Estimated glomerular filtration rate and cardiometabolic risk factors in a longitudinal cohort of children

Xargay-Torrent, Sílvia; Puerto-Carranza, Elsa; Marcelo, Irene; Mas-Parés, Berta; Gómez-Vilarrubla, Ariadna; Martínez-Calcerrada, José-María; Zegher, Francis de; Ibáñez, Lourdes; López‐Bermejo, Abel; Bassols, Judit

doi:10.1038/s41598-021-91162-x

Cited by 5 publications

(5 citation statements)

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“…In this study, 744 apparently healthy school-age children (coming from the general population and without a prior diagnosis of disease) were seen in a primary care setting (primary care centers of Girona and Figueres, both regions in Northeastern Spain) and recruited between 2009 and 2015 in a prospective longitudinal study of obesity and cardiovascular risk factors in children [ 12 , 13 ].…”

Section: Methodsmentioning

confidence: 99%

Body surface area-based kidney length percentiles misdiagnose small kidneys in children with overweight/obesity

et al. 2022

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Background We evaluated the diagnostic performance of height-, age- and body surface area (BSA)-based kidney length (KL) percentiles in the identification of at least one small kidney (KL < 3rd) and in the prediction of reduced estimated glomerular filtration rate (eGFR) and/or elevated blood pressure (BP) in children with and without overweight (OW)/obesity(OB). Methods In this cross-sectional study, 744 apparently healthy children (mean age 8.3 years) were recruited in a primary care setting. Clinical data were collected, and serum creatinine and KL were measured. Height-, age- and BSA-based percentiles of KL were calculated and the association of at least one small kidney per subject with reduced eGFR and/or elevated BP was explored by logistic regression. Results Two hundred fifty-seven out of seven hundred forty-four (34.5%) subjects were OW/OB and 127 (17.1%) had reduced eGFR or elevated BP. In separate analyses in children with OW/OB, the KL percentiles calculated on the basis of BSA were lower compared with height- and age-based KL percentiles. Consequently, the prevalence of a small kidney was significantly higher when evaluating percentiles of KL based on BSA compared with other percentiles. In logistic regression analysis, a small kidney was significantly associated with reduced eGFR and/or elevated BP only when using height-based KL percentiles. The KL percentiles according to BSA for the ideal weight (iBSA) showed similar performance compared with height-based percentiles. No differences in the diagnostic performance of different percentiles were found in children with normal weight. Conclusions BSA-based percentiles underestimate KL in children with OW/OB. In these subjects, the use of height-based or iBSA-based percentiles should be preferred. Graphical abstract

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Section: Methodsmentioning

confidence: 99%

Body surface area-based kidney length percentiles misdiagnose small kidneys in children with overweight/obesity

et al. 2022

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“…A study population of 208 apparently healthy school-age children (107 girls and 101 boys) were consecutively recruited among those seen in primary care settings in Girona, a region in North-eastern Spain, as previously reported ( 11 ). A follow-up visit was offered to all the families after 4 years of the initial baseline visit, and longitudinal follow-up data was available in all the studied children.…”

Section: Methodsmentioning

confidence: 99%

“…Clinical examination followed by venous blood sampling in the fasting state was performed in the morning as previously reported ( 11 ). Briefly, weight and height were measured with a calibrated scale and a Harpenden stadiometer, respectively.…”

Section: Methodsmentioning

confidence: 99%

Higher levels of serum α-Klotho are longitudinally associated with less central obesity in girls experiencing weight gain

Carreras-Badosa,

Puerto-Carranza,

Mas-Parés

et al. 2023

Front. Endocrinol.

