Rapid molecular diagnosis of the Gilbert's syndrome-associated exon 1 mutation within the UGT1A1 gene.

Gilbert's syndrome is suspected in patients with unconjugated hyperbilirubinemia caused by decreased activity of the UDP-glucuronosyltransferase 1A1 (UGT1A1) gene in the absence of abnormal liver function and hemolysis. The major genetic variants underlying Gilbert's syndrome are TATA-box repeats of the promoter region and exon 1 G211A of the coding region, particularly in Asians. The efficacy of DNA melting curve analysis, however, has not been established for the G211A mutation. For rapid and accurate molecular diagnosis of Gilbert's syndrome, DNA melting curve analysis was evaluated for its genotyping capability not only for TATA-box repeats of the UGT1A1 promoter, but also for G211A of UGT1A1 exon 1. TA repeats within the TATA-box sequence and the exon 1 G211A mutation of the UGT1A1 gene were analyzed by DNA melting curve analysis. To evaluate the assay reliability, direct sequencing or polyacrylamide gel electrophoresis was used as a comparative method. All homozygous and heterozygous polymorphisms of A(TA)7TAA within the TATA-box allele and of exon 1 G211A mutants of the UGT1A1 gene were successfully identified with DNA melting curve analysis. DNA melting curve analysis is, therefore, an effective molecular method for the rapid diagnosis of Gilbert's syndrome, as it detects not only TATA-box polymorphisms but also the exon 1 G211A mutation located within the UGT1A1 gene.

Nutritional Status and Renal Function in Relation to Frailty among the Community-Dwelling Elderly Taiwanese Population.

OBJECTIVES: Frailty is a significant public health and clinical issue among the elder population. This study aimed to evaluate the nutritional status and renal function in relation to frailty among elderly Taiwanese. DESIGN: We administered community-based health surveys to the elder population in Chiayi County, Taiwan, from 2017 to 2019. MEASUREMENTS: We measured nutritional status (including serum albumin and total protein levels), renal function (including serum blood urea nitrogen, creatinine, urine protein, and urine creatinine levels), hand grip strength (GS) and calculated appendicular muscle mass (AMM). RESULTS: The study recruited 3739 participants (2139 women). Participants of both sexes with normal GS had higher serum albumin levels and lower urine protein/creatinine ratios (UPCRs). For the men with normal and weak GS, serum albumin levels were 4.15 ± 0.2 and 4.10 ± 0.2 g/dL (p < 0.01), and UPCRs were 123.1 ± 219.6 and 188.7 ± 366.2 (p < 0.001), respectively. GS was positively correlated with serum albumin and urine creatinine levels (r = 0.136 and 0.177, both p < 0.001). AMM was also positively correlated with serum albumin and urine creatinine levels (r = 0.078 and 0.091, both p < 0.001). In the multivariate regression model, for every 1 g/dL increase in serum albumin level, there was a 1.9 and 1.7-kg increase in GS for men and women (p < 0.05 and p < 0.01), respectively. The final model for predicting GS included age, albumin, BUN, and UPCR (urine creatinine for women) which presented a variance of 22.1% and 13.8%, respectively. CONCLUSION: Proper dietary nutritional intake and maintaining renal function are key elements for preventing frailty among elder population in Taiwan.

Combined effect of C-reactive protein gene SNP +2147 A/G and interleukin-6 receptor gene SNP rs2229238 C/T on anthropometric characteristics among school children in Taiwan.

