ABSTRACT
Ghrelin, a regulator of food intake and energy expenditure, has been shown to be associated with insufficient sleep. The goal of the present study was to investigate the effect of a single night of total sleep deprivation on fasting saliva ghrelin and on nocturnal variation of saliva ghrelin concentration. A further aim of the study was to investigate the influence of body mass index on changes in saliva ghrelin levels. Altogether 35 adolescents (18 boys; age: 13.8 ± 1.14 years) were studied on two subsequent days (sleep and total sleep deprivation). Saliva samples were collected during the two experimental nights at 21:00â hours, 01:00â hours and 06:00â hours. Total-ghrelin concentration showed a continuous increase from the evening until 06:00â hours. This increase was blunted significantly (p = 0.003) by total sleep deprivation. Total-ghrelin level was significantly lower (p = 0.02) during total sleep deprivation at 06:00â hours (median 403.6 pgâ ml-1 ; 95% confidence interval: 343.1-468.9 pgâ ml-1 ) as compared with values during the sleep condition (median 471.2 pgâ ml-1 ; 95% confidence interval: 205.4-1578.7 pgâ ml-1 ). Acyl-ghrelin levels did not present any change at the three time points, and were not affected by total sleep deprivation. Stratifying the study population according to body mass index (normal weight and overweight/obese groups), the blunting effect of total sleep deprivation was more pronounced in the obese/overweight group (sleep: median 428.2 pgâ ml-1 ; 95% confidence interval: 331.3-606.9 pgâ ml-1 versus total sleep deprivation: median 333.1 pgâ ml-1 ; 95% confidence interval: 261.5-412.9 pgâ ml-1 ; p = 0.0479). Saliva total-ghrelin concentrations gradually increased during the night, and total sleep deprivation significantly blunted this increase. This blunting effect was mainly observed in subjects with overweight/obesity. The physiological and clinical implications of the present observation are to be clarified by further studies.
Subject(s)
Ghrelin , Sleep Deprivation , Male , Humans , Adolescent , Child , Sleep Deprivation/complications , Overweight/complications , Saliva , Obesity/complications , Sleep/physiologyABSTRACT
Obesity is a chronic disease, in which treatment outcomes are highly dependent on patient and family adherence to behavioural recommendations. The role of healthy eating, physical activity, medication adherence as well as adherence to pre- and post-bariatric surgery protocols are of utmost importance for long-term treatment outcomes. Even the best interventions are not likely to reach their maximum benefit without significant levels of adherence on the part of the individual and family. Traditionally, the annual meeting of the European Childhood Obesity Group (ECOG) includes an expert workshop addressing one specific topic within the field of childhood obesity. During the 30th annual meeting, hosted by the University of Pécs, Hungary, as a virtual meeting, "adherence to treatment recommendations in obesity as a chronic disease" was addressed. The discussions that developed during the workshop are summarized in the following article.
Subject(s)
Pediatric Obesity , Child , Humans , Chronic Disease , Exercise , Hungary , Pediatric Obesity/therapyABSTRACT
INTRODUCTION: While international prevention guidelines recently advocated, in addition to moderate and vigorous physical activity (MVPA) guidelines, for a minimization of sedentary (SED) time, recommendations remain to be developed for youths with obesity. METHODS: A literature search was conducted in PubMed, the Cochrane Library, plus the reference lists of selected articles for relevant publications in English, including original papers, systematic reviews, and meta-analyses, with search terms "sedentary behaviors" or "sedentary time" or "screen time" AND "children" or "adolescents" AND "obesity" or "adiposity" or "cardiometabolic risk" or "cardiometabolic disease." The results were summarized as a narrative review and presented to the scientific board of the European Childhood Obesity Group (ECOG), who then discussed their implication in clinical practice and proposed the position outlined in this paper. RESULTS: SED and screen times are associated with adiposity and cardiometabolic risks, independently of youths' physical activity (PA) level. Besides considering MVPA and SED times as separate variables, comprehensive studies have questioned the impact of different patterns of MVPA and SED levels. Although lower body adiposity and better cardiometabolic health are achieved among those with desirable movement behavior patterns (i.e., more MVPA/less SED or active/not SED), youths with intermediate patterns (i.e., high MVPA/high SED and low MVPA/low SED, or active/SED and inactive/not SED) have been found to be associated with intermediate risks. CONCLUSION: There is a need to decrease SED behaviors irrespective of MVPA and to consider PA-SED patterns in youth with obesity. The ECOG encourages anti-obesity strategies targeting both PA and SED behaviors to support the shift from long periods of SED time, especially screen time, to daily routines incorporating bouts of PA. Stepwise or sequential approaches to movement behavior counseling might start with targeting SED at first to decrease cardiometabolic risks when implementing MVPA is not yet possible.
