Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 14 de 14
Filter
1.
Article in English, Portuguese | LILACS, SES-SP | ID: biblio-1136774

ABSTRACT

ABSTRACT Objective: Asthma and obesity are prevalent and interrelated diseases. In the pediatric population, the effect of systemic inflammation associated to obesity, leading to inflammation of the airways, is currently controversial. Our aim was to compare inflammatory, clinical and spirometric patterns between children with asthma and obesity and those within the normal weight status range. Methods: A total of 79 boys and girls from 6 to 10 years old were selected and divided into four groups: obese asthmatics, non-obese asthmatics, obese non-asthmatics, and non-obese non-asthmatics. In addition to collecting clinical and anthropometric data, all children underwent spirometry and skin prick tests for inhalant allergens. Blood samples for measurement of cytokines and adipokines were also collected. Results: Obese asthmatics had significantly worse control of asthma than non-obese asthmatics (OR 4.9; 95%CI 1.1‒22.1), regardless of sex, physical activity and atopy. No differences in spirometry, Th1 and Th2 cytokines and adipokines levels were observed among the four groups. The prick tests were positive in 81.8 and 80% of non-obese asthmatics and obese asthmatics, respectively. Conclusions: The degree of control of asthma was significantly lower in the obese group, regardless of the findings of no differences in spirometry. Extra-pulmonary factors could be responsible for this symptomatic profile. High positivity of skin test in both groups, which is considered a good marker of atopy, shows a preponderant atopic component in the genesis of asthma, both in children with obesity and in those within the normal weight status.


RESUMO Objetivo: A asma e a obesidade são doenças prevalentes e inter-relacionadas. Na população pediátrica, o efeito da inflamação sistêmica associada à obesidade, levando à inflamação das vias aéreas, é controverso. Nosso objetivo foi comparar padrões inflamatórios, clínicos e espirométricos entre crianças obesas e aquelas com peso normal. Métodos: Setenta e nove meninos e meninas de 6‒10 anos de idade foram selecionados e divididos em quatro grupos: asmáticos obesos, asmáticos não obesos, não asmáticos obesos e não asmáticos não obesos. Além de dados clínicos e antropométricos, todas as crianças foram submetidas a espirometria e testes cutâneos para alérgenos inalantes. Também foram coletadas amostras de sangue para dosagem de citocinas e adipocinas. Resultados: Obesos asmáticos tiveram um controle significativamente pior da asma do que os não obesos (RP 4,9; IC95% 1,1‒22,1), independentemente do sexo, atividade física e atopia. Não foram observadas diferenças nos níveis de espirometria, citocinas Th1 e Th2 e adipocinas entre os quatro grupos. Os testes cutâneos foram positivos em 81,8 e 80% dos não obesos asmáticos e obesos asmáticos, respectivamente. Conclusões: O grau de controle da asma foi significativamente menor no grupo obeso, apesar de não ter havido diferenças nos achados espirométricos. Esse resultado sugere que fatores extrapulmonares podem ser responsáveis por esse perfil sintomático. A alta positividade do teste cutâneo nos dois grupos, considerado um bom marcador de atopia, demonstrou o componente atópico como preponderante na gênese da asma, tanto em crianças com obesidade quanto naquelas com peso normal.


Subject(s)
Humans , Male , Female , Child , Asthma/complications , Spirometry/statistics & numerical data , Pediatric Obesity/complications , Asthma/drug therapy , Asthma/blood , Severity of Illness Index , Brazil , Cross-Sectional Studies , Surveys and Questionnaires , Adrenal Cortex Hormones/therapeutic use , Pediatric Obesity/blood
2.
J. appl. oral sci ; 27: e20180088, 2019. tab, graf
Article in English | LILACS, BBO | ID: biblio-975894

ABSTRACT

Abstract Obesity is considered a risk factor for periodontal health due to the low- grade inflammation promoted by the increased adipose tissue. Objective: This study aimed to determine correlations and associations between gingival inflammation (Simplified Oral Hygiene Index, and Gingival Index), salivary immunoglobulin A (s-IgA), and salivary parameters (salivary flow and osmolality) in normal-weight and overweight/obese children. Material and Methods: Ninety-one children, aged 6 to 12 years old (8.6±1.9 years), were divided into two groups according to their body mass index (BMI), circumferences, skinfold measurements and body fat percentage: normal- weight group (NWG; n =50) and overweight/obese group (OG; n =41). A calibrated examiner performed the clinical examination using the Simplified Oral Hygiene Index, Gingival Index, and salivary collection. Data analysis included descriptive statistics and association tests ( p <0.05). Results: OG presented statistically higher s-IgA values compared with NWG, especially among the obese children ( p <0.05). Significant positive correlations between s-IgA and salivary osmolality in OG ( p <0.05), and between s-IgA and BMI values ( p <0.05) and body fat percentage ( p <0.05) were observed among all the children. Effect size varied from moderate for s-IgA values ( d =0.57) to large for BMI ( d =2.60). Conclusion: Gingival inflammation and salivary parameters were similar for NWG and OG; however, s-IgA presented higher values in OG, with correlations between BMI and body fat percentage.