OBJECTIVE: The purpose of this study was to explore the combined effect of the C-reactive protein (CRP) +2147 A/G (rs1205) and interleukin (IL)-6R rs2229238 C/T single-nucleotide polymorphisms (SNPs) on the anthropometric variables of school children in Taiwan. SUBJECTS AND DESIGN: Cross-sectional analyses were performed using the data from the Taipei Children Heart Study-II. After multi-stage sampling, we selected 430 boys and 463 girls with an average age of 13.1 years. We genotyped these individuals for the CRP +2147 A/G and IL-6R rs2229238 C/T SNPs using a TaqMan 5' nuclease assay. Anthropometric characteristics, which included body height, body weight (BW), body mass index (BMI), waist circumference (WC), hip circumference (HC), body fat percentage (BF), and waist circumference to height ratio (WHtR), were measured/calculated. RESULTS: When considering the CRP +2147 A/G polymorphism, GG genotype boys were heavier and had larger BMI, WC, HC, BF and WHtR than A allele carriers. The odds ratio (OR) of larger WHtR in GG genotype boys was 2.14 (95% CI: 1.09-4.21). For the IL-6R rs2229238 C/T polymorphism, T allele carrier girls had larger WC and WHtR than those carrying the CC genotype. The OR of a larger HC for T allele carrier boys was 2.33 (95% CI: 1.16-4.68). Boys with the GG genotype of CRP +2147 A/G and the CC genotype of IL-6R rs2229238 C/T had higher OR for BW, BMI, WC, HC, BF and WHtR than boys who were carriers of the A allele of CRP +2147 A/G and had the CC genotype of IL-6R rs2229238 C/T (OR range=3.86-8.04, all P<0.05). CONCLUSION: Boys who carry the GG genotype of CRP +2147 A/G and the CC genotype of IL-6R rs2229238 C/T have a greater risk of having abnormal BW, BMI, WC, HC, BF and WHtR and of developing obesity than individuals who do not have these genotypes.

Prevalence of obesity in Taiwan.

In Taiwan, the prevalence and problem of obesity has increased significantly in recent decades and has became an important public health issue. In children (12-15 years), the prevalence of obesity (defined as body weight > 120% of mean body weight with age- and gender-specification) was 12.4%, 14.8% and 15.6% among boys and 10.1%, 11.1% and 12.9% among girls in 1980, 1986 and 1996 respectively. A survey of 1500 12-15-year-old children during 1995-1996 in Taipei city found that about 16.6% of boys and 11.1% of girls were obese, while an additional 11.6% of boys and 10.2% of girls were overweight. In adults, using the criteria defined by the Department of Health in Taiwan [overweight as (body mass index) BMI > or = 24 and obese as BMI > or = 27], the age-adjusted prevalence of obesity was 10.5% and 15.9% for men and 13.2% and 10.7% for women from 1993-1996 to 2000-2001. From these data, we found that the prevalence of obesity in Taiwan has increased steadily from 1980 to 2000 especially in children and in men.

Clustering of cardiovascular disease risk factors among obese schoolchildren: the Taipei Children Heart Study.

BACKGROUND: Childhood obesity increases the risk of obesity in adulthood and is associated with cardiovascular disease (CVD) risk factors such as hypertension, diabetes mellitus, and dyslipidemia. OBJECTIVE: We evaluated the clustering of CVD risk factors among obese schoolchildren in Taiwan. DESIGN: After multistage sampling of 85 junior high schools in Taipei, we randomly selected 1366 children (681 boys and 685 girls) aged 13.3 y (range: 12-16 y). Anthropometric, blood pressure (BP), and biochemical CVD risk factors (including blood glucose, lipid, and lipoprotein concentrations) were measured. RESULTS: Boys had a higher body mass index, systolic BP, and glucose concentrations than girls and girls had higher lipid and lipoprotein concentrations than boys. After adjustment for age, obese boys had a significantly higher BP, ratio of total to HDL cholesterol, and glucose, cholesterol, triacylglycerol, HDL cholesterol, LDL cholesterol, apolipoprotein A-I, and apolipoprotein B concentrations than nonobese boys. BP, HDL cholesterol, LDL cholesterol, and ratio of total to HDL cholesterol were significantly different between nonobese and obese girls. Approximately 70% of obese boys had one and 25% had two or more CVD risk factors other than obesity. Obese girls had a significantly higher prevalence of high BP and a higher prevalence of CVD risk factor clustering than nonobese girls. CONCLUSIONS: Boys had higher glucose concentrations and BP and lower lipid concentrations than girls. We found an association between obesity and higher BP and between obesity and blood glucose and lipid concentrations for both sexes. Clustering of CVD risk factors was especially apparent among the obese children. A clustering of CVD risk factors may begin during early adolescence among the obese.

