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Calcaterra V, Verduci E, De Silvestri A, Magenes VC, Siccardo F, Schneider L, Vizzuso S, Bosetti A, Zuccotti G. Predictive Ability of the Estimate of Fat Mass to Detect Early-Onset Metabolic Syndrome in Prepubertal Children with Obesity. Children (Basel) 2021; 8:966. [PMID: 34828680 PMCID: PMC8626042 DOI: 10.3390/children8110966] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/23/2021] [Accepted: 10/25/2021] [Indexed: 01/19/2023]
Abstract
Body mass index (BMI), usually used as a body fatness marker, does not accurately discriminate between amounts of lean and fat mass, crucial factors in determining metabolic syndrome (MS) risk. We assessed the predictive ability of the estimate of FM (eFM) calculated using the following formula: FM = weight - exp(0.3073 × height2 - 10.0155 ×d-growth-standards/standards/body-mass-index-for-age-bmi-for-age weight- 1 + 0.004571 × weight - 0.9180 × ln(age) + 0.6488 × age0.5 + 0.04723×male + 2.8055) (exp = exponential function, score 1 if child was of black (BA), south Asian (SA), other Asian (AO), or other (other) ethnic origin and score 0 if not, ln = natural logarithmic transformation, male = 1, female = 0), to detect MS in 185 prepubertal obese children compared to other adiposity parameters. The eFM, BMI, waist circumference (WC), body shape index (ABSI), tri-ponderal mass index, and conicity index (C-Index) were calculated. Patients were classified as having MS if they met ≥ 3/5 of the following criteria: WC ≥ 95th percentile; triglycerides ≥ 95th percentile; HDL-cholesterol ≤ 5th percentile; blood pressure ≥ 95th percentile; fasting blood glucose ≥ 100 mg/dL; and/or HOMA-IR ≥ 97.5th percentile. MS occurred in 18.9% of obese subjects (p < 0.001), with a higher prevalence in females vs. males (p = 0.005). The eFM was correlated with BMI, WC, ABSI, and Con-I (p < 0.001). Higher eFM values were present in the MS vs. non-MS group (p < 0.001); the eFM was higher in patients with hypertension and insulin resistance (p < 0.01). The eFM shows a good predictive ability for MS. Additional to BMI, the identification of new parameters determinable with simple anthropometric measures and with a good ability for the early detection of MS, such as the eFM, may be useful in clinical practice, particularly when instrumentation to estimate the body composition is not available.
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Affiliation(s)
- Valeria Calcaterra
- Pediatric Department, "V. Buzzi" Children's Hospital, 20154 Milano, Italy
- Pediatric and Adolescent Unit. Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
| | - Elvira Verduci
- Pediatric Department, "V. Buzzi" Children's Hospital, 20154 Milano, Italy
- Department of Health Sciences, University of Milano, 20142 Milano, Italy
| | - Annalisa De Silvestri
- Biometry & Clinical Epidemiology, Scientific Direction, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | | | - Francesca Siccardo
- Pediatric Department, "V. Buzzi" Children's Hospital, 20154 Milano, Italy
| | - Laura Schneider
- Pediatric Department, "V. Buzzi" Children's Hospital, 20154 Milano, Italy
| | - Sara Vizzuso
- Pediatric Department, "V. Buzzi" Children's Hospital, 20154 Milano, Italy
- Department of Health Sciences, University of Milano, 20142 Milano, Italy
| | - Alessandra Bosetti
- Pediatric Department, "V. Buzzi" Children's Hospital, 20154 Milano, Italy
| | - Gianvincenzo Zuccotti
- Pediatric Department, "V. Buzzi" Children's Hospital, 20154 Milano, Italy
- Department of Biomedical and Clinical Science "L. Sacco", University of Milano, 20157 Milano, Italy
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Gonçalves R, Mendes RC, de Paula Símola RÁ, Oliveira Damasceno V, Alves Lamounier J, Granjeiro PA. Prevalence of metabolic syndrome in Brazilian children using three different sets of international criteria. NUTR HOSP 2021; 38:228-35. [PMID: 33588574 DOI: 10.20960/nh.03224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Introduction Background: the aim of the present study was to compare the prevalence of metabolic syndrome in Brazilian children aged 6-10 years using three different international criteria. Methods: systolic and diastolic blood pressure (SBP and DBP), high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, fasting glucose, and insulin levels were measured in 290 schoolchildren, and the presence of metabolic syndrome was analyzed according to the criteria established by Cook, Boney, and Ferreira. Results: the prevalence of metabolic syndrome was 2.27 % (Boney and Ferreira criteria) and 7.58 % (Cook criteria) for girls, and 3.8 % (Boney and Ferreira criteria) and 5.06 % (Cook criteria) for boys. Agreement in pairs showed a concordance of 57.5 % (Kappa = 0.57) between Boney and Cook criteria, and 65.2 % (Kappa = 0.65) between Cook and Ferreira. The greatest concordance found was 77 % (Kappa = 0.77) between Boney and Ferreira criteria, demonstrating a substantial agreement. Conclusion: prevalence according to Boney and Ferreira criteria was lower than according to Cook criteria. Therefore, we suggest the use of Cook criteria in clinical practice for the diagnosis of metabolic syndrome, since this criterion provided a wider diagnostic range, thereby reducing the risk of underdiagnosis.