Subject(s)
Humans , Animals , Male , Female , Child , Saliva/metabolism , Body Mass Index , Overweight/blood , Pediatric Obesity/blood , Gingivitis/blood , Reference Values , Case-Control Studies , Linear Models , Periodontal Index , Adipose Tissue/metabolism , Cross-Sectional Studies , Risk Factors , Statistics, Nonparametric , Overweight/complications , Pediatric Obesity/complications , Gingivitis/etiology
3.
Rev. chil. pediatr ; 89(3): 346-351, jun. 2018. tab
Article in Spanish | LILACS | ID: biblio-959532

ABSTRACT

INTRODUCCIÓN: La presencia de un estado de inflamación de bajo grado en niños obesos, se debería, entre otros factores, a que el tejido adiposo de los obesos produce moléculas proinflamatorias que contribuyen al desarrollo de aterosclerosis. OBJETIVO: Determinar en una población de niños obesos los niveles séricos de ligando CD-40 soluble (sCD40L), proteína quimioatractante de monocitos 1 (MCP-1), interleuquina 6 (IL-6), Factor de Necrosis tumoral a (TNF-a) y Proteína C Reactiva ultrasensible (PCR-us), comparados con un grupo control y analizar la correlación de estas moléculas con las variables antropométricas y metabólicas. PACIENTES Y MÉTODO: Estudio transversal de 37 niños obesos de 8 a 12 años y 20 niños con peso normal. A todos los pacientes se les realizó una historia clínica consignando edad, peso, talla, IMC, circunferencia de cintura, estadios de Tanner y antecedentes familiares. Se determinaron los niveles séricos de sCD40L, MCP-1, IL-6, TNF-a y PCR-us mediante ELISA, PCR-us por quimioluminiscencia, glucemia, insulina plasmática, perfil lipídico y se calculó el índice HOMA. Los datos se expresaron como la mediana y rango intercuartil y se utilizó el coeficiente de Spearman para investigar las correlaciones entre variables. RESULTADOS: Los niños obesos presentaron valores significativamente mayores de sCD40L, MCP-1, IL-6, TNF-a, PCR-us que los niños controles. El índice de masa corporal y la circunferencia de cintura se correlacionaron positivamente con sCD40L y MCP-1. CONCLUSIÓN: Los niveles elevados de las moléculas estudiadas sugieren la presencia de inflamación de bajo grado asociada a obesidad en esta población.


INTRODUCTION: Obesity is a chronic disease that affects adults as well as children and is associated with insulin resistance, type 2 diabetes and cardiovascular disease. One of the reasons for the presence of low-grade inflammation in these patients could be that adipose tissue of the obese produces proin flammatory molecules that favor the development of atherosclerosis. OBJECTIVE: To determine serum levels of soluble CD40 ligand (sCD40L), monocyte chemoattractant protein 1 (MCP-1), interleukin 6 (IL-6), Tumor Necrosis Factor alpha (TNF-Α) and high sensitivity CRP (hsCRP), in an obese chil dren population compared to a control group, also to analyze the correlation of these molecules with the anthropometric and metabolic variables. PATIENTS AND METHOD: A cross-sectional, observational study was carried out on 37 obese children, aged 8 to 12 years, and 20 children with normal weight. Serum levels of sCD40L, MCP-1, IL-6, TNF-Α and hsCRP were determined. Data were expressed as the median and interquartil range and Spearman coefficient was used to investigate correlations between variables. RESULTS: Compared to the control group, obese children presented significantly higher values of sCD40L, MCP-1, IL-6, TNF-Α, and hsCRP than control group. Body mass index and waist circumference correlated positively with sCD40L and MCP-1. CONCLUSION: Elevated levels of the studied molecules studied suggest the presence of low-grade inflammation associated with obesity in this population.


Subject(s)
Humans , Male , Female , Child , Pediatric Obesity/physiopathology , Inflammation/etiology , Biomarkers/blood , Case-Control Studies , Cross-Sectional Studies , Pediatric Obesity/blood , Inflammation/diagnosis , Inflammation/blood
4.
Arch. endocrinol. metab. (Online) ; 62(2): 193-200, Mar.-Apr. 2018. tab, graf
Article in English | LILACS | ID: biblio-887652

ABSTRACT

ABSTRACT Objective To study the effect of using a one time high dose "stoss therapy" of vitamin D2 (ergocalciferol: VD2) on indices of insulin sensitivity {whole body sensitivity index: WBISI} and secretion {insulinogenic index: IGI} measured during an oral glucose tolerance test (OGTT) in obese adolescents with VDD (25 OHD; serum metabolite of vit D: < 30 ng/dL). Subjects and methods In a randomized placebo controlled cross over design 20 obese adolescents with vitamin D deficiency (VDD) had baseline OGTT. Arm A received one time high dose 300,000 IU of ergocalciferol and Arm B received placebo. After 6 weeks the adolescents were reassigned to Arm A if they were in Arm B and vice versa. 25OHD, calcium, parathyroid hormone, comprehensive metabolic panel, urine calcium creatinine ratio were measured at each study visit. OGTTs to assess indices of sensitivity and secretion were done at baseline, 6 weeks and 12 weeks respectively. Results Adolescents were obese and insulin resistant (mean ± SD: mean age = 15.1 ± 1.9 years; BMI: 32.7 ± 9.8; homeostatic model of insulin resistance: HOMA-IR: 4.2 ± 2.8). Stoss therapy with VD2 increased 25OHD from baseline (16.7 ± 2.9 to 19.5 ± 4.5; p = 0.0029) when compared to the placebo. WBISI (2.8 ± 1.9) showed a trend towards improvement in Rx group (p = 0.0577) after adjustment for covariates. IGI (3 ± 2.2) showed an improvement in both Rx and placebo groups. Conclusions Our study demonstrated that using a high dose of VD2 (300,000 IU) did not have any beneficial effect on insulin sensitivity (whole body sensitivity index {WBISI}) and secretory indices (insulinogenic index {IGI}) in obese adolescents. High dose "stoss therapy" of VD2 did not appear to have any beneficial effect on glucose homeostasis on obese adolescents.