Plasma insulin, leptin, and soluble TNF receptors levels in relation to obesity-related atherogenic and thrombogenic cardiovascular disease risk factors among men.

Obesity is related to cardiovascular disease (CVD) morbidity and mortality, however, the mechanisms for the development of obesity-induced CVD risk remain unclear. Hyperinsulinemia and insulin resistance are considered key components in the metabolic cardiovascular syndrome and as independent risk factors for CVD. Plasma leptin and tumor necrosis factor-alpha (TNF-alpha), two adipocyte products, are also proposed to be associated with the development of CVD risk. The purpose of this study is to evaluate the association of plasma leptin, soluble TNF receptors (sTNF-R), and insulin levels as possible mediators of the effect of obesity on atherogenic and thrombogenic CVD risk factors among men. From the Health Professionals Follow-up Study (HPFS), we selected 268 men, aged 47--83 years, who were free of CVD, diabetes, and cancer (except non-melanoma skin cancer), and who had provided a fasting blood sample in 1994. We measured plasma insulin and leptin levels by radioimmunoassay and sTNF-R levels by ELISA. Men in the highest quintile of body mass index (BMI, mean=30.5 kg/m(2)) were less physically active and had a more adverse cardiovascular lipid and homeostatic profile, as indicated by levels of insulin, triglyceride (TG), tissue plasminogen activator (t-PA) antigen levels, and apolipoprotein A1 (Apo-A1). In a multivariate regression model controlling for age, smoking, alcohol intake, physical activity and diet, BMI was inversely associated with HDL-cholesterol (HDL-C) and Apo-A1 and positively associated with TG, Apo-B and t-PA antigen levels. The associations between BMI and these CVD risk factors were only slightly changed after adjusting for leptin and/or sTNF-R; but were substantially attenuated after controlling for insulin levels. These data suggest that the association between obesity and biological predictors of CVD may be mediated through changes in plasma insulin, rather than leptin or sTNF-R levels. However, plasma leptin may still play a role in CVD through independent effects on lipid metabolism.

The reappraisal of the association of glycosylated hemoglobin A1c (HbA1c) and blood pressure: a hypertension and diabetes study in a Taiwan rural area.

The association of age, body weight, body mass index (BMI) and glycosylated hemoglobin A1c (HbA1c) to blood pressure in the general population of the Ho-long area in Taiwan was examined. A total of 1341 subjects, 746 men and 595 women, aged 40-90 years, were studied. Sex-specific multiple regression analyses were carried out on variables both univariately and significantly associated with blood pressure. Results show HbA1c to be significantly associated with SBP in both males and females before age, weight and/or BMI are adjusted (p < 0.05). After controlling for these confounders, the strength of SBP-HbA1c association was slightly reduced in males, but remained significant. In contrast, there was no significance in females. Moreover, no significant relationship in DBP-HbA1c was found in either sex group. These findings suggest that although a positive correlation was found between HbA1c and SBP, HbA1c or glucose status appeared to be a less important contributing factor in hypertension than age or body weight.

The interrelationship between impaired glucose tolerance and other risk factors for cardiovascular disease: is it a predictor for cardiovascular disease?