Subject(s)
Cardiovascular Diseases , Pediatric Obesity , Adiposity , Adolescent , Cardiovascular Diseases/prevention & control , Child , Exercise , Humans , Pediatric Obesity/prevention & control , Sedentary BehaviorABSTRACT
Gonadal dysgenesis (GD) is a rare cause of differences of sex development (DSD) with highly variable clinical and genetic conditions. Although identification of the causative genetic alterations can offer a clearer prognosis and personalized management to patients, more than 50% of the DSD cases still do not have an accurate genetic diagnosis. NR5A1 (previously known as SF-1), is a transcriptional regulator of genes required for normal development and functional maintenance of the gonads and the adrenal glands. Nucleotide sequence variants of the NR5A1 gene have been reported in numerous patients with GD with or without adrenal failure, however, microdeletion or partial deletion in the NR5A1 gene have been described only in a few GD cases. In this case study, we present a subject with female phenotype, mild clitoromegaly, partial GD and normal adrenal function. Cytogenetic analysis revealed a 46,XY SRY + karyotype. Microarray analysis did not identify pathogenic copy number variations, nor did panel sequencing of the most common DSD genes. Subsequently, multiplex ligation-dependent probe amplification (MLPA) was performed to test for small deletion/duplication of the most frequently affected genes associated with GD. Using this method, we have identified a novel heterozygous deletion involving exons 5 and 6 of the NR5A1 gene as the cause of abnormal sexual development of the patient. This report expands our knowledge about the range and pathogenetic role of NR5A1 mutations associated with partial gonadal dysgenesis in 46,XY DSD. Furthermore, our data emphasises the indispensable role of MLPA in the diagnosis of DSD with unclear etiology.
Subject(s)
Disorder of Sex Development, 46,XY/genetics , Multiplex Polymerase Chain Reaction/methods , Steroidogenic Factor 1/genetics , Testis/abnormalities , DNA Copy Number Variations/genetics , Disorder of Sex Development, 46,XY/diagnosis , Disorders of Sex Development/genetics , Exons/genetics , Female , Heterozygote , Humans , Mutation/genetics , Sequence Deletion/genetics , Sexual Development/geneticsSubject(s)
Pediatric Obesity , Periodicals as Topic , Translational Research, Biomedical , Child , Europe , Humans , OrganizationsABSTRACT
UNLABELLED: There are no population-based data on the autoimmune morbidity and vascular complications of young adults with childhood-onset type 1 diabetes in Hungary. AIMS: To assess the prevalence of these morbidities after 20 years of diabetes duration. METHOD: Postal questionnaire. RESULTS: 6.2% of the patients had celiac disease. Diabetes was diagnosed at a significantly earlier age in patients with diabetes and celiac disease as compared to those without celiac diasease. Thyroid autoimmunity was reported in 7.6% of cases. They were significantly older with longer duration of diabetes. Every fifth patients reported retinopathy, one sixth of patients was treated for hypertension. Neuropathy was found in 3.4% and kidney disease in 4.8% of the cases. CONCLUSIONS: Apart from retinopathy and hypertension, the prevalence of microvascular complications was relatively low. Considering the limitations of questionnaire studies, laboratory screening is warranted to assess the true prevalence of comorbidities and complications.
