Impact of obesity on metabolic syndrome components and adipokines in prepubertal children

Madeira, Isabel Rey; Carvalho, Cecília N. M.; Mussi, Fernanda Carneiro; Pinto, Liana Wernersbach; Borges, Marcos Antonio; Bordallo, Maria Alice Neves

doi:10.2223/jped.1873

Cited by 24 publications

(26 citation statements)

References 30 publications

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“…Insulin resistance seems to be more related to fragmentation of lipids in several tissues, such as viscera, muscles and liver, than to obesity (27) . In previous studies with the same group of children, we observed a positive correlation of BMIZ with leptin, which refl ects the visceral fat, independent of HOMA-IR, age and HDL-cholesterol (28) .…”

Section: Discussionsupporting

confidence: 55%

“…Another aspect emphasized by some studies is that adiponectin circulates in blood in the form of multimeric complexes, so that the form of high molecular weight, but not of total adiponectin, is inversely correlated with visceral fat in obese children (38) . Regarding the role of adiponectin, in another study with the same group of children, a positive correlation of adiponectin and HDL-cholesterol was found, independent of BMIZ, HOMA-IR, waist, age or sex, which allows speculation that adiponectinemia would be more strongly related to dyslipidemia than to the degree of obesity, and that adiponectin would play an anti-atherogenic role through the interaction with the lipid metabolism (28) .…”

Section: Discussionmentioning

confidence: 93%

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The role of metabolic syndrome components and adipokines in insulin resistance in prepubertal children

Madeira

Bordallo²,

Carvalho³

et al. 2011

Journal of Pediatric Endocrinology and Metabolism

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Objective: Insulin resistance has a central role in the pathophysiology of cardiovascular atherosclerotic disease. Adipose tissue is of capital importance in view of its production of adipokines. The present study aims to determine the association of metabolic syndrome components, which constitute risk factors for cardiovascular atherosclerotic disease, and leptin and adiponectin with insulin resistance in prepubertal children. Methods: We conducted a cross-sectional study involving 197 children. Of these, 112 children were obese, 36 were overweight and 49 had normal weight. The association of sex, waist circumference, Acanthosis nigricans , age, BMI Z -score, serum lipids, leptin and adipocytokines with insulin resistance [defi ned as the homeostatic model assessment for insulin resistance (HOMA-IR) index higher than or equal to 2.5] was investigated using logistic regression. Results: There was positive association of sex (female), age, BMI Z-score, triglycerides and leptin with insulin resistance (p < 0.05). Conclusion: Among the conventional components of metabolic syndrome, the role of BMI Z-score and triglycerides stands out in insulin resistance of prepubertal children. Sex (female), age and leptin also showed to be of major importance.

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Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 93%

The role of metabolic syndrome components and adipokines in insulin resistance in prepubertal children

Madeira

Bordallo²,

Carvalho³

et al. 2011

Journal of Pediatric Endocrinology and Metabolism

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“…Sabe-se que o aumento de gordura visceral é fator de risco para o desenvolvimento de síndrome metabólica 27,28 e que os efeitos adversos do aumento da gordura intra-abdominal incluem resistência à insulina, diabetes tipo 2, dislipidemia e doença cardiovascular [29][30][31] .…”

Section: Discussionunclassified

Normalization of height and excess body fat in children with salt-wasting 21-hydroxylase deficiency

et al. 2011

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Objective: To evaluate growth and body composition of patients with the salt wasting form of classical congenital adrenal hyperplasia due to 21-hydroxylase deficiency and to compare them with healthy children.Methods: Twenty-one prepubertal patients (eight boys and 13 girls) between 2.1 and 10.2 years and 67 prepubertal healthy controls (36 boys and 31 girls) between 1.2 and 11.7 years were included. Weight, height, upper-arm circumference, skinfolds, body composition determined by bioimpedance, and bone age were measured. The following data were obtained from the medical records: parents' height, serum levels of 17-hydroxyprogesterone and Δ4-androstenedione, prescribed hydrocortisone doses, weight and length at birth, in the beginning of the treatment, and at 2 years. Results:Patients had lower weight and length z scores at the first appointment compared with the same data at birth, showing recovery after the beginning of the treatment without advanced bone age. Mean height z score was higher in controls (0.28±0.86) than in patients (-0.61±0.99, p < 0.001); this difference disappeared when the patients' height was adjusted to their bone age (0.33±1.68, p = 0.912). Patients had higher body mass index (p < 0.001), fat mass (p < 0.001), and fat mass index (p < 0.001) than controls. There was no difference in the skinfolds between the two groups (p = 0.157). Conclusions:Patients had growth recovery with mean height similar to the general population; however, they had higher body fat, which seems to be visceral, since there was no difference between the skinfolds of both groups. J Pediatr (Rio J). 2011;87(3):263-268:Congenital adrenal hyperplasia, adrenal, body composition, growth, child. ResumoObjetivo: Avaliar crescimento e composição corporal de portadores da forma clássica perdedora de sal da hiperplasia adrenal congênita por deficiência da 21-hidroxilase, comparando-os com crianças saudáveis. Métodos:Foram incluídos 21 pacientes (oito meninos e 13 meninas), entre 2,1 e 10,2 anos, e 67 controles pré-púberes (36 meninos e 31 meninas), entre 1,2 e 11,7 anos. Avaliou-se peso, estatura, perímetro braquial, dobras cutâneas, composição corporal por bioimpedância e idade óssea. Foram obtidas dos prontuários dos pacientes as seguintes informações: estatura dos pais, valores de 17-OH progesterona e Δ4-androstenediona, dose de hidrocortisona prescrita, dados de peso e estatura ao nascimento, no início do tratamento e aos 2 anos de idade. Resultados:Os pacientes apresentaram menor escore z de peso e de altura na primeira consulta em relação à situação de nascimento, com posterior recuperação após o início do tratamento, sem apresentar avanço da idade óssea. A média do escore z da altura dos controles (0,28±0,86) foi maior que a dos casos (-0,61±0,99, p < 0,001). Essa diferença desaparece quando se ajusta a altura dos pacientes para a idade óssea (0,33±1,68, p = 0,912). Os pacientes apresentaram maiores índices de massa corporal (p < 0,001), massa gorda (p < 0,001) e índice de massa gorda (p < 0,001) do que os contr...

