A systemic review on association between on maternal atmospheric pollution exposure during pregnancy and childhood obesity / 环境与职业医学

Background Maternal atmospheric pollution during pregnancy may alter fetal intrauterine development programming, thereby increasing the risk of childhood obesity in the future. Objective To investigate the effects of atmospheric pollution exposure during pregnancy on the incidence of childhood obesity in offspring. Methods English databases (PubMed, Web of Science, and Medline) and Chinese databases (Wanfang Data Knowledge Service Platform, China National Knowledge Infrastructure, and VIP Information Chinese Journal Service Platform) were searched for literature reporting exposure to atmospheric pollution during pregnancy and childhood obesity published from 1 January 2000 to 31 August 2023. The quality of the included literature was evaluated using the quality assessment tools for observational cohort and cross-sectional studies recommended by the US National Institutes of Health. Results Twenty-four studies meeting the inclusion criteria were identified and the associated atmospheric pollutants included particulate matter, ozone, nitrogen oxide, carbon oxide, and sulfur oxide. In comparison to the non-exposed group, prenatal exposure to various common atmospheric pollutants were significantly associated with an elevated risk of childhood obesity in offspring. Conclusion Maternal exposure to atmospheric pollution during pregnancy is associated with an elevated risk of childhood obesity in subsequent years. Future studies should pay more attention to the effects of atmospheric pollution on the distribution of children's body fat and metabolic development, and further identify potential mechanisms of atmospheric pollutant exposure leading to childhood obesity.

Sobrepeso y obesidad en infancias de Bariloche, Argentina: más allá de la alimentación y la actividad física / Childhood overweight and obesity in Bariloche, Argentina: Beyond eating habits and physical activity

La incidencia de sobrepeso y obesidad es alarmante en el mundo. En Argentina son escasos los estudios multifactoriales a pesar de los altos índices de sobrepeso y obesidad en la población infantil (SOI). En este estudio evaluamos la prevalencia de SOI y sus factores de riesgo asociados desde una perspectiva multicausal: analizamos hábitos de sueño, uso de pantallas, estrés crónico en niños y sus cuidadores, problemas de relación social, alimentación y actividad física. De los 397 niños de primer y séptimo grado que completaron los cuestionarios, el 41 % presentó SOI. Los niños con obesidad mostraron realizar menos actividad física, tener un menor consumo de alimentos protectores, más riesgos de trastornos del sueño, mayores niveles de estrés crónico (tanto en los niños como en sus cuidadores) y mayor índice de rechazo entre pares. En la mayoría de los niños se encontró un uso generalizado de pantallas antes de acostarse. El presente estudio evidencia la diversidad de factores asociados a esta problemática y destaca la conveniencia de utilizar un enfoque multidimensional para abordar la obesidad en la infancia. Asimismo, los resultados de este trabajo sugieren la necesidad de considerar los hábitos de vida como estrategia preventiva y terapéutica para el tratamiento de esta enfermedad desde etapas tempranas.

The incidence of overweight and obesity is alarming worldwide. In Argentina, multifactorial studies are scarce despite the high rates of childhood overweight and obesity (OW/OB). In this study we assessed the prevalence of childhood OW/OB and the associated risk factors from a multicausal perspective: we analyzed sleep habits, screen use, chronic stress in children and their caregivers, social relationship problems, eating habits, and physical activity. Of the 397 first and seventh graders who completed the questionnaires, 41% had childhood OW/OB. In children with obesity, a lower level of physical activity, a lower consumption of protective foods, a higher risk for sleep disorders, higher levels of chronic stress (in both children and their caregivers), and higher rates of peer rejection were observed. Widespread use of screens before bedtime was noted in most children. This study evidences the diversity of factors associated with childhood OW/OB and highlights the convenience of a multidimensional approach to address it. In addition, the results of this study suggest the need to consider lifestyle habits as a preventive and therapeutic strategy for the management of OW/OB from early stages.

Ultra-processed food consumption and nutritional status in Uruguayan and Brazilian children between three to five years / Consumo de alimentos ultraprocesados y estado nutricional en niños de tres a cinco años uruguayos y brasileños

Introduction. There is growing consensus globally that the consumption of ultra- processed food (UPF) can negatively affect the nutritional status of children. Objective. The present study aims to evaluate associations between the consumption of UPF and the nutritional status in a sample of Uruguayan and Brazilian preschoolers belonging to two studies: the ENDIS Study and the Pelotas 2015 Birth Cohort. Materials and methods. We conducted a cross-sectional analysis. The main outcome measure was obesity defined as BMI for age and sex ≥ +3 z-scores. The score of UPF consumption was the main exposure measured. Each positive answer of habitual intake was added up to create a UPF score ranging from zero to six or more UPF. Crude and adjusted logistic regressions were performed for the associations between UPF consumption and nutritional status in preschoolers. Results. The final sample consisted of 8,687 preschool children, 50.8% belonging to the Uruguayan study, while the remaining 49.2% belonged to the Brazilian study. Nearly 5% of the sample of young children were obese. We didn't observe a relationship between the score of UPF consumption and obesity, the odds ratio (OR) was 1.04 (95% CI, 1.00­1.09). Adjustments resulted in modest attenuation of the relationship and a lack of statistical significance. However, in children under 48 months, the score of UPF consumption was directly associated with childhood obesity. Conclusions. Results suggest that higher consumption of UPF is associated with obesity in Uruguayan and Brazilian preschool children under 4 years of age. These findings suggest that actions to reduce ultra- processed food consumption could lead to diminish obesity patterns and bring important public health benefits(AU)

Introducción. Existe creciente consenso a nivel mundial de que el consumo de alimentos ultraprocesados puede afectar negativamente el estado nutricional de los niños. Objetivo. El presente estudio tiene como objetivo evaluar asociaciones entre el consumo de ultraprocesados y el estado nutricional en una muestra de preescolares uruguayos y brasileños pertenecientes a dos estudios: el Estudio ENDIS y la Cohorte de Nacimiento de Pelotas 2015. Materiales y métodos. Se realizó un análisis transversal. La principal medida de resultado fue la obesidad definida como el IMC/edad y sexo ≥ +3 puntuaciones z. La puntuación del consumo de ultraprocesados fue la principal exposición. Cada respuesta positiva de la ingesta habitual se sumó para crear una puntuación de ultraprocesados que oscilaba entre cero y seis o más. Se realizaron regresiones logísticas crudas y ajustadas. Resultados. La muestra final estuvo constituida por 8.687 niños, de los cuales el 50,8% pertenecía al estudio uruguayo, mientras que el 49,2% restante pertenecía al estudio brasileño. Casi el 5% de la muestra de niños pequeños eran obesos. No observamos relación entre la puntuación del consumo de ultraprocesados y la obesidad, el odds ratio (OR) fue de 1,04 (IC 95%, 1,00-1,09). Los ajustes dieron lugar a modesta atenuación de la relación y falta de significación estadística. Sin embargo, en menores de 48 meses la puntuación de consumo de ultraprocesados se asoció directamente con la obesidad infantil. Conclusiones. Los resultados sugieren que un mayor consumo de ultraprocesados se asocia con obesidad en prescolares uruguayos y brasileños menores de 4 años. Estos hallazgos sugieren que las acciones para reducir el consumo de alimentos ultraprocesados podrían conducir a una disminución de los patrones de obesidad y traer importantes beneficios para la salud pública(AU)