Subject(s)
Autoimmunity , Diabetes Mellitus, Type 1/complications , Diabetes Mellitus, Type 1/epidemiology , Diabetic Angiopathies/epidemiology , Adolescent , Adult , Age of Onset , Celiac Disease/epidemiology , Celiac Disease/immunology , Child , Child, Preschool , Comorbidity , Diabetic Nephropathies/epidemiology , Diabetic Nephropathies/immunology , Diabetic Neuropathies/epidemiology , Diabetic Neuropathies/immunology , Diabetic Retinopathy/epidemiology , Diabetic Retinopathy/immunology , Female , Humans , Hungary/epidemiology , Hypertension/epidemiology , Hypertension/immunology , Male , Microcirculation , Prevalence , Surveys and Questionnaires , Thyroiditis, Autoimmune/epidemiology , Time Factors , Young AdultABSTRACT
Prader-Willi syndrome (PWS) is a complex genetic disorder which involves the endocrine and neurologic systems, metabolism, and behavior. The aim of this paper is to summarize current knowledge on dietary management and treatment of PWS and, in particular, to prevent excessive weight gain. Growth hormone (GH) therapy is the recommended standard treatment for PWS children, because it improves body composition (by changing the proportion of body fat and lean body mass specifically by increasing muscle mass and energy expenditure), linear growth, and in infants, it promotes psychomotor and IQ development. In early childhood, the predominant symptom is hyperphagia which can lead to early onset, severe obesity with different obesity-related comorbidities. There are several studies on anti-obesity medications (metformin, topiramate, liraglutide, setmelanotide). However, these are still limited, and no widely accepted consensus guideline exists concerning these drugs in children with PWS. Until there is a specific treatment for hyperphagia and weight gain, weight must be controlled with the help of diet and exercise. Below the age of one year, children with PWS have no desire to eat and will often fail to thrive, despite adequate calories. After the age of two years, weight begins to increase without a change in calorie intake. Appetite increases later, gradually, and becomes insatiable. Managing the progression of different nutritional phases (0-4) is really important and can delay the early onset of severe obesity. Multidisciplinary approaches are crucial in the diagnosis and lifelong follow-up, which will determine the quality of life of these patients.
Subject(s)
Obesity, Morbid , Prader-Willi Syndrome , Child , Child, Preschool , Humans , Hyperphagia/etiology , Hyperphagia/prevention & control , Infant , Obesity, Morbid/complications , Prader-Willi Syndrome/complications , Prader-Willi Syndrome/drug therapy , Quality of Life , Weight GainABSTRACT
BACKGROUND: During adolescence, health behaviors and weight status are increasingly influenced by friendship and peer networks. This paper examines resemblances in weight-related characteristics and how they differ by sociodemographic factors. METHODS: Over 3,000 friendships were reported by 1,603 adolescents, aged 11-16 years, who participated in the school-based I.Family study in 6 European countries. Each "source child" named 1-10 friends for whom standardized weight-related traits were available in the same survey. The mean value of the friends' traits weighted by time spent together was calculated, and related to the source child's trait. Country, age and sex of the source child, parental education, and immigrant background were considered for confounding and moderation. RESULTS: Source children's z-scores of body fat percent and BMI were positively associated with their friends' characteristics, in particular if they had highly educated parents. Positive associations were also found regarding the frequency of fast-food consumption, impulsivity, screen time, preference for sugar-sweetened foods, and hours spent in sports clubs, in increasing order of effect size. Additionally, correlations were observed between friends' cognitive and school functioning and being bullied. No associations were seen for a preference for high-fat foods, weight concerns, and health-related quality of life. Finally, parental education and immigrant background were associated between friends in all countries except Sweden, where no associations were observed. CONCLUSION: Adolescent friends shared a number of weight-related characteristics. For weight measures per se, positive associations with friends' characteristics were only observed in adolescents with high parental education. Associations regarding energy-balance behaviors and indicators of school-related well-being did not differ by parental education. Parental education and immigrant background correlated positively in friends in most countries showing that social aggregation is already occurring in adolescence. The wide spectrum of friendship associations in weight-related traits and behaviors suggests that health promotion initiatives in adolescents should be directed towards peer groups in both school-related and leisure-time environments. ISRCTN Registry: Pan-European IDEFICS/I.Family children cohort (ID ISRCTN62310987; https://doi.org/10.1186/ISRCTN62310987).