Subject(s)
Humans , Male , Female , Adolescent , Vitamin D Deficiency/drug therapy , Vitamins/administration & dosage , Ergocalciferols/administration & dosage , Pediatric Obesity/blood , Vitamin D Deficiency/complications , Vitamin D Deficiency/blood , Blood Glucose/drug effects , Insulin Resistance , Body Mass Index , Cross-Over Studies , Pediatric Obesity/complications , Glucose Tolerance Test , Homeostasis/drug effects
5.
Arch. argent. pediatr ; 116(1): 34-46, feb. 2018. ilus, graf, tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-887431

ABSTRACT

Introducción: La obesidad infantil es una epidemia global. La edad escolar y la adolescencia son etapas cruciales para la implementación de hábitos alimentarios y estilo de vida. Objetivo: Evaluar el estado nutricional, antropométrico, bioquímico e ingesta alimentaria de niños, su relación con factores socioeconómicos y georreferenciación. Métodos: Estudio transversal en escolares de 6 a 14 años, del Partido de General Pueyrredón, durante agosto-noviembre de 2013. Se evaluó la ingesta por recordatorio de 24 horas; se georreferenció con el programa gvSIG. Resultados: Se incluyeron 1296 niños para evaluación antropométrica y socioeconómica. Una sub muestra incluyó 362 niños para parámetros bioquímicos e ingesta. El 42,97% (IC 95%: 40,3-45,7) presentó exceso de peso y el 18,5% (IC 95%: 16,3-20,5), obesidad. Desayunar se relacionó con menor riesgo de exceso de peso (OR: 0,7; IC 95%: 0,5-0,9) y obesidad (OR: 0,7; IC 95%: 0,5-0,9). Concurrir al secundario se asoció a menor prevalencia de exceso de peso (OR: 0,45; IC 95%: 0,3-0,7); el sexo masculino presentó mayor riesgo de obesidad (OR: 1,7; IC 95%: 1,3-2,3). Presentaron anemia 4,44%, hipercolesterolemia 19,6% e hipertrigliceridemia 21,3%. La ingesta de lípidos y grasas saturadas fue alta y de colesterol dietario y fibra, baja. La distribución geográfica fue homogénea. Conclusiones: La prevalencia de exceso de peso fue elevada. El riesgo de obesidad fue mayor en varones; el desayuno surgió como factor protector para sobrepeso/obesidad. La baja ingesta de fibras y elevada de grasas, y los niveles altos de colesterol y triglicéridos en sangre, reflejan que la malnutrición por exceso es un problema de salud pública prevalente.


Introduction: Childhood obesity is a global epidemic. School age and adolescence are critical stages for the implementation of eating and lifestyle habits. Objective: To assess anthropometric and biochemical assessment of nutritional status and dietary intake in children, their relationship with socioeconomic factors and georeferencing. Methods: Cross-sectional study in schoolchildren aged 6-14 years from the District of General Pueyrredon, during August-November 2013. Dietary intake was assessed using a 24-hour dietary recall interview, and georeferencing was done using the gvSIG software. Results: A total of 1296 children were included for anthropometric and socioeconomic assessment. A sub-sample included 362 children for intake and biochemical parameters. Overweight was observed in42.97% (95% confidence interval --#91;CI--#93;: 40.3-45.7) and obesity, in 18.5% (95% CI: 16.320.5). Breakfast was related to a lower risk for overweight (OR: 0.7, 95% CI: 0.5-0.9) and obesity (OR: 0.7, 95% CI: 0.5-0.9). Attending high school was related to a lower prevalence of weight excess (OR: 0.45, 95% CI: 0.3-0.7); male sex posed a higher risk for obesity (OR: 1.7, 95% CI: 1.3-2.3). Also, 4.44% of participants had anemia; 19.6%, hypercholesterolemia; and 21.3%, hypertriglyceridemia. Lipid and saturated fat intake was high, whereas dietary cholesterol and fiber intake was low. Geographic distribution was homogeneous. Conclusions: The prevalence of overweight was high. The risk for obesity was higher among boys; breakfast appeared as a protective factor against overweight/obesity. A low-fiber and high-fat intake, and high blood cholesterol and triglyceride levels reveal that overnutrition is a prevalent public health problem.


Subject(s)
Humans , Male , Female , Child , Adolescent , Body Weight , Nutritional Status , Eating , Waist Circumference , Pediatric Obesity/blood , Argentina/epidemiology , Socioeconomic Factors , Cross-Sectional Studies , Overweight , Pediatric Obesity/epidemiology
6.
Salud pública Méx ; 60(1): 5-11, Jan.-Feb. 2018. tab
Article in English | LILACS | ID: biblio-903849

ABSTRACT

Abstract: Objective: To investigate the correlation among pro- or anti-inflammatory cytokines and the two main gut microbiota phyla in obese children. Materials and methods: Anthropometric data were obtained from 890 children under 14 years old to determine the degree of obesity. Serum cytokine concentration was measured by ELISA. Relative abundance of gut microbiota in feces was evaluated by quantitative Real-Time PCR assays. Results: Anthropometric and biochemical parameters were statistically higher in overweight /obese children than in lean ones. Increased TNF-α levels were found in obese children that also have a high relative abundance of Firmicutes. Conclusions: Obese children have a high relative abundance of Firmicutes that correlates with increased levels of TNF-α. This is the first study that shows a relation between Firmicute abundance and TNF-α serum concentration in obese children.


Resumen: Objetivo: Investigar la correlación entre las citocinas proinflamatorias o antiinflamatorias y los dos principales filos de la microbiota intestinal en niños obesos. Material y métodos: Se obtuvieron mediciones antropométricas de 890 niños de 6 a 14 años; posteriormente se clasificaron en normopeso y sobrepeso/obeso. Las concentraciones séricas fueron medidas por el método de ELISA. La abundancia relativa de la microbiota intestinal en heces se evaluó por PCR tiempo real. Resultados: Los parámetros bioquímicos y antropométricos fueron estadísticamente más altos en niños con sobrepeso / obesidad que en niños delgados. Se encontraron niveles más altos de FNT-α en niños obesos que también tenían una abundancia relativa alta de Firmicutes. Conclusiones: Los niños obesos tienen una alta abundancia relativa de Firmicutes, la cual se correlaciona con un incremento de los niveles de FNT-α. Este es el primer estudio que evalúa la reacción entre la abundancia de Firmicutes y la concentración sérica de FNT-α en niños obesos.