Sobrepeso y obesidad en escolares de la Región de Magallanes y Antártica Chilena, Chile, (2009 ­ 2019), y comparación de dos metodologías para el diagnóstico / Overweight and obesity in schoolchildren in the Magallanes and Chilean Antarctica Region, Chile, (2009 - 2019), and comparison of two methodologies for diagnosis

Introducción. En Chile la prevalencia de obesidad total en población escolar alcanza al 31% y la obesidad severa al 10,8%. La Región de Magallanes y Antártica Chilena, es una de las más afectadas por esta epidemia. El diagnóstico nutricional confiable y una intervención oportuna pueden evitar que los niños enfermen y deterioren su calidad de vida. Objetivo: Analizar la tendencia del estado nutricional de escolares de la Región de Magallanes, según datos reportados por la Junta Nacional de Auxilio Escolar y Becas, JUNAEB, entre 2009-2019 y comparar resultados del año 2010 con un estudio propio. Materiales y métodos. Se analizó el estado nutricional de 71.334 escolares de la Región de Magallanes y Antártica Chilena por nivel educacional y variables demográficas, según información de JUNAEB. Luego se compararon los resultados de escolares de 1º básico del año 2010, obtenidos a través de dos metodologías: fuente secundaria, Encuesta JUNAEB, y fuente primaria, estudio antropométrico realizado en la misma región y año. Resultados. Según datos de JUNAEB el exceso ponderal se incrementó en escolares de la región en 4,4 % entre 2009 y 2019, el grupo más afectado fue 1º básico. En el año 2010 la prevalencia de obesidad para escolares de 1º básico según JUNAEB fue 21,8% y según estudio regional propio fue 25,7%. Conclusiones. La malnutrición por exceso afecta al 53,8% de los escolares de la Región de Magallanes y podría ser mayor, considerando que la información censal podría estar subestimando el sobrepeso y obesidad. Es urgente intervenir para evitar perpetuar esta epidemia(AU)

Introduction. In Chile the prevalence of total obesity in school population reaches 31% and severe obesity 10.8%. The Magallanes and Chilean Antarctica Region is one of the most affected by this epidemic. Reliable nutritional diagnosis and timely intervention can prevent children from getting sick and deteriorating their quality of life. Objective. To analyze the trend of nutritional status of schoolchildren in the Magallanes Region, according to data reported by the National Board of School Aid and Scholarships, JUNAEB between 2009-2019 and compare results from 2010 with our own study. Materials and methods. The nutritional status of 71,334 schoolchildren in the Magallanes Region and Chilean Antarctica was analyzed by educational level and demographic variables, according to information from JUNAEB. Then, the results of schoolchildren in 1st grade in 2010 were compared, obtained through two methods: secondary source, JUNAEB survey, and primary source, anthropometric study carried out in the same region and year. Results. According to JUNAEB data, overweight increased in school children in the region by 4.4% between 2009 and 2019, the most affected group was 1st grade. In 2010 the prevalence of obesity for 1st grade schoolchildren according to JUNAEB was 21.8% and according to our own regional study it was 25.7%. Conclusions. Excess malnutrition affects 53.8% of school children in the Magallanes Region and could be higher, considering that census information could be underestimating overweight and obesity. It is urgent to intervene to avoid perpetuating this epidemic(AU)

Propiedades psicométricas del Children Eating Behavior Questionnaire en niños mexicanos menores de 3 años / Psychometric properties of the Children's Eating Behavior Questionnaire in Mexican children under 3 years of age

Resumen Objetivo: México es uno de los países con mayor prevalencia de obesidad infantil a nivel mundial. Se requieren de instrumentos de valoración integrales válidos para el abordaje del problema. El Children Eating Behavior Questionnaire. (CEBQ) permite evaluar las conductas alimentarias de los niños relacionadas con el riesgo de obesidad, por lo que se planteó el siguiente objetivo evaluar las propiedades psicométricas de la versión original del CEBQ en niños mexicanos de 1 a 3 años. Material y Métodos: 201 madres residentes del noreste de México completaron el CEBQ en centros de salud comunitarios. Se realizó un análisis factorial confirmatorio (AFC) a través de componentes principales y fiabilidad (consistencia interna) con alfa de Cronbach (α). Resultados: Se identificó un modelo con siete factores y 24 ítems, los índices de bondad de ajuste del modelo propuesto fueron adecuados: índice de ajuste comparativo (CFI= 0.90), y error cuadrático medio de aproximación (RMSEA= 0.06). Los factores que integran el CEBQ tienen aceptable confiabilidad internaα > 0.70. Conclusión: El CEBQ en niños mexicanos de 1 a 3 años tiene propiedades psicométricas que lo hace una medida confiable y válida para evaluar comportamientos alimentarios relacionados con el riesgo de obesidad. Se recomienda contrastar este modelo en poblaciones similares.

Abstract Objective: Mexico is one of the countries with the highest prevalence of childhood obesity worldwide. Valid comprehensive assessment instruments are required to address the problem. The Child Eating Behavior Questionnaire(CEBQ) allows the assessment of children's eating behaviors related to obesity risk, so the following objective was to evaluate the psychometric properties of the original version of the CEBQ in Mexican children aged 1 to 3 years. Material and Methods: 201 mothers residing in northeastern Mexico completed the CEBQ in community health centers. A confirmatory factor analysis (CFA) was performed through principal components and reliability (internal consistency) with Cronbach's alpha (α). Results: A model with seven factors and 24 items was identified, the goodness-of-fit indices of the proposed model were adequate: comparative fit index (CFI=0.90), and root mean square error of approximation (RMSEA= 0.06). The factors that make up the CEBQ have acceptable internal reliability α > 0.70. Conclusion: The CEBQ in Mexican children aged 1 to 3 years has psychometric properties that make it a reliable and valid measure to assess eating behaviors related to obesity risk. It is recommended to contrast this model in similar populations.