Subject(s)
Friends , Adolescent , Adolescent Behavior , Body Mass Index , Child , Cohort Studies , Europe , Family , Fast Foods , Female , Friends/psychology , Health Behavior , Humans , Leisure Activities , Male , Peer Group , Quality of Life , Schools , Sports , Surveys and QuestionnairesABSTRACT
Obesity is the result of interactions between genes and environmental factors. Since monogenic etiology is only known in some obesity-related genes, a genetic risk score (GRS) could be useful to determine the genetic predisposition to obesity. Therefore, the aim of our study was to build a GRS able to predict genetic predisposition to overweight and obesity in European adolescents. A total of 1069 adolescents (51.3% female), aged 11-19 years participating in the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) cross-sectional study were genotyped. The sample was divided in non-overweight (non-OW) and overweight/obesity (OW/OB). From 611 single nucleotide polymorphisms (SNP) available, a first screening of 104 SNPs univariately associated with obesity (p < 0.20) was established selecting 21 significant SNPs (p < 0.05) in the multivariate model. Unweighted GRS (uGRS) was calculated by summing the number of risk alleles and weighted GRS (wGRS) by multiplying the risk alleles to each estimated coefficient. The area under curve (AUC) was calculated in uGRS (0.723) and wGRS (0.734) using tenfold internal cross-validation. Both uGRS and wGRS were significantly associated with body mass index (BMI) (p < .001). Both GRSs could potentially be considered as useful genetic tools to evaluate individual's predisposition to overweight/obesity in European adolescents.
Subject(s)
Genetic Predisposition to Disease , Obesity/genetics , Overweight/genetics , Adolescent , Adult , Alleles , Body Mass Index , Child , Europe/epidemiology , Female , Genome-Wide Association Study , Genotype , Humans , Male , Obesity/epidemiology , Obesity/pathology , Overweight/epidemiology , Overweight/pathology , Polymorphism, Single Nucleotide/genetics , Risk Factors , Young AdultABSTRACT
While most of the time unconsidered, child and adolescent obesity has been also associated with impaired brain health and function that can definitely affect their social interaction and integration, and then well-being and mental health. The European Childhood Obesity Group recently gathered experts in the field who discussed the main available and reliable evidence regarding the role of physical activity on brain health and cognitive functioning in children and adolescents with obesity and who propose here their main conclusions and recommendations.
Subject(s)
Brain/physiopathology , Exercise/physiology , Pediatric Obesity/physiopathology , Adolescent , Child , Cognition/physiology , Europe , Expert Testimony , HumansABSTRACT
Obesity and metabolic syndrome (MetS) are worldwide major health challenges. The Mediterranean diet (MD) is associated with a better cardiometabolic profile, but these beneficial effects may be influenced by genetic variations, modulating the predisposition to obesity or MetS. The aim was to assess whether interaction effects occur between an obesity genetic risk score (obesity-GRS) and the MD on adiposity and MetS in European adolescents. Multiple linear regression models were used to assess the interaction effects of an obesity-GRS and the MD on adiposity and MetS and its components. Interaction effects between the MD on adiposity and MetS were observed in both sex groups (p < 0.05). However, those interaction effects were only expressed in a certain number of adolescents, when a limited number of risk alleles were present. Regarding adiposity, a total of 51.1% males and 98.7% females had lower body mass index (BMI) as a result of higher MD adherence. Concerning MetS, only 9.9% of males with higher MD adherence had lower MetS scores. However, the same effect was observed in 95.2% of females. In conclusion, obesity-related genotypes could modulate the relationship between MD adherence and adiposity and MetS in European adolescents; the interaction effect was higher in females than in males.