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“…Se antes era considerada uma sín-drome tipicamente do adulto, com o aumento das taxas de obesidade infantil e em adolescentes, a presença de componentes da SM ocorre em idades cada vez mais tenras. [20][21][22] A patogênese da agregação dos componentes da SM ainda não está totalmente conhecida e, até o momento, não se encontrou um mecanismo único. Acredita-se que a resistência insulínica e o excesso de tecido adiposo visceral (denominado obesidade visceral) sejam os mecanismos iniciais mais importantes.…”

Section: Obesidadeunclassified

Fatores de risco cardiovasculares em crianças obesas

Mussi

Bordallo

Madeira

et al. 2014

Revista Hospital Universitário Pedro Ernesto

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ResumoDesde os anos pré-púberes, crianças com excesso de peso são expostas precocemente a fatores de risco cardiovascular que atuam de forma negativa no endotélio vascular e na íntima-média dos vasos, levando ao início da doença aterosclerótica nessa faixa etária. Esta revisão tem por objetivo trazer ao conhecimento dos profissionais de saúde a importância da identificação e da intervenção terapêutica precoces em crianças com excesso de peso, sabidamente em risco para a instalação da síndrome metabólica, na tentativa de evitar a evolução para doenças crônicas, em especial para as doenças cardiovasculares. Atualmente a obesidade atinge todas as faixas etárias da população e, assim como nos adultos, vem alcançando proporções epidêmicas nas crianças e adolescentes, já sendo considerada um dos desafios mais sérios de saúde pública no século XXI. Ao contrário do que se acreditava, que crianças obesas não apresentavam risco cardiovascular até atingirem a idade adulta, os estudos apontam que a aterosclerose se inicia na infância. A constatação de que o excesso de peso na infância e os fatores de risco a ele relacionados persistem até a vida adulta foi documentada em ao menos três grandes estudos de coorte: o Muscatine Study, o Cardiovascular Risk in Young Finns Study e o Bogalusa Heart Study. O tempo de exposição aos múltiplos fatores de risco nessa etapa da vida até a adultícia parece estar diretamente associado à morbimortalidade por doença cardiovascular. A demonstração de que as doenças cardiovasculares podem ter sua origem na infância leva à necessidade de que seus fatores de risco sejam amplamente investigados nesse período, com o objetivo de planejar intervenções cada vez mais precoces e possivelmente mais efetivas, reduzindo no futuro a morbimortalidade por doenças cardiovasculares.Descritores: Criança; Obesidade; Fatores de risco; Doenças cardiovasculares. AbstractPrepubertal children with excess weight are already exposed to cardiovascular risk factors that affect negatively the vascular endothelium and the intima media of the blood vessels inducing atherosclerotic changes. The objective of this review is to bring to the attention of health professionals the importance of early identification and intervention in children with excess weight, a known risk factor for metabolic syndrome, with the goal of preventing the development of chronic diseases, especially cardiovascular diseases. Obesity affects people of all ages and is considered an epidemic in children and adolescents, already the most important health challenge of the 21st century. Previously considered an adult disease, atherosclerosis is now believed to initiate during childhood. The proof that excess weight and its cardiovascular risk factors persist to adulthood came from at least three large cohort studies: the Muscatine Study, the Cardiovascular Risk in Young Finns Study, and the Bogalusa Heart Study. The length of time exposed to the multiple risk factors during this stage of life seems to be directly associated to cardiovascular disease morbimo...

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Impact of obesity on metabolic syndrome components and adipokines in prepubertal children

Cited by 24 publications

References 30 publications

The role of metabolic syndrome components and adipokines in insulin resistance in prepubertal children

The role of metabolic syndrome components and adipokines in insulin resistance in prepubertal children

Normalization of height and excess body fat in children with salt-wasting 21-hydroxylase deficiency

Fatores de risco cardiovasculares em crianças obesas

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