Motivational Techniques and Hacks for Treating Childhood Obesity

Treating obesity in children and adolescents is not a cakewalk. Asking them directly to get up and run, or just serving them a four-quadrant plate won’t serve the purpose at all. An obese child is already under the repercussions of oppressive remarks by the society. If at home as well, their mental milieu is not taken care of, there are chances of them being trapped in the shackles of depression. To avoid such drastic consequences, one must be prudent enough, while conversing with their children/patients regarding their weight. Motivation enhancement is very crucial in childhood obesity management, as the required changes in diet, behavior and physical activity are difficult to carry out with an insufficient level of motivation.1 The motivational hacks presented here might be helpful for parents and health care professionals in convincing their children/patients to stride through the road to health.

Influencia de la seropositividad contra adenovirus-36 sobre riesgo de obesidad y resistencia a la insulina en población infanto-juvenil de la Región de la Araucanía / Influence of adenovirus 36 seropositivity on the risk of obesity and insulin resistance in a population of children and adolescents from the Región de la Araucanía

La infección previa por el adenovirus-36 (Ad-36) se ha asociado con el proceso adipogénico y el control glicémico en modelos experimentales de cultivos celulares y animales. En humanos, la presencia de anticuerpos contra Ad-36 ha mostrado aumentar el riesgo de obesidad y, paradójicamente, mejorar el control glicémico en diferentes poblaciones. Se evaluó la influencia de la seropositividad contra Ad-36 sobre riesgo de obesidad, el perfil lipídico y glicémico en una población de niños en edad escolar. Métodos: Doscientos ocho individuos de entre 9 y 13 años se agruparon según estado nutricional como normopeso (IMC z-score de -1 a +1), con sobrepeso (IMC z-score de +1 a +2) y con obesidad (IMC z-score > +3). Se evaluaron medidas antropométricas, desarrollo puberal según Tanner y parámetros bioquímicos (perfil lipídico, glucemia e insulina) y la seropositividad contra Ad-36. Se determinó la resistencia a la insulina (RI) según criterio para la población infantil chilena. La seropositividad contra Ad-36 se determinó mediante ELISA. Resultados: Hubo una alta prevalencia de sobrepeso/obesidad en la población de estudio. La seropositividad contra Ad-36 fue del 5,4% en el grupo total, pero no se observó una asociación con el estado nutricional. No se encontró correlación entre la seropositividad contra Ad-36 y los parámetros del perfil lipídico. La insulina y la HOMA-RI fueron significativamente más bajas en el grupo Ad-36 (+) (p<0,001), no habiendo sido reportados casos de RI en el grupo Ad-36 (+) en nuestra población. Conclusiones: Nuestros resultados sugieren que la infección previa por el adenovirus-36 afecta la secreción de insulina y la resistencia a la insulina, como se ha descrito anteriormente, sin embargo, no se observa correlación con el desarrollo de la obesidad infantil en la población pediátrica del sur de Chile.

Previous infection with Adenovirus-36 (Ad-36) has been associated with adipogenic process and glycemic control in experimental models of cell culture and animals. In humans, the presence of antibodies against Ad-36 has been shown to increase the risk of obesity and, paradoxically, improve glycemic control in different populations. The influence of Ad-36 seropositivity on obesity risk, lipid and glycemic profile was evaluated in a population of school-age children. Methods: Two hundred eight individuals aged 9 to 13 years were grouped according to their nutritional status as normal weight (BMI z-score from -1 to +1), overweight (BMI z-score from +1 to +2) or obese (BMI z-score from -1 to +1). z-score > +3). Anthropometric measurements, pubertal development according to Tanner stage, biochemical parameters (lipid profile, glycemia and insulin) and seropositivity against Ad-36 were evaluated. Insulin resistance (IR) was determined according to criteria for the Chilean child population. Seropositivity against Ad-36 was determined by ELISA. Results: There was a high prevalence of overweight/obesity in the study population. Seropositivity against Ad-36 was 5.4% in the total group, but no association with nutritional status was observed. No correlation was found between Ad-36 seropositivity and lipid profile parameters. Insulin and HOMA-RI were significantly lower in the Ad-36 (+) group (p<0.001), and no cases of RI were reported in the Ad-36 (+) group in our population. Conclusions: Our results suggest that previous adenovirus-36 infection affects insulin secretion and insulin resistance, as previously described, however, no correlation is observed with the development of childhood obesity in the pediatric population. from southern Chile.

Changes in body mass index-z scores in 3-year-old children during the COVID-19 pandemic: a 2-year retrospective cohort study

SUMMARY OBJECTIVE: Given how dramatically the pandemic has affected food systems, the economy, and the daily lives of children over the past 2 years, the potential impact of the pandemic on childhood obesity requires careful investigation. The aim of this study was to investigate the change in body mass index z-score in 3-year-old children and the inducing factors during the pandemic period. METHODS: The body mass index z-scores of all children participating in the study were calculated at the beginning of the pandemic (3-year-old body mass index z-score) and in its second year (5-year-old body mass index z-score). RESULTS: This study, conducted during the 2-year pandemic period, found a strong association between the body mass index z-scores of children aged 3 and 5 years. The mean body mass index z-score increased between these time points for both boys and girls (p=0.013; p=0.034). In two different linear regression models created for the change in body mass index z score, gestational weight gain was found to be related. The regression coefficients (95% confidence intervals) and corresponding p-values were 0.580 (0.217-0.944) and p=0.002 for model 1, whereas they were 0.585 (0.217-0.961) and p=0.002 for model 2. CONCLUSION: This study showed an increase in body mass index z-scores in early childhood period during the COVID-19 pandemic. To prevent this increase, new strategies should be developed by considering the changes brought by the pandemic period.

Lactancia materna y alimentación complementaria en relación con la obesidad infantil

Introducción: La obesidad infantil es un problema de salud mundial, no resuelto, con incremento en todos los países. Para ello no existen estrategias de tratamiento estandarizadas. Objetivo: Describir la relación entre la lactancia materna, la alimentación complementaria y leche de fórmula con el riesgo de obesidad infantil. Método: Se realizó un estudio observacional, de corte transversal, en 126 niños comprendidos entre 6 meses a 2 años de edad, atendidos en el Hospital General Docente Ambato en el año 2019. Las variables estudiadas fueron edad, sexo, estado nutricional, el tiempo de lactancia exclusiva, el inicio de alimentación complementaria y el tiempo de consumo de la leche de fórmula. Se aplicó la estadística descriptiva y la prueba no paramétrica de U de Mann-Whitney. Resultados: Predominaron en este estudio los infantes entre 6 y 12 meses de edad que representaron el 50,8 %, se destacó el sexo femenino con el 55,2 %. De los 126 niños estudiados se observó que el 62,1 % estaban dentro del perfil de obesos, el 70,6 % recibió lactancia exclusiva en los primeros 6 meses de vida, siendo 2 meses menor por los clasificados en el perfil de obesos. Igual comportamiento se observó en los que recibieron alimentación complementaria y en 2,5 meses los que consumieron leche de fórmula. Conclusiones: La mayoría de los niños en el estudio estaban clasificados como obesos. Los niños obesos tuvieron un tiempo de lactancia exclusiva más corto y consumieron alimentación suplementaria y leche de fórmula por un período de tiempo más largo que los niños con un peso normal.