Subject(s)
Adiposity/genetics , Adolescent Nutritional Physiological Phenomena/genetics , Diet, Mediterranean/statistics & numerical data , Metabolic Syndrome/diet therapy , Obesity/genetics , Adolescent , Cardiometabolic Risk Factors , Child , Cross-Sectional Studies , Europe/epidemiology , Female , Genetic Predisposition to Disease , Humans , Linear Models , Male , Metabolic Syndrome/complications , Metabolic Syndrome/genetics , Obesity/prevention & control , Risk Factors , Sex Factors , Young AdultABSTRACT
Type 1 diabetes is often accompanied with acute hypoinsulinemia that may theoretically inhibit the conversion of essential fatty acids to their longer-chain metabolites. Previously, we found significant reduction in plasma arachidonic (C20:4n-6) and docosahexaenoic (C22:6n-3) acid values in a group of diabetic children during diabetic ketoacidosis. Here we report data on the changes of fatty acids in plasma phospholipids in a diabetic teenager during and after nine subsequent episodes of diabetic ketoacidosis (DKA). Plasma phospholipid linoleic acid (C18:2n-6) values significantly decreased [23.05 (1.05) versus 19.22 (3.22), % w/w, median (IQR), p < 0.01], while values of dihomo-gamma-linolenic acid (C20:3n-6) and docosatetraenoic acid (C22:4n-6) significantly increased [1.72 (0.44) versus 1.80 (0.63) and 0.40 (0.01) versus 0.45 (0.07), respectively, p < 0.05]. Values of alpha-linolenic acid (C18:3n-3) did not change, while values of docosahexaenoic acid were significantly higher after than during the ketoacidosis [1.57 (0.67) versus 1.87 (0.32), p < 0.05). These data obtained in the same patient during repeated episodes of diabetic ketoacidosis support the concept that hypoinsulinemia plays an important role in disturbances of essential fatty acid metabolism in diabetes.
Subject(s)
Diabetes Mellitus, Type 1/blood , Diabetic Ketoacidosis/blood , Diabetic Ketoacidosis/drug therapy , Fatty Acids, Unsaturated/blood , Adolescent , Blood Glucose/metabolism , Body Mass Index , Diabetes Mellitus, Type 1/physiopathology , Diabetic Ketoacidosis/physiopathology , Female , Glycated Hemoglobin/metabolism , Humans , Insulin Infusion Systems , RecurrenceABSTRACT
â¢Traditional sports might be considered as part of obesity treatments.â¢Traditional sports are interesting strategies for the prevention of pediatric overweight and obesity.â¢A fully adapted medical checkup is mandatory before considering the use of traditional sports for the treatment of pediatric obesity.â¢Making adaptations in the practice of traditional sports (duration, rules, dimensions of the field) offers possible opportunities for obesity treatment among children and adolescents.
ABSTRACT
There is a difficulty in the molecular diagnosis of congenital adrenal hyperplasia (CAH) due to the c.955C>T (p.(Q319*), formerly Q318X, rs7755898) variant of the CYP21A2 gene. Therefore, a systematic assessment of the genetic and evolutionary relationships between c.955C>T, CYP21A2 haplotypes and the RCCX copy number variation (CNV) structures, which harbor CYP21A2, was performed. In total, 389 unrelated Hungarian individuals with European ancestry (164 healthy subjects, 125 patients with non-functioning adrenal incidentaloma and 100 patients with classical CAH) as well as 34 adrenocortical tumor specimens were studied using a set of experimental and bioinformatic methods. A unique, moderately frequent (2%) haplotypic RCCX CNV structure with three repeated segments, abbreviated to LBSASB, harboring a CYP21A2 with a c.955C>T variant in the 3'-segment, and a second CYP21A2 with a specific c.*12C>T (rs150697472) variant in the middle segment occurred in all c.955C>T carriers with normal steroid levels. The second CYP21A2 was free of CAH-causing mutations and produced mRNA in the adrenal gland, confirming its functionality and ability to rescue the carriers from CAH. Neither LBSASB nor c.*12C>T occurred in classical CAH patients. However, CAH-causing CYP21A2 haplotypes with c.955C>T could be derived from the 3'-segment of LBSASB after the loss of functional CYP21A2 from the middle segment. The c.*12C>T indicated a functional CYP21A2 and could distinguish between non-pathogenic and pathogenic genomic contexts of the c.955C>T variant in the studied European population. Therefore, c.*12C>T may be suitable as a marker to avoid this genetic confound and improve the diagnosis of CAH.