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Figueira SF, Wolf C, D'Innocenzo M, de Carvalho JPV, Barbosa MG, Zlotnik E, Cordioli E. Economic evaluation of sFlt-1/PlGF ratio test in pre-eclampsia prediction and diagnosis in two Brazilian hospitals. Pregnancy Hypertens 2018; 13:30-36. [DOI: 10.1016/j.preghy.2018.04.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 04/06/2018] [Accepted: 04/16/2018] [Indexed: 12/21/2022]
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Batista da Silva J, de Melo EM, Micussi MT, Dantas de Azevedo G, Lemos TM, Spyrides MH, Arrais RF, Maranhão TM. [Prevalence of metabolic syndrome in pubertal stages of female students]. Rev Salud Publica (Bogota) 2017; 18:425-436. [PMID: 28453105 DOI: 10.15446/rsap.v18n3.43065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 11/24/2015] [Indexed: 11/09/2022] Open
Abstract
Objective To analyze the prevalence of metabolic syndrome (MS) in pubertal stages of female students. Methods Cross-sectional study of 449 school children between eight and 18 years, stratified by pubertal stage, body mass index (BMI) and body fat percentage (BF %). The MS was classified according to the International Diabetes Federation. The analysis by frequency distribution, confidence intervals (95 %), Chi-square and odds ratio for associations was performed. Results The prevalence of MS was 3.3 % (CI:2 %-5 %) and 2.5 % (CI: 0.1 - 5 %) in pubertal and 7.9% (CI:3.2 % - 12.6 %) in the post-pubescent, with a significant association of this group with MS (X² = 5.2 [p <0.02]). The odds ratio shows that post-pubescent girls (3.3 [CI: 1.2 to 5]) and obese girls (2.1 [CI: 2 - 2.2]) are more likely to have MS, indicating significant linear association between BMI and the outcome (X²=29.4 [p<0.001]). Pubescent children under 10 years of age with MS had higher %G. The prevalent components were altered waist circumference (27.2 % [CI23 %-31 %]) and low HDL cholesterol (39.6 % [CI 35 % - 44 %]), as well as prevalence of systemic hypertension in post-pubertal girls. Conclusions MS begins in the pubertal stage, with prevalence in the post-pubertal stage. Excess fat is a trigger in children under 10 years of age. Prevention strategies are needed for the population of children and adolescents.
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Affiliation(s)
- João Batista da Silva
- Faculdade de Educação Física-FAEF, Universidade do Estado do Rio Grande do Norte, Mossoró, Brasil,
| | - Elza M de Melo
- Universidade do Estado do Rio Grande do Norte, Natal, Brasil,
| | | | | | - Telma M Lemos
- Universidade do Estado do Rio Grande do Norte, Natal, Brasil,
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Suarez-Ortegón MF, Aguilar-de Plata C. Prevalence of metabolic syndrome in children aged 5-9 years from southwest colombia: a cross-sectional study. World J Pediatr 2016; 12:477-83. [PMID: 26830308 DOI: 10.1007/s12519-016-0008-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Accepted: 12/24/2014] [Indexed: 02/06/2023]
Abstract
BACKGROUND Exploration of cardiometabolic alterations in the pre-adolescent stage is necessary to characterize possible patterns for matabolic syndrome (MetS) in the earliest stages of the life. However, defining specific cutoff points for metabolic and vascular markers represents a complex task in pre-adolescent populations. This study aimed to estimate the prevalence of MetS and its components in children aged 5-9 years old by using the MetS definition for adolescents with the lowest cut-off points, and evaluate its relationship with overweight and socio-demographic determinants. METHODS A total of 494 children were evaluated. Multivariate models with filtered variables in preliminary univarite analyses were built to find predictive factors of MetS and its components. RESULTS The prevalence of MetS was 8.7% in the studied children. Multivariate models showed that age, overweight and low socioeconomic stratum were associated with MetS; low high-density lipoprotein cholesterol was not significantly associated with any variable; high triglycerides were positively associated with age, overweight and inversely associated with kilocalories/day; female gender was the only variable significantly associated with high fasting glucose (inverse association); and age, gender and overweight were significant factors for increased waist circumference. In the case of high blood pressure, no variable was classified to the multivariate analysis. CONCLUSION This study showed disturbing figures regarding cardiometabolic risk in the children based on comparisons with studies in adolescents. Further studies are needed to confirm the utility of the de Ferranti Mets definition in children.
