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OBJECTIVE: To describe the 25-hydroxyvitamin D [25(OH)D] concentrations in children and adolescents and to verify the association with the body mass index z-score (ZBMI), lipid profile and Homeostasis Model Assessment-Insulin Resistance (HOMA-IR). METHOD: Cross-sectional study with 170 children and adolescents aged between 4 and 15 years (106 normal weight and 64 overweight) from a public institution in Santo André-Brazil. Weight, height and waist circumference were verified and ZBMI and waist-to-height ratio (WHtR) were calculated. Biochemical analysis: 25(OH)D levels [deficiency: 25(OH)D < 20 ng/ml]; glycemia and insulin (HOMA-IR), lipid profile and ultra-sensitive C-reactive protein. RESULTS: Mean age was 8.37 ± 3.17 years; 89 (52.4%) were male; 77 (45.3%) Caucasians and 121 (71.2%) pre-pubescent. Overweight was observed in 64 (37.6%), dyslipidemia in 108 (63.5%) and 25(OH)D deficiency in 117 (68.8%) of the individuals. ZBMI (r = -0.209; p = 0.006), WHtR (r = -0.154; p = 0.045), triglycerides (TGs) (r = -0.161; p = 0.037) and TGs/high-density lipoprotein (HDL) ratio (r = -0.168; p = 0.028) were inversely correlated with 25(OH)D concentrations. Overweight children and adolescents were four times more likely to have vitamin D deficiency (odds ratio = 4.28; 95% confidence interval 1.152 to 4.907; p = 0.019), after adjustment for pubertal development (prepubertal), sex (male), HDL-c (<45 mg/dl), non-HDL (>120 mg/dl), TG/HDL ratio (>2.0) and HOMA-IR. CONCLUSIONS: A high prevalence of vitamin D deficiency (68.8%) was observed. There was an independent association between vitamin D deficiency and overweight, not observed for dyslipidemia and insulin resistance. The data point to the need for periodic monitoring of serum concentrations of 25(OH)D and reinforcement of guidelines for combating and preventing overweight in the pediatric age group.
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Resistencia a la Insulina , Deficiencia de Vitamina D , Adolescente , Índice de Masa Corporal , Calcifediol , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Masculino , Sobrepeso/epidemiología , Triglicéridos , Vitamina D , VitaminasRESUMEN
OBJECTIVE: To compare serum amyloid A concentrations between overweight and eutrophic children and adolescents and to relate it to lipid profiles, glucose tolerance, and carotid intima-media thickness. METHODS: One hundred children and adolescents (mean age: 10.8±3.16 years) were included and divided into two groups: overweight and non-overweight. The following were evaluated: Z-score body mass index, carotid intima-media thickness, lipid metabolism biomarkers (lipid profile and apolipoproteins A1 and B), inflammatory biomarkers (ultra-sensitive C-reactive protein and serum amyloid A), and glucose homeostasis model assessment of insulin resistance. RESULTS: The groups were homogeneous in age, sex, and pubertal stage. Higher levels of triglycerides, apolipoprotein B, homeostasis model assessment of insulin resistance, ultrasensitive C-reactive protein, serum amyloid A, and carotid intima-media thickness were observed in the overweight group. In the multivariate analysis, age (OR=1.73; 95%CI: 1.16-2.60, p=0.007), Z-score body mass index (OR=3.76; 95%CI: 1.64-8.59, p=0.002), apolipoprotein-B (OR=1.1; 95%CI: 1.01-1.2, p=0.030), and carotid intima-media thickness (OR=5.00; 95%CI: 1.38-18.04, p=0.014) were independently associated with serum amyloid A levels above the fourth quartile of the studied sample (>9.4mg/dL). CONCLUSION: Overweight children and adolescents had higher serum amyloid A concentrations than eutrophic children. There was an independent association between higher concentrations of serum amyloid A and Z-score, body mass index, apolipoprotein B, and carotid intima-media thickness, indicating the importance of this inflammatory biomarker in identifying the early risk of atherosclerosis.
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Grosor Intima-Media Carotídeo , Resistencia a la Insulina , Humanos , Adolescente , Niño , Proteína C-Reactiva , Proteína Amiloide A Sérica , Glucosa , SobrepesoRESUMEN
OBJECTIVE: To evaluate whether there is an association between the body mass index z-score and waist-to-height ratio of children and adolescents. METHODS: This was a cross-sectional study conducted in a school in Santo André, SP, between June and August 2019. Body mass index was measured for all participants, adopting the z-score cutoff of +2 recommended by the World Health Organization. The waist-to-height ratio was determined in children over two years of age and considered abnormal when ≥0.5. The qualitative variables are presented as absolute numbers and percentages. To compare qualitative data, we used the χ2 test or Fisher's exact test. Pearson's test was applied to assess the correlation between BMI and waist-to-height ratio. The level of significance adopted was 5%. RESULTS: The body mass index was calculated for 518 children and the waist-to-height ratio for 473 children. Regarding body mass index, 60.6% of the participants had normal weight, 3.1% were underweight, and 36.3% were overweight. overweight (24.7%) and obesity (22.7%) were more prevalent in adolescents. The waist-to-height ratio was abnormal in 50.5% of the sample. There was an increasing association between body mass index and waist-to-height ratio with age, according to the Pearson correlation coefficients for the age groups <5 years (r=0.459; p<0.001), 5 to 10 years (r=0.687; p<0.001) and >10 years (r=0.805; p<0.001). CONCLUSION: There was a significant correlation between body mass index and waist-to-height ratio. This association was higher in adolescents. The waist-to-height ratio is easy to apply and may be useful as a predictor of cardiometabolic risk.
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Obesidad , Sobrepeso , Adolescente , Estatura , Índice de Masa Corporal , Niño , Preescolar , Estudios Transversales , Humanos , Sobrepeso/epidemiología , Factores de Riesgo , Delgadez , Circunferencia de la CinturaRESUMEN
ABSTRACT Objective To compare serum amyloid A concentrations between overweight and eutrophic children and adolescents and to relate it to lipid profiles, glucose tolerance, and carotid intima-media thickness. Methods One hundred children and adolescents (mean age: 10.8±3.16 years) were included and divided into two groups: overweight and non-overweight. The following were evaluated: Z-score body mass index, carotid intima-media thickness, lipid metabolism biomarkers (lipid profile and apolipoproteins A1 and B), inflammatory biomarkers (ultra-sensitive C-reactive protein and serum amyloid A), and glucose homeostasis model assessment of insulin resistance. Results The groups were homogeneous in age, sex, and pubertal stage. Higher levels of triglycerides, apolipoprotein B, homeostasis model assessment of insulin resistance, ultrasensitive C-reactive protein, serum amyloid A, and carotid intima-media thickness were observed in the overweight group. In the multivariate analysis, age (OR=1.73; 95%CI: 1.16-2.60, p=0.007), Z-score body mass index (OR=3.76; 95%CI: 1.64-8.59, p=0.002), apolipoprotein-B (OR=1.1; 95%CI: 1.01-1.2, p=0.030), and carotid intima-media thickness (OR=5.00; 95%CI: 1.38-18.04, p=0.014) were independently associated with serum amyloid A levels above the fourth quartile of the studied sample (>9.4mg/dL). Conclusion Overweight children and adolescents had higher serum amyloid A concentrations than eutrophic children. There was an independent association between higher concentrations of serum amyloid A and Z-score, body mass index, apolipoprotein B, and carotid intima-media thickness, indicating the importance of this inflammatory biomarker in identifying the early risk of atherosclerosis.
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SUMMARY OBJECTIVE: To evaluate whether there is an association between the body mass index z-score and waist-to-height ratio of children and adolescents. METHODS: This was a cross-sectional study conducted in a school in Santo André, SP, between June and August 2019. Body mass index was measured for all participants, adopting the z-score cutoff of +2 recommended by the World Health Organization. The waist-to-height ratio was determined in children over two years of age and considered abnormal when ≥0.5. The qualitative variables are presented as absolute numbers and percentages. To compare qualitative data, we used the χ2 test or Fisher's exact test. Pearson's test was applied to assess the correlation between BMI and waist-to-height ratio. The level of significance adopted was 5%. RESULTS: The body mass index was calculated for 518 children and the waist-to-height ratio for 473 children. Regarding body mass index, 60.6% of the participants had normal weight, 3.1% were underweight, and 36.3% were overweight. overweight (24.7%) and obesity (22.7%) were more prevalent in adolescents. The waist-to-height ratio was abnormal in 50.5% of the sample. There was an increasing association between body mass index and waist-to-height ratio with age, according to the Pearson correlation coefficients for the age groups <5 years (r=0.459; p<0.001), 5 to 10 years (r=0.687; p<0.001) and >10 years (r=0.805; p<0.001). CONCLUSION: There was a significant correlation between body mass index and waist-to-height ratio. This association was higher in adolescents. The waist-to-height ratio is easy to apply and may be useful as a predictor of cardiometabolic risk.