Glucose intolerance and cardiovascular risk factors were assessed among 215 subjects aged 27-86 years in Ho-long, Taiwan. An oral glucose tolerance test (OGTT) was normal in 107 subjects, impaired in 41 subjects, and abnormal in 67 subjects (as noninsulin dependent diabetes mellitus, NIDDM). Body fatness, blood pressure, carbohydrate and lipid metabolic factors were examined. One-way ANCOVA was used to compare age- and/or BMI-adjusted differences among these groups. Male subjects with NIDDM and impaired glucose tolerance (IGT) had higher systolic (SBP) and diastolic (DBP) blood pressures, plasma insulin (fasting and 1-hour after OGTT), serum triglycerides (TG), heavier body weight, and larger BMI than normal. IGT subjects were also found to have higher TG, insulin (2-hour) and larger insulin area under curve (IAUC) after OGTT than NIDDM. In females, subjects with NIDDM had higher TG, insulin (fasting and 1-hour after OGTT), and larger IAUC than normal. Moreover, female IGT subjects were also found to have significantly higher SBP, DBP, insulin (1-and 2-hour after OGTT), and larger IAUC than both normal and NIDDM subjects. These results suggest that adverse cardiovascular risk factors are present not only in NIDDM subjects, but also in IGT subjects.

Obesity, leptin and blood pressure among children in Taiwan: the Taipei Children's Heart Study.

BACKGROUND: Obesity is associated with the occurrence of hypertension; however, the mechanisms of obesity-induced high blood pressure (BP) remain unclear. Leptin, the obese (ob) gene product, is associated with the occurrence of obesity and related disorders in humans. The purpose of this study was to evaluate the association between plasma leptin and BP among children. METHODS: After multistage sampling, we randomly selected 1265 children (618 boys and 647 girls) with a mean age of 13.3 years (12 to 16 years old) in this cross-sectional survey. Obesity measurements included body mass index (BMI) and waist-to-hip circumference ratio (WHR). Plasma leptin levels were measured by radioimmunoassay. RESULTS: The mean and median plasma leptin levels were 4.1 and 2.4 ng/mL among boys and 10.1 and 8.8 ng/mL among girls. Children in the highest quintile of leptin level (mean, 11.1 and 19.7 ng/mL for boys and girls, respectively) had higher body weight, BMI, WHR, BP, and insulin levels than children in the lowest quintile (mean, 1.1 and 3.9 ng/mL for boys and girls, respectively). Boys had a higher BMI, WHR, and BP levels, yet had lower leptin levels than girls. In both genders, BMI and plasma leptin levels were significantly positively correlated with BP. In multivariate regression analyses, plasma leptin levels were positively associated with BP; however, this association became insignificant among girls and even inversely associated with systolic BP among boys after adjusting for BMI. CONCLUSIONS: Obesity is positively associated with BP among school children in Taiwan; however, the role of plasma leptin on the development of obesity-related hypertension is still controversial among school children.

Assessment of proteinuria by using the protein/creatinine ratio of single-voided urine.

Quantitative 24-hour urine protein excretion is used in the diagnosis, the monitoring of therapeutic effects and the prognosis of renal disease. However, this method is time-consuming, cumbersome and often inaccurate. Many studies have shown that the single voided urine protein/creatinine (Pr/Cr) ratio relates well with 24-hour urine protein excretion and can be substituted for evaluating some conditions. In our study, 41 patient with renal disease (25 men, 16 women) with a mean age of 43 years (range, 20-79 years), not only collected 24-hour urine, but also collected single voided urine at four different times. There was an excellent correlation between 24-hour urine protein excretion and the single voided urine Pr/Cr ratio at various degrees of creatinine clearance and ranges of proteinuria. The highest correlation was found in urine specimens collected at 16:00 hours with a correlation coefficient (r) of 0.91. Other urine specimens also showed a good relation with a correlation coefficient of above 0.80. The creatinine clearance (Ccr) greater than or equal to 70 ml/min group showed a better relationship than the Ccr less than 70 ml/min group. The proteinuria more than 1.0 g/day group also showed a better relationship than the group with proteinuria of less than 1.0 g/day. However, these differences were not statistically significant. No significant differences between the different age groups or sexes, using the single voided urine Pr/Cr ratio to estimate the 24-hour urine protein excretion were found. It is concluded that the single voided urine Pr/Cr ratio correlates highly with 24-hour urine protein excretion and could be an alternative means for disease monitoring and screening.

