Association of insulin signaling pathway -related gene polymorphisms and gene -gene interactions with MAFLD in obese children / 中南大学学报(医学版)

OBJECTIVES@#Insulin signaling pathway plays an important role in metabolic associated fatty liver disease (MAFLD), however, the association between polymorphisms of genes related to insulin signaling pathway and MAFLD remains unclear. This study aims to investigate the association between insulin signaling pathway-related gene polymorphisms and gene-gene interactions with MAFLD susceptibility in obese children so as to provide scientific basis for further study of genetic mechanism.@*METHODS@#A total of 502 obese children with MAFLD who admitted to Hunan Provincial Children's Hospital from September 2019 to October 2021, were recruited as a case group, and 421 obese children with non-MAFLD admitted during the same period were recruited as a control group. Socio-demographic information, preterm birth history, eating habits, and exercise status of the subjects were collected by inquiry survey, and anthropometric information was collected by physical measurement. At the same time, 2 mL of venous blood was collected to extract DNA, and the polymorphism of insulin signaling pathway-related genes (5 representative candidate genes, 12 variants) was detected. Multivariate Logistic regression analysis was used to investigate the association between insulin signaling pathway-related gene polymorphisms and MAFLD in obese children.@*RESULTS@#After adjusting for confounder factors, INS rs3842748 was significantly associated with the risk of MAFLD in obese children in allele, heterozygous, and dominant models [OR and 95% CI 1.749 (1.053 to 2.905), 1.909 (1.115 to 3.267), 1.862 (1.098 to 3.157), all P<0.05]; INS rs3842752 was significantly associated with the risk of MAFLD in obese children in heterozygous and dominant models [OR and 95% CI 1.736 (1.028 to 2.932), 1.700 (1.015 to 2.846), all P<0.05]. NR1H3 rs3758674 was significantly correlated with the risk of MAFLD in obese children in allele model [OR and 95% CI 0.716 (0.514 to 0.997), P<0.05]. SREBP-1c rs2297508 was significantly associated with the risk of MAFLD in obese children in allele and dominant models [OR and 95% CI 0.772 (0.602 to 0.991) and 0.743 (0.557 to 0.991), all P<0.05]. SREBP-1c rs8066560 was significantly associated with the risk of MAFLD in obese children in allele, heterozygous, and dominant models [OR and 95% CI 0.759 (0.589 to 0.980), 0.733 (0.541 to 0.992), 0.727 (0.543 to 0.974), all P<0.05]. NR1H3 rs3758674 mutant C and SREBP-1c rs2297508 mutant G had interaction in the development of MAFLD in obese children [OR and 95% CI 0.407 (0.173 to 0.954), P<0.05].@*CONCLUSIONS@#The INS, NR1H3, and SREBP-1c gene polymorphisms in the insulin signaling pathway are associated with the susceptibility of MAFLD in obese children, but the functions and mechanisms of these genes need to be further studied.

Analysis of the efficacy of negative pressure suction and topical testosterone cream in the treatment of simple micropenis in school-aged obese children / 现代泌尿外科杂志

【Objective】 To investigate the efficacy of negative pressure suction and topical testosterone cream in the treatment of simple micropenis in school-aged obese children and the effects on blood lipids and serum sex hormones. 【Methods】 A total of 79 children aged 7 to 14 (10.50±1.62) years treated and followed up during Nov.2020 and Jul.2022 were involved. The patients were randomly enrolled in the negative pressure suction group (n=39) and the topical testosterone cream group (n=40). The negative pressure suction group was treated with negative pressure suction for 30 min/time, 1 time/day, for 30 d. The topical testosterone cream group was treated with topical testosterone cream applied to the scrotum of the penis 2 times/day for 30d. The transverse and longitudinal diameter of the glans, penile flaccidity, retraction length, serum sex hormones and blood lipids were measured before and after treatment. 【Results】 In both groups, penile flaccidity, retracted length and transverse and longitudinal diameter of the glans were significantly greater at 30 days of treatment and 2 months of follow-up than those before treatment (P0.025). In the topical testosterone cream group, at 30 days of treatment, there were significant differences in serum total cholesterol (CHOL), apolipoprotein B (Apo B), apolipoprotein A1 (Apo A1), high-density lipoprotein (HDL), low-density lipoprotein (LDL), sex hormone binding protein (SBG), estradiol (E2) and testosterone (TES) compared to those before treatment; at 2 months of follow-up, the differences in Apo A1, HDL, TES and DHS were still significant (P<0.025). 【Conclusion】 Both topical testosterone cream and negative pressure suction have significant efficacy in the treatment of micropenis in school-aged obese children, while topical testosterone cream has some side effects and retraction may occur after treatment. Negative pressure suction is safe and easy to operate, without side effects and retraction, and can be promoted for the treatment of micropenis in obese children.

