[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.

[Correlation of uric acid with carotid intima media thickness in obese adolescents]. / Correlación del ácido úrico con el grosor de la íntima media de la carótida en adolescentes con obesidad.

Introduction: Introduction: obesity in the pediatric population is a public health problem. The correlation of uric acid and carotid intima media thickness in adults has been demonstrated. Objective: to identify the correlation of uric acid and carotid intima media thickness in adolescents with obesity. Material and methods: an observational, cross-sectional study was carried out. Patients aged ten to 16 years with a diagnosis of obesity were included. Uric acid, lipid profile and carotid intima media thickness were determined. In relation to the statistical analysis, carotid intima media thickness was correlated with uric acid levels through Spearman's correlation coefficient. Results: one hundred and sixty-nine adolescents were included with a median age of 13 years, without predominance of sex. A positive correlation of uric acid with carotid intima media thickness was identified (r = 0.242, p = 0.001). When stratified according to sex, there was no correlation in women (r = -0.187, p = 0.074), while in men it increased (r = 0.36, p = 0.001) and by pubertal stage, pubertal male adolescents had a positive correlation (p = 0.384, p = 0.002). Conclusion: a weak positive correlation was identified between carotid intimal thickness and uric acid in obese adolescents.

Introducción: Introducción: la obesidad en la población pediátrica es un problema de salud pública. Se ha demostrado la correlación del ácido úrico y el grosor de la íntima media de la carótida en adultos. Objetivo: identificar la correlación del ácido úrico y el grosor de la íntima media de la carótida en adolescentes con obesidad. Material y métodos: se realizó un estudio observacional, transversal. Se incluyeron pacientes de diez a 16 años con diagnóstico de obesidad. Se determinó ácido úrico, perfil de lípidos y grosor de la íntima media carotidea. En el análisis estadístico, se correlacionó el grosor de la íntima media carotídea con los niveles de ácido úrico a través del coeficiente de correlación de Spearman. Resultados: se incluyeron 169 adolescentes con una mediana para la edad de 13 años, sin predominio de sexo. Se identificó una correlación positiva del ácido úrico con el grosor de la íntima media carotídea (r = 0,242, p = 0,001). Al estratificarse de acuerdo con el sexo, no hubo correlación en las mujeres (r = -0,187, p = 0,074), mientras que en los hombres aumentó (r = 0,36, p = 0,001) y por estadio puberal, los adolescentes varones púberes tuvieron una correlación positiva (p = 0,384, p = 0,002). Conclusión: se identificó una correlación positiva débil entre el grosor de la íntima de la carótida y el ácido úrico en adolescentes con obesidad.

Models Predictive of Metabolic Syndrome Components in Obese Pediatric Patients.

BACKGROUND AND AIMS: Components of metabolic syndrome (MetS) are complications caused by abdominal obesity and insulin resistance (IR). Diagnosis of MetS by clinical indicators could help to identify patients at risk of cardiovascular disease and type 2 diabetes. We undertook this study to propose predictive indicators of MetS in obese children and adolescents. METHODS: A cross-sectional study was carried out. After obtaining informed consent and the registration of the study with an institutional research committee, 172 obese patients from an Obesity Clinic, aged 6-15 years, were included. Variables included were waist circumference (WC), glucose, high-density lipoprotein (HDL), triglycerides (TGL), blood pressure, insulin resistance (by homeostatic model assessment HOMA-index), acanthosis nigricans (AN), uric acid, serum glutamic oxaloacetic transaminase (GOT) and alanine transaminase, and hepatic sonogram. International standards for age and sex variables were used. Multivariate analysis was applied. RESULTS: Variables predicted components of MetS in children: HOMA-IR (insulin resistance by HOMA index) was increased by 2.4 in hepatic steatosis, by 0.6 for each unit of SUA (serum uric acid), and by 0.009 for every mg/dL of triglycerides. In adolescents, every cm of waist circumference increased systolic blood pressure by 0.6 mmHg, and each unit of SUA increased it by 2.9 mmHg. CONCLUSIONS: Serum uric acid and waist circumference are useful and accessible variables that can predict an increased risk of cardiovascular disease in obese pediatric patients.

Síndrome metabólico en pacientes con cáncer durante el tratamiento con quimioterapia / Metabolic syndrome in cancer patients under chemotherapy treatment

Introducción. El síndrome metabólico es uno de los principales problemas de salud a nivel mundial del cual no escapan los pacientes con cáncer. Objetivos: conocer y comparar la prevalencia del síndrome metabólico en niños con diferentes neoplasias durante el tratamiento con quimioterapia. Métodos. A través de un estudio prospectivo, longitudinal, comparativo y analítico se realizaron mediciones antropométricas, de indicadores clínicos y sanguíneos del síndrome metabólico a un grupo de pacientes pediátricos con cáncer. El análisis de datos fue con estadística no paramétrica. Resultados. Participaron 58 pacientes. La prevalencia global del síndrome fue de inicio 32.75, y 79.31% al final. Se encontró diferencia entre las 3 mediciones para indicadores del síndrome y número de pacientes positivos a ellos (P <0.05). La tensión arterial, talla y peso mostraron asociación moderada con los perímetros de cintura y cadera. Conclusiones. La prevalencia del síndrome metabólico en el grupo es muy alta, sin mostrar diferencia de acuerdo al tumor.

Introduction. Metabolic syndrome is one of the main health problem worldwide including cancer patients. Objectives. To know and to compare the prevalence of the metabolic syndrome in children with different neoplasms over chemotherapy treatment. Methods. Through prospective, longitudinal, comparative and analytical study, anthropometric, clinical and blood measurements were carried out in a group of pediatrics patients with cancer. Results. Fifty-eight patients participated. The global prevalence of the syndrome was 32.75 at the beginning, and 79.31% at the end. The 3 measurements were different for syndrome indicators as well as the number of positive patients (P <0.05). Blood pressure, height and weight were moderately associated with waist and hip perimeters. Conclusions. The metabolic syndrome prevalence in pediatric cancer patients is very high, with no difference due to cancer type.