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Morais PRSD, Sousa ALL, Jardim TDSV, Nascente FMN, Mendonça KL, Povoa TIR, Carneiro CDS, Ferreira VR, Souza WKSBD, Jardim PCBV. Correlation of Insulin Resistance with Anthropometric Measures and Blood Pressure in Adolescents. Arq Bras Cardiol 2016; 106:319-26. [PMID: 27007222 PMCID: PMC4845705 DOI: 10.5935/abc.20160041] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 11/19/2015] [Indexed: 12/28/2022] Open
Abstract
Background Blood pressure is directly related to body mass index, and individuals with
increased waist circumference have higher risk of developing hypertension,
insulin resistance, and other metabolic changes, since adolescence. Objective to evaluate the correlation of blood pressure with insulin resistance, waist
circumference and body mass index in adolescents. Methods Cross-section study on a representative sample of adolescent students. One
group of adolescents with altered blood pressure detected by casual blood
pressure and/or home blood pressure monitoring (blood pressure >
90th percentile) and one group of normotensive adolescents
were studied. Body mass index, waist circumference were measured, and
fasting glucose and plasma insulin levels were determined, using the HOMA-IR
index to identify insulin resistance. Results A total of 162 adolescents (35 with normal blood pressure and 127 with
altered blood pressure) were studied; 61% (n = 99) of them were boys and the
mean age was 14.9 ± 1.62 years. Thirty-eight (23.5%) adolescents had
altered HOMA-IR. The group with altered blood pressure had higher values of
waist circumference, body mass index and HOMA-IR (p<0.05). Waist
circumference was higher among boys in both groups (p<0.05) and girls
with altered blood pressure had higher HOMA-IR than boys (p<0.05). There
was a significant moderate correlation between body mass index and HOMA-IR
in the group with altered blood pressure (ρ = 0.394; p < 0.001),
and such correlation was stronger than in the normotensive group. There was
also a significant moderate correlation between waist circumference and
HOMA-IR in both groups (ρ = 0.345; p < 0.05). Logistic regression
showed that HOMA-IR was as predictor of altered blood pressure (odds ratio -
OR = 2.0; p = 0.001). Conclusion There was a significant association of insulin resistance with blood pressure
and the impact of insulin resistance on blood pressure since childhood. The
correlation and association between markers of cardiovascular diseases was
more pronounced in adolescents with altered blood pressure, suggesting that
primary prevention strategies for cardiovascular risk factors should be
early implemented in childhood and adolescence.
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Affiliation(s)
| | - Ana Luiza Lima Sousa
- Liga de Hipertensão Arterial, Hospital das Clínicas, Universidade Federal de Goiás, GO, Brazil
| | | | | | - Karla Lorena Mendonça
- Liga de Hipertensão Arterial, Hospital das Clínicas, Universidade Federal de Goiás, GO, Brazil
| | | | | | - Vanessa Roriz Ferreira
- Liga de Hipertensão Arterial, Hospital das Clínicas, Universidade Federal de Goiás, GO, Brazil
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Mbowe O, Diaz A, Wallace J, Mazariegos M, Jolly P. Prevalence of metabolic syndrome and associated cardiovascular risk factors in Guatemalan school children. Matern Child Health J 2014; 18:1619-27. [PMID: 24337775 DOI: 10.1007/s10995-013-1402-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Guatemala is experiencing a nutritional and lifestyle transition. While chronic malnutrition is prevalent, overweight, obesity and chronic diseases have increased substantially in the country. This study was conducted to investigate the prevalence of metabolic syndrome and the associated cardiovascular risk factors in the pre-adolescent Guatemalan population. A cross-sectional study was conducted among 302 Guatemalan children (8-13 years old) attending public and private schools in the Municipality of Chimaltenango. Demographic data and anthropometric and blood pressure measurements were collected. A blood sample was taken after an 8 h overnight fast and analyzed for glucose, triglyceride and high-density lipoprotein cholesterol levels. The data were analyzed to identify factors associated with metabolic syndrome and with its components. The prevalence of metabolic syndrome in the study population was 2.0 %. However, approximately 54 % of the children had at least one component of metabolic syndrome, while none had four or five of the components. The three most prevalent risk factors were high triglycerides (43.4 %), low HDL cholesterol (17.2 %) and obesity (12.3 %). Boys were more likely to be obese than girls and rural children were more likely to have higher triglyceride levels than urban children. Although the prevalence of metabolic syndrome is low, the fact that majority of the children already have at least one component of metabolic syndrome is cause for concern since components of metabolic syndrome can continue into adulthood and increase the risk for chronic diseases later in life. Therefore, immediate action should be taken to address the problem.
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Villalobos Reyes M, Mederico M, Paoli de Valeri M, Briceño Y, Zerpa Y, Gómez-Pérez R, Camacho N, Martínez JL, Valeri L, Arata-Bellabarba G. Metabolic syndrome in children and adolescents from Mérida city, Venezuela: Comparison of results using local and international reference values (CREDEFAR study). ACTA ACUST UNITED AC 2014; 61:474-85. [PMID: 24840131 DOI: 10.1016/j.endonu.2014.03.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Revised: 03/13/2014] [Accepted: 03/18/2014] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To obtain local reference values for blood lipids and blood pressure (BP), and to determine the prevalence of metabolic syndrome (MS) in children and adolescents from Mérida, Venezuela, and to compare results using local and international cut-off values. MATERIALS AND METHODS The study enrolled 916 participants of both sexes aged 9-18 years of age from educational institutions. Demographic, anthropometric, and BP data were collected. Fasting blood glucose and lipid profile were measured. Percentile distribution of lipid and BP values was done by age group and sex. Prevalence of MS was estimated based on the NCEP-ATPIII classification (as modified by Cook et al.) and the classification of the International Diabetes Federation, using percentiles of Mérida and the USA as cut-off points. Agreement between both classifications was estimated using the kappa test (κ). RESULTS Prevalence of MS was 2.2% by Cook-Merida percentiles, as compared to 1.8% by Cook-USA percentiles, a moderate agreement (κ=0.54). Agreement between Cook et al. and IDF using Merida percentiles was weak (κ=0.28). There was a higher frequency of abdominal obesity, hypertriglyceridemia and hypertension, and a lower frequency of low HDL-C using Mérida percentiles. The risk (odds ratio) of having MS is greater if abdominal obesity exists (OR: 98.63, CI: 22.45-433.35, p=0.0001). MS was significantly more common in obese subjects (18.3%, p=0.0001). CONCLUSIONS Prevalence of MS in this sample of children and adolescents was 2.2%. Lipid and BP values were lower in Venezuelan as compared to US, European, and Asian children and adolescents, and similar to those in Latin-American references. Own reference values are required for accurate diagnosis of MS, as well as a worldwide consensus on its diagnostic criteria.
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Affiliation(s)
- Marjorie Villalobos Reyes
- Unidad de Endocrinología, Instituto Autónomo Hospital Universitario de los Andes, Universidad de Los Andes, Mérida, Venezuela
| | - Maracelly Mederico
- Unidad de Endocrinología, Instituto Autónomo Hospital Universitario de los Andes, Universidad de Los Andes, Mérida, Venezuela
| | - Mariela Paoli de Valeri
- Unidad de Endocrinología, Instituto Autónomo Hospital Universitario de los Andes, Universidad de Los Andes, Mérida, Venezuela.
| | - Yajaira Briceño
- Unidad de Endocrinología, Instituto Autónomo Hospital Universitario de los Andes, Universidad de Los Andes, Mérida, Venezuela
| | - Yajaira Zerpa
- Unidad de Endocrinología, Instituto Autónomo Hospital Universitario de los Andes, Universidad de Los Andes, Mérida, Venezuela
| | - Roald Gómez-Pérez
- Unidad de Endocrinología, Instituto Autónomo Hospital Universitario de los Andes, Universidad de Los Andes, Mérida, Venezuela
| | - Nolis Camacho
- Servicio de Nutrición, Crecimiento y Desarrollo Infantil, Instituto Autónomo Hospital Universitario de los Andes, Universidad de Los Andes, Mérida, Venezuela
| | - José Luis Martínez
- Servicio de Nutrición, Crecimiento y Desarrollo Infantil, Instituto Autónomo Hospital Universitario de los Andes, Universidad de Los Andes, Mérida, Venezuela
| | - Lenín Valeri
- Unidad de Endocrinología, Instituto Autónomo Hospital Universitario de los Andes, Universidad de Los Andes, Mérida, Venezuela
| | - Gabriela Arata-Bellabarba
- Laboratorio de Neuroendocrinología y Reproducción, Departamento de Fisiopatología, Universidad de Los Andes, Mérida, Venezuela
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Sewaybricker LE, Antonio MÂRGM, Mendes RT, Barros Filho ADA, Zambon MP. Metabolic syndrome in obese adolescents: what is enough? Rev Assoc Med Bras (1992) 2013; 59:64-71. [PMID: 23440144 DOI: 10.1590/s0104-42302013000100013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2012] [Accepted: 08/14/2012] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To study the agreement among three distinct criteria for metabolic syndrome (MS) adapted to adolescents, and to identify associated factors for MS. METHODS Cross-sectional study with 65 obese subjects aged 10 to 18 years, attended to at the Outpatient Clinic for Obese Children and Adolescents at the Clinical Hospital of the Universidade Estadual de Campinas (Unicamp). MS was defined using the criteria of the World Health Organization (WHO), the International Diabetes Federation (IDF), and the Adult Treatment Panel III (ATP III). Clinical, anthropometrical, and laboratorial data were associated to MS. RESULTS From the 65 subjects, none had MS according to the WHO criteria, while 18 were diagnosed with MS (27.6%) according to the IDF, and 19 (29.2%) according to the ATP III. Agreement between IDF and ATP III was excellent (kappa 81%). In this study, puberty and triglycerides levels showed significant statistical difference when comparing subjects with and without MS, the first for ATP III (p = 0.03), and the second for IDF (p = 0.005) and ATP III (p = 0.001) criteria. CONCLUSION The WHO criteria does not seem to be adequate for adolescents. IDF and ATP III criteria had an excellent agreement. Puberty and triglycerides were associated with MS.
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Affiliation(s)
- Leticia Esposito Sewaybricker
- Postgraduate Course in Child and Adolescent Health, Medical School, Universidade Estadual de Campinas, Campinas, SP, Brazil
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Dantas EMDM, Pereira FVM, Queiroz JW, Dantas DLDM, Monteiro GRG, Duggal P, Azevedo MDF, Jeronimo SMB, Araújo ACPF. Preeclampsia is associated with increased maternal body weight in a northeastern Brazilian population. BMC Pregnancy Childbirth 2013; 13:159. [PMID: 23927768 PMCID: PMC4231463 DOI: 10.1186/1471-2393-13-159] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2012] [Accepted: 07/31/2013] [Indexed: 12/02/2022] Open
Abstract
Background Preeclampsia is a disease with great variability in incidence across the world. The mortality is higher in lower income countries, where it is the leading cause of maternal mortality. This study aimed to determine the frequency of and risk factors for preeclampsia in a low income population from an urban area of Brazil. Methods A prospective case control study of 242 women of which 30 developed preeclampsia, 4 had gestational hypertension, 2 had superimposed hypertension, 11 had spontaneous abortion, 13 were lost to follow up and 192 had normal pregnancy. This latter group was considered the normotensive controls. The rate of preeclampsia and the risk of cardiovascular disease, after onset of preeclampsia, were determined. Results Of the 218 women who completed the study, the frequency of hypertensive disorder of pregnancy was 16.5% (36 of 218) and of preeclampsia was 13.8% (30 of 218). Women with preeclampsia had a higher body mass index (BMI), mean of 25.3 ± 4.8 compared to 23.5 ± 3.7 for the normotensive controls, p = 0.02. The risk of preeclampsia increased with BMI [Odds ratio (OR) 1.12, 95% Confidence Interval (CI = 1.02;1.24, p-value = 0.023)]. Women with preeclampsia developed chronic hypertension more often than normotensive controls (p = 0.043) and their systolic and ambulatory blood pressure monitoring was elevated (p = 0.034). Women with preeclampsia had higher BMI even 5 years post-pregnancy (p = 0.008). Conclusions Women who are overweight or older have an increased risk of preeclampsia. Previous history of preeclampsia increases the risk of early onset of chronic hypertension. Therefore, effective preventive measures are needed, particularly women at lower social economic stratum who have less access to proper medical care and adequate nutrition.
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Strufaldi MWL, Puccini RF, Silvério OMA, do Pinho Franco MC. Association of adipokines with cardiovascular risk factors in low birth weight children: a case-control study. Eur J Pediatr 2013; 172:71-6. [PMID: 23015046 DOI: 10.1007/s00431-012-1846-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Revised: 08/19/2012] [Accepted: 09/17/2012] [Indexed: 10/27/2022]
Abstract
UNLABELLED Our aim was to investigate plasma levels of adiponectin, monocyte chemoattractant protein-1 (MCP-1) and plasminogen activator inhibitor-1 (PAI-1) in low birth weight (LBW) children and to determine correlations among these adipokines and birth weight and cardiovascular disease risk factors. In a case-control study, the concentrations of adiponectin, MCP-1 and PAI-1 were measured in 180 schoolchildren (ages 6-11 years). MCP-1 and PAI-1 levels were significantly elevated in LBW children. Conversely, adiponectin concentration was significantly reduced in these children. Similar findings were observed after adjustment for current age, gender and abdominal circumference. Because the children with LBW had altered adipokine levels, as well as higher abdominal circumference, HOMA-IR and systolic blood pressure (SBP), we evaluated the correlation among these variables. These analyses showed that adiponectin levels were inversely correlated with systolic blood pressure (SBP) (r = -0.501; P < 0.001), HOMA-IR (r = -0.293; P = 0.023) and waist circumference (r = -0.317; P = 0.014). The proinflammatory markers were positively correlated with HOMA-IR (PAI-1: r = 0.358; P = 0.005) and waist circumference (PAI-1: r = 0.571; P < 0.001 and MCP-1: r = 0.267; P = 0.039). CONCLUSION Adipokines levels were correlated with cardiovascular risk factors in LBW children, and these compounds could be involved in the mechanism that links birth weight to the development of cardiovascular diseases in adulthood.
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Affiliation(s)
- Maria Wany Louzada Strufaldi
- Department of Pediatrics, School of Medicine, Federal University of Sao Paulo, Rua Botucatu, 598 Sao Paulo, Brazil.
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Abstract
BACKGROUND Metabolic syndrome has been identified as a condition of childhood relatively recently. The aim in this study was to describe the prevalence of metabolic syndrome in children allowing for differences in metabolic syndrome definitions. METHODS This was a systematic review of the OVID, EMBASE, and CINAHL databases, capturing details of overall prevalence and prevalence within groups categorized by obesity, gender, age, and ethnicity. RESULTS In all, 378 studies published since 2003 were identified, and of these 85 papers were included in the present review. When all studies were considered, the median prevalence of metabolic syndrome in whole populations was 3.3% (range 0%-19.2%), in overweight children was 11.9% (range 2.8%-29.3%), and in obese populations was 29.2% (range 10%-66%). Within-study analyses confirmed higher prevalence for obese compared to overweight (P=0.012) and obese compared to nonobese, nonoverweight children (P<0.001). Within-study analyses also revealed higher median metabolic syndrome prevalence for boys compared to girls (5.1% versus 3.0%, P<0.001) and also in older compared with younger children (5.6% versus 2.9%, P=0.001). Limited evidence was found to suggest differences between ethnic groups, and there were insufficient studies to determine whether metabolic syndrome prevalence was increasing over time. CONCLUSIONS This is the first systematic review of all of the relevant literature. It describes the magnitude of associations between metabolic syndrome and obesity, age, and gender. We find evidence that ethnicity and geography may be important to metabolic syndrome prevalence in children and these associations require further study.
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Affiliation(s)
- Amanda Friend
- Child Health, University of Aberdeen, Aberdeen, Scotland
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Fujii C, Sakakibara H. Association between insulin resistance, cardiovascular risk factors and overweight in Japanese schoolchildren. Obes Res Clin Pract 2012; 6:e1-8. [DOI: 10.1016/j.orcp.2011.04.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2011] [Revised: 04/08/2011] [Accepted: 04/12/2011] [Indexed: 11/20/2022]
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Momoi C, Vasconcelos SRDS, Silva EMKD, Strufaldi MWL, Terao SM, Puccini RF. Saúde da criança: fatores de risco aplicados em programas de atenção básica à saúde. ACTA PAUL ENFERM 2012. [DOI: 10.1590/s0103-21002012000200012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: comparar as frequências dos fatores de risco em crianças matriculadas em unidades básicas de saúde (UBS) em dois períodos (1988-1989 e 2005-2006) e analisar a associação desses fatores com desnutrição, internação e óbito. MÉTODOS:Estudo de abordagem quantitativa, tipo coorte retrospectiva com amostra probabilística (n=414) de crianças menores de um ano matriculadas em duas UBSs do Embu (SP), em 2005-2006. Variáveis independentes: alto risco e presença de fatores de risco. Desfechos: evolução ponderal desfavorável, déficit nutricional, internação, óbito. Estatística: Qui-Quadrado e Odds Ratio. RESULTADOS: em 2005-2006, verificou-se: maior frequência de intercorrências neonatais e mães adolescentes; menor freqüência de desnutrição ou óbito de irmão < 5 anos; evolução ponderal desfavorável (1,6%); deficit nutricional (2,9%); IMC > 2z (17,9%); internações (21,8%); nenhum óbito. Baixo peso ao nascer associou-se à internação (OR=4,04;IC95%:1,35-12,04). CONCLUSÕES: Baixo peso ao nascer permanece, como importante fator de risco e a proporção de sobrepeso/obesidade indica necessidade de redirecionamento das ações de saúde da criança.
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Chehuen MDR, Bezerra AIL, Bartholomeu T, Junqueira NO, Rezende JAS, Basso L, Oliveira JA, Lemos WP, Tani G, Prista A, Maia JAR, Forjaz CLDM. Risco cardiovascular e prática de atividade física em crianças e adolescentes de Muzambinho/MG: influência do gênero e da idade. REV BRAS MED ESPORTE 2011. [DOI: 10.1590/s1517-86922011000400003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
INTRODUÇÃO E OBJETIVO: A doença cardiovascular inicia na infância e está atrelada à presença de fatores de risco cardiovascular (FRC). A prevalência desses fatores varia em diferentes populações brasileiras, tendo sido estudada principalmente em cidades de médio e grande porte. Este estudo avaliou a prevalência dos FRC e da prática de atividade física (AF) em crianças e adolescentes de Muzambinho, uma cidade de pequeno porte. MÉTODO: Foram avaliados 205 sujeitos (entre sete e 18 anos - 108 do gênero masculino). Foram medidos: peso, estatura, glicemia, colesterolemia, pressão arterial (PA) e prática de AF. As comparações foram realizadas pelo teste do Qui-quadrado. RESULTADOS: A prevalência de sobrepeso foi de 19% e de valores alterados de PA, glicemia e colesterolemia foram de, respectivamente, 11, 5 e 15%. Não houve diferença na prevalência dos FRC entre os sexos. O tabagismo, o alcoolismo, a PA alterada e a insuficiência de AF aumentaram com a idade. Setenta e nove por cento dos sujeitos praticavam AF de locomoção, 10% ocupacional, 97% nas aulas de educação física, 72% no recreio e 90% de lazer. Noventa e dois por cento foram considerados ativos. A prática de AF ocupacional foi maior nas meninas e aumentou nos meninos com a idade. A prevalência de AF de lazer e recreio diminuiu com a idade nos dois sexos. CONCLUSÃO: A prevalência de FRC, exceto do sedentarismo, foi expressiva, não diferiu entre os sexos e aumentou com a idade. A prática de AF de todos os tipos foi alta, diferenciou-se entre os sexos e diminuiu com a idade.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Go Tani
- Universidade de São Paulo, Brasil
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Rodrigues LG, Pombo N, Koifman S. Prevalência de alterações metabólicas em crianças e adolescentes com sobrepeso e obesidade: uma revisão sistemática. Rev paul pediatr 2011. [DOI: 10.1590/s0103-05822011000200021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJETIVO: Descrever a prevalência de síndrome metabólica em crianças e adolescentes com sobrepeso ou obesidade bem como os critérios utilizados em sua classificação. FONTES DOS DADOS: Revisão sistemática realizada por meio de busca eletrônica nas bases de dados Pubmed e na Biblioteca Virtual em Saúde. Os critérios de inclusão ado-tados foram apresentar dados de prevalência de síndrome metabólica em crianças e adolescentes com sobrepeso e obesidade, sendo publicados em português, inglês, espanhol e francês. Foram excluídos artigos de revisão, comunica-ção breve e estudos em populações com doenças de base (genética, endócrina, imunológica, hipertensão primária e presença de acantose). SÍNTESE DOS DADOS: Foram levantados 1.226 resumos, sendo selecionados 65 artigos para análise na íntegra, dos quais 46 atendiam os critérios mencionados no período de 2003 a 2009, representando cinco regiões geográficas: América do Norte (33%), América do Sul (20%), América Central (4%), Ásia (30%) e Europa (13%). As prevalências descritas variaram de 2,1 a 58,3%, sendo 31,2% a prevalência mediana. Houve divergência nos critérios, com 26 estudos usando os mesmos componentes (triglicerídeos, HDL, glico-se, circunferência de cintura e pressão arterial), sem consenso nos pontos de corte adotados. Nos demais estudos, houve inclusão de glicemia pós-prandial, índice de massa corporal, colesterol, e índice HOMA-IR. CONCLUSÕES: A prevalência descrita de síndrome metabólica em crianças e adolescentes na literatura apresentou uma ampla variabilidade, ocorrendo heterogeneidade na escolha das variáveis empregadas na definição dos componentes da doença, bem como nos pontos de corte adotados.
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Affiliation(s)
| | - Nina Pombo
- Universidade Federal do Estado do Rio de Janeiro
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Rodrigues LG, Mattos AP, Koifman S. Prevalência de síndrome metabólica em amostra ambulatorial de crianças e adolescentes com sobrepeso e obesidade: análise comparativa de diferentes definições clínicas. Rev paul pediatr 2011. [DOI: 10.1590/s0103-05822011000200008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJETIVO: Descrever a prevalência de síndrome metabólica em amostra ambulatorial de crianças e adolescentes com sobrepeso e obesidade segundo critérios propostos pela literatura para sua definição. MÉTODOS: Estudo descritivo observacional transversal com 74 crianças e adolescentes, entre seis e 17 anos, selecionados para participarem de um estudo de intervenção, no qual foram coletados dados antropométricos (peso, estatura, índice de massa corporal e circunferência da cintura), laboratoriais (perfil lipídico e glicemia), além de pressão arterial. A prevalência de síndrome metabólica foi determinada pelas quatro propostas mais frequentemente adotadas em uma revisão sistemática sobre o tema (SM1 a SM4), sendo obtidas as diferenças de proporções, com nível de significância de 0,05. RESULTADOS: A prevalência de síndrome metabólica variou de 55,6% (IC95% 43,4-67,1%) a 74,0% (IC95% 62,2-83,2%) de acordo com as propostas escolhidas, sendo mais elevada quando os pontos de corte eram mais sensíveis. O uso do índice de massa corporal como critério antropométrico não comprometeu, de forma significativa, o diagnóstico de síndrome metabólica. Apesar da variação, a prevalência encontrada foi elevada, atingindo, simultaneamente, por todas as propostas, 52,7% da amostra. As anormalidades mais observadas foram obesidade abdominal e hipertrigliceridemia e, a menos observada, foi a hiperglicemia. CCONCLUSÕES: As alterações metabólicas investigadas foram prevalentes em toda a amostra e o excesso de peso parece ter sido fator determinante no quadro descrito. Esse fato denota a importância do diagnóstico precoce e do monitoramento dessa população com o intuito de reduzir o risco de desenvolvimento de comorbidades cardiovasculares na vida adulta jovem.
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Rinaldi AEM, Pimentel GD, Pereira AF, Gabriel GFCP, Moreto F, Burini RC. Metabolic syndrome in overweight children from the city of Botucatu - São Paulo State - Brazil: agreement among six diagnostic criteria. Diabetol Metab Syndr 2010; 2:39. [PMID: 20529375 PMCID: PMC2893090 DOI: 10.1186/1758-5996-2-39] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2009] [Accepted: 06/09/2010] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The metabolic syndrome has been described in children; however, a standard criterion has not been established for its diagnosis. Also, few studies have been conducted to specifically observe the possible existence of agreement among the existing diagnostic criteria. The purpose of the study is to evaluate agreement concerning prevalence rates of the metabolic syndrome diagnosed by six different criteria in overweight schoolchildren in the city of Botucatu - SP -Brazil. METHODS This is a cross-sectional study on 128 overweight schoolchildren. Clinical examination included anthropometry, pubertal staging evaluation, and blood pressure. Triacylglycerol, glycemia, HDL-cholesterol, insulin levels, and HOMA-IR were determined. The Kappa index, the Mann-Whitney test and the chi-square test were used for statistical analysis. RESULTS The prevalence of the metabolic syndrome varied from 10 to 16.5% according to different diagnostic criteria. Results were similar for boys and girls and pubertal stage. Great agreement was observed among the six different diagnostic criteria for the metabolic syndrome. CONCLUSIONS Different diagnostic criteria, when adopted for subjects with similar demographic characteristics, generate similar and compatible prevalence. Results suggest that it is possible to adopt any of the analyzed criteria, and the choice should be according to the components available for each situation.
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Affiliation(s)
- Ana Elisa M Rinaldi
- Uberlândia School of Medicine, Nutrition Course, Uberlândia Federal University - UFU, Uberlândia, MG, Brazil
- Exercise and Nutrition Metabolism Center (CeMENutri), Botucatu School of Medicine - UNESP, Botucatu, SP, Brazil
| | - Gustavo D Pimentel
- Exercise and Nutrition Metabolism Center (CeMENutri), Botucatu School of Medicine - UNESP, Botucatu, SP, Brazil
- Department of Physiology, Nutrition Physiology Division - UNIFESP, São Paulo, SP, Brazil
| | - Avany F Pereira
- Department of Nutrition and Dietetics - Rio de Janeiro Federal University - UFRJ, Rio de Janeiro, RJ, Brazil
| | - Gleice FCP Gabriel
- Department of Internal Medicine, Course of Physiopathology in Internal Medicine, Botucatu School of Medicine - UNESP, Botucatu, SP, Brazil
| | - Fernando Moreto
- Exercise and Nutrition Metabolism Center (CeMENutri), Botucatu School of Medicine - UNESP, Botucatu, SP, Brazil
- Department of Pathology, Botucatu School of Medicine - UNESP, Botucatu, SP, Brazil
| | - Roberto C Burini
- Exercise and Nutrition Metabolism Center (CeMENutri), Botucatu School of Medicine - UNESP, Botucatu, SP, Brazil
- Department of Public Health, Exercise and Nutrition Metabolism Center (CeMENutri), Botucatu School of Medicine - UNESP, Botucatu, SP, Brazil
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Hirschler V, Oestreicher K, Maccallini G, Aranda C. Relationship between obesity and metabolic syndrome among Argentinean elementary school children. Clin Biochem 2009; 43:435-41. [PMID: 19913002 DOI: 10.1016/j.clinbiochem.2009.11.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2009] [Revised: 10/20/2009] [Accepted: 11/01/2009] [Indexed: 02/06/2023]
Abstract
BACKGROUND Argentina has experienced marked increases in the prevalence of childhood overweight (OW)/obesity over the last few decades. OBJECTIVES We examined (1) the distribution of the mean values of lipids, glucose, and HOMA-IR according to the presence of OW/obesity, age, and sex and (2) the association between metabolic syndrome and OW/obesity, Tanner stage, gender, and HOMA-IR. METHODS Data were collected from 1009 children (508 males) in 10 elementary schools between April and September 2007. BMI, waist circumference, blood pressure, Tanner, lipids, insulin, and glucose were determined. Criteria analogous to ATPIII were used for metabolic syndrome in children. RESULTS Over 1009 children (508 males) aged 9.4 + or - 2.0 years were evaluated. One hundred and sixty-five (16.4%) were obese (>95th percentile), and 166 (16.5%) were OW (85-95th). Twenty-five (2.5%) were severely obese (BMI>99th). Most of the children (62%; 613/979) were at Tanner 1. Triglycerides, insulin, and HOMA-IR were higher (p<0.001) and HDL-C lower (p<0.001) in OW/obesity in both age groups and genders. The prevalence of metabolic syndrome was 5.8% overall, 32% in severely obese, 16.4% in OW/obese and 0.4% in normal weight children. Multiple logistic regression showed that BMI (OR 24.48; 95% CI 9.14-65.57), and HOMA-IR (OR 2.09; 95% CI 1.04-4.18) were associated with metabolic syndrome adjusted by gender and Tanner stage. Multiple linear regression also showed that BMI and HOMA-IR were independently associated with the number of metabolic syndrome components (R(2)=0.46). CONCLUSIONS A substantial number of OW/obese children have the metabolic syndrome. HOMA-IR and BMI were strong predictors of metabolic syndrome in children suggesting that OW/obese school children are at a higher risk for future cardiovascular disease.
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Affiliation(s)
- Valeria Hirschler
- Nutrition and Diabetes Department, Durand Hospital Maipu 812 5 M, Buenos Aires, 1006 Argentina.
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Paoli M, Uzcátegui L, Zerpa Y, Gómez-Pérez R, Camacho N, Molina Z, Cichetti R, Vallarroel V, Fargier A, Arata-Bellabarba G. [Obesity in schoolchildren from Merida, Venezuela: association with cardiovascular risk factors]. ACTA ACUST UNITED AC 2009; 56:218-26. [PMID: 19627742 DOI: 10.1016/S1575-0922(09)71404-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2009] [Accepted: 04/27/2009] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To investigate the prevalence of obesity and associated cardiovascular risk factors in schoolchildren in our city, given the influence of these factors on the development of atherosclerosis. METHODS We studied a representative sample of second grade students composed of 370 children aged 7.82+/-0.62 years (47.8% girls and 52.2% boys); 52.4% were from public schools and 47.6% were from private schools. Surveys were performed and anthropometric measurements, blood pressure (BP) values and glucose and lipid profiles in capillary blood were determined. RESULTS A total of 9.7% (36 schoolchildren) were obese and 13.8% were overweight. There were no differences according to sex or school system. Abdominal obesity was observed in 69.4% (p<0.0001), normal-high BP (90-97th percentile) in 27.8% (p<0.0001), dyslipidemia in 66.7% (p<0.05) and metabolic syndrome in 38.9% (p<0.0001) of the obese children compared with 1.3%, 5.1%, 48.9% and 0.4% of the children with normal weight, respectively. No association was found between fasting hyperglycemia and obesity. There were no cases of hypertension or diabetes mellitus. The risk (odds ratio) for normal-high BP, dyslipidemia, abdominal obesity and metabolic syndrome was 6.3, 2.2, 60.9, and 70.2 times higher in obese children than in non-obese children, respectively. A positive and significant correlation was found between waist circumference and body mass index with BP and the atherogenic indexes triglycerides/high-density lipoprotein cholesterol (HDL-C), total cholesterol/HDL-C and low-density lipoprotein cholesterol/HDL-C (p=0.0001). CONCLUSIONS Compared with cities in other countries, the city of Mérida, Venezuela, has an intermediate prevalence of overweight and obesity in schoolchildren. The high frequency of cardiovascular risk factors in the obese and its positive correlation with adiposity highlights the need to implement population-based strategies for its prevention in childhood.
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