ABSTRACT
High blood pressure (HBP) and obesity is a well-established major risk factor for stroke and coronary heart disease. However, the literatures are scarce about these informations in adolescents from low-and-middle income countries. This school-based survey was carried out among students from Maringá (Brazil) and Buenos Aires (Argentina) selected random sampling. We studied 991 Brazilian adolescents (54.5% girls) in the age range of 14-18 years. In Argentina, we studied 933 adolescents (45.9% female) in the age range of 11-17 years. The outcomes of this study are general obesity, abdominal obesity and HBP. The associated factors analysed were gender, age and health behaviours. The prevalence of obesity was 5.8% in Brazil and 2.8% in Argentina, the prevalence of abdominal obesity was 32.7% in Brazil and 11.1% in Argentina, the prevalence of HBP was 14.9% in Brazil and 13.5% in Argentina. The multilevel analysis showed that older adolescents (>14 years old) have a little likelihood of being overweight, whereas male adolescents are more likely to be obese and have HBP. The abdominal obesity in both indicators were not associated with the independent variables. The prevalence of cardiovascular risk factors is high in Latin American adolescents independent of each country, and was associated with male gender.
Subject(s)
Cardiovascular Diseases/etiology , Hypertension/epidemiology , Obesity/epidemiology , Overweight/epidemiology , Adolescent , Anthropometry , Argentina/epidemiology , Brazil/epidemiology , Female , Humans , Male , Prevalence , Risk Factors , SchoolsABSTRACT
La obesidad en la infancia está asociada con dislipemia, hipertensión arterial, intolerancia a la glucosa y predisposición temprana a enfermedad cardiovascular. La obesidad abdominal juega un rol central en el Síndrome Metabólico (SM), entidad que predispone a los individuos afectados al desarrollo de diabetes y enfermedad cardiovascular en la adultez. La insulinorresistencia que acompaña al SM puede evaluarse a través de distintos marcadores El objetivo de este trabajo fue evaluar la presencia de SM y de factores de riesgo cardiovascular (RCV) (dislipemias, hipertensión arterial y obesidad) y de marcadores metabólicos (Apo B y PCR ultrasensible) en nuestra población de adolescentes. Fueron evaluados 943 estudiantes adolescentes (429 mujeres y 541 varones), entre 11 y 14 años, de escuelas secundarias de la Universidad de Buenos Aires. Se midieron parámetros antropométricos y se determinaron las concentraciones plasmáticas de glucemia, lípidos, apolipoproteína B (apo B) y PCR ultrasensible (PCRus). Los varones presentaron mayor peso (p= 0.004), mayor circunferencia de cintura (p= 0.0002) y mayor presión arterial sistólica y diastólica (p= 0.008 y p= 0.002 respectivamente) con respecto a las mujeres. También presentaron mayor nivel de glucemia (p= 0.04) y menor nivel de HDL-colesterol (p= 0.004). No hubo diferencia significativa en los niveles plasmáticos de triglicéridos, PCRus y apo B entre ambos sexos. La presencia de SM fue de 5,45% en varones y de 1,63% en mujeres. El grupo de adolescentes con SM presentó mayor peso, IMC, circunferencia de cintura, presión sistólica y diastólica, como también valores más elevados de glucemia, triglicéridos y menor HDL-colesterol, siendo las diferencias significativas. Los niveles séricos de ApoB fueron mayores en el grupo con SM (p= 0.001). En conclusión, este estudio muestra la presencia de SM y de factores de riesgo cardiometabólico con incremento de apoB en edades tempranas, por lo cual su detección precoz en niños y adolescentes, ayudaría a implementar medidas preventivas.
Obesity in the infancy is associated with dyslipidemia, hypertension, glucose intolerance and early development of cardiovascular risk. Abdominal obesity associated with metabolic syndrome predisposes to diabetes mellitus and cardiovascular disease in adulthood. Insulin resistance is present in this syndrome and should be evaluated. The aim of the study was to evaluate the presence of metabolic syndrome (MS) and cardiovascular risk (dyslipidemia, hypertensión and obesity) and metabolic risk markers (apolipoprotein B and high sensitivity C-reactive protein) in this group of adolescents. We evaluated 943 adolescents from high school (429 women y 541men), ages between 11 and 14. Weight, height, body mass index (BMI), waist circumference (WC) and blood pressure were determined in all subjects. Fasting serum concentrations of glucose, lipids, apolipoprotein B (apoB) and high sensitivity C-reactive protein (hs-CRP) were measured. Boys showed higher weight (p= 0.004), higher WC (p= 0.0002) and higher systolic and diastolic blood pressure (p= 0.008 y p= 0.002)) than girls. They also showed higher glycemia (p= 0.04) and lower HDLcolesterol levels (p= 0.004). There were no differences in triglycerides, hs-CRP and apo B levels between both sexes. The frequency of MS was 5.45% in males and 1.63% in females. The group with MS had higher weight, BMI, WC, and systolic and diastolic blood pressure as well as higher glucose and triglycerides and lower HDL-cholesterol levels Although no differences in hs-CRP were observed between groups, hs-CRP correlated with WC (r=0.14, p<0.001) and BMI (r=0.17, p< 0.001). ApoB levels were higher in the group with MS (p= 0.001). In conclusion this study shows the presence of MS and cardiovascular risk factors with high apo B levels at early age. Early detection of children and adolescents with metabolic abnormalities should be useful to implement strategies to avoid the development of cardiovascular disease in later life.
ABSTRACT
MEN-1 is a hereditary autosomal dominant syndrome characterized by the involvement of parathyroid glands, pancreatic islet cells and anterior pituitary gland. Today molecular genetics permit gene carrier analysis to compare the data obtained with the clinical biochemical tests. The twenty living members of the first, second and third generation of a family with MEN-1 were studied to determine the presence of genetic markers in MEN-1 loci 11q13, by linkage analysis and in affected individuals by biochemical tests and clinical examination. Two very informative polymorphic markers immediately flanking the MEN-1 gene on chromosome 11 band q13 were detected: PYGM and D11S987, haplotypes segregated by two members of the second generation, inherited from their father and two of the third generation: the affected one and one presymptomatic. The third generation had the affected member with renal stones and elevated PTH, PRL and glucagon. The presymptomatic carrier of MEN-1 allele showed elevated PTH. Among the members who inherited the normal allele we found one with elevated gastrin, one with elevated glucagon and one with elevated PTH, all asymptomatic. Of one Argentine family studied, molecular diagnosis allowed us to detect one presymptomatic carrier in the members at risk. As suggested by the available literature, accuracy of molecular diagnosis seems to make it the test of choice to exclude those members at risk for MEN-1 inheriting the normal allele.