Subject(s)
Humans , Male , Female , Child , Tumor Necrosis Factor-alpha/blood , Pediatric Obesity/microbiology , Pediatric Obesity/blood , Firmicutes/isolation & purification , Gastrointestinal Microbiome , Bacteroides/isolation & purification , Blood Glucose/analysis , Energy Intake , Exercise , Anthropometry , Interleukins/blood , Feces/microbiology , Feeding Behavior , Insulin/blood , Lipids/blood
7.
Bol. méd. Hosp. Infant. Méx ; 74(6): 413-418, nov.-dic. 2017. tab
Article in Spanish | LILACS | ID: biblio-951280

ABSTRACT

Resumen: Introducción: Los niveles bajos de vitamina D se han asociado con una gama de condiciones clínicas como obesidad, resistencia a la insulina y diabetes mellitus. Existen pocos estudios donde se hayan realizado mediciones de la forma activa de la vitamina D (1,25 (OH)2 vitamina D) en niños con obesidad. Sin embargo, los datos publicados no son concluyentes. El objetivo de este estudio fue determinar los niveles de la forma activa de la vitamina D en niños con obesidad y sobrepeso y determinar la asociación entre los niveles bajos de esta vitamina, la obesidad y las alteraciones del metabolismo de la glucosa. Métodos: Estudio transversal analítico en niños de 6 a 12 años de edad con exceso de adiposidad determinado por el índice cintura-estatura y el índice Z de masa corporal. Se midieron niveles de glucosa, insulina, perfil de lípidos completo, modelo homeostático para evaluar la resistencia a la insulina y la forma activa de la vitamina D. Se consideraron como niveles bajos de vitamina D aquellos menores a 30 pg/ml. Resultados: La prevalencia de niveles bajos de la forma activa de la vitamina D fue del 36%. La asociación entre niveles bajos de la forma activa de la vitamina D y niveles altos de insulina resultó estadísticamente significativa. No se encontró asociación significativa entre los niveles de la vitamina y las medidas de adiposidad. Conclusiones: Se encontraron niveles bajos de la forma activa de la vitamina D en el 36% de la población estudiada, y se demostró su asociación con la resistencia a insulina e hiperinsulinemia.


Abstract: Background: Low levels of vitamin D have been associated with a range of clinical conditions such as obesity, insulin resistance, and diabetes mellitus, among others. There are few studies that measure the active form of vitamin D (1,25 (OH)2 vitamin D) in obese children. However, published data are inconclusive. The aim of this study was to determine the active levels of vitamin D in obese and overweight children and to find an association between low levels of vitamin D, obesity and impaired glucose metabolism. Methods: A cross-sectional, analytical study was conducted in 6 to 12-year-old children with excess adiposity determined by waist-stature index and body mass index. Levels of glucose, insulin, complete lipid profile, homeostatic model assessment and the active form of vitamin D were measured in each patient. Levels < 30 pg/ml were considered as low levels of vitamin D. Results: The prevalence of low levels of active vitamin D was 36%. A significant association between low levels of active vitamin D and high levels of insulin was found. No significant association was found between vitamin levels and adiposity measures. Conclusions: Low levels of active vitamin D were found in 36% of the population studied. A significant association with insulin resistance and hyperinsulinemia was demonstrated.


Subject(s)
Child , Female , Humans , Male , Vitamin D/analogs & derivatives , Blood Glucose/metabolism , Overweight/epidemiology , Pediatric Obesity/epidemiology , Vitamin D/blood , Insulin Resistance , Cross-Sectional Studies , Overweight/blood , Adiposity , Waist Circumference/physiology , Pediatric Obesity/blood , Hyperinsulinism/epidemiology , Insulin/metabolism , Lipids/blood , Mexico/epidemiology
8.
Arq. bras. cardiol ; 108(3): 198-203, Mar. 2017. tab, graf
Article in English | LILACS | ID: biblio-838701

ABSTRACT

Abstract Background: Childhood obesity is associated with increased risk of atherosclerosis and cardiovascular disease in adulthood. Increased intima-media thickness (IMT) of the carotid artery is linked to the initiation and progression of the chronic inflammatory processes implicated in cardiovascular disease. Matrix metalloproteinase-9 (MMP-9) plays an important role in the degradation of the extracellular matrix and, consequently, in the development, morphogenesis, repair and remodeling of connective tissues. Objectives: (i) to determine and compare the concentrations of MMP-9, tissue inhibitor of metalloproteinase -1 (TIMP-1), and MMP-9/TIMP-1 ratio in obese and non-obese children and adolescents; (ii) to investigate the association of these markers with common and internal IMT of carotid arteries. Methods: Cross-sectional study involving 32 obese and 32 non-obese (control) individuals between 8 - 18 years of age. Results: Significantly (p < 0.05) higher values of MMP-9 concentration, as well as a higher MMP-9/TIMP-1 ratio were detected in the obese group compared to control counterparts. Common and internal carotid IMT values were significantly higher (p < 0.001) in the obese group compared to the control group. Positive correlations were observed between the common carotid IMT values and MMP-9 concentrations as well as MMP-9/TIMP-1 ratio. Conclusions: Our data demonstrate that obese children and adolescents present higher mean IMT values, plasma MMP-9 and MMP-9/TIMP-1 ratio compared to the non-obese. Thus, these findings indicate that this group presents a risk profile for early atherosclerosis.