Subject(s)
Adrenal Hyperplasia, Congenital/genetics , DNA Copy Number Variations , Steroid 21-Hydroxylase/genetics , Adrenal Glands/metabolism , Adrenal Hyperplasia, Congenital/pathology , Evolution, Molecular , Female , Haplotypes , Humans , Male , Steroid 21-Hydroxylase/metabolismABSTRACT
OBJECTIVE: To assess the frequencies of common polymorphisms of genes associated with energy expenditure among Hungarian obese children and investigate their influences on obesity-related traits and metabolic complications of common childhood obesity. RESEARCH METHODS AND PROCEDURES: In a total of 528 obese children (age 13.2±2.6 years) an oral glucose tolerance test and determination of fasting serum lipid levels were carried out, blood pressure and resting energy expenditure were measured and the children were genotyped for the following gene polymorphisms: Trp64Arg of ß3-adrenoreceptor (ADRB3), -3826 A/G of uncoupling protein (UCP)-1, exon 8 45 bp del/ins and -866 G/A of UCP-2, -55 C/T of UCP-3, and Pro12Ala of peroxisome-proliferator activated receptor gamma-2. RESULTS: Carriers of the ADRB3 Arg64 allele had a significantly higher relative body weight and relative body mass index compared with non-carriers. The UCP-2 exon 8 del/ins polymorphism was associated with higher degree of obesity, insulin resistance, dyslipideamia and lower adjusted metabolic rate. Children with UCP-3 -55 T/T genotype had a significantly lower adjusted metabolic rate than the C allele carriers. CONCLUSION: We found evidence for associations between common polymorphisms of the ADRB3, the UCP-2 and UCP-3 genes and basic metabolic rate as well as level and metabolic consequences of common obesity among Hungarian school-aged children.
Subject(s)
Basal Metabolism/genetics , Body Weight/genetics , Dyslipidemias/genetics , Genotype , Insulin Resistance/genetics , Pediatric Obesity/genetics , Polymorphism, Genetic , Adolescent , Alleles , Body Mass Index , Child , Dyslipidemias/complications , Energy Metabolism , Exons , Female , Humans , Hungary , Male , Pediatric Obesity/complications , Phenotype , Polymorphism, Single NucleotideABSTRACT
OBJECTIVE: Gln223 Arg polymorphism of the leptin receptor (LEPR) gene is one of the most frequently examined polymorphisms of this gene and has been suggested to be associated with energy expenditure (EE). The aim of the present study was to investigate the association of this variant on indicators of EE-resting metabolic rate (RMR), postabsorptive and postprandial respiratory quotient (RQ), and food-induced thermogenesis (FIT)-in obese children. METHODS: The study included 486 genotyped children (obese, n = 355). RMR was measured by indirect calorimetry for 45 min. Subsequent to test-food consumption, FIT was measured in a subsample of obese children (n = 121, body mass index 31.9 kg/m(2) (mean ± SD 5.1). RESULTS: Obese children with the Gln223 Gln genotype showed a significantly lower post-absorptive and postprandial RQ (P = 0.0055 versus P = 0.0002, adjusted for age, sex, and lean body mass) than did groups of children with Gln223 Arg and Arg223 Arg genotypes. No significant differences were observed in FIT and RMR among the carriers and non-carriers of the 223 Arg allele. CONCLUSION: The significantly lower post-absorptive and postprandial RQ in the group of Gln223 Gln genotype children indicates that the fat oxidation of these children maybe increased before and subsequent to food consumption, which can be important in the planning of diet of these children.