Introduction: Childhood obesity globally is an unresolved health problem, becoming increasingly present in all countries with not appropriate standard treatment strategies. Objective: To describe the relationship between breastfeeding, complementary feeding and formula milk in childhood obesity. Method: An observational cross-sectional study was conducted in 126 children, aged of 6 months to 2 years, treated at the Hospital General Docente Ambato, Ecuador, in 2019. The variables studied were as follow: age, sex, nutritional status, exclusive breastfeeding duration, time of initiation in complementary feeding and duration providing formula milk. Descriptive statistics and the nonparametric Mann-Whitney U test were applied. Results: Infants between the age of 6 to 12 months (50.8%) and female sex (55.2%) predominated. Of the total of children, 62.1% apply in obese profile, 70.6 % were exclusively breastfed in their early 6 months (2 months less than obese patients). The same behavior was observed in those who received complementary feeding and in those who consumed formula milk for 2.5 months. Conclusions: Most children in the study were classified as obese. Obese children had a short frequency of exclusive breastfeeding and consumed complementary feeding and formula milk for a longer period of time rather than children with normal weight.

Introdução: a obesidade infantil é um problema de saúde global não resolvido, com aumento em todos os países. Não há estratégias de tratamento padronizadas para isso. Objetivo: descrever a relação entre aleitamento materno, alimentação complementar e fórmula láctea com o risco de obesidade infantil. Método: estudo observacional, transversal, realizado em 126 crianças entre 6 meses e 2 anos de idade, atendidas no Hospital Geral de Ambato em 2019. As variáveis estudadas foram idade, sexo, estado nutricional, tempo de amamentação exclusiva, o início da alimentação complementar e o tempo de consumo da fórmula láctea. Aplicou-se estatística descritiva e o teste não paramétrico Mann-Whitney U. Resultados: lactentes entre 6 e 12 meses de idade predominaram neste estudo, representando 50,8%, o sexo feminino se destacou com 55,2%. Das 126 crianças estudadas, observou-se que 62,1% estavam dentro do perfil obeso, 70,6% receberam aleitamento materno exclusivo nos primeiros 6 meses de vida, sendo 2 meses mais jovem para aquelas classificadas no perfil obeso. O mesmo comportamento foi observado naqueles que receberam alimentação complementar e em 2,5 meses os que consumiram leite de fórmula. Conclusões: a maioria das crianças do estudo foi classificada como obesa. As crianças obesas apresentaram menor tempo de aleitamento materno exclusivo e consumiram alimentação complementar e fórmula láctea por mais tempo do que as crianças com peso normal.

Skeletal changes of the axial axis and lower limbs in overweight children and adolescents / Alterações esqueléticas do eixo axial e de membros inferiores em crianças e adolescentes com excesso de peso

Abstract Objective: To evaluate the presence of axial skeletal deviations in children and adolescents and to relate them to body mass index (BMI), age and sex. Methods: 101 patients aged 7 to 17 years old were included in this study; exclusion criteria were primary orthopedic diseases and syndromes or treatments that affect growth. Patients were grouped according to their BMI Z-score: eutrophic (n=29), overweight (n=18) and obese (n=54). They underwent static clinical inspection was made by simetrographic technique. Intermaleolar distance was obtained, Adam's forward bend and tiptoe tests were performed. Results: When comparing obese and eutrophic patients, changes in the cervical spine (p<0.01), spine (p<0.001), hip (p<0.01) and shoulders (p<0.001) were present in more than half of the obese patients (62.5%, 62.2%, 79.9% and 55.4%, respectively). Changes in the knees were more frequent among obese (p<0.001) when compared to eutrophic patients. There was no variation regarding age or sex (p>0.05). Conclusions: being overweight influences skeletal deviations in children and adolescents.

RESUMO Objetivo: Avaliar a presença de desvios do esqueleto axial em crianças e adolescentes e relacioná-los com índice de massa corpórea, idade e sexo. Métodos: Fizeram parte deste estudo 101 pacientes de sete a 17 anos, os quais não possuíam doenças ortopédicas primárias, síndromes ou tratamentos que afetassem o crescimento. Os pacientes foram agrupados conforme os escores Z do índice de massa corpórea em: eutróficos (n=29), com sobrepeso (n=18) e obesos (n=54). Foram avaliados por meio da inspeção clínica estática, com simetrógrafo de parede, medida da distância intermaleolar, manobra de Adams e teste da ponta dos pés. Resultados: Quando comparados os pacientes obesos com os eutróficos, alterações de coluna cervical (p<0,01), coluna (p<0,001), quadril (p<0,01) e ombros (p<0,001) ocorreram em mais da metade dos obesos (62,5, 62,2, 79,9 e 55,4%, respectivamente). Alterações nos joelhos foram mais frequentes entre os obesos (p<0,001) quando comparados aos eutróficos. Não houve variação com a idade ou o sexo (p>0,05). Conclusões: Conclui-se que o excesso de peso exerce influência sobre desvios do esqueleto em crianças e adolescentes.

Associations between urinary paraben levels and obesity of 10-year-old children / 环境与职业医学

