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INTRODUCTION: a relationship has been observed between elevated levels of liver enzymes and uric acid with the presence of metabolic syndrome (MS) in the pediatric population. OBJECTIVE: to compare serum liver enzyme and uric acid levels between adolescents with and without MS. METHODS: a cross-sectional study was carried out in adolescents with obesity between 10 and 18 years old. Somatometric data, serum insulin, lipid profile, uric acid levels and liver enzymes (aspartate aminotransferase [AST], alanine aminotransferase [ALT] and gamma-glutamyl transferase [GGT]) were analyzed. STATISTICAL ANALYSIS: Student's t test or the Chi-square test was used to evaluate differences between groups. RESULTS: a total of 1095 adolescents with obesity were included (444 with MS and 651 without MS). The group with MS had a higher BMI (with MS 2.28 vs without MS 2.11 p < 0.001), with no difference in body fat (42.9 % vs 42.9 %, p = 0.978). The MS group had significantly higher levels of AST (34.4 vs. 29.5, p = 0.013), ALT (42.2 vs. 34.6, p = 0.003), and uric acid (6.17 vs. 5.74, p = 0.002). comparison to the group without MS. The proportion of ALT (40.5 % vs 29.5 %, p = 0.029) and altered uric acid (58.1 % vs. 45.6 %, p = 0.019) was higher in the MS group. CONCLUSIONS: serum levels of ALT, AST and uric acid in adolescents with obesity and MS were higher compared to those without MS. Altered ALT was a risk factor for SM.
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Introducción: la obesidad en la población pediátrica es un problema de salud pública. Se ha demostrado la correlación del ácido úrico y el grosor de la íntima media de la carótida en adultos. Objetivo: identificar la correlación del ácido úrico y el grosor de la íntima media de la carótida en adolescentes con obesidad. Material y métodos: se realizó un estudio observacional, transversal. Se incluyeron pacientes de diez a 16 años con diagnóstico de obesidad. Se determinó ácido úrico, perfil de lípidos y grosor de la íntima media carotidea. En el análisis estadístico, se correlacionó el grosor de la íntima media carotídea con los niveles de ácido úrico a través del coeficiente de correlación de Spearman. Resultados: se incluyeron 169 adolescentes con una mediana para la edad de 13 años, sin predominio de sexo. Se identificó una correlación positiva del ácido úrico con el grosor de la íntima media carotídea (r = 0,242, p = 0,001). Al estratificarse de acuerdo con el sexo, no hubo correlación en las mujeres (r = -0,187, p = 0,074), mientras que en los hombres aumentó (r = 0,36, p = 0,001) y por estadio puberal, los adolescentes varones púberes tuvieron una correlación positiva (p = 0,384, p = 0,002). Conclusión: se identificó una correlación positiva débil entre el grosor de la íntima de la carótida y el ácido úrico en adolescentes con obesidad. (AU)
Introduction: obesity in the pediatric population is a public health problem. The correlation of uric acid and carotid intima media thickness in adults has been demonstrated.Objective: to identify the correlation of uric acid and carotid intima media thickness in adolescents with obesity.Material and methods: an observational, cross-sectional study was carried out. Patients aged ten to 16 years with a diagnosis of obesity were included. Uric acid, lipid profile and carotid intima media thickness were determined. In relation to the statistical analysis, carotid intima media thickness was correlated with uric acid levels through Spearman's correlation coefficient. Results: one hundred and sixty-nine adolescents were included with a median age of 13 years, without predominance of sex. A positive correlation of uric acid with carotid intima media thickness was identified (r = 0.242, p = 0.001). When stratified according to sex, there was no correlation in women (r = -0.187, p = 0.074), while in men it increased (r = 0.36, p = 0.001) and by pubertal stage, pubertal male adolescents had a positive correlation (p = 0.384, p = 0.002).Conclusion: a weak positive correlation was identified between carotid intimal thickness and uric acid in obese adolescents. (AU)