The trend of hypertension and its relationship to the weight status among Taiwanese young adolescents.

This study evaluates prevalence of hypertension in 1996 and 2006, and examines the relationship between hypertension and weight of Taiwanese young adolescents. Two cross-sectional surveys, administered in 1996 and 2006, to junior-high school in Taipei were included. Anthropometric and blood pressure were measured using standard methods, and structured questionnaire was used to collect personal history and lifestyle characteristics. Overweight and obesity are defined based on Taiwan's Department of Health criteria and bases pre-hypertension and hypertension on the 90th and 95th percentile distribution of blood pressure of the population of both surveys. The prevalence of pre-hypertension in Taiwan between 1996 and 2006 increased from 12.0 to 14.4% for boys and decreased from 9.5 to 9.4% for girls. Hypertension increased from 22.8-29.7% and 12.5-20.7% for both boys and girls, respectively. In 1996, compared with normal young adolescents, the risk of hypertension for overweight was 1.8 times higher for boys and 3.4 times for girls. However, the risk of hypertension for overweight in 2006 was 1.7 times higher for boys and 1.5 times higher for girls compared with normal. Every unit increment of body mass index and waist circumference was associated with 17-27% and 6-11% risk of hypertension in both genders in 1996, and was associated with 9-13% and 4% risk of hypertension among young adolescents in 2006, respectively. The prevalence of hypertension has increased significantly in young adolescents, especially for overweight. It is necessary to enrol young adolescents in weight management programs to prevent hypertension-related co-morbidities.

Correlation of plasma leptin and adiponectin with insulin sensitivity and beta-cell function in children - the Taipei Children Heart Study.

To investigate the association between plasma leptin and adiponectin and insulin sensitivity in children, 580 school children (294 boys and 286 girls) with mean age of 13.3 years (12-16 years) were randomly selected from the Taipei Children Heart Study. Baseline measurements included body weight, body mass index (BMI), plasma glucose, insulin, proinsulin, leptin and adiponectin levels. Insulin resistance and beta-cell function were assessed using the method of homeostatic model, HOMA-IR and HOMA-beta, respectively. We found that girls had higher levels of plasma leptin, adiponectin and HOMA-beta than boys. There was no significant difference in HOMA-IR between boys and girls. Plasma leptin concentrations were positively correlated with body weight, BMI, insulin and proinsulin concentrations, HOMA-IR and HOMA-beta, whereas plasma adiponectin levels were inversely associated with body weight, BMI and proinsulin levels in both sexes. In girls, adiponectin concentrations were negatively correlated with insulin concentration and HOMA-IR. In multiple regression analyses, plasma leptin was more positively associated with insulin and proinsulin levels, HOMA-IR and HOMA-beta than was adiponectin in boys. This association persisted even after adjusting for body weight, BMI and pubertal status. In conclusion, plasma leptin was more strongly associated with insulin sensitivity and beta-cell function than was adiponectin among children, particularly in boys.

Prevalence and trends of obesity among school children in Taiwan--the Taipei Children Heart Study.