Background Parabens, a widely used class of preservatives, are suspected to be potential obesogens as emerging endocrine disrupting chemicals with reproductive and developmental toxicity. Objective To analyze five urinary parabens (PBs) and estimate the associations of exposure to PBs with adiposity measures in 10-year-old school-age children. Methods A total of 471 school-age children aged 10 years from the Sheyang Mini Birth Cohort were enrolled in this study. A questionnaire survey was conducted to collect socio-demographic information, physical activity, and dietary intake. Weight, height, and waist circumference of children were measured, and age- and sex-adjusted body mass index (BMI-Z score) was calculated. Spot urine samples were collected during the follow-up visits. Urinary concentrations of five PBs including methyl-paraben (MeP), ethyl-paraben (EtP), propyl-paraben (PrP), butyl-paraben (BuP), and benzyl-paraben (BzP) were detected by gas chromatography-tandem mass spectrometry (GC-MS/MS). Generalized linear models (GLMs) and Bayesian kernel machine regression (BKMR) models were applied to estimate associations of individual/overall urinary PBs concentrations with BMI Z-score and waist circumference. Results The positive rates of selected five urinary PBs were in the range from 78.98% to 98.94%. The urinary PBs concentrations (geometric mean) were in the range of 0.31-5.43 μg·L−1. The children's BMI Z-score and waist circumference (mean ± standard deviation) were (0.56±1.40) and (67.62±10.07) cm respectively. The GLMs results showed that the urinary BzP concentration was negatively associated with waist circumference (b=−0.08, 95%CI: −0.14, −0.02; P=0.01). In sex-stratified analysis, the urinary concentration of BzP was negatively associated with BMI-Z score (b=−0.59, 95%CI: −0.88, −0.30; P<0.001) and waist circumference (b=−0.80, 95%CI: −1.23, −0.37; P<0.001) in boys, but not in girls. The BKMR results also found significant negative correlations of urinary BzP concentrations with BMI-Z score and waist circumference, which were consistent with the GLM results. Conclusion The selected 10-year-old children are extensively exposed to PBs in the study area. Furthermore, childhood PBs exposure may have potential impacts on childhood adiposity measures with sex-specific effects.

Association of dietary pattern and childhood obesity with cardiovascular disease in patients from Tangail city, Bangladesh

@#Introduction: Obesity in childhood is a major cause for developing cardiovascular diseases (CVD) at adulthood. The present study was a cross-sectional research aimed to examine the relationship between childhood obesity and dietary pattern with CVD in patients (n=100) from Tangail City, Bangladesh. Methods: Dietary patterns, laboratory tests, demographic, and anthropometric interrelated data were measured in patients with stroke and heart attack from five hospitals. The research also used 24-hour recall method and a food frequency questionnaire for assessing daily energy and macronutrient intakes. Results: Weight (p=0.004), body mass index (BMI) (p=0.001), mid-upper arm circumference (MUAC) (p=0.009), and waist circumference (WC) (p=0.030) was significantly different between males and females whereas lipid profile was not significantly different between genders. There were no significant associations between intakes of red meat, salt, fast food, fish, egg, nuts and seeds with heart attack and stroke. On the contrary, there were significant associations between fried food intake with heart attack and stroke (p=0.080 and p=0.020). The results indicated that there was a significant relationship between carbohydrate (p=0.001), protein (p=0.001), and fat (p=0.001) intakes with the total energy intake of respondents. The findings also showed that there was a significant relationship between carbohydrate (p=0.003), protein (p=0.001), and fat (p=0.001) intakes with body mass index of the respondents. Conclusion: CVD diagnosis in adult patients was found to be associated with fried food intake but not with childhood obesity.

Programa de intervención psicológica para el manejo de la obesidad infantil / Program of psychological intervention for the handling of the infantile obesity

RESUMEN Introducción: La obesidad es un problema de salud asociado a una morbilidad variada y cada vez en edades más tempranas de la vida. El documento actual tiene como objetivo exponer resultados de un estudio acerca de los hábitos asociados a la obesidad infantil, en la medida, además, en que se evalúan las relaciones afectivas compensatorias y las actitudes generadoras de alteraciones psicológicas en la familia, en función de la presentación de elementos del programa de intervención psicológica dirigido al manejo de la obesidad en un grupo de niños obesos que constituyeron parte de la muestra. Método: La muestra estuvo constituida por 13 niños obesos y 21 familiares remitidos de la consulta de Pediatría del Centro de Investigaciones Médico-Quirúrgicas. La elaboración del programa intervención psicológica se realizó en el primer semestre de 2019 y la experiencia derivada su aplicación se extiende hasta el momento actual. Resultados: Se realiza un análisis cualitativo, en el que se exponen los resultados a partir de la observación de la tendencia de las variables en el grupo. Se aplicaron la entrevista al niño y a la familia, el análisis psicográfico y las Siete figuras de Collins. Se examinan variables psicológicas. Discusión: Se constata la influencia de las variables analizadas en la obesidad infantil, teniendo en cuenta la correspondencia con los estudios de investigadores de Cuba y el mundo, lo cual redunda en la validez y actualidad de los resultados, para la implementación del programa con sesiones dirigidas a los niños y familiares.

ABSTRACT Introduction: Obesity is a health problem associated with varied morbidity and increasingly at earlier ages of life. The current document aims to present the results of a study about the habits associated with childhood obesity, to the extent, in addition, that the compensatory affective relationships and the attitudes that generate psychological alterations in the family are evaluated, depending on the presentation. of elements of the psychological intervention program aimed at managing obesity in a group of obese children who were part of the sample. Method: The sample consisted of 13 obese children and 21 relatives referred from the Pediatric consultation of the Medical-Surgical Research Center. The elaboration of the psychological intervention program was carried out in the first semester of 2019 and the derived experience of its application extends until the current moment. Results: A qualitative analysis is carried out, in which the results are presented from the observation of the trend of the variables in the group. The interview with the child and the family, the psychographic analysis and the Seven figures of Collins were applied. Psychological variables are examined. Discussion: The influence of the variables analyzed on childhood obesity is verified, taking into account the correspondence with the studies of researchers from Cuba and the world, which results in the validity and timeliness of the results, for the implementation of the program with Sessions for children and families.

Avaliação da Qualidade de Vida em Crianças Obesas em um Ambulatório Universitário / Quality of Life Assessment in Obese Children in a University Outpatient Clinic

Introdução: A obesidade infantil representa um grande desafio de saúde pública, pois suas repercussões na criança englobam alterações físicas, fisiológicas e emocionais, resultando em risco de interferência na qualidade de vida. O presente estudo buscou avaliar a qualidade de vida de crianças obesas de um ambulatório universitário do sul de Santa Catarina. Métodos: Estudo observacional com delineamento transversal com crianças obesas dos Ambulatórios Médicos de Saúde da Universidade do Sul de Santa Catarina. Aplicaram-se os seguintes instrumentos: Autoquestionnaire Qualité de Vie Enfant Imagé (AUQEI), questionário sociodemográfico elaborado pelas autoras e pesquisa de dados em prontuário. Resultados: Participaram do estudo 44 crianças obesas com idades entre quatro e doze anos. O escore médio total obtido pela avaliação da qualidade de vida através do AUQEI foi de 48,7 pontos, representando qualidade de vida não prejudicada. O fator família obteve o maior valor e os fatores autonomia e lazer, os menores valores. Quanto às questões específicas, os mais altos escores foram aqueles relacionados a aniversário e férias, e os mais baixos, à hospitalização e a estar longe da família. Houve associação estatisticamente significativa entre o fator autonomia com a frequência à escola e entre o fator família com a presença de irmãos. Conclusão: Não houve prejuízo na qualidade de vida das crianças obesas, apesar da proximidade do escore médio total com a nota de corte (<48). A maior média no AUQEI para o fator família demonstrou a importância desse meio para a vida das crianças.

