[Comparison of serum uric acid and liver enzyme levels in adolescents with obesity and with metabolic syndrome]. / Comparación de los niveles séricos de ácido úrico y enzimas hepáticas entre adolescentes con obesidad y con síndrome metabólico.

INTRODUCTION: a relationship has been observed between elevated levels of liver enzymes and uric acid with the presence of metabolic syndrome (MS) in the pediatric population. OBJECTIVE: to compare serum liver enzyme and uric acid levels between adolescents with and without MS. METHODS: a cross-sectional study was carried out in adolescents with obesity between 10 and 18 years old. Somatometric data, serum insulin, lipid profile, uric acid levels and liver enzymes (aspartate aminotransferase [AST], alanine aminotransferase [ALT] and gamma-glutamyl transferase [GGT]) were analyzed. STATISTICAL ANALYSIS: Student's t test or the Chi-square test was used to evaluate differences between groups. RESULTS: a total of 1095 adolescents with obesity were included (444 with MS and 651 without MS). The group with MS had a higher BMI (with MS 2.28 vs without MS 2.11 p < 0.001), with no difference in body fat (42.9 % vs 42.9 %, p = 0.978). The MS group had significantly higher levels of AST (34.4 vs. 29.5, p = 0.013), ALT (42.2 vs. 34.6, p = 0.003), and uric acid (6.17 vs. 5.74, p = 0.002). comparison to the group without MS. The proportion of ALT (40.5 % vs 29.5 %, p = 0.029) and altered uric acid (58.1 % vs. 45.6 %, p = 0.019) was higher in the MS group. CONCLUSIONS: serum levels of ALT, AST and uric acid in adolescents with obesity and MS were higher compared to those without MS. Altered ALT was a risk factor for SM.

The leptin/adiponectin ratio as prognostic marker for dyslipidemia during 1 year of follow-up in pediatric patients receiving kidney replacement therapy.

Introduction: Background: leptin and adiponectin are associated with cardiovascular disease in chronic kidney disease (CKD) patients and could be useful prognostic factors. Objectives. to explore the usefulness of the leptin/adiponectin ratio (LAR) to predict the presence or worsening of dyslipidemia during 1 year of follow-up in children receiving kidney replacement therapy (KRT). Material and methods: a prospective cohort study was performed. Pediatric KRT patients aged between 8 and 17 years who were undergoing hemodialysis or peritoneal dialysis were included. At enrollment, the lipid profile, adiponectin and leptin levels, and somatometric measurements, including body fat percentage, were determined. At the one-year follow-up, the lipid profile was reassessed. Results: of the 70 patients included, the median age was 13 years, and there was no sex predominance (52.8 % males). At the end of follow-up, the patients were divided into three groups: those without dyslipidemia (WOD), those who developed or experienced worsening of their dyslipidemia (DWD) and those with persistent dyslipidemia (PD). A LAR > 0.85 (OR, 16.7) and body fat percentage (OR, 1.46) were associated with an increased risk of PD and DWD at 12 months, independently of urea level, BMI Z-score, benzafibrate treatment, CKD progression time, and replacement treatment. Conclusions: a LAR > 0.85 and fat body percentage at the beginning of follow-up were strongly associated with the presence, persistence or worsening of dyslipidemia at the 12-month follow-up in children with KRT.