Prevalence of Metabolic Syndrome and its associated risk factors in Pediatric Obesity / Journal of the ASEAN Federation of Endocrine Societies

Objective@#We aimed to study the prevalence of metabolic syndrome (MetS) and the factors associated with metabolic syndrome among obese children.@*Methodology@#We recruited 175 subjects, aged 7 to 18 years old, referred for obesity. We studied their demography (age, gender, ethnicity, family background), performed clinical/auxological examinations [weight, height, body mass index (BMI), waist circumference (WC), blood pressure (BP)], and analyzed their biochemical risks associated with metabolic syndrome [fasting plasma glucose (FPG), fasting lipid profile (FLP), fasting insulin, liver function tests (LFT)]. MetS was identified according to the criteria proposed by the International Diabetes Federation (IDF) for pediatric obesity. Multiple logistic regression models were used to examine the associations between risk variables and MetS.@*Results@#The prevalence of metabolic syndrome among children with obesity was 56% (95% CI: 48.6 to 63.4%), with a mean age of 11.3 ± 2.73 years. Multiple logistic regression analysis showed age [adjusted odds ratio (OR) 1.27, 95% CI: 1.15 to 1.45] and sedentary lifestyle (adjusted OR 3.57, 95% CI: 1.48 to 8.59) were the significant factors associated with metabolic syndrome among obese children.@*Conclusion@#The prevalence of metabolic syndrome among obese children referred to our centers was 56%. Older age group, male gender, birth weight, sedentary lifestyle, puberty and maternal history of gestational diabetes mellitus (GDM) were found to be associated with MetS. However, older age group and sedentary lifestyle were the only significant predictors for metabolic syndrome.

Characteristics of Short-Term Static Balance in Obese Children / 医用生物力学

Objective To explore the characteristics of short-term static balance of obese children by comparing the excursion of center of pressure (COP) in obese and non-obese children under six kinds of standing circumstances. Methods By using the Footscan balance plate system, parameters of COP excursion for 47 obese children and 50 non-obese children standing on both feet or single foot with eyes open or eyes closed for 10 seconds were obtained, respectively. Results The maximum COP displacement in anterior-posterior direction of obese children was significantly greater than that of non-obese children during standing on both feet with eyes closed. During standing on left foot with eyes open, the sway velocity of obese boys was significantly lower than that of non-obese boys; the maximum COP displacement in medial-lateral direction of obese boys was significantly lower than that of non-obese boys and the maximum displacement of COP in medial-lateral direction of obese girls was significantly greater than that of non-obese girls. The sway velocity of boys was significantly greater than that of girls during standing on left foot with eyes closed. Conclusions In short period of time, the static balance of obese children in anterior-posterior direction was worse than that of non-obese children during standing on both feet with eyes closed. Obesity had different impacts on static balance of different genders. The performance of static balance for obese boys was better than that of non-obese boys, while the performance of static balance for obese girls was worse than that of non-obese girls during standing on left foot with eyes open. Girls had a better static balance performance than boys during standing on left foot with eyes closed. There were no significant differences in static balance performance between boys and girls under the other circumstances. As static balance of children is affected by obesity and gender, it is suggested that different methods of losing weight should be considered for obese children of different genders.

Probiotic and Lifestyle Modification in Obese Pediatrics with Non-Alcoholic Fatty Liver Disease

Background: Non alcoholic fatty liver disease is an upcoming causes of chronic liver disease in pediatric population in Asia. Aims & Objective: To evaluate the potential of probiotic VSL#3 and Lifestyle modification in obese pediatrics with Non alcoholic fatty liver disease (NAFLD). Material & Methods: we conducted clinical trial in 106 obese children in age group of 5 to18 years and divided in to four groups;VSL#3 plus lifestyle intervention (n=26), VSL#3 (n=27), Lifestyle intervention (n=26) and Placebo (n=27) received interventions for four months. To identify NAFLD by ultrasonography, Body mass index (BMI), mid arm circumference (MAC), waist circumference (WC) and triceps skinfold thickness (TSF) were done. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), low-density lipoprotein cholesterol(LDL-c),high-density lipoprotein cholesterol (HDL-c), triglyceride (TG), cholesterol, fasting blood glucose(FBG), high sensitivity C-reactive protein (HSCRP), uric acid, obesity hormones were measured along with their dietary intake at baseline and post trial. Results: VSL#3 plus lifestyle intervention significantly the most pronounced therapy for reducing fatty liver grades, anthropometric with biochemical parameters and beneficial impact on obesity hormones (p<0.001) as compared to single therapy of VSL#3 and lifestyle intervention alone. Conclusion: Combined therapy of VSL#3 plus lifestyle intervention is promising treatment for management of NAFLD in Indian obese children.