Introduction: Childhood obesity represents a significant public health challenge because its repercussions on the child encompass physical, physiological, and emotional alterations, resulting in a risk of interference with quality of life. The present study aimed to evaluate the quality of life of obese children from a university outpatient clinic in southern Santa Catarina. Methods: Observational study with cross-sectional design with obese children from the outpatient clinic of the University of Southern Santa Catarina (Universidade do Sul de Santa Catarina [UNISUL]). The following instruments were applied: Autoquestionnaire Qualité de Vie Enfant Imagé (AUQEI), a sociodemographic questionnaire prepared by the authors, and research of data in medical records. Results: Forty-four obese children with ages ranging from four to twelve years participated in the study. The total mean score obtained by evaluating the quality of life through the AUQEI was 48.7 points, representing an unimpaired quality of life. The family factor achieved the highest score, and the autonomy and leisure factors the lowest scores. As for the specific questions, birthdays and vacations got the highest scores, and hospitalization and being away from the family scored the lowest. There was a statistically significant association between the autonomy factor and school attendance and between the family factor and the presence of siblings. Conclusion: There was no impairment in the quality of life of obese children despite the proximity of the total mean score to the cutoff score (<48). The highest mean AUQEI score for the family factor demonstrated the importance of this environment for the children's lives.

Correlación del índice de masa corporal y de la circunferencia de cintura de las niñas y adolescentes con su ascendencia femenina hasta la tercera generación

RESUMEN Introducción: La intergeneracionalidad nutricional es reconocida como uno de los factores que influye en el aumento de la prevalencia de obesidad, principalmente a través de generaciones maternas. Poco se conoce sobre esta situación en nuestro país. Objetivo: evaluar la correlación del índice de masa corporal (IMC) y la circunferencia de cintura (CC) de niñas y adolescentes con su ascendencia femenina hasta la tercera generación durante los meses de julio a setiembre del 2019. Materiales y Métodos: Estudio analítico de corte transversal en 98 tríos (niñas y adolescentes, madres y abuelas maternas). Se recolectaron datos antropométricos de los tríos (peso, talla y CC). Se realizaron correlaciones entre: el IMC de la madre y la abuela con el puntaje Z del IMC/E de las niñas y adolescentes y la CC de la madre con las niñas y adolescentes. Se aplicó el coeficiente de correlación de Pearson. Investigación aprobada por Comité de Ética (Dictamen 460/19). Resultados: en promedio las niñas y adolescentes tuvieron 10,1±1,1 años, 0,8±1,6 DE puntaje Z IMC/Edad y 69,5±9,7 cm de CC; las madres tenían 37,4±6,8 años, 13 años de escolaridad, 28,8±7,3 kg/m2 de IMC y 92,1±13,4 cm de CC; y las abuelas 64,9±10,8 años, 7 años de escolaridad y 28,7±6,9 kg/m2 de IMC (Sobrepeso). La correlación del IMC de la madre con el puntaje Z de las niñas y adolescentes fue r: 0,2937 (p0,05). La correlación de CC entre madre-niña fue r: 0,264, (p<0,05). Conclusión: el IMC y la CC de las niñas y adolescentes se correlaciona con el IMC y CC de las madres, pero su potencia no es muy fuerte. Las hijas de madres obesas tienen mayor IMC medido por puntaje Z.

ABSTRACT Introduction: Nutritional intergenerationality is recognized as one of the factors that influences the increase in obesity prevalence, mainly through maternal generations. Little is known about this situation in our country. Objective: to evaluate the correlation of the body mass index (BMI) and the waist circumference (WC) of girls and adolescents compared to their female ancestry up to the third generation during the months of July to September 2019. Materials and methods: This was an analytical, cross-sectional study of 98 trios (girls and adolescents, maternal mothers and grandmothers). Anthropometric data of the trios (weight, height and WC) were collected. Correlations were made between: the BMI of the mother and the grandmother with the Z score of the BMI/E of the girls and adolescents and the WC of the mother with the girls and adolescents. Pearson's correlation coefficient was applied. The study was approved by the Ethics Committee (Approval # 460/19). Results: On average, the girls and adolescents were 10.1±1.1 years old, had a BMI/Age Z score of 0.8±1.6 SD and a WC of 69.5±9.7 cm; the mothers were 37.4±6.8 years old, had 13 years of schooling, BMI 28.8±7.3 kg/m2 and WC 92.1±13.4 cm; and the grandmothers 64.9±10.8 years, had 7 years of schooling and 28.7±6.9 kg/m2 BMI (Overweight). The correlation of the BMI of the mother with the Z score of the girls and adolescents was r: 0.2937 (p0.05). The WC correlation between mother and girl was r: 0.264, (p<0.05). Conclusion: The BMI and WC of girls and adolescents correlate with the BMI and WC of mothers, but its power is not very strong. The daughters of obese mothers have higher BMI measured by Z score.

Validation of the Family Health Behavior Scale for the Brazilian population

Abstract Objective: To validate the Family Health Behavior Scale (FHBS) for Brazilian families. Methods: The sample included 272 children aged 5 to 12 years old. Caregivers and their healthy answered the FHBS and questions about physical activity. In addition, anthropometric measurements of the children's weight and height were performed, as well as the bioimpedance exam. The scale was translated and the following validities were assessed: content (qualitative analysis and content validity index), construct (factor analysis) and concurrent validity (difference between domains and the total score with the categories of BMI, fat percentage and physical activity). Reliability (Cronbach's alpha, ceiling-floor effect, two-half test, intraclass correlation and Bland - Altman) was also assessed. Results: FHBS instrument performed well with regard to the psychometric properties in the Brazilian population. The content validity index was 0.987. Fit indices of the factor analysis were considered satisfactory, according to Bartlett's sphericity test (χ 2 = 1927, df = 351; p < 0.001) and the Kaiser-Meyer-Olkin index (KMO = 0.789). Concurrent validity, the differences between the mean of the domains and the total score between the categories of BMI (p = 0.011), percentage of fat (0.004) and physical activity (p < 0.001) were all significant. The reliability results were Cronbach's alpha internal consistency = 0.83, adequate ceiling-floor effect, 0.8105 (0.09 SD) two-half test, 0.626 intraclass correlation (95% CI: 0.406 to 0.777) and Bland - Altman -0.840 (-22.76 to 21.07). Conclusion: The FHBS adapted for the Brazilian population showed evidence of adequate psychometric performance.

Efetividade de uma estratégia para tratamento da obesidade infantil baseada no Guia Alimentar para a População Brasileira: um ensaio randomizado / Effectiveness of a strategy for the treatment of childhood obesity based on the Food Guide for the Brazilian Population: a randomized trial

O Guia Alimentar para a População Brasileira (GAPB) baseia suas recomendações na extensão e propósito do processamento ocorrido nos alimentos, e sugere que a redução do consumo de alimentos ultraprocessados (AUP) está relacionada a melhora na qualidade da alimentação e consequentemente perda de peso. Apesar de alguns estudos terem observado impacto importante na qualidade da dieta, não há evidências que a redução no consumo de AUP seja acompanhada por redução no consumo de energia total. O objetivo deste estudo é avaliar a efetividade de uma proposta de intervenção para tratamento da obesidade em crianças baseada no GAPB. Foi realizado um ensaio clínico randomizado com crianças entre 7 e 12 anos, encaminhados pelo Sistema Nacional de Regulação (SISREG) para atendimento ao ambulatório de nutrição do Hospital Universitário Pedro Ernesto (HUPE). Os participantes do Grupo controle (GC) e do Grupo Intervenção (GI) participaram de 6 atividades educativas padronizadas e contextualizadas com os 10 passos do GAPB. No GI, também foi prescrito um plano alimentar individualizado, com base nas recomendações nutricionais. Análise de intenção de tratar foi realizada para avaliar a taxa de variação do desfecho primário (índice de massa corporal (IMC)) e secundários (circunferência da cintura (CC) e peso), entre os GI e GC, com base em modelos de efeito mistos. Estas análises também foram aplicadas para medir o consumo alimentar, avaliado pela taxa de variação de gramas de AUP. Adicionalmente, os resultados do IMC foram comparados com curvas de crescimento, desenvolvidas pelo método LMS, que representa a evolução do IMC da população do estudo sem intervenção. Dos 101 participantes, 51 foram alocados no GI. Ao final do estudo, o IMC declinou no GI (Δ = -0,27 kg/m2) em relação ao GC (Δ = + 0,53 kg/m2), com diferença estatisticamente significativa entre os grupos (p=0.0002). Ao comparar o GC com a curva LMS, observou-se maior aumento do IMC no grupo LMS (Δ = + 1,02 kg/m2; p<0,0001). Para mudança de peso, o aumento foi maior no GC (Δ= +5,51), comparado ao GI (Δ= +3,7, p=<0,0001). E não houve diferença significativa na trajetória da CC entre os grupos. Ambos os grupos apresentaram um declínio no consumo de gramas de AUP até o quarto mês e um aumento gradual nos meses seguintes, sem diferença estatisticamente significativa (p=0,77). A combinação de uma abordagem qualitativa baseada nas recomendações do guia com o aconselhamento da restrição energética por meio do plano alimentar mostrou-se eficaz na redução da obesidade infantil. As atividades educativas tiveram impacto no consumo de AUP, porém, há uma dificuldade em manter em longos períodos mudanças comportamentais. Uma vez que o consumo destes alimentos pode prejudicar o tratamento da obesidade infantil, são necessárias estratégias que proporcionem a redução do consumo de AUP ao longo do tempo.

The Dietary Guidelines for the Brazilian Population (DGBP) rely its recommendation on the of extent and purpose that occurred in food and suggests that the reducing the consumption of ultra-processed foods (UPF) improves diet quality and consequent weight loss. Although some studies have observed an important impact on the quality of the diet, there is no evidence that the reduction in the consumption of UPF is accompanied by a reduction in total energy consumption. Thus, the goal of this study is to evaluate the effectiveness of an intervention proposal for the treatment of obesity in children based on the DGBP. A randomized clinical trial was carried out with children between 7 and 12 years old, referred by the National Regulatory System (SISREG) to the nutrition outpatient clinic of University Hospital Pedro Ernesto (HUPE) are evaluated. Participants in the Control Group (CG) and Intervention Group (IG) participated in 6 standardized educational activities contextualized with the 10 Steps of DGBP. In the IG, an individualized food plan was prescribed, based on nutritional recommendations. Intent-to-treat analysis were performed to assess the rate of change of primary (body mass index (BMI)) and secondary (waist circumference (WC) and weight) outcomes between IG and CG, based on mixed-effects models. These analyzes were also applied to measure food consumption, assessed by the rate of change of grams of AUP. Additionally, the BMI results were compared with growth curves, developed by the LMS method, which represents the BMI evolution of the study population without intervention. Of the 101 participants, 51 were allocated to the IG. At the end of the study, BMI declined in the IG (Δ = -0.27 kg/m2) in relation to the CG (Δ = + 0.53 kg/m2), with a statistically significant difference between the groups (p=0.0002). When comparing the GC with the LMS curve, a greater increase in BMI was observed in the LMS group (Δ = + 1.02 kg/m2; p<0.0001). For weight change, the increase was greater in the CG (Δ= +5.51), compared to the IG (Δ= +3.7, p=<0.0001). And there was no significant difference in the trajectory of WC between groups. Both groups showed a decline in grams of UPF until the fourth month and a gradual increase in the following months, with no statistically significant difference (p=0.77). The combination of a qualitative approach based on the DGBP with energy restriction advice through the food plan proved to be effective in reducing childhood obesity. Educational activities had an impact on UPF consumption, however, there is a difficulty in maintaining behavioral changes over long periods. Since the consumption of these foods can impair the treatment of childhood obesity, strategies are needed to reduce UPF consumption over time.

Childhood obesity: an ecological perspective

Abstract Objective: To describe the participation of the environment in the childhood obesity epidemic, since childhood obesity currently represents a great challenge, with high prevalence worldwide, including in Brazil. Data source: Survey of articles published in the last 10 years in PubMed, evaluating the interface between the environment and childhood obesity. Data synthesis: Recent studies show that the environment is very important in the etiopathogenesis of obesity and its comorbidities. Therefore, factors such as air pollution, exposure to chemical substances that interfere with the metabolism, excessive consumption of ultra-processed foods, changes in the intestinal microbiota, and sedentary lifestyle are associated with increased obesity, insulin resistance, type 2 diabetes, and changes in lipid metabolism. These factors have a greater impact on some stages of life, such as the first thousand days, as they affect the expression of genes that control the adipogenesis, energy expenditure, and the mechanisms for hunger/satiety control. Conclusions: Environmental aspects must be taken into account in the prevention and treatment of childhood obesity, both from the individual and the population point of view, with adequate and comprehensive public health policies.

Genetic polymorphisms and plasma concentrations of leptin (rs7799039) and adiponectin (rs17300539) are associated with obesity in children and adolescents / Polimorfismos genéticos e concentrações plasmáticas de leptina (rs7799039) e adiponectina (rs17300539) associados à obesidade em crianças e adolescentes

ABSTRACT Objective: The aim of this study was to compare the anthropometric, biochemical, and hormonal characteristics and the presence of genetic polymorphisms of leptin, adiponectin, and tumor necrosis factor alpha (TNF-α) between eutrophic and obese children and adolescents. Methods: This is a case-control study involving 104 children and adolescents. All subjects were assessed for anthropometric characteristics and clinical, laboratory, and genetic polymorphism parameters. The sample was selected from the pediatric endocrinology outpatient clinic specialized in the treatment of obesity in children and adolescents according to the Centers for Disease Control and Prevention (CDC) classification, and controls were selected from the same location in the general pediatric outpatient clinic. Results: As a result, the parameters, such as black color, obese parents, hypertensive parents, and early weaning, were found to be associated with obesity. Increased levels of insulin, triglyceride, total cholesterol, LDL cholesterol, CRP-U, AST, ALT, GGT, free T4, IGF-1, and uric acid and low levels of HDL cholesterol are found to be associated with a higher chance of obesity. The presence of AG/AA polymorphisms in the leptin is associated with a 290% (OR 3.9) higher chance of obesity, and for adiponectin genes, the chances are 740% (OR 8.4) higher. In these obese children and adolescents with AG/AA haplotypes, serum leptin levels were increased and adiponectin levels were decreased in eutrophic individuals, whereas serum TNF-α levels did not change. Conclusions: The AG/AA polymorphisms in the leptin and adiponectin genes alter the serum levels of these adipokines and predispose them to obesity, and many anthropometric, biochemical, and hormonal markers are altered, demonstrating early consequences for the health of these obese children and adolescents.

RESUMO Objetivo: Comparar as características antropométricas, bioquímicas, hormonais e a presença de polimorfismos genéticos de leptina, adiponectina e fator de necrose tumoral alfa (TNF-α) entre crianças e adolescentes eutróficos e obesos. Métodos: Trata-se de um estudo caso-controle conduzido com 104 crianças e adolescentes. Todos os indivíduos foram avaliados quanto às características antropométricas e parâmetros clínicos, laboratoriais e de polimorfismo genético. A amostra foi selecionada no ambulatório de endocrinologia pediátrica especializado no tratamento da obesidade em crianças e adolescentes de acordo com a classificação do Centers for Disease Control and Prevention (CDC), e os controles foram selecionados no mesmo local, porém no ambulatório de pediatria geral. Resultados: Alguns parâmetros foram associados à obesidade em nosso estudo: cor preta, pais obesos, pais hipertensos e desmame precoce. Níveis aumentados de insulina, triglicerídeos, colesterol total, colesterol LDL, PCR-U, AST, ALT, GGT, T4 Livre, IGF-1, ácido úrico e níveis baixos de colesterol HDL estão associados a uma chance maior de obesidade. A presença de polimorfismos AG/AA na leptina está associada a uma chance 290% (OR 3,9) maior de obesidade, enquanto para os genes da adiponectina as chances são 740% (OR 8,4) maiores. Nessas crianças e adolescentes obesos com haplótipos AG/AA, os níveis séricos de leptina aumentaram e os níveis de adiponectina diminuíram em relação aos eutróficos, já os níveis séricos de TNF-α não se alteraram. Conclusões: Concluiu-se que os polimorfismos AG/AA nos genes da leptina e adiponectina alteram os níveis séricos dessas adipocinas e predispõem à obesidade precoce, e muitos marcadores antropométricos, bioquímicos e hormonais ficam alterados, trazendo consequências para a saúde dessas crianças e adolescentes.

Prevalencia de Cistatina C elevada en pacientes con sobrepeso y obesidad en el noroeste de México

RESUMEN Introducción: en los últimos años se ha reportado un incremento en la prevalencia de obesidad infantil, siendo este un factor de riesgo para enfermedades crónico-degenerativas como la Enfermedad Renal Crónica; por ende, se requieren de biomarcadores endógenos para detectar las alteraciones en el filtrado glomerular, siendo la Cistatina C uno de ellos. Objetivo: Identificar la frecuencia de Cistatina C elevada en pacientes con sobrepeso y Obesidad del noroeste de México. Material y Métodos: se estudió un grupo de infantes de 6 a 12 años, a los cuales según antropometría se clasificó en normopeso, sobrepeso u obesidad. Se obtuvo la somatometria y los niveles de Cistatina C de cada uno de ellos para el cálculo del filtrado glomerular y clasificar la función renal y se buscó asociación entre estas dos condiciones mediante prueba de chi cuadrado. Resultados: de un grupo de 80 pacientes el 51.3% presentó sobrepeso/obesidad; de estos en el 46.3% se reportaron niveles altos de Cistatina C, de acuerdo con el rango de referencia propuesto por Filler 2003. La media para Tasa de Filtración Glomerular (TFG) en el grupo con sobrepeso/obesidad fue de 103.1 ml/min/1.73 m2, comparada con el grupo normopeso de 121.2 ml/min/1.73 m2. La frecuencia de niveles altos de Cistatina C en población con sobrepeso/obesidad fue de 62.9% comparado con un 26.6% en normopeso. Conclusiones: Los Niños de 6 a 12 años con exceso de peso presentan mayor frecuencia de nivel elevado de Cistatina C.

ABSTRACT Introduction: in recent years an increase has been reported in the prevalence of childhood obesity, which is a risk factor for chronic degenerative diseases such as Chronic Kidney Disease; therefore, endogenous biomarkers are needed to detect alterations in glomerular filtration, Cystatin C being one of them. Objective: To identify the frequency of elevated Cystatin C in overweight and obese patients in northwestern Mexico. Materials and Methods: a group of infants aged 6 to 12 years was studied, who according to anthropometry were classified as normal weight, overweight or obesity. Somatometry and Cystatin C levels were obtained from each of them to calculate glomerular filtration rate and classify renal function, and an association between these two conditions was sought using the chi-square test. Results: of a group of 80 patients, 51.3% were overweight / obese; Of these, 46.3% had high levels of Cystatin C, according to the reference range proposed by Filler 2003. The mean Glomerular Filtration Rate (GFR) in the overweight / obese group was 103.1 ml / min / 1.73 m2, compared to the normal weight group of 121.2 ml / min / 1.73 m2. The frequency of high levels of Cystatin C in the overweight / obese population was 62.9% compared to 26.6% in normal weight. Conclusions: Children from 6 to 12 years of age with excess weight have a higher frequency of high levels of Cystatin C.