION TMI is a useful screening tool in pediatric clinical practice and epidemiologic studies concerning childhood obesity.
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Affiliation(s)
- Antonino De Lorenzo
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
| | - Lorenzo Romano
- Specialization School of Food Science, University of Rome Tor Vergata, Rome, Italy
| | - Laura Di Renzo
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Paola Gualtieri
- PhD School of Applied Medical-Surgical Sciences, University of Rome Tor Vergata, Rome, Italy
| | - Chiara Salimei
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | | | - Tiziana Rampello
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Renata Costa de Miranda
- PhD School of Applied Medical-Surgical Sciences, University of Rome Tor Vergata, Rome, Italy; CAPES Scholarship, CAPES Foundation, Ministry of Education of Brazil, Brasilia, Brazil
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García Cuartero B. Body mass index, tri-ponderal mass index, and pubertal growth pattern: New data in a Spanish population. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2018. [DOI: 10.1016/j.anpede.2018.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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García Cuartero B. [Body mass index, tri-ponderal mass index, and pubertal growth pattern. New data in a Spanish population]. An Pediatr (Barc) 2018; 89:135-136. [PMID: 30033109 DOI: 10.1016/j.anpedi.2018.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 07/03/2018] [Indexed: 10/28/2022] Open
Affiliation(s)
- Beatriz García Cuartero
- Unidad de Endocrinología y Diabetes Pediátrica, Servicio de Pediatría, Hospital Universitario Ramón y Cajal, Madrid, España.
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