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Humanos , Masculino , Feminino , Adolescente , Obesidade , Ácido Úrico , Espessura Intima-Media Carotídea , Estudos Transversais , México , Correlação de DadosRESUMO
Introducción: El síndrome metabólico (SM) consiste en conjunto de alteraciones metabólicas y cardiovasculares relacionadas con resistencia insulínica y la grasa visceral. Los índices antropométricos de adiposidad visceral son herramientas útiles que pudieran detectar complicaciones metabólicas en niños obesos. Objetivos: Determinar correlación entre índices de adiposidad visceral y componentes del SM en pacientes pediátricos obesos. Métodos: Estudio transversal, pacientes de 6-16 años. Inclusión: IMC ≥ 85p, exclusión: obesidad endógena, genopatías, uso de esteroides, silla de ruedas y yesos. Variables: CC (circunferencia de cintura), ICE (índice cintura-estatura), ICC (índice de cintura-cadera), TAS, TAD (tensión arterial sistólica y diastólica), triglicéridos, colesterol total, HDL (lipoproteína alta densidad), LDL (lipoproteína de baja densidad), VLDL (lipoproteína de muy baja densidad), ácido úrico sérico, insulina, índice de HOMA. Estándares internacionales para variables. Estadística: Frecuencias, porcentajes, medias/medianas, DS/rango, correlación Pearson. Resultados: 83 pacientes, mediana 11 años. 49 (51%) masculinos. Media IMC 31.4 (DS 6.3). Diagnóstico de obesidad visceral por ICE= 96.3%; por CC =80.7% y por ICC= 57.8%. Correlaciones: CC con TAS= r 0.35, p 0.001; TAD =r 0.29, p= 0.008; ácido úrico r =0.25, p 0.02 y con LDL-C = r 0.23, p 0.029. ICE con LDL r = 0.29, p 0.009. ICC con HDL r 0.34, p 0.002. Conclusiones: El ICE fue el que más detectó adiposidad visceral y el ICC fue el que menos diagnosticó. Las correlaciones significativas fueron: ICE con LDL; ICC con HDL y CC con TAS, TAD, LDL y ácido úrico sérico. La CC correlacionó con más componentes del SM (AU)
Metabolic syndrome (MS) consisting of set of metabolic and cardiovascular disorders related to insulin resistance and visceral fat. Anthropometric visceral adiposity indices are useful tools that could detect metabolic complications in obese children. Objective to determine correlation between visceral adiposity indices and components of MS in obese pediatric patients. Transversal, patients 6-16 years. Inclusion: BMI ≥ 85p, exclusion endogenous obesity, genopathies, steroid use, wheelchair and plasters. Variables: WC (waist circumference), WHtI (waist-height index), WHR (waist-hip ratio), SBP, DBP (systolic and diastolic blood pressure), triglycerides, total cholesterol, HDL (high lipoprotein density), LDL (low density lipoprotein) VLDL (very low-density lipoprotein), serum uric acid, insulin, HOMA index. international standards for variables. Statistics: frequencies, percentages, means / medium, DS / range, Pearson correlation. Results: 83 patients, median 11 years. 49 (51%) male. Average BMI 31.4 (SD 6.3). Diagnosis of visceral obesity = 96.3% by WHI; WC = 80.7% and 57.8% WHR. Correlations WC with SBP, r = 0.35, p 0.001; DBP, r = 0.29, p = 0.008; Uric acid r = 0.25, p 0.02 and LDL-C r= 0.23, p 0.029. WHI with LDL, r = 0.29, p 0.009. WHR with HDL, r 0.34, p 0.002. The WHtI was the most detected visceral adiposity and the WHR was the least diagnosed. We concluded the WC correlated with more components of MS. Significant correlations: WHtI with LDL; WHR with HDL and WC with SBP, DBP, LDL and serum uric acid (AU)
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Humanos , Masculino , Feminino , Criança , Adolescente , Sobrepeso/complicações , Adiposidade/fisiologia , Síndrome Metabólica/complicações , Antropometria/métodos , Obesidade/complicações , Relação Cintura-Quadril/métodos , Sobrepeso/dietoterapia , Estudos Transversais/métodos , Composição Corporal/fisiologiaRESUMO