BACKGROUND: In Taiwan, the availability of a high-fat and high-energy diet has steadily risen over the past 30 y, while people have become increasingly sedentary. This lifestyle of poor diet and little physical activity has caused the prevalence of obesity to increase among adults and children. Obesity and associated chronic disease risk factors are becoming important public health issues. The purpose of this study is to evaluate the prevalence and secular trends of being overweight and obese among school children in Taiwan. METHODS: We conducted a cross-sectional survey among junior high school students in Taipei in 1994 to ascertain a representative distribution of demographic, lifestyle and biochemical characteristics, including several cardiovascular disease risk factors. After multistage sampling of 85 junior high schools in Taipei, we randomly selected 1500 children for this survey. We defined being overweight and obese based on ideal body weight (IBW) criteria. Children are considered to be overweight if their body weight is 110-120% of IBW, and obese if their body weight is greater than 120% of IBW within age- and gender-specific strata. RESULTS: In general, obese children have higher blood pressure, plasma glucose and triglyceride levels and lower high-density-lipoprotein cholesterol levels than normal-weight children. From 1980 to 1994, the mean value of body weight increased significantly over increases in body height (especially among boys). Although the percentage of overweight children remained steady from 1980 to 1994 in both genders, the prevalence and trends of obesity increased significantly, especially among boys and older girls. CONCLUSION: From this survey we find that in Taiwan from 1980 to 1994 body weight increased dramatically over body height among school children. The prevalence of obesity also increased significantly, especially among boys, while the percentage of overweight children did not vary. Overall, this study indicates that obesity and the adverse effects of being over the ideal body weight is no longer just a problem of Western countries.

Relationship between single voided urine protein/creatinine ratio and 24-hour urine protein excretion rate among children and adolescents in Taiwan.

BACKGROUND: As there have been few studies conducted on children or adolescents, the purpose of this study was evaluate the relationship between single voided urine protein/creatinine (Up/Ucr) ratio and 24-hour urine protein excretion rate (PER), especially among children and adolescents in Taiwan. METHODS: After multistage random sampling, we collected 1,072 fasting single voided urine samples and 125 24-hour urine samples from seven- to 18-year-old students in Taiwan. We calculated the Up/Ucr of single voided urine samples and the 24-hour PER in urine. RESULTS: The mean value and the 95th percentile of the fasting single voided urine Up/Ucr ratio were 0.118 and 0.235, respectively. The mean value and the 95th percentile of the 24-hour PER were 3.61 and 5.66 mg/h/m2, respectively. There was no significant difference in Up/Ucr ratio between boys and girls. Up/Ucr ratio decreased significantly as age increased. The fasting single voided Up/Ucr ratio was highly correlated with 24-hour PER, with r2 = 0.95 (p < 0.001). CONCLUSIONS: Fasting single voided Up/Ucr ratio is a good marker of 24-hour PER. It is also a simple, easy, convenient and speedy method to measure Up excretion. The single voided Up/Ucr ratio may also serve as a reference for the clinical diagnosis of Up excretion among normal subjects.

Quality of life assessment in end-stage renal disease patients with maintenance hemodialysis therapy.

This is a pilot study assessing the quality of life for a total of twenty uremic patients being treated with maintenance hemodialysis. It includes eight males and twelve females with a mean age of fifty three years, having been on hemodialysis for an average of forty-five months (from five to 143 months). The quality of life study was obtained from a structured questionnaire, which contained 10 categories including: sense of well-being, sense of mood, family life, marriage life, neighborhood relationships, friend relationships, working ability, job condition, intelligence condition and life satisfaction. Each category consisted of 3 to 5 items, with a maximum score of 100 points. Among these 20 patients, the highest score on the quality of life study is marriage life with 80.4 +/- 10.0 points, the lowest score is life satisfaction with 59.7 +/- 15.3 points. There was no significant difference in the scores of quality of life between different sex groups. The scores in the sense of well-being group greater than 60 years were lower than those less than 60 years with a significant difference (P less than 0.05). A significant difference was also found in both the sense of well-being and sense of mood depending on the duration of hemodialysis therapy. Those who received hemodialysis therapy more than 3 years produced better scores in the sense of well-being and sense of mood category than those who received hemodialysis less than 3 years.

Plasma C-reactive protein concentrations in relation to 5-year body weight change among children: the Taipei Children Heart Study.

OBJECTIVE: C-reactive protein (CRP), a nonspecific inflammatory marker, may be associated with the development of cardiovascular disease (CVD) among adults. The purpose of this study is to evaluate the relation between plasma CRP levels and 5-y body weight and body mass index (BMI) change among school children in Taiwan. METHOD: In 1995, we conducted an epidemiological survey to evaluate the anthropometric characteristics and CVD risk factors among 1500, aged 12-15 y, school children in Taipei. We measured plasma high sensitivity CRP levels using nephelometric method. In 2000, we followed these children to evaluate their changes in body height, weight and BMI during 5 y. RESULTS: In general, boys were taller, heavier and had higher BMI than girls at the baseline (1995) and at the 5-y follow-up (2000). Baseline plasma CRP levels were positively correlated with body weight and BMI in both 1995 and 2000. However, plasma CRP levels were negatively correlated with 5-y BMI change in both genders. We further divided the children into three subgroups based on their baseline CRP levels (nondetected, 0.188-1.00 and >1.0 mg/dl). Children in the higher plasma CRP levels (>1.0 mg/dl) were heavier and had higher BMI (both in 1995 and 2000) than those children with nondetected CRP levels. However, children with higher CRP subgroup had a lower 5-y increasing of BMI and there was even a decrease of BMI levels among the higher CRP girls. CONCLUSION: From this prospective study, we found that baseline plasma CRP levels were positively correlated with the baseline and the 5-y follow-up body weight and BMI in both genders. However, plasma CRP levels may not be a good predictor of 5-y body weight and BMI changes among children in Taiwan.

Relationship between plasma leptin levels and lipid profiles among school children in Taiwan--the Taipei Children Heart Study.

Leptin, an adipose tissue-derived of gene product, is important in energy metabolism. However, the role of leptin in the metabolism of lipids is still not clear in humans. The purpose of this study was to evaluate the association of plasma leptin concentrations and lipid profiles among school children in Taiwan. After multistage sampling of 85 junior high schools in Taipei, we randomly selected 1264 children (617 boys and 647 girls) aged 12-16 years for this study. We measured the anthropometric variables, lifestyle factors and biochemical parameters among these children. Anthropometric measurements included body height (BH) and weight (BW) and we calculated body mass index (BMI) as the ratio of the BW to the square of the BH, expressed in kg/m2. Plasma leptin levels were measured by radioimmunoassay. We also measured lipid profiles including serum total cholesterol (CHOL), triglyceride (TG), high density lipoprotein-cholesterol (HDL-C), apolipoprotein-A1 (Apo-A1), apolipoprotein-B (Apo-B), and lipoprotein(a) (Lp(a)) levels, and calculated low density lipoprotein-cholesterol (LDL-C) levels and CHOL to HDL-C ratio (TCHR). Girls had higher leptin, CHOL, TG, HDL-C, (LDL-C), Apo-A1, Apo-B, and Lp(a) levels and lower BMI than boys did. Plasma leptin concentrations were significantly positively correlated with TG, LDL-C, and Apo-B, but negatively with HDL-C and Apo-A1 in both the genders. Children with higher plasma leptin levels (>75th percentiles) have significantly higher TG, HDL-C, LDL-C, TCHR, and Apo-B than those with relatively lower leptin levels. In multivariate regression analyses, the association between plasma leptin level and lipid profiles (such as CHOL, TG, and Apo-B) were still significant (p < 0.05) even after adjusting for BMI among boys. However, this association became attenuated and insignificant among girls. Finally, in the model that included the standard covariates, plasma leptin was the most predictive of CHOL, TG and Apo-B levels among those school children in Taiwan. Our results suggest that plasma leptin and BMI were independently associated with the lipids and lipoprotein profiles among Taiwanese Children. In both genders, children in the top 25% of the leptin distribution have more adverse lipid and lipoprotein profiles.

Plasma leptin concentrations and obesity in relation to insulin resistance syndrome components among school children in Taiwan--The Taipei Children Heart Study.

OBJECTIVE: Leptin, an adipose tissue-derived product of the obesity (OB) gene, is an important regulator of energy metabolism and may be associated with the occurrence of insulin resistance and diabetes in humans. The purpose of this study was to evaluate the association of plasma leptin concentration with obesity and the components of insulin resistance syndrome (IRS) among school children in Taiwan. METHODS: After multistage sampling of 85 junior high schools in Taipei, we randomly selected 1,264 children (617 boys and 647 girls) aged 12-16y. Obesity measurements included body mass index (BMI) and waist-to-hip circumference ratio (WHR). We calculated an IRS summary score for each individual by adding the quartile ranks from the distribution of systolic blood pressure (BP), serum triglyceride (TG), HDL-cholesterol (inverse), and insulin levels. RESULTS: Boys had a higher BMI and WHR, BP and IRS score and lower leptin, insulin, TG and HDL-C levels than girls. BMI, WHR and plasma leptin levels were significantly associated with the IRS summary score and each of its components in both genders. Children with higher plasma leptin levels (> 75th percentiles) have significantly higher BP, TG, insulin levels and IRS score than children with low leptin levels. The associations between plasma leptin level and the IRS components and score were still significant after adjusting for BMI in boys, but less so in girls. In both genders, after adjusting for WHR, plasma leptin levels were still significantly associated with the IRS components and summary score (P< 0.001). The final model that included the standard covariates, BMI and leptin, but not WHR, was the most predictive of the IRS summary score among school children. CONCLUSIONS: Insulin resistance syndrome in childhood, characterized by high blood pressure, dyslipidemia, and hyperinsulinemia, may be an early marker of cardiovascular risk. From the present BMI and leptin in combination are the most predictive markers of insulin resistance syndrome among school children in Taiwan.

Anthropometry and lipoproteins-related characteristics of young adult males in Taiwan.

OBJECTIVES: To investigate the prevalence of obesity and the lipoprotein-related characteristics among young male adults in the Taiwan area. DESIGN AND SUBJECTS: After cluster sampling, a cross-sectional survey with a total of 936 males (mean age 20, 18-24) were enrolled. MAIN OUTCOME MEASURES: The distribution of anthropometric and lipoprotein-related variables and their correlations in young male adults were measured. The prevalence of obesity by different criterion and the lipoprotein characteristics of obese and non-obese were analyzed separately. RESULTS: The prevalence of obesity was 9.6% by the criterion of body weight greater than 20% of ideal body weight, or 12.6% by the criterion of body mass index (BMI) greater than 25. The obese subjects had significantly higher serum total cholesterol (CHOL), triglyceride (TG) and apo-lipoprotein B (apo B) and lower higher density lipoprotein-cholesterol (HDL-C) levels than the non-obese. The apo A1 levels were 141.3 and 141.9 mg/dl and the lipoprotein [a] (Lp[a]) were 17.4 and 17.1 mg/dl in obese and non-obese respectively, the difference being not statistically significant. Pearson correlation coefficients of body weight, body height, BMI, waist circumference, hip circumference and waist-hip ratio (WHR) to lipoprotein variables showed that both BMI and WHR are positively correlated with CHOL, TG and apo B, but negatively correlated with HDL-C. Furthermore the lipoprotein variables were better correlated with BMI than WHR in lean subjects (BMI < 25). However, this phenomenon was quite different in obese (BMI > 25) subjects, where the WHR was more highly correlated with lipoprotein variables than with BMI. CONCLUSION: The prevalence of obesity is slightly higher than reported in previous studies in Taiwan. The obese subjects had various abnormal lipoprotein metabolic characteristics, such as higher CHOL, TG, and apo B and lower HDL-C levels than non-obese subjects. The BMI was more highly correlated with lipoprotein variables than was WHR in lean subjects, but the WHR was more highly correlated with lipoprotein variables than was BMI in obese subjects.