Subject(s)
Basal Metabolism/genetics , Body Mass Index , Genotype , Pediatric Obesity/genetics , Polymorphism, Genetic , Receptors, Leptin/genetics , Adolescent , Calorimetry, Indirect , Child , Energy Metabolism/genetics , Female , Humans , Male , Pediatric Obesity/metabolism , Postprandial Period , Thermogenesis/geneticsABSTRACT
OBJECTIVE: This paper introduces health professionals to the different psychological models thought to influence eating behaviour in the absence of hunger in children who are obese and to propose a method of assessing these behaviours in practice. METHODS: Clinical researchers from the European Childhood Obesity Group (ECOG) adopted an evidence-based approach to examine the literature concerning the assessment of eating behaviour in children who are obese. Studies published in English were filtered out of the medical and psychological literature from 1960 to the present, and the resulting bibliography was searched for relevant articles. Key themes from the current evidence were compiled and classified according to the underpinning psychological models. Based on the current evidence and the authors' combined clinical experience, a three-staged approach to assessment was agreed by consensus. RESULTS: Valid and reliable tools for assessing and monitoring each of the three identified models (Dietary Restraint Theory, Emotional Eating and the Diathesis-Stress Model) are suggested for use in clinical practice, and the ECOG three-staged approach to assessing eating behaviours in the absence of hunger is described. CONCLUSIONS: This paper presents practical guidance on how to assess eating behaviour in the absence of hunger in children who are clinically obese and suggests a focus for future research.
Subject(s)
Feeding Behavior/psychology , Pediatric Obesity/psychology , Adolescent , Bulimia/psychology , Child , Craving , Emotions , Family/psychology , Feeding and Eating Disorders/diagnosis , Feeding and Eating Disorders/psychology , Humans , Hunger , SatiationABSTRACT
BACKGROUND/AIMS: The association of bone mass with body composition, bone turnover markers and gonadal steroids was examined in Hungarian children during pre- and midpuberty. METHODS: Two hundred and thirty-seven 7- to 16-year-old subjects (56% girls) were investigated. Bone mineral density (BMD), fat mass and total and appendicular lean mass were estimated with dual-energy X-ray absorptiometry (Lunar Prodigy). The fat mass index and appendicular lean mass index (LMI) were calculated. Serum bone markers, parathyroid hormone, estradiol and testosterone were analyzed. Associations between variables were evaluated by multiple regression analysis. RESULTS: During prepuberty, bone biomarkers, gonadal steroids and appendicular LMI were associated with bone mass in both genders (p < 0.05). During midpuberty, girls' bone turnover markers were negatively associated with bone mass (p < 0.001). In prepuberty, appendicular LMI and ß-crosslaps were predictors of bone mass in both genders. During midpuberty, appendicular LMI and gonadal steroids positively contributed to bone mass in both genders, while osteocalcin exerted a negative influence on total and L1-L4 spine BMD in girls and on L1-L4 BMD in boys (all p < 0.001). CONCLUSIONS: Predictors for bone development varied according to Tanner stage and gender. The most significant determinants of bone mass were appendicular LMI and estradiol.