Resumo Fundamento: A obesidade infantil está associada a um aumento do risco de aterosclerose e doenças cardiovasculares na fase adulta. O aumento da espessura da íntima-média carotídea (EIMC) está associado ao início e progresso do processo inflamatório crônico envolvido em doenças cardiovasculares. A metaloproteinase-9 da matriz (MMP-9) tem um papel importante na degradação da matriz extracelular e, consequentemente, no desenvolvimento, morfogênese, reparação e remodelação de tecidos conjuntivos. Objetivos: (i) determinar e comparar as concentrações de MMP-9, inibidor de tecido de metaloproteinase-1 (TIMP-1) e a razão MMP-9/TIMP-1 em crianças e adolescente obesos e não obesos; (ii) investigar a associação desses marcadores com a EIM das carótidas interna e comum. Métodos: Estudo transversal com 32 indivíduos obesos e 32 não obesos (controle) entre 8 e 18 anos de idade. Resultados: Foram detectados valores significativamente mais altos (p < 0,05) de concentrações de MMP-9 e da razão MMP-9/TIMP-1 no grupo de obesos em comparação ao grupo de não obesos. Valores de EIM das carótidas comum e interna mostraram-se significativamente mais altos (p < 0,001) no grupo de obesos em comparação ao grupo controle. Correlações positivas foram observadas entre os valores de EIM da carótida comum e concentrações de MMP-9 e razão MMP-9/TIMP-1. Conclusões: Nossos dados demonstram que crianças e adolescente obesos apresentam valores médios mais altos de EIMC, MMP-9 plasmática e da razão MMP-9/TIMP-1 em comparação aos não obesos. Portanto, esses achados indicam que esse grupo apresenta maior risco de aterosclerose precoce.


Subject(s)
Humans , Male , Female , Child , Adolescent , Tissue Inhibitor of Metalloproteinase-1/blood , Matrix Metalloproteinase 9/blood , Carotid Intima-Media Thickness , Pediatric Obesity/pathology , Pediatric Obesity/blood , Reference Values , Biomarkers/blood , Carotid Arteries/pathology , Case-Control Studies , Anthropometry , Cross-Sectional Studies , Risk Factors , Statistics, Nonparametric , Risk Assessment , Atherosclerosis/etiology , Pediatric Obesity/complications
9.
J. pediatr. (Rio J.) ; 92(6): 624-630, Nov.-Dec. 2016. tab, graf
Article in English | LILACS | ID: biblio-829127

ABSTRACT

Abstract Objective: Childhood obesity has been associated with metabolic syndrome and cardiovascular diseases. This study aimed to compare plasma levels of traditional metabolic markers, adipokines and soluble tumor necrosis factor receptor type 1 (sTNFR1) in overweight, obese and lean children. We also assessed the relationships of these molecules with classical metabolic risk factors. Methods: This study included 104 children and adolescents, which were grouped as: lean (n = 24), overweight (n = 30), and obese subjects (n = 50). They were subjected to anthropometrical, clinical and laboratorial measurements. All measurements were compared between groups. Correlation analyses were also performed to evaluate the association between clinical data, traditional metabolic markers, adipokines and sTNFR1. Results: Fasting glucose, insulin, homeostatic model assessment of insulin resistance (HOMA-IR), LDL-cholesterol and triglycerides were comparable in lean, overweight and obese subjects. Plasma levels of sTNFR1 were similar in lean and overweight subjects, but significantly increased in obese group. Leptin, adiponectin and resistin levels did not differ when overweight were compared to obese subjects. However, all adipokines differed significantly when lean subjects were compared to overweight and obese individuals. Plasma levels of adiponectin were negatively correlated with body mass index (BMI), whereas leptin, resistin and sTNFR1 concentrations positively correlated with BMI. Conclusion: Our results showed significant differences in circulating levels of the evaluated markers when lean, overweight and obese individuals were compared, suggesting that these biomarkers may change from lean to overweight and from overweight to obesity.


Resumo Objetivo: A obesidade na infância tem sido associada à síndrome metabólica e a doenças cardiovasculares. O objetivo deste estudo foi comparar níveis plasmáticos de marcadores metabólicos tradicionais, adipocinas e do receptor solúvel de fator de necrose tumoral tipo 1 (sTNFR1) em crianças com sobrepeso, obesas e magras. Também avaliamos as relações dessas moléculas com fatores de risco metabólico clássicos. Métodos: Este estudo incluiu 104 crianças e adolescentes, agrupados da seguinte forma: indivíduos magros (n = 24), com sobrepeso (n = 30) e obesos (n = 50). Eles foram submetidos a medições antropométricas, clínicas e laboratoriais. Todas as medições foram comparadas entre os grupos. Também foram feitas análises de correlação para avaliar a associação entre dados clínicos, marcadores metabólicos tradicionais, adipocinas e sTNFR1. Resultados: Glicemia de jejum, insulina, modelo de avaliação da homeostase da resistência à insulina (HOMA-IR), colesterol LDL e triglicerídeos foram comparáveis em indivíduos magros, com sobrepeso e obesos. Os níveis plasmáticos de sTNFR1 foram similares em indivíduos magros e com sobrepeso, porém significativamente maiores no grupo obeso. Os níveis de leptina, adiponectina e resistina não diferiram quando indivíduos com sobrepeso foram comparados aos obesos. Contudo, todas as adipocinas diferiram significativamente quando indivíduos magros foram comparados a indivíduos com sobrepeso e obesos. Os níveis plasmáticos de adiponectina estavam negativamente correlacionados ao índice de massa corporal (IMC), ao passo que as concentrações de leptina, resistina e sTNFR1 estavam positivamente correlacionadas ao IMC. Conclusão: Nossos resultados mostraram diferenças significativas nos níveis circulantes dos marcadores avaliados ao comparar indivíduos magros, com sobrepeso e obesos. Isso sugere que esses biomarcadores poderão mudar de indivíduos magros para indivíduos com sobrepeso e de indivíduos com sobrepeso para obesos.