Evaluation of nonalcoholic fatty liver disease using magnetic resonance in obese children and adolescents / Avaliação de doença hepática gordurosa não alcoólica utilizando ressonância em crianças e adolescentes obesos

Abstract Objective: To determine the frequency of nonalcoholic fatty liver disease using nuclear magnetic resonance as a noninvasive method. Methodology: This was a cross-sectional study conducted on 50 children and adolescents followed up at an outpatient obesity clinic. The subjects were submitted to physical examination, laboratory tests (transaminases, liver function tests, lipid profile, glycemia, and basal insulin) and abdominal nuclear magnetic resonance (calculation of hepatic, visceral, and subcutaneous fat). Results: Nonalcoholic fatty liver disease was diagnosed in 14 (28%) participants, as a severe condition in eight (percent fat >18%), and as non-severe in four (percent fat from 9% to 18%). Fatty liver was associated with male gender, triglycerides, AST, ALT, AST/ALT ratio, and acanthosis nigricans. Homeostasis model assessment of insulin resistance and metabolic syndrome did not show an association with fatty liver. Conclusion: The frequency of nonalcoholic fatty liver disease in the present population of children and adolescents was lower than that reported in the international literature. It is suggested that nuclear magnetic resonance is an imaging exam that can be applied to children and adolescents, thus representing an effective noninvasive tool for the diagnosis of nonalcoholic fatty liver disease in this age range. However, further national multicenter studies with longitudinal design are needed for a better analysis of the correlation between nonalcoholic fatty liver disease and its risk factors, as well as its consequences.

Resumo Objetivo: Determinar a frequência da doença hepática gordurosa não alcoólica utilizando ressonância magnética nuclear como um método não invasivo. Metodologia: Este foi um estudo transversal realizado em 50 crianças e adolescentes acompanhadas em uma Clínica Ambulatorial de Obesidade. Os indivíduos foram submetidos a exame físico, testes de laboratório (transaminases, testes de função hepática, perfil lipídico, glicemia e insulina basal) e ressonância magnética nuclear abdominal (cálculo da gordura hepática, visceral e subcutânea). Resultados: A doença hepática gordurosa não alcoólica foi diagnosticada em 14 (28%) participantes, como uma condição grave em oito (percentual de gordura > 18%) e não grave em quatro (percentual de gordura de 9 a 18%). Fígado gorduroso foi associado a sexo masculino, triglicerídeos, aspartato aminotransferase (AST), alanina aminotransferase (ALT), proporção de AST/ALT e acanthosis nigricans. O Modelo de Avaliação da Homeostase de Resistência à Insulina e a síndrome metabólica não mostraram associação com fígado gorduroso. Conclusão: A frequência da doença hepática gordurosa não alcoólica na população atual de crianças e adolescentes foi inferior à relatada na literatura internacional. Sugerimos que a ressonância magnética nuclear seja um exame de imagem que pode ser aplicado em crianças e adolescentes, representando, assim, uma ferramenta não invasiva eficaz no diagnóstico de doença hepática gordurosa não alcoólica nessa faixa etária. Contudo, estudos multicêntricos nacionais adicionais de modelo longitudinal são necessários para uma melhor análise da correlação entre a doença hepática gordurosa não alcoólica e seus fatores de risco, bem como suas consequências.

Clinical profile and factors associated with Non-Alcoholic Fatty Liver Disease (NAFLD) among overweight and obese children: A prospective study