Introducción: Antecedentes: la leptina y la adiponectina se asocian con enfermedad cardiovascular en los pacientes con enfermedad renal crónica (ERC) y podrían ser factores pronósticos útiles. Objetivos: explorar la utilidad del cociente leptina/adiponectina (LAR) para predecir la presencia o empeoramiento de la dislipidemia durante 1 año de seguimiento en niños que reciben terapia de reemplazo renal (TRR). Material y métodos: se realizó un estudio de cohortes prospectivo. Se incluyeron pacientes pediátricos con TRR de entre 8 y 17 años que estaban en hemodiálisis o diálisis peritoneal. Al inicio del estudio se determinaron el perfil lipídico, los niveles de adiponectina y leptina, y las mediciones somatométricas, incluido el porcentaje de grasa corporal. En el seguimiento de un año, se reevaluó el perfil de lípidos. Resultados: de los 70 pacientes incluidos, la mediana de edad fue de 13 años y no hubo predominio de sexo (52,8 % de varones). Al final del seguimiento, los pacientes se dividieron en tres grupos: aquellos sin dislipidemia (SD), aquellos que desarrollaron o experimentaron un empeoramiento de su dislipidemia (ED) y aquellos con dislipidemia persistente (PD). Un LAR > 0,85 (OR: 16,7) y el porcentaje de grasa corporal (OR: 1,46) se asociaron con un mayor riesgo de ED y PD a los 12 meses, independientemente del nivel de urea, la puntuación Z del IMC, el tratamiento con benzafibrato, el tiempo de progresión de la ERC y el tratamiento de reemplazo. Conclusiones: un LAR > 0,85 y el porcentaje de grasa corporal al inicio del seguimiento se asociaron fuertemente con la presencia, persistencia o empeoramiento de la dislipidemia a los 12 meses de seguimiento en niños con TRR.

The leptin/adiponectin ratio as prognostic marker for dyslipidemia during 1 year of follow-up in pediatric patients receiving kidney replacement therapy / Índice leptina/adiponectina como indicador pronóstico de dislipidemia durante 1 año de seguimiento en pacientes pediátricos que reciben terapia de reemplazo renal

Background: leptin and adiponectin are associated with cardiovascular disease in chronic kidney disease (CKD) patients and could be useful prognostic factors. Objectives: to explore the usefulness of the leptin/adiponectin ratio (LAR) to predict the presence or worsening of dyslipidemia during 1 year of follow-up in children receiving kidney replacement therapy (KRT). Material and methods: a prospective cohort study was performed. Pediatric KRT patients aged between 8 and 17 years who were undergoing hemodialysis or peritoneal dialysis were included. At enrollment, the lipid profile, adiponectin and leptin levels, and somatometric measurements, including body fat percentage, were determined. At the one-year follow-up, the lipid profile was reassessed. Results: of the 70 patients included, the median age was 13 years, and there was no sex predominance (52.8 % males). At the end of follow-up, the patients were divided into three groups: those without dyslipidemia (WOD), those who developed or experienced worsening of their dyslipidemia (DWD) and those with persistent dyslipidemia (PD). A LAR > 0.85 (OR, 16.7) and body fat percentage (OR, 1.46) were associated with an increased risk of PD and DWD at 12 months, independently of urea level, BMI Z-score, benzafibrate treatment, CKD progression time, and replacement treatment. Conclusions: a LAR > 0.85 and fat body percentage at the beginning of follow-up were strongly associated with the presence, persistence or worsening of dyslipidemia at the 12-month follow-up in children with KRT. (AU)

Antecedentes: la leptina y la adiponectina se asocian con enfermedad cardiovascular en los pacientes con enfermedad renal crónica (ERC) y podrían ser factores pronósticos útiles. Objetivos: explorar la utilidad del cociente leptina/adiponectina (LAR) para predecir la presencia o empeoramiento de la dislipidemia durante 1 año de seguimiento en niños que reciben terapia de reemplazo renal (TRR). Material y métodos: se realizó un estudio de cohortes prospectivo. Se incluyeron pacientes pediátricos con TRR de entre 8 y 17 años que estaban en hemodiálisis o diálisis peritoneal. Al inicio del estudio se determinaron el perfil lipídico, los niveles de adiponectina y leptina, y las mediciones somatométricas, incluido el porcentaje de grasa corporal. En el seguimiento de un año, se reevaluó el perfil de lípidos. Resultados: de los 70 pacientes incluidos, la mediana de edad fue de 13 años y no hubo predominio de sexo (52,8 % de varones). Al final del seguimiento, los pacientes se dividieron en tres grupos: aquellos sin dislipidemia (SD), aquellos que desarrollaron o experimentaron un empeoramiento de su dislipidemia (ED) y aquellos con dislipidemia persistente (PD). Un LAR > 0,85 (OR: 16,7) y el porcentaje de grasa corporal (OR: 1,46) se asociaron con un mayor riesgo de ED y PD a los 12 meses, independientemente del nivel de urea, la puntuación Z del IMC, el tratamiento con benzafibrato, el tiempo de progresión de la ERC y el tratamiento de reemplazo. Conclusiones: un LAR > 0,85 y el porcentaje de grasa corporal al inicio del seguimiento se asociaron fuertemente con la presencia, persistencia o empeoramiento de la dislipidemia a los 12 meses de seguimiento en niños con TRR. (AU)

