Association of serum uric acid concentration with components of pediatric metabolic syndrome: A systematic review and meta-analysis.

BACKGROUND: Hyperuricemia is implicated in the pathogenesis of inflammatory diseases and metabolic disorders. Metabolic syndrome (MetS) in childhood is one of the most important causes of different noncommunicable diseases in adulthood. This study aimed to systematically review the association between serum uric acid (UA) concentration and components of pediatric MetS. MATERIALS AND METHODS: In this meta-analysis and systematic review, related articles were gathered by searching English databases including PubMed, Web of Science, Scopus, and Google Scholar. We used the following keywords: uric acid, metabolic syndrome, hypertension, fasting blood sugar (FBS), hyperglycemia; the search was limited to English language and included observational and cohort studies performed among children or adolescents. Pooled relative risks (odds ratio [OR]) and corresponding 95% confidence interval (95% CI) were extracted. A random-effect model was used. RESULTS: On the basis of 34 eligible studies, the pooled correlation between UA with metabolic components including FBS (r = 0.24, 95% CI = 0.09-0.40), fasting insulin (r = 0.26, 95% CI = 0.15-0.37), and hyperglycemia (r for triglyceride and UA = 0.23, 95% CI = 0.19-0.38) (r for high-density lipoprotein and UA = -0.28, 95% CI = -0.37 to -0.20) was statistically significant. The association of both diastolic blood pressure (DBP) and systolic blood pressure (SBP) was statistically significant with UA (r for SBP and UA = 0.34, 95% CI = 0.24-0.43; r for DBP and UA = 0.18, 95% CI = 0.11-0.25). The OR between risk of abdominal obesity with UA was statistically significant (OR = 2.62, 95% CI = 1.41-3.84). CONCLUSION: Serum UA concentration is associated with major components of the pediatric MetS. Its measurement and control should be underscored in at-risk children and adolescents.

Subjective Proximity to Green Spaces and Blood Pressure in Children and Adolescents: The CASPIAN-V Study.

Evidence favoring a beneficial association between greenness and blood pressure (BP) in adults is accumulating. However, children and adolescents have been understudied accordingly. Methodologically, the data on "exposure" to residential green spaces are commonly satellite-derived, including rare existing studies on the relationship between proximity to green spaces and BP in children. Despite perfectly obliterating subjective biases, remote sensing methods of greenness data collection fail to address pragmatic interaction with such settings. This study aimed to assess the relationship between subjective proximity to green spaces and average/elevated BP in children. Through our study, systolic and diastolic BPs of 12,340 schoolchildren living in CASPIAN-V study areas were examined and recorded. We performed surveys to obtain the data on their proximity to green spaces, defined as having access to such spaces within a 15-minute walk from their homes. Linear mixed-effects models with BP as the outcome variable and the measure of exposure to green spaces as fixed-effect predictor were applied. The analysis was adjusted for several covariates. We found that perceived residential proximity to green spaces was associated with -0.08 mmHg (95% confidence intervals (CIs): -0.58, 0.41; p value = 0.72) reduction in systolic BP and -0.09 (95% CIs: -0.49, 0.31; p value = 0.66) reduction in diastolic BP. We also observed statistically nonsignificant odds ratio of 1.03 (95% CIs: 0.76, 1.39), 0.96 (95% CIs: 0.80, 1.16), and 0.98 (95% CIs: 0.82, 1.16) for isolated systolic/diastolic hypertension and hypertension, respectively. Our observations remained consistent after adjustment for height, parental employment, low birth weight, parental obesity, single parent, and breastfeeding. In conclusion, subjective proximity to green spaces might not be associated with a lower mean BP in children. Well-designed studies applying both subjective and objective data should be performed to elaborate on the relationship further.

Mapping the relative risk of weight disorders in children and adolescents across provinces of Iran: the CASPIAN-V study.

Background: This study aimed to find possible spatial variation in children's weight disorders and in predicting the spatial distribution. Methods: The study population of this ecological study consisted of 7-18-year-old students living in 30 provinces of Iran. We used Besag, York and Mollie (BYM) model, a Bayesian model, to study the relative risk (RR) of underweight and excess weight (overweight and obese). The model was fitted to data using OpenBUGS (3.2.1) software. Results: The highest RR of underweight was found in southeastern provinces. Whereas, the highest RR of excess weight was documented in northern, northwestern and capital provinces.Sistan-Balouchestan (RR=1.973; Bayesian confidence interval [BCI]: 1.682, 2.289), Hormozgan(RR=1.482; BCI: 1.239, 1.749), South Khorasan (RR=1.422; BCI: 1.18, 1.687) and Kerman(RR=1.413; BCI: 1.18, 1.669) had the highest RR of underweight. Mazandaran (RR=1.366; BCI:1.172,1.581), Gilan (RR=1.346; BCI: 1.15,1.562), Tehran (RR=1.271; BCI: 1.086,1.472) and Alborz (RR=1.268; BCI: 1.079,1.475) provinces are high risk regions for excess weight. Conclusion: The significant variations in geographical distribution of weight disorders are because of various sociodemographic and ethnic differences. The current findings should be considered in health policy making in different regions of the country.