Subject(s)
Humans , Male , Female , Child , Adolescent , Receptors, Tumor Necrosis Factor, Type I/blood , Overweight/blood , Adipokines/blood , Pediatric Obesity/blood , Triglycerides/blood , Blood Glucose/analysis , Insulin Resistance , Biomarkers/blood , Body Mass Index , Cross-Sectional Studies , Fasting/blood , Cholesterol, LDL/blood
10.
J. pediatr. (Rio J.) ; 92(5): 532-538, Sept.-Oct. 2016. tab
Article in English | LILACS | ID: lil-796110

ABSTRACT

Abstract Objective: To investigate the relationship between serum thyrotropin (TSH), insulin resistance (IR), and cardiovascular risk factors (CRF) in a sample of overweight and obese Brazilian adolescents. Methods: A retrospective, longitudinal analysis of 199 overweight and obese pubescent adolescents was performed. The TSH and free T4 (fT4) levels, anthropometric measurements, and laboratory test results of these patients were analyzed. Results: 27 individuals (13.56%) presented with TSH levels above the normal level (subclinical hypothyroidism [SCH]). Their waist circumference (WC) was significantly higher than those of euthyroid individuals. Serum TSH was positively correlated with the homeostasis model assessment of insulin resistance (HOMA-IR) index, triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C). Using TSH and BMI as independent variables, TSH levels were shown to be independently related to HOMA-IR (p = 0.001) and TG (p = 0.007). Among euthyroid subjects, individuals with TSH values <2.5 mIU/mL exhibited statistically significant decreases in waist-to-hip ratio, HDL-C levels, and HOMA-IR scores and a tendency toward lower WC values. Conclusion: SCH in overweight and obese adolescents appears to be associated with excess weight, especially visceral weight. In euthyroid adolescents, there appears to be a direct relationship between TSH and some CRF. In conclusion, in the present sample of overweight and obese adolescents, TSH levels appear to be associated with IR and CRF.


Resumo Objetivo Investigar a relação entre tireotrofina sérica (TSH), resistência à insulina (RI) e fatores de risco cardiovascular (FRC) em uma amostra de adolescentes brasileiros acima do peso e obesos. Métodos Foi realizada uma análise longitudinal retrospectiva de 190 adolescentes púberes acima do peso e obesos. Foram analisados os níveis de TSH e T4 livre (T4l), as medidas antropométricas e os resultados de exames laboratoriais desses pacientes. Resultados 27 indivíduos (13,56%) apresentaram níveis de TSH acima do normal (hipotireoidismo subclínico (HSC)). Eles apresentaram circunferência da cintura (CC) significativamente maior que os indivíduos eutireoideos. A TSH sérica foi positivamente correlacionada ao índice do modelo de avaliação da homeostase de resistência à insulina (HOMA-IR), triglicerídeos (TG) e lipoproteína de alta densidade-colesterol (HDL-C). Usando TSH e IMC como variáveis independentes, os níveis de TSH estavam relacionados ao HOMA-IR (p = 0.001) e a TG (p = 0.007) de forma independente. Entre os pacientes eutireoideos, indivíduos com valores de TSH < 2.5 mIU/mL apresentaram reduções estatisticamente significativas na razão cintura/quadril, nos níveis de HDL-C e nos escores de HOMA-IR e tendência a menores valores de CC. Conclusão O HSC em adolescentes acima do peso e obesos parece estar associado ao excesso de peso, principalmente de peso visceral. Em adolescentes eutireoideos, parece haver uma relação direta entre TSH e alguns FRC. Concluindo, em nossa amostra de adolescentes acima do peso e obesos, os níveis de TSH parecem estar associados a RI e FRC.


Subject(s)
Humans , Male , Female , Child , Adolescent , Thyrotropin/blood , Cardiovascular Diseases/blood , Overweight/blood , Pediatric Obesity/blood , Triglycerides/blood , Brazil , Insulin Resistance , Cardiovascular Diseases/complications , Retrospective Studies , Risk Factors , Longitudinal Studies , Overweight/complications , Waist Circumference , Pediatric Obesity/complications , Hypothyroidism/complications , Cholesterol, HDL/blood
11.
Invest. clín ; 57(2): 120-130, jun. 2016. tab
Article in English | LILACS | ID: biblio-841105

ABSTRACT

Obesity is associated with a state of chronic low-grade inflammation. Generally, there are significant correlations between body mass index and increased C-reactive protein levels. We investigated the relationship of high sensitivity C-reactive protein (hsCRP) levels with body adiposity distribution and blood cell count in obese children. A cross-sectional study was performed in 225 Mexican children. In the study were included 106 obese and 119 normal-weight children, aged 6-13 years old. The body composition was evaluated by BMI, body circumferences and skinfold thickness. hsCRP levels and hematological parameters were analyzed in all children. The hsCRP levels were higher in obese children than in the control group (1.5 and 0.41 mg/L respectively, P<0.001). Interestingly, hsCRP levels >3 mg/L were associated with the increase of circumferences of the waist, hip and arms (ORs= 9.08, 6.78 and 8.73, respectively, P<0.001), and a higher thickness of triceps, subscapular and suprailiac skinfolds (ORs= 4.73, 6.39 and 5.26, respectively, P=0.001), as well as a higher leukocyte and platelet counts. The data suggest that hsCRP levels are associated with skinfold thickness and body circumferences, and a moderate relationship was found with leukocyte and platelet counts in the studied children.


La obesidad se asocia con un estado de inflamación crónica de bajo grado. Generalmente, hay correlaciones significativas entre el índice de masa corporal y el incremento en los niveles de la proteína C reactiva (CRP). Se investigó la relación de los niveles de CRP de alta sensibilidad (hsCRP) con la distribución de la adiposidad corporal y la cuenta de las células sanguíneas en niños obesos. Se realizó un estudio transversal en 225 niños mexicanos. En el estudio se incluyeron 106 niños obesos y 119 con peso normal, edad de 6-13 años. La composición corporal fue evaluada por IMC, circunferencias corporales y grosor de pliegues cutáneos. Los niveles de la hsCRP de alta sensibilidad y los parámetros hematológicos fueron analizados en todos los niños. Los niveles de la hsCRP presentaron un incremento en los niños obesos con respecto al grupo control (1,5 y 0,41 mg/L respectivamente, P<0,001). Es interesante que los niveles de hsCRP>3 mg/L se asociaron con mayor circunferencia de cintura, cadera y brazo (ORs= 9,08, 6,78 y 8,73, respectivamente, P<0,001) y mayor grosor de los pliegues como tríceps, subescapular y suprailiaco (ORs= 4,73, 6,39 y 5,26, respectivamente, P=0,001), así como con el aumento en la cuenta de leucocitos y plaquetas. Los datos sugieren que los niveles de la hsCRP se asocian con el grosor de los pliegues cutáneos y las circunferencias corporales y fue encontrada una relación moderada con las cuentas de leucocitos y plaquetas en los niños estudiados.