@#<p style="text-align: justify;"><strong>INTRODUCTION:</strong> In the past decades, the prevalence of childhood overweight and obesity has increased worldwide. Childhood obesity has been associated with wide range of serious health complications and increased risk of premature adult illnesses. Non-alcoholic Fatty Liver Disease (NAFLD) was of concern because of limited data among children. The study aims to determine the prevalence and demographic /clinical factors associated with NAFLD among overweight and obese children.</p><p style="text-align: justify;"><strong>METHODOLOGY:</strong> The study was a cross-sectional study among overweight and obese participants aged 2-18 years old. A total of 96 subjects were included. Frequencies and percentages of clinical characteristics were determined. Chi-square, linear correlation and logistic regression analysis for different factors were performed.</p><p style="text-align: justify;"><strong>RESULTS:</strong> Among the 92 subjects, 26 (28%) were overweight while 66 (72%) were obese. The M:F ratio was 1.8:1 and majority belonged to 6-10 years old (44%). As to socioeconomic class, the rity (59%) were from the low-income group. The overall prevalence of NAFLD among overweight and obese subjects was 29.3%. None of the clinical factors (age, gender, socioeconomic status, BMI, waist circumference, actual caloric intake, and dietary fat consumption) were significantly associated with NAFLD. Analysis of biochemical factors revealed that alanine aminotransferase, aspartate aminotransferase, serum triglycerides and total cholesterol were found to be associated with NAFLD. Among which AST and ALT were identified predictors of NAFLD.</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> There was high prevalence of NAFLD among overweight and obese children. Screening among the pediatric population may aid on early identification and prevent its progression. ALT, AST, serum triglycerides and total cholesterol were independently related wih NAFLD. AST and ALT were identified predictors of NAFLD.</p>

Metformin improves glucose metabolism and serum levels of lipoprotein derived hormones in obese children with hyperinsulinemia / 中国生化药物杂志

Objective To explore metformin improves hyperinsulinemia in obese children, glucose metabolism, serum lipid derived hormone levels. Methods 40 cases of healthy children were selected and included in the control group, 40 cases of mild, moderate and severe obese children in the obese group, moderately obese group, obese group given category; metformin in obese children orally for 3 months, then in each group of body mass index (BMI), the learning situation of adipose derived hormones, blood glucose levels were detected and compared. Results Compared the condition of blood glucose metabolism and body weight obviously, obesity group and control group before treatment there are very significant differences after treatment, the obese group appeared to be improved, indicates that the difference is obvious(P<0.05). Compare the hormone levels of serum leptin and adiponectin are visible in before the treatment and health examination Significant differences after the treatment showed some improvement, but the resistin in the treatment had no obvious improvement. Conclusion The application of metformin improves hyperinsulinemia in obese children with sugar metabolism, visible analysis of serum adipose derived hormones, the patients with improvement of glucose metabolism has a positive effect, while improving the serum hormone level, reduce patient weight (BMI), so it is worthy of clinical use.

Nutrition Knowledge, Attitude and Practices (NKAP) and Health-Related Quality of Life (HRQOL) Status among Overweight and Obese Children: An Analysis of Baseline Data from the Interactive Multimedia-based Nutrition Education Package(IMNEP) Study

This randomised school-based controlled study aimed to evaluate the baseline results of nutrition knowledge, attitude, and practice (NKAP), health-related quality of life (HRQoL), and parents’ report of parenting skills (PRPS) among overweight and obese children. Methods: This study was performed on three intervention groups and one control group. It was conducted among Year Five students from primary schools who had overweight or obese status and were generally healthy without any chronic diseases. The children completed NKAP and child self-report of Pediatric Quality of Life (PedsQoL) questionnaires, while parents completed parent proxy report of PedsQoL and PRPS questionnaires. Descriptive statistics and parametric test in SPSS were utilised. Results: Out of 139 participants involved in the baseline study, 18.7% and 81.3% were overweight and obese respectively. This study revealed a significantly higher knowledge score among boys (p = 0.016) and among those who lived in urban areas (p = 0.019). The children’s selfreport PedsQoL recorded highest score for Social Functioning domain and lowest score for Emotional Functioning domain. A contradictory finding was obtained from the parent proxy report, where the Physical Functioning domain scored the lowest and the Emotional Functioning domain had the highest score. Notably, some of the findings from PRPS questionnaires completed by their parents were unfavourable. Conclusions: This study provided prospective evidence of the current status of NKAP, HRQoL among overweight and obese children as well as findings from PRPS among their parents.