Introducción: Los componentes del Síndrome Metabólico (SM) en niños son complicaciones que sin intervención oportuna tendrán repercusiones dramáticas, antes de llegar a la adultez. Objetivos: Identificar y comparar componentes clá- sicos y no tradicionales del síndrome metabólico en ni- ños y adolescentes con exceso ponderal. Material y métodos: Estudio transversal en pacientes 6-15 años con exceso ponderal. Variables: Circunferencia de cintura (cm), glucosa(mg/dl), lipoproteína de alta densidad (mg/dl), triglicéridos(mg/dl), presión arterial (mm/Hg), insulina(µU/ml), índice de resistencia insulínica (HOMA), acantosis nigricans (AN), ácido úrico (mg/dl) e hígado graso no alcohólico. Protocolo: estándares internacionales para edad y gé- nero de variables y ultrasonido hepático, diagnóstico de SM por Federación Internacional de Diabetes (FID) y Asociación Latinoamericana de Diabetes (ALAD). Estadística. Frecuencias, porcentajes y X2. Resultados: N= 172. 55.2% sexo femenino, 69.8% adolescentes (11-15 años), 30.2% niños en etapa escolar (6-10 años). Promedio de edad: 11.7 ± 2.3. Componentes de SM: Obesidad visceral 94%; pre-hipertensión 18%; hipertensión arterial 25.6%; hipertrigliceridemia 72.6%; HDL bajo 59.3%; Hiperglucemia 6.4%; Hiperuricemia 52.9%; Hiperinsulinemia 76.7%; Resistencia Insulínica (HOMA) 80.8%; Diabetes Mellitus 2.3%; AN 88.4% e Hígado graso no alcohólico 14%.Diagnóstico de SM: 48.8%. La hipertensión arterial, hiperinsulinemia, RI, hiperuricemia y AN fueron más frecuentes en adolescentes. Un componente fue mayor en niños (p 0.017) y 4 componentes en adolescentes (p 0.002). Conclusiones: Los componentes más frecuentes del SM en pediatría son factores de riesgo cardiovascular, la hiperuricemia es componente novel que debiera investigarse por ser predictor de daño endotelial. Los niños presentaron menos componentes, aumentando en cantidad y severidad en adolescentes (AU)
Introduction: The components of the metabolic syndrome (MS) in children are complications that without opportune intervention will cause dramatic repercussions before reaching adulthood. Aim: To Identify and compare the traditional and nontraditional components of the metabolic syndrome in overweight children and adolescents. Methods: A cross-sectional study was performed using data from 172 obese patients (6-15 years old). The variables analyzed were: Waist circumference (cm), glucose (mg / dl), high density lipoprotein (mg / dl), triglycerides (mg / dl), blood pressure (mm / Hg), insulin (microU / ml), index insulin resistance (HOMA), acanthosis nigricans (AN), uric acid (mg / dl) and NAFLD. Protocols: International standards for age and gender applied to the variables and liver ultrasound, diagnosis of MS by the International Diabetes Federation (IDF) and Latin American Diabetes Association (ALAD). The statistics performed were frequencies, percentages and X2. Results: N = 172. 55.2% female, 69.8% adolescents (11-15 years), 30.2% children (6-10 years). Average age: 11.7 ± 2.3. Components of MS: visceral obesity 94%; pre-hypertension 18%; hypertension 25.6%; hypertriglyceridemia 72.6%; Low HDL 59.3%; Hyperglycemia 6.4%; Hyperuricemia 52.9%; Hyperinsuli nemia 76.7%; Insulin Resistance (HOMA) 80.8%; Diabetes Mellitus 2.3%; AN 88.4% and Nonalcoholic fatty liver 14%. Diagnosis of MS: 48.8%. Hypertension, hyperinsulinemia, RI, hyperuricemia and AN were more common in adolescents. One component was higher in children (p 0.017) and 4 components in adolescents (p 0.002). Conclusions: The most frequent pediatric components of MS are cardiovascular risk factors, the hyperuricemia is a novel component that should be investigated for being predictor of endothelial damage. The children had fewer components, increasing in quantity and severity in adolescents (AU)
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Adolescente , