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Renier TJ, Mai HJ, Zheng Z, Vajravelu ME, Hirschfeld E, Gilbert-Diamond D, Lee JM, Meijer JL. Utilizing the Glucose and Insulin Response Shape of an Oral Glucose Tolerance Test to Predict Dysglycemia in Children with Overweight and Obesity, Ages 8-18 Years. Diabetology (Basel) 2024; 5:96-109. [PMID: 38576510 PMCID: PMC10994153 DOI: 10.3390/diabetology5010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
Common dysglycemia measurements including fasting plasma glucose (FPG), oral glucose tolerance test (OGTT)-derived 2 h plasma glucose, and hemoglobin A1c (HbA1c) have limitations for children. Dynamic OGTT glucose and insulin responses may better reflect underlying physiology. This analysis assessed glucose and insulin curve shapes utilizing classifications-biphasic, monophasic, or monotonically increasing-and functional principal components (FPCs) to predict future dysglycemia. The prospective cohort included 671 participants with no previous diabetes diagnosis (BMI percentile ≥ 85th, 8-18 years old); 193 returned for follow-up (median 14.5 months). Blood was collected every 30 min during the 2 h OGTT. Functional data analysis was performed on curves summarizing glucose and insulin responses. FPCs described variation in curve height (FPC1), time of peak (FPC2), and oscillation (FPC3). At baseline, both glucose and insulin FPC1 were significantly correlated with BMI percentile (Spearman correlation r = 0.22 and 0.48), triglycerides (r = 0.30 and 0.39), and HbA1c (r = 0.25 and 0.17). In longitudinal logistic regression analyses, glucose and insulin FPCs predicted future dysglycemia (AUC = 0.80) better than shape classifications (AUC = 0.69), HbA1c (AUC = 0.72), or FPG (AUC = 0.50). Further research should evaluate the utility of FPCs to predict metabolic diseases.
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Affiliation(s)
- Timothy J. Renier
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA
| | - Htun Ja Mai
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA
| | - Zheshi Zheng
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Mary Ellen Vajravelu
- Division of Pediatric Endocrinology, Diabetes and Metabolism, UPMC—Children’s Hospital of Pittsburgh, Pittsburgh, PA 15224, USA
| | - Emily Hirschfeld
- Department of Pediatrics, Division of Pediatric Endocrinology, Susan B. Meister Child Health Evaluation and Research Center, University of Michigan, Ann Arbor, MI 48109, USA
| | - Diane Gilbert-Diamond
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA
- Department of Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA
- Department of Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA
| | - Joyce M. Lee
- Department of Pediatrics, Division of Pediatric Endocrinology, Susan B. Meister Child Health Evaluation and Research Center, University of Michigan, Ann Arbor, MI 48109, USA
| | - Jennifer L. Meijer
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA
- Department of Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA
- Department of Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA
- Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA
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Renier TJ, Yeum D, Emond JA, Lansigan RK, Ballarino GA, Carlson DD, Loos RJF, Gilbert-Diamond D. Elucidating pathways to pediatric obesity: a study evaluating obesity polygenic risk scores related to appetitive traits in children. Int J Obes (Lond) 2024; 48:71-77. [PMID: 37736781 PMCID: PMC10841756 DOI: 10.1038/s41366-023-01385-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 09/05/2023] [Accepted: 09/08/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND/OBJECTIVES Obesity polygenic risk scores (PRS) explain substantial variation in body mass index (BMI), yet associations between PRSs and appetitive traits in children remain unclear. To better understand pathways leading to pediatric obesity, this study aimed to assess the association of obesity PRSs and appetitive traits. SUBJECTS/METHODS This study included 248 unrelated children aged 9-12 years. DNA from the children was genotyped (236 met quality control thresholds) and four weighted polygenic risk scores from previous studies were computed and standardized: a 97 SNP PRS, 266 SNP pediatric-specific PRS, 466 SNP adult-specific PRS, and ~2 million SNP PRS. Appetitive traits were assessed using a parent-completed Child Eating Behavior Questionnaire, which evaluated food approach/avoidance traits and a composite obesogenic appetite score. BMI was directly measured and standardized by age and sex. Three associations were evaluated with linear regression: (1) appetitive traits and BMI, (2) PRSs and BMI, and (3) PRSs and appetitive traits, the primary association of interest. RESULTS Expected positive associations were observed between obesogenic appetitive traits and BMI and all four PRSs and BMI. Examining the association between PRSs and appetitive traits, all PRSs except for the 466 SNP adult PRS were significantly associated with the obesogenic appetite score. Each standard deviation increase in the 266 SNP pediatric PRS was associated with an adjusted 2.1% increase in obesogenic appetite score (95% CI: 0.6%, 3.7%, p = 0.006). Significant partial mediation of the PRS-BMI association by obesogenic appetite score was found for these PRSs; for example, 21.3% of the association between the 266 SNP pediatric PRS and BMI was explained by the obesogenic appetite score. CONCLUSIONS Genetic obesity risk significantly predicted appetitive traits, which partially mediated the association between genetic obesity risk and BMI in children. These findings build a clearer picture of pathways leading to pediatric obesity.
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Affiliation(s)
- Timothy J Renier
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
| | - Dabin Yeum
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Jennifer A Emond
- Department of Biomedical Data Sciences, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
- Department of Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Reina K Lansigan
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Grace A Ballarino
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Delaina D Carlson
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Ruth J F Loos
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Diane Gilbert-Diamond
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
- Department of Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
- Department of Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
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Renier TJ, Paetz OR, Paal MC, Long AB, Brown MR, Vuong SH, Perumal SK, Kharbanda KK, Listenberger LL. Changing the phospholipid composition of lipid droplets alters localization of select lipid droplet proteins. MicroPubl Biol 2023; 2023:10.17912/micropub.biology.000960. [PMID: 38021172 PMCID: PMC10656625 DOI: 10.17912/micropub.biology.000960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 10/30/2023] [Accepted: 10/31/2023] [Indexed: 12/01/2023]
Abstract
Our experiments aim to determine if decreasing the amount of phosphatidylcholine (PC) relative to phosphatidylethanolamine (PE) at the lipid droplet surface changes the localization of specific lipid droplet proteins. We manipulate lipid droplet phospholipids in both a cultured mouse hepatocyte (AML12) cell line and on synthetic lipid droplets. Decreasing the PC:PE ratio increases perilipin 2, decreases DGAT2, and does not change rab18 or lanosterol synthase levels on lipid droplets. These differences may be explained by the distinct structural motifs that mediate the protein-lipid droplet interactions.
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Affiliation(s)
- Timothy J. Renier
- Departments of Biology and Chemistry, St. Olaf College, Northfield, Minnesota, United States
| | - Olivia R. Paetz
- Departments of Biology and Chemistry, St. Olaf College, Northfield, Minnesota, United States
| | - Matthew C. Paal
- Departments of Biology and Chemistry, St. Olaf College, Northfield, Minnesota, United States
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, United States
| | - Alex B. Long
- Departments of Biology and Chemistry, St. Olaf College, Northfield, Minnesota, United States
| | - Margaret R. Brown
- Departments of Biology and Chemistry, St. Olaf College, Northfield, Minnesota, United States
| | - Sunny H. Vuong
- Departments of Biology and Chemistry, St. Olaf College, Northfield, Minnesota, United States
| | - Sathish Kumar Perumal
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, United States
- Research Service, Veterans Affairs Nebraska-Western Iowa Health Care System, Omaha, Nebraska, United States
| | - Kusum K. Kharbanda
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, United States
- Research Service, Veterans Affairs Nebraska-Western Iowa Health Care System, Omaha, Nebraska, United States
- Department of Biochemistry & Molecular Biology, University of Nebraska Medical Center, Omaha, Nebraska, United States
| | - Laura L. Listenberger
- Departments of Biology and Chemistry, St. Olaf College, Northfield, Minnesota, United States
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Yeum D, Gilbert-Diamond D, Masterson TD, Carlson DD, Ballarino GA, Lansigan RK, Renier TJ, Emond JA. Associations between behavioral self-regulation and external food cue responsiveness (EFCR) in preschool-age children and evidence of modification by parenting style. Appetite 2023; 188:106637. [PMID: 37352897 PMCID: PMC10528472 DOI: 10.1016/j.appet.2023.106637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 05/05/2023] [Accepted: 06/14/2023] [Indexed: 06/25/2023]
Abstract
Decreased behavioral regulation is hypothesized to be a risk factor for excess weight gain among children, possibly via reduced appetite-specific regulation. Little research has specifically focused on behavioral regulation and food cue responsiveness, a conditioned precursor to eating, at a young age. This study examined the association between behavioral regulation and external food cue responsiveness among preschool-age children and explored if a more structured parenting style moderated that association. Baseline data from a prospective study on media use among preschool-age children (n = 83) in Northern New England were used. Parents reported on three domains of children's behavioral regulation (attentional focusing, inhibitory control, and emotional self-regulation), the children's external food cue responsiveness (EFCR), and their parenting styles (authoritative and permissive) via validated questionnaires. Mean age among children was 4.31 (SD 0.91) years, 57% of children were male, 89% were non-Hispanic white, and 26.2% had overweight or obesity. In a series of adjusted linear regression models, lower attentional focusing (standardized β, βs = -0.35, p = 0.001), inhibitory control (βs = -0.30, p = 0.008), and emotional self-regulation (standardized beta, βs = -0.38, p < 0.001) were each significantly associated with greater EFCR. In exploratory analyses, a more structured parenting style (more authoritative or less permissive) mitigated the associations between inhibitory control and EFCR (Bonferroni-adjusted p-interaction < 0.017). Findings support that lower attentional focusing, inhibitory control, and emotional self-regulation relate to greater ECFR in preschool-age children. The association between inhibitory control and EFCR may be modified by parenting style. Further research is needed to understand if children's responsiveness to external food cues may account for reported associations between lower behavioral regulation and adiposity gain over time.
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Affiliation(s)
- Dabin Yeum
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Williamson Translational Research Building 7th Floor, 1 Medical Center Drive, Lebanon, NH, 03756, USA.
| | - Diane Gilbert-Diamond
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Williamson Translational Research Building 7th Floor, 1 Medical Center Drive, Lebanon, NH, 03756, USA; Department of Medicine, Geisel School of Medicine at Dartmouth College, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, 03756, USA; Department of Pediatrics, Geisel School of Medicine at Dartmouth College, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, 03756, USA
| | - Travis D Masterson
- Department of Nutritional Sciences, College of Health and Human Development, The Pennsylvania State University, 110 Chandlee Laboratory, University Park, PA, 16802, USA
| | - Delaina D Carlson
- Department of Pediatrics, Geisel School of Medicine at Dartmouth College, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, 03756, USA
| | - Grace A Ballarino
- Department of Pediatrics, Geisel School of Medicine at Dartmouth College, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, 03756, USA
| | - Reina K Lansigan
- Department of Pediatrics, Geisel School of Medicine at Dartmouth College, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, 03756, USA
| | - Timothy J Renier
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Williamson Translational Research Building 7th Floor, 1 Medical Center Drive, Lebanon, NH, 03756, USA
| | - Jennifer A Emond
- Department of Pediatrics, Geisel School of Medicine at Dartmouth College, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, 03756, USA; Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth College, Williamson Translational Research Building 3rd Floor, 1 Medical Center Drive, Lebanon, NH, 03756, USA
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Meijer JL, Roderka MN, Chinburg EL, Renier TJ, McClure AC, Rothstein RI, Barry EL, Billmeier S, Gilbert-Diamond D. Alterations in Fecal Short-Chain Fatty Acids after Bariatric Surgery: Relationship with Dietary Intake and Weight Loss. Nutrients 2022; 14:nu14204243. [PMID: 36296927 PMCID: PMC9607039 DOI: 10.3390/nu14204243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 10/05/2022] [Accepted: 10/08/2022] [Indexed: 11/28/2022] Open
Abstract
Bariatric surgery is associated with weight loss attributed to reduced caloric intake, mechanical changes, and alterations in gut hormones. However, some studies have suggested a heightened incidence of colorectal cancer (CRC) has been associated with bariatric surgery, emphasizing the importance of identifying mechanisms of risk. The objective of this study was to determine if bariatric surgery is associated with decreases in fecal short-chain fatty acids (SCFA), a group of bacterial metabolites of fiber. Fecal samples (n = 22) were collected pre- (~6 weeks) and post-bariatric surgery (~4 months) in patients undergoing Roux-en-Y gastric bypass and sleeve gastrectomy. SCFA levels were quantified using liquid chromatography/mass spectrometry. Dietary intake was quantified using 24-h dietary recalls. Using an aggregate variable, straight SCFAs significantly decreased by 27% from pre- to post-surgery, specifically acetate, propionate, butyrate, and valerate. Pre-surgery weight was inversely associated with butyrate, with no association remaining post-surgery. Multiple food groups were positively (sugars, milk, and red and orange vegetables) and inversely (animal protein) associated with SCFA levels. Our results suggest a potential mechanism linking dietary intake and SCFA levels with CRC risk post-bariatric surgery with implications for interventions to increase SCFA levels.
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Affiliation(s)
- Jennifer L. Meijer
- Weight and Wellness Center, Dartmouth-Health, Lebanon, NH 03756, USA
- Department of Medicine, Geisel School of Medicine, Dartmouth College, Hanover, NH 03755, USA
- Department of Pediatrics, Geisel School of Medicine, Dartmouth College, Hanover, NH 03755, USA
- Correspondence: ; Tel.: +1-603-650-5250
| | | | - Elsa L. Chinburg
- Weight and Wellness Center, Dartmouth-Health, Lebanon, NH 03756, USA
| | - Timothy J. Renier
- Department of Medicine, Geisel School of Medicine, Dartmouth College, Hanover, NH 03755, USA
| | - Auden C. McClure
- Weight and Wellness Center, Dartmouth-Health, Lebanon, NH 03756, USA
- Department of Medicine, Geisel School of Medicine, Dartmouth College, Hanover, NH 03755, USA
- Department of Pediatrics, Geisel School of Medicine, Dartmouth College, Hanover, NH 03755, USA
| | - Richard I. Rothstein
- Weight and Wellness Center, Dartmouth-Health, Lebanon, NH 03756, USA
- Department of Medicine, Geisel School of Medicine, Dartmouth College, Hanover, NH 03755, USA
| | - Elizabeth L. Barry
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Hanover, NH 03755, USA
| | - Sarah Billmeier
- Department of Surgery, Geisel School of Medicine, Dartmouth College, Hanover, NH 03755, USA
| | - Diane Gilbert-Diamond
- Department of Medicine, Geisel School of Medicine, Dartmouth College, Hanover, NH 03755, USA
- Department of Pediatrics, Geisel School of Medicine, Dartmouth College, Hanover, NH 03755, USA
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Hanover, NH 03755, USA
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