DNA Methylation Profiles of Blood Cells Are Distinct between Early-Onset Obese and Control Individuals

Obesity is a highly prevalent, chronic disorder that has been increasing in incidence in young patients. Both epigenetic and genetic aberrations may play a role in the pathogenesis of obesity. Therefore, in-depth epigenomic and genomic analyses will advance our understanding of the detailed molecular mechanisms underlying obesity and aid in the selection of potential biomarkers for obesity in youth. Here, we performed microarray-based DNA methylation and gene expression profiling of peripheral white blood cells obtained from six young, obese individuals and six healthy controls. We observed that the hierarchical clustering of DNA methylation, but not gene expression, clearly segregates the obese individuals from the controls, suggesting that the metabolic disturbance that occurs as a result of obesity at a young age may affect the DNA methylation of peripheral blood cells without accompanying transcriptional changes. To examine the genome-wide differences in the DNA methylation profiles of young obese and control individuals, we identified differentially methylated CpG sites and investigated their genomic and epigenomic contexts. The aberrant DNA methylation patterns in obese individuals can be summarized as relative gains and losses of DNA methylation in gene promoters and gene bodies, respectively. We also observed that the CpG islands of obese individuals are more susceptible to DNA methylation compared to controls. Our pilot study suggests that the genome-wide aberrant DNA methylation patterns of obese individuals may advance not only our understanding of the epigenomic pathogenesis but also early screening of obesity in youth.

Marcadores de daño vascular y renal en orina en niños y adolescentes obesos / Vascular and renal damage markers observed in urine from obese children and adolescents

INTRODUCCIÓN: la microalbuminuria es considerada un marcador de disfunción endotelial, daño vascular, daño renal y enfermedad cardiovascular, considerada un factor de riesgo independiente de morbilidad y mortalidad. De igual manera, la proteinuria ha sido identificada como un factor de riesgo independiente de enfermedad renal crónica, y un predictor de todas las causas de mortalidad. Ambas, son relativamente frecuentes en los sujetos obesos. OBJETIVO: determinar la frecuencia de marcadores de daño vascular y renal en orina en niños y adolescentes obesos. MÉTODOS: se presenta un estudio observacional, analítico y prospectivo que incluyó a niños y adolescentes obesos atendidos en consulta de referencia "Obesidad y riñón", en el Hospital Pediátrico Docente de Centro Habana. El estudio fue realizado en el periodo comprendido entre enero de 2009 y diciembre de 2012. Se determinaron marcadores de daño vascular y renal en orina (microalbuminuria y proteinuria). El análisis estadístico fue realizado con el programa SPSS versión 13,0. RESULTADOS: solo a un paciente se le identificó proteinuria (0,5 %); sin embargo, al determinar la microalbuminuria, se encontró que más de la mitad (70,8 %) tenía este marcador de daño vascular y renal positivo. En el análisis histopatológico de la biopsia renal del paciente con proteinuria se encontró glomerulomegalia con lesión segmentaria de esclerosis y adherencia a la cápsula de Bowman. CONCLUSIONES: los niños y adolescentes obesos tienen una elevada frecuencia de positividad de marcadores de daño vascular y renal, fundamentalmente microalbuminuria.

INTRODUCTION: microalbuminuria is considered to be a marker of endothelial dysfunction, vascular damage, renal damage and cardiovascular disease in addition to be an independent risk factor for morbidity and mortality. Similarly, proteinuria has been identified as an independent risk factor for chronic renal disease and a predictor of all causes of mortality. Both are relatively frequent in obese subjects. OBJECTIVE: to determine the frequency of vascular and renal markers in the urine from obese children and adolescents. METHODS: prospective, observational and analytical study of obese children and adolescents seen at the reference service called obesity and kidney in the teaching pediatric hospital of Centro Habana. The study was conducted from January 2009 through December 2012. Vascular and renal markers were determined in the urine (microalbuminuria and proteinuria). The statistical analysis was based on SPSS program version 13.0. RESULTS: there was just one patient detected with proteinuria (0.5 %); however, in the microalbuminuria test, it was found that over half of the patients (70.8 %) were positive to this vascular and renal damage marker. In the histopathological analysis of the renal biopsy taken from the patient with proteinuria, segmental glomerulosclerosis and adhesion to Bowman's capsule was discovered. CONCLUSIONS: obese children and adolescents have very frequent positivity to vascular and renal damage markers, mainly microalbuminuria.