[Usefulness of a nutritional strategy on dyslipidemia in pediatric patients with terminal chronic kidney disease]. / Utilidad de una estrategia nutricional sobre la dislipidemia en pacientes pediátricos con enfermedad renal crónica terminal.

Introduction: Background and objective: in chronic kidney disease (CKD) there are several factors that increase the presence of dyslipidemia. The aim of this study was to identify the usefulness of a nutritional intervention, in children with terminal CKD, on dyslipidemia 6 months after intervention start. Materials and methods: a quasi-experiment study (before and after) was performed. End-stage CKD patients on peritoneal dialysis and hemodialysis were included. Each child underwent a determination somatometry, and lipid profile at the beginning and at 6 months of follow-up. A nutritional guide was made with food traffic lights, turning the food that should be consumed in the least amount possible in red. In addition to including life-size food using educational models. To compare the quantitative variables before and after the intervention, the variables were transformed to their logarithm and a paired Student's t-test was applied. Results: a total of 41 patients were analyzed. After the intervention, the parameters in the lipid profile were modified; meanwhile HDL concentrations increased (41.0 mg/dL vs 44.4 mg/dL, p = 0.048), triglyceride concentrations decreased (227.1 mg/dL vs 185.9 mg/dL, p = 0.007), and these changes persist even after excluding patients who were under lipid-lowering treatment (195 mg/dL vs 171.6, p = 0.049). Regarding the state of dyslipidemia, hypertriglyceridemia decreased, without reaching significance (80.5 % vs 62.5 %, p = 0.073). Conclusions: the nutritional intervention improved HDL and triglyceride concentrations 6 months afterwards in children with terminal CKD.

Introducción: Antecedentes y objetivo: en la enfermedad renal crónica (ERC) existen múltiples factores que incrementan la presencia de la dislipidemia. El objetivo fue identificar la utilidad de una intervención nutricional sobre la dislipidemia, en niños con ERC terminal, a los 6 meses del inicio de la intervención. Materiales y métodos: estudio cuasiexperimental (antes y después). Se incluyeron pacientes con ERC terminal en diálisis peritoneal y hemodiálisis. A cada niño se le realizaron una somatometría y un perfil de lípidos al inicio y a los 6 meses de seguimiento. Se realizó un manual de alimentación con semaforización de los alimentos, poniendo de color rojo los alimentos que se deben consumir en la menor cantidad posible, además de incluir alimentos a tamaño real utilizando modelos educativos. Para comparar las variables cuantitativas antes y después de la intervención se transformaron las variables a su logaritmo y se aplicó la "t" de Student pareada. Resultados: se analizaron 41 pacientes. Posteriormente a la intervención se modificaron los parámetros del perfil lipídico; las concentraciones de HDL se incrementaron (41,0 mg/dL vs. 44,4 mg/dL, p = 0,048), mientras que las concentraciones de triglicéridos disminuyeron (227,1 mg/dL vs. 185.9 mg/dL, p = 0,007), lo cual persiste incluso una vez excluidos aquellos pacientes que se encontraban bajo tratamiento hipolipemiante (195 mg/dL vs. 171,6, p = 0,049). En cuanto al estado de dislipidemia, la hipertrigliceridemia disminuyó sin alcanzar la significancia (80,5 % vs. 62,5 %, p = 0,073). Conclusiones: la intervención nutricional mejoró las concentraciones de HDL y triglicéridos pasados 6 meses de la intervención en niños con ERC terminal.