Subject(s)
Biomarkers/blood , Body Composition/physiology , Bone Density , Bone and Bones/metabolism , Gonadal Steroid Hormones/blood , Puberty/blood , Puberty/metabolism , Adipose Tissue/anatomy & histology , Adolescent , Age Factors , Biomarkers/metabolism , Body Mass Index , Bone Density/physiology , Bone and Bones/anatomy & histology , Child , Cohort Studies , Female , Gonadal Steroid Hormones/metabolism , Humans , Male , Organ Size , Puberty/physiology , Sex CharacteristicsABSTRACT
AIM: To investigate the association of plasma fatty acids with the -866 G/A polymorphism of uncoupling protein 2 (UCP2) in obese children. METHODS: Fatty acid composition of plasma phospholipids and sterol esters were investigated in 80 obese children. RESULTS: Values of dihomo-gamma-linolenic acid (C20:3n-6) were significantly lower in children with the -866 A/A (n = 12) than in those with the -866 G/A (n = 34) or -866 G/G (n = 34) genotype in plasma phospholipids (3.01 [0.42] vs. 3.56 [1.02] vs. 3.53 [0.84], % weight/weight, median [interquartile range], p < 0.05), and were significantly lower in children with the -866 A/A genotype than in the other two groups in plasma sterol esters (0.73 [0.22] vs. 0.92 [0.23] vs. 0.94 [0.25], p < 0.05). Phospholipid C20:3n-6 and arachidonic acid (C20:4n-6) values showed only in children with the -866 G/G and -866 G/A genotypes significant positive correlations with plasma insulin concentrations. CONCLUSIONS: Significantly lower values of C20:3n-6 can be detected in obese children with the homozygous (-866 A/A) mutation of UCP2 than in equally obese children with heterozygous mutation or the normal genotype. High glucose-stimulated insulin response is associated with high plasma C20:3n-6 and C20:4n-6 values only in obese children with the G allele of the -866 G/A polymorphism.
Subject(s)
Fatty Acids, Omega-6/genetics , Fatty Acids, Unsaturated/genetics , Genotype , Ion Channels/genetics , Mitochondrial Proteins/genetics , Obesity/genetics , Arachidonic Acid/blood , Child , Female , Gene Expression/genetics , Humans , Insulin/blood , Male , Phospholipids/blood , Uncoupling Protein 2ABSTRACT
UNLABELLED: There is increasing evidence that obesity may damage the kidney in otherwise healthy individuals. Our study investigated the effect of childhood obesity on urinary albumin and beta-2-microglobulin excretion, and the association of these with obesity-related cardiovascular risk factors. Random morning spot urine samples were collected from clinically healthy obese (n = 86; median age 12.9 years, range 8.9-17.2 years; median weight 80.6 kg, range 46.1-136.8 kg; median body mass index 30.4 kg/m2, range 24.5-43.2 kg/m2) and normal weight children (n = 79; median age 13.5 years, range 10.7-14.9 years; median weight 51.0 kg, range 27.3-72.5 kg; median body mass index 18.2 kg/m2, range 13.2-23.9 kg/m2). The obese children were examined for the presence of common obesity-related cardiovascular risk factors including hyperinsulinaemia, impaired glucose tolerance (IGT), dyslipidaemia, hypercholesterolaemia, and hypertension. Obese children had a significantly higher urinary albumin/creatinine ratio (U-ACR) (median 11.7 mg/g, interquartile range 12.9 mg/g versus median 9.0 mg/g, interquartile range 5.1 mg/g; P = 0.003) and urinary beta-2-microglobulin/creatinine ratio (U-BMCR) (median 63.9 microg/g, interquartile range 34.7 microg/g versus median 34.6 microg/g, interquartile range 44.1 microg/g; P < 0.001) than normal weight children. Among the obese children, the U-ACR was associated with fasting hyperinsulinaemia, IGT, and hypercholesterolaemia (all P < 0.05), and significantly correlated with the fasting (r = 0.23, P < 0.05) and 2-h (r = 0.37, P < 0.001) plasma glucose levels measured during an oral glucose tolerance test. Obese children with no more than one of the features of the metabolic syndrome had significantly lower U-ACRs than obese children with two or more features (median 10.4 mg/g, interquartile range 5.8 mg/g versus median 15.3 mg/g, interquartile range 14.9 mg/g; P < 0.05). CONCLUSION: According to our results, clinically healthy obese children have a higher degree of albuminuria and beta-2-microglobulinuria than normal weight children, indicating early renal glomerular and tubular dysfunction as a consequence of childhood obesity. The urinary albumin/creatinine ratio in the obese children was associated with certain metabolic derangements linked to obesity, and also with the clustering of features of the metabolic syndrome.