Kinematic analysis on gait of overweight and obese primary school children during level walking / 医用生物力学

Objective To investigate the effects of overweight and obesity on the gait of primary school children by comparing the kinematic parameters between overweight/obese children and normal weight children during level walking. Methods Forty overweight/obese children (age: (9.6±1.72) year; height: (142.16±12.19) cm; BMI: (24.32±2.96) kg/m2) and 50 normal weight healthy children (age: (10.26±0.72) year; height: (139.0±7.50) cm; BMI: (17.08±1.25) kg/m2) were recruited as the subjects. All of the subjects completed 3 walking trials at preferred speed along a 10 m walkway with barefoot. A digital video camera was used to record these subjects’ level walking images, and their gait parameters, such as step length, stride length and joint angle of the lower extremity, were obtained through Shixun motion analysis system. SPSS 16.0 was used for data analysis. A paired t-test was used to assess differences of all the variables between lefe side and right side for the subjects. An independent t-test was used to assess differences of all the variables between the overweight/obese and normal weight children. Statistical significance was defined as P<0.05. Results (1) There were significant differences between overweight/obese children ((0.44±0.001)) and normal weight children ((0.45±0.001)) for relative step length (P<0.05). (2) There were significant differences in left hip and knee joint angle in the frontal plane between overweight/obese children (left hip angle: (165.36±5.29)°, left knee angle: (178.82±5.51)°, right knee angle: (177.84±5.25)°) and normal weight children (left hip angle: (161.99±4.28)°, left knee angle: (174.67±4.91)°, right knee angle: (174.67±4.91)°) during heel strike phase (P<0.05). Significant differences were found in the left ankle joint angle of the frontal plane during toe off phase between overweight/obese children((121.73±8.03)°) and normal weight children((118.44±6.70)°)(P<0.05). Conclusions Relative step length of overweight/obese children was significantly smaller than that of normal weight children during level walking. The left hip and knee joint angle in the frontal plane of overweight/obese children during heel strike phase were significantly larger than those of normal weight children. The left ankle joint angle in the frontal plane of overweight/obese children during toe off phase was significantly larger than that of normal weight children. These differences may affect the function of the lower extremity in overweight/obese children.

Efeito do treinamento concorrente e destreinamento sobre o biomarcador anti-inflamatório e níveis de condicionamento físico em crianças obesas / Effect of concurrent training and detraining on anti-inflammatory biomarker and physical fitness levels in obese children

OBJETIVO: Examinar o efeito de 12 semanas de (3 dias/sem) de treinamento concorrente e 4 semanas de destreinamento nas concentrações séricas de adiponectina e níveis de condicionamento físico em meninos obesos sem intervenção dietética. MÉTODOS: vinte e quatro meninos saudáveis, 11-13 anos de idade com índice de massa corporal > 28 participaram voluntariamente do estudo. Estes foram divididos em dois grupos, experimental (n= 12) e controle (n=12). RESULTADOS: Concentrações de adiponectina após 12 semanas tiveram declínio significativo em ambos os grupos em comparação com o nível basal (p < 0,05). VO2 pico, flexibilidade, força, endurance de abdominais e agilidade aumentaram significativamente no grupo experimental comparado com o grupo controle (p < 0.05). Foi evidenciado que após destreinamento de 4 semanas, a adiponectina sérica não se alterou significativamente no grupo experimental e que condicionamento físico benéfico foi gradualmente diminuído. CONCLUSÃO: Nossos resultados sugerem que os efeitos benéficos do exercício físico no condicionamento são temporários. Uma vez que o processo de adaptação é reversível, parece que as concentrações de adiponectina foram inevitavelmente afetadas pelas alterações morfológicas e hormonais que ocorreram durante a puberdade em meninos.

OBJECTIVE: To examine the effect of 12 weeks of (3 days/week) concurrent training and 4 weeks of detraining on serum adiponectin concentrations and physical fitness levels in obese boys without dietary intervention. METHODS: 24 healthy boys, 11-13 years old with body mass index >28 voluntarily participated in the study. They were divided into two groups, experimental (n = 12) and control (n = 12). RESULTS: Adiponectin concentrations after 12 weeks presented significant decline in both experimental and control group compared with the baseline (p < 0.05). VO2 peak, flexibility, strength, endurance of sit-ups and agility significantly increased in the experimental group compared with the control group (p < 0.05). It was shown that after a 4-week detraining, serum adiponectin did not significantly change in the experimental group and that beneficial physical fitness was gradually decreased. CONCLUSION: Our results suggest that the beneficial effects of exercise training on physical fitness are temporary. Since the process of adaptation is reversible, it seems that adiponectin concentrations were inevitably affected by morphological and hormonal changes that occurred during puberty in boys.

The relationship between plasma glucose,insulin,HbA1c and cardiovascular risk in obese children / 国际儿科学杂志

Obesity,diabetes mellitus and aging are generally recognized as the causes of intima injury.The incidence of childhood obesity increases rapidly in the world,in line with the lifestyle change and upturn living standards.Some cardiovascular diseases,which just occur in older population before,have appeared in adolescents and children now.The persistence of obesity status,can lead to the increasing morbidity and mortality of cardiovascular diseases in their adulthood.There are many factors leading to cardiovascular disease.Diabetes is the independent risk factor for cardiovascular disease,especially in adults.However,there are rare reports about this aspect for obesity children who are not diabetes.This review focuses on the correlation between plasma glucose,insulin,glycated hemoglobin and cardiovascular risk factors of obese children.