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IntroductionKlotho is an anti-aging protein that reduces adiposity and increases caloric expenditure, among others. Although associations between secreted α-Klotho levels and obesity have been described, its relationship with central obesity and visceral fat accumulation during childhood is poorly understood. Our objective was to study the longitudinal associations between serum α-Klotho concentrations and obesity-related parameters in apparently healthy children.Subjects and methodsWe studied a cohort of 208 apparently healthy school-age children (107 girls and 101 boys) assessed at baseline (mean age 8.5 ± 1.8 years) and at follow-up 4 years later. Serum α-Klotho concentrations were measured at baseline in all subjects. Obesity-related parameters, such as BMI, waist circumference, body fat, visceral fat, triglyceride levels, HOMA-IR index, and C-reactive protein were studied. Boys and girls were classified into 3 groups according to weight change between baseline and follow-up visits: weight loss, stable weight, or weight gain (based on a BMI-SDS change cut-off > 0.35 SD).ResultsIn girls (N=107), but not in boys, we observed negative associations of serum α-Klotho protein with BMI, waist circumference, body fat, visceral fat, HOMA IR index, and C-reactive protein at baseline and also at follow-up. The associations of α-Klotho and obesity-related parameters were more evident in girls who exhibited weight gain. In such girls, multivariate regression analyses (adjusting for age, puberty and baseline weight/height ratio) showed that α-Klotho protein was negatively associated with follow-up BMI, waist circumference, and visceral fat (p = 0.003 to 0.028). For each 1 SD-increase in baseline α-Klotho, follow-up waist circumference decreased by 4.15 cm and visceral fat by 1.38 mm.ConclusionsIn school-age girls, serum α-Klotho concentrations are longitudinally related to a more favorable metabolic profile. In girls experiencing weight gain, α-Klotho may prove to be a protective factor against the accumulation of visceral fat.

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“…A review of the data on thyroid function in 599 apparently healthy school-age children (291 girls and 308 boys) was performed. Subjects were consecutively recruited among those seen in primary care settings in Girona and Figueres, regions in North-eastern Spain, as previously reported ( 14 ). A follow-up visit was offered to all the families after 4 years of the initial baseline visit, and follow-up data were finally available in 270 of the children (141 girls and 129 boys).…”

Section: Methodsmentioning

confidence: 99%

“…A clinical examination followed by venous blood sampling in the fasting state was performed in the morning as previously reported ( 14 ).…”

Section: Methodsmentioning

confidence: 99%

Circulating free T3 associates longitudinally with cardio-metabolic risk factors in euthyroid children with higher TSH

Carreras-Badosa,

Puerto-Carranza,

Mas-Parés

et al. 2023

Front. Endocrinol.

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IntroductionThyroid hormones play major roles in the regulation of body composition and metabolism, and therefore, the relationship between thyroid hormones and cardio-metabolic risk has been extensively studied in adults. In this study, we aimed to test whether free triiodothyronine (fT3) associates longitudinally with cardio-metabolic risk factors in euthyroid children.MethodsA prospective study cohort of 599 apparently healthy school-age children were assessed at baseline (mean age 8.1 ± 2.1 years), of whom 270 children were also assessed at follow-up (4 years later). Circulating thyroid-stimulating hormone (TSH), free thyroxine (fT4), and fT3 were measured, and cardio-metabolic risk was assessed by means of body mass index (BMI), waist circumference, visceral fat (by ultrasound), blood pressure, circulating lipids, and homeostasis model assessment of insulin resistance (HOMA-IR) index, both at baseline and at follow-up.ResultsAll studied children had normal thyroid function tests. Independent associations between baseline fT3 and both baseline and follow-up BMI, systolic blood pressure, mean arterial blood pressure, triglycerides, and HOMA-IR were found using multivariate regression analysis (adjusting for sex and baseline age and BMI). Analyses of effect sizes showed that for each 1 unit-increase in baseline fT3 (pg/ml), follow-up BMI–standard deviation score (SDS) increased by 0.31 units (z-score) and systolic blood pressure by 6.6 units (mmHg). The observed longitudinal associations were more robust in children belonging to the upper TSH tertile who showed higher TSH levels and were characterized by weighing more and having the highest fT3 levels. In these children, for each 1 unit-increase in baseline fT3 (pg/ml), follow-up BMI-SDS increased by 0.67 units (z-score) and systolic blood pressure by 10.2 units (mmHg).ConclusionsCirculating fT3 associates longitudinally with cardio-metabolic risk factors in euthyroid children with higher TSH. The observed associations of thyroid hormones in these children could conceivably respond to a homeostatic attempt to reduce their cardio-metabolic risk.

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Estimated glomerular filtration rate and cardiometabolic risk factors in a longitudinal cohort of children

Cited by 5 publications

References 32 publications

Body surface area-based kidney length percentiles misdiagnose small kidneys in children with overweight/obesity

Body surface area-based kidney length percentiles misdiagnose small kidneys in children with overweight/obesity

Higher levels of serum α-Klotho are longitudinally associated with less central obesity in girls experiencing weight gain

Circulating free T3 associates longitudinally with cardio-metabolic risk factors in euthyroid children with higher TSH

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