Subject(s)
Adolescent , Child , Female , Humans , Male , C-Reactive Protein/analysis , Body Fat Distribution , Pediatric Obesity/blood , Blood Cell Count , Cross-Sectional Studies
12.
Invest. clín ; 57(2): 143-157, jun. 2016. tab
Article in Spanish | LILACS | ID: biblio-841107

ABSTRACT

La prevalencia mundial de obesidad infantil ha aumentado considerablemente en las últimas tres décadas. La creciente incidencia en niños de trastornos como diabetes tipo 2, se cree es consecuencia de esta epidemia. Aunque los mecanismos exactos aún no están claros, la producción o secreción de adipocinas causadas por el exceso de tejido adiposo y su disfunción, pueden contribuir al desarrollo de enfermedades metabólicas relacionadas con la obesidad. El objetivo del estudio fue determinar en escolares las concentraciones séricas de interleucina-6 (IL-6) y resistina, y relacionarlas con las medidas antropométricas. Se estudiaron 103 escolares. La evaluación antropométrica incluyó peso, talla, pliegue tricipital (PTr), circunferencia de cintura (CC), índice cintura-talla (C/T) e índice de masa corporal (IMC). Las concentraciones de IL-6 y resistina fueron determinadas según el método ELISA. Los datos fueron analizados con el programa estadístico SPSS versión 20. Se consideró el 95% de confiabilidad estadística (p<0,05). La prevalencia de sobrepeso fue 15,54% y obesidad 11,65%. Los escolares con CC aumentada, índice C/T (sobrepeso/obeso) e IMC (sobrepeso) mostraron valores significativamente más elevados de IL-6. Solo los escolares con CC aumentada e índice C/T (sobrepeso/obeso) mostraron valores promedio más altos de resistina (p<0,05). La interleucina-6 mostró correlación positiva con CC (r=0,229;p=0,020) e índice cintura-talla (r=0,397;p<0,001); la resistina con el índice cintura-talla (r=0,283;p=0,004). Estos resultados sugieren que la CC y el índice cintura-talla son buenos indicadores antropométricos en escolares, pues su incremento se correlaciona de manera positiva con las citocinas proinflamatorias, vinculadas con el aumento del riesgo cardio-metabólico en la población infantil.


The worldwide prevalence of childhood obesity has increased greatly over the past three decades. The increasing occurrence in children of disorders, such as type 2 diabetes, is believed to be a consequence of this obesity epidemic. Although the precise mechanisms are still unclear, dysregulated production or secretion of adipokines caused by excess adipose tissue and adipose tissue dysfunction can contribute to the development of obesity-related metabolic diseases. The objective of the study was to determine the serum levels of interleukin-6 and resistin in relation to anthropometric measurements in school children. One hundred and three school-age children were studied. The anthropometric assessment included weight, height, triceps skinfold (TSF), waist circumference (WC), waist-to-height ratio (WHtR) and Body Mass Index (BMI). Interleukin-6 and resistin levels were measured by ELISA. The data were analyzed using the SPSS version 20 statistical program and 95% CIs (p<0.05) was considered significant. BMI values indicated that 15.54 % of the population was overweight, and 11.65 % was obese. We found that scholars with excess WC, WHtR and BMI (overweight) had higher levels of IL-6 and scholars with excess WC and WHtR had higher levels of resistin (p <0.05). Interleukin-6 showed positive correlation with WC (r=0.229; p = 0.020) and waist-to-height ratio (r=0.397; p<0.001); and resistin with waist-to-height ratio (r=0.283; p= 0.004). These results suggest that WC and waist-to-height ratio are good anthropometric indicators in school children, contributing to early detection and prognosis of metabolic risks in children, due to their positive correlation with pro-inflammatory cytokines (interleukin-6 and resistin).


Subject(s)
Adolescent , Child , Female , Humans , Male , Body Weights and Measures , Interleukin-6/blood , Overweight/blood , Resistin/blood , Pediatric Obesity/blood , Cross-Sectional Studies
13.
Arq. bras. cardiol ; 104(4): 266-273, 04/2015. tab
Article in English | LILACS | ID: lil-745743

ABSTRACT

Introduction: Obesity-related comorbidities are present in young obese children, providing a platform for early adult cardiovascular disorders. Objectives: To compare and correlate markers of adiposity to metabolic disturbances, vascular and cardiac morphology in a European pediatric obese cohort. Methods: We carried out an observational and transversal analysis in a cohort consisting of 121 obese children of both sexes, between the ages of 6 and 17 years. The control group consisted of 40 children with normal body mass index within the same age range. Markers of adiposity, plasma lipids and lipoproteins, homeostasis model assessment-insulin resistance, common carotid artery intima-media thickness and left ventricular diameters were analyzed. Results: There were statistically significant differences between the control and obese groups for the variables analyzed, all higher in the obese group, except for age, high-density lipoprotein cholesterol and adiponectin, higher in the control group. In the obese group, body mass index was directly correlated to left ventricular mass (r=0.542; p=0.001), the homeostasis model assessment-insulin resistance (r=0.378; p=<0.001) and mean common carotid artery intima-media thickness (r=0.378; p=<0.001). In that same group, insulin resistance was present in 38.1%, 12.5% had a combined dyslipidemic pattern, and eccentric hypertrophy was the most common left ventricular geometric pattern. Conclusions: These results suggest that these markers may be used in clinical practice to stratify cardiovascular risk, as well as to assess the impact of weight control programs. .


Fundamento: As comorbidades relacionadas com a obesidade encontram-se patentes em crianças jovens obesas e são, potencialmente, um ponto de partida para as doenças cardiovasculares em adultos jovens. Objetivos: Comparar e correlacionar marcadores de adiposidade com distúrbios metabólicos e alterações cardiovasculares numa coorte de crianças obesas europeias. Métodos: Estudo observacional e transversal de uma coorte composta por 121 crianças obesas de ambos os gêneros, entre 6 e 17 anos de idade. O grupo controle incluiu 40 crianças com índice de massa corporal normal dentro da mesma faixa etária. Analisamos marcadores de adiposidade, lípides e lipoproteínas, o índice de insulino-resistência, a espessura da camada íntima-média da artéria carótida comum e os diâmetros do ventrículo esquerdo. Resultados: Observamos diferenças significativas entre os grupos controle e obeso para todos os parâmetros em análise, com todos os valores mais elevados no grupo obeso, exceto a idade, a lipoproteína de alta densidade e a adiponectina, superiores no grupo controle. No grupo obeso, o índice de massa corporal correlacionou‑se diretamente com a massa ventricular esquerda (r=0,542; p=0,001), com o índice de insulino-resistência (r = 0,378; p = < 0,001) e com a espessura da camada íntima-média da artéria carótida comum (r = 0,378; p = <0,001). Ainda no grupo obeso, 38,1% tinham insulino-resistência, 12,5% apresentavam um padrão de dislipidemia combinada, e hipertrofia excêntrica foi a forma geométrica ventricular mais observada. Conclusões: Os resultados obtidos sugerem que os marcadores analizados podem ser utilizados para aferir risco cardiovascular, assim como para avaliar o impacto analítico e morfológico dos programas de redução de peso. .


Subject(s)
Adolescent , Child , Female , Humans , Male , Adiposity , Dyslipidemias , Insulin Resistance , Pediatric Obesity , Age Factors , Acanthosis Nigricans/complications , Acanthosis Nigricans/diagnosis , Adiponectin/blood , Body Mass Index , Biomarkers/blood , Carotid Intima-Media Thickness , Case-Control Studies , Cross-Sectional Studies , Cardiovascular Diseases/etiology , Cardiovascular Diseases/prevention & control , Dyslipidemias/blood , Dyslipidemias/complications , Hypertrophy, Left Ventricular/pathology , Leptin/blood , Lipoproteins/blood , Pediatric Obesity/blood , Pediatric Obesity/complications , Risk Factors , Sex Factors , Waist Circumference
14.
Arq. bras. endocrinol. metab ; 58(3): 243-250, abr. 2014. tab, graf
Article in Portuguese | LILACS | ID: lil-709348

ABSTRACT

Objetivo : Avaliar o efeito da sibutramina na perda de peso de adolescentes obesos.Sujeitos e métodos : Estudo duplo-cego placebo controlado tipo cross over com duração de 13 meses. Foram incluídos no estudo 73 adolescentes obesos de ambos os sexos com idades entre 10 e 18 anos. A avaliação antropométrica foi realizada a cada 40 dias em média. Os exames laboratoriais e de imagem foram realizados antes, no período de wash-out e ao final dos 13 meses.Resultados : A porcentagem de pacientes que perderam 10% do peso inicial no placebo foi de 46% e, no grupo sibutramina, foi de 75%. Quando usaram o placebo, o peso em média se elevou em 1,61 kg, e o IMC reduziu em média 0,24 kg/m2, enquanto com o uso da sibutramina o peso reduziu em média 4,47 kg e o IMC reduziu em média 2,38 kg/m2 com p < 0,001.Conclusões : A sibutramina induziu significantemente mais perda de peso em adolescentes obesos em comparação ao placebo, sem efeitos colaterais significativos. A curva de evolução ponderal foi diferente de acordo com o momento em que a sibutramina foi introduzida. Esse achado indica que o melhor momento de introdução da sibutramina é quando a adesão começa a falhar. Arq Bras Endocrinol Metab. 2014;58(3):243-50.


Objective : To evaluate the effect of sibutramine on weight loss in obese adolescents.Subjetcs and methods A double-blind controlled study lasting 13 months. The study included 73 obese adolescents of both sexes aged between 10 and 18 years. Laboratory tests and imaging studies were performed before, during wash-out, and at the end of 13 months.Results : The percentage of patients who lost 10% of their initial weight in the placebo group was 46%, and in the sibutramine group was 75%. When placebo was used, average weight rose by 1.61 kg, and BMI decreased by 0.24 kg/m2 whereas with the use of sibutramine, weight decreased by 4.47 kg, and average BMI decreased, 2.38 kg/m2, with p < 0.001.Conclusions : Sibutramine induced significantly more weight loss in obese adolescents compared with placebo, without significant side effects. The weight loss curve was different depending on the moment sibutramine was introduced. This finding indicates that the best time to start sibutramine is when adhesion begins to fail. Arq Bras Endocrinol Metab. 2014;58(3):243-50.


Subject(s)
Adolescent , Child , Female , Humans , Male , Appetite Depressants/therapeutic use , Cyclobutanes/therapeutic use , Pediatric Obesity/drug therapy , Weight Loss/drug effects , Appetite Depressants/adverse effects , Body Mass Index , Blood Glucose/analysis , Cross-Over Studies , Cholesterol/blood , Cyclobutanes/adverse effects , Double-Blind Method , Insulin/blood , Leptin/blood , Patient Safety , Pediatric Obesity/blood , Treatment Outcome , Triglycerides/blood
SELECTION OF CITATIONS
SEARCH DETAIL