Metabolic Syndrome in obese and normal weight Myanmar children / Journal of the ASEAN Federation of Endocrine Societies

Objectives@#To estimate the frequency of Metabolic Syndrome (MS in Myanmar obese children and to determine the risk factors associated with MS in obese children comparing with normal weight children. @*Methodology@#A cross-sectional study was conducted to compare the risk factors for metabolic syndrome between normal and obese children by using the pediatric definition for metabolic syndrome [International Diabetes Federation (IDF), 2007]. Twenty-three obese children (BMI, ≥ 97th percentile) and 23 normal weight children (BMI, < 85th percentile) aged 5-12 years were included in the study. Blood pressure, body weight, height, waist circumference (WC), fasting triglycerides, HDL-cholesterol, total cholesterol and glucose concentrations were determined. @*Results@#Based on the IDF pediatric criteria, 9 obese children (39.1%) had metabolic syndrome while no normal weight child had metabolic syndrome. Ten (43.5%) normal weight children and 3 (13.0%) obese children had at least one risk factor for the metabolic syndrome. Central obesity (WC ³ 90th percentile for age and sex), the most common risk factor, was observed in 25 children (54.4% of the total population). @*Conclusion@#This study highlights the need for early recognition of risk factors for metabolic syndrome in all children to halt the progression of type 2 diabetes and cardiovascular diseases (CVD) in later life.

The validity of HbA1C detection in diagnosing and screening dysglycemia in children with obesity / 中华内分泌代谢杂志

The validity of the recently recommended HbA1C criterion by the American Diabetes Association (ADA) in identification of dysglycemia in children with obesity was evaluated. 293 obese children underwent oral glucose tolerance test. Receiver operating characteristic ( ROC ) curve analysis was used to examine the sensitivity and specificity of fasting plasma glucose (FPG) and HbA1C in identifying dysglycemia. The results showed that the prevalence of type 2 diabetes mellitus (T2DM) was 3.8％ and prediabetes 16. 0％ based on plasma glucose standard. 4. 1％ and 25.6％ were categorized as T2DM and “at high risk of diabetes mellitus” based on both HbA1C and plasma glucose criteria. HbA1C was more efficacious than FPG in detecting abnormal glucose tolerance as shown by the areas under the curve in ROC of 0. 875 and 0. 713 respectively (P＜0. 01 ). The sensitivity and specificity were 60. 5％ and 86. 8％ at HbA1C ≥5.7％, and 30. 5％ and 94.0％ at FPG ≥ 5.6 mmol/L.

Effect of Nutrition Education and Exercise Intervention on Physical and Dietary Patterns of Some Obese Children / 대한지역사회영양학회지

This study set out to investigate the effects of 16-week nutrition education and exercise intervention run by a public health center on the physical activities and dietary patterns of obese children at the before, after, and after one month point. After the program, the obese index of the obese children dropped by 5.9% from 38.4% to 32.5%. One month after the end of the program, their obese index increased by 1.4% to 33.9% (p < 0.001). The obese children's hours of walking of physical activities increased to 2.6 hours from 1.2 hours after the program and remained at the 2.6 hours range one month after the end of the program (p < 0.01). The total scores of their food habits increased to 10.4 points from 9.1 points after the program and 10.3 points one month after the end of the program with significant differences (p < 0.01). The total scores of their eating behavior made a significant increase to 6.5 points from 5.3 points after the program and then dropped to 5.9 points one month after the end of the program (p < 0.05). As for changes to their dietary pattern scores according to the obese index, only the food habits scores showed significant main effects of term (p < 0.05). According to these results, there is still a need to develop proper programs to help them increase regular exercise, improve their physical activities by cutting down time with TV, computer, Internet, and video games, and enhance their nutritional knowledge and to provide them with ongoing management and guidance until the improved food habits and eating behavior become part of their habits.

Nutrient Intakes, Nutritional Knowledge, Food Habits, and Lifestyle Behaviors of Obese Children

The purpose of this study was to investigate the nutrient intakes, nutritional knowledge, food habits, and lifestyle behaviors of moderately or severely obese children living in the Kyonggi-do area. The subjects in this study were 37 obese children with an obesity index higher than 130% in the forth to sixth grades of elementary school. Anthropometric measurements, 24-hour recall of dietary intakes, and a survey on nutritional knowledge, food habits, and lifestyles behavior were conducted in the 37 obese children (25 boys and 12 girls). The average age, body weight, BMI, and Rohrer Index were 12.4 years, 68.6 kg, 29.6 kg/m2, and 194.9 in boys and 12.7 years, 65.7 kg, 29.8 kg/m2, and 201.8 in girls, respectively. The percentage of correct answers on nutritional knowledge and nutritional attitude score/max score were 85.8% and 23.0/50 in boys and 87.0% and 17.5/50 in girls, respectively. Except for calcium (85.3%) in girls and calcium (62.7%) and folic acid (83.3%) in boys, the average daily nutrient intakes percentages of nutrients were greater than the DRIs values (107.9~327.3% in boys and 103.0~416.0% in girls). This study showed the existence of some problems associated with obesity, such as higher frequency of skipping breakfast, irregular meal times, unbalanced diet, lack of intake of some nutrients, low nutritional attitude, lack of physical activity, and time management in obese children. These results suggest that a systematic education program including nutritional education on balanced diet, good eating habits and behaviors, and importance of eating breakfast and meal regularity must be emphasized to improve nutrient intakes and food habits in obese children. Obese children also require a more concentrated program that includes physical activity, weight reduction, and weight maintenance strategies to improve their life habits.

Effects of gender and BMI on dynamic plantar pressure distribution in children / 医用生物力学

Objective To investigate the effects of gender and body mass index(BMI) on dynamic plantar pressure among children by comparing the plantar pressure parameters of obese boys and girls, as well as normal boys and girls when walking at preferred speed on flat ground and reviewing the relativity of children’s BMI and these parameters. Method 79 children were enrolled in this research to make gait test when walking naturally, using a 0.5m footscan plate system (RSscan International, Belgium). The results were statistically processed and analyzed by SPSS16.0. Results(1) There is no significant difference in mostly dynamic plantar pressure parameters between genders for both obese and normal children; (2) There is significant difference in the impulse percentage in mid foot and ground, and appearing time of pressure peak values of several areas including M5, MF and HL for normal children; (3) There is no significant correlation between BMI and foot support duration, impulse percentage between mid foot and ground, pressure peak value of T2 5, appearing time of pressure peak value of HM and HL; (4) BMI and the other plantar pressure distribution indicators are well correlated. Conclusions(1) There is no significant difference on dynamic plantar pressure distribution between genders for obese children, but there are effects of genders on partial dynamic plantar pressure distribution parameters for normal children; (2) Children with larger BMI are of worse walking stability and lower efficiency; (3) Children with larger BMI tend to feel fatigue in walking and get injured in ankle joints and other parts of the body more easily.

Metabolic Syndrome Based on IDF Criteria in a Sample of Normal Weight and Obese School Children

Metabolic syndrome was once reported only in adults but is now occurring more frequently in children. This study compared the incidence of metabolic syndrome and its components among normal and obese children using the 2007 International Diabetes Federation (IDF) pediatric definition for metabolic syndrome. Subjects comprised 78 school children aged 8-10 years, with 34 obese and 44 normal weight children. Body weight, height, and waist circumference (WC) were measured and body mass index was calculated. Clinical profiles measured included fasting blood glucose, triglyceride, HDL cholesterol, LDL cholesterol, total cholesterol, and blood pressure. Metabolic syndrome (MS) was defined using the 2007 IDF pediatric criteria. Obese subjects had a significantly (p<0.001) higher mean BMI (26.0 ± 3.6 kg/m2) compared to normal weight subjects (15.1 ± 0.8 kg/m2). Only one obese subject (1.3% of subjects) had metabolic syndrome based on the IDF definition, but all obese subjects had at least one component of metabolic syndrome. In comparison, no normal weight subjects had metabolic syndrome and only 9.1% of normal weight subjects had at least one component of metabolic syndrome. The most common component was central obesity, observed in 43.6% of subjects having WC equal to or greater than the 90th percentile. In concurrence with central obesity as the core feature of the IDF criteria, WC showed the strongest correlation with indicators of obesity such as BMI (r=0.938, p<0.001), fat mass (r=0.912, p<0.001) and fat-free mass (r=0.863, p<0.001). We conclude that the problem of metabolic syndrome is more prominent among obese children, although the incidence of MS as defined by the 2007 pediatric IDF criteria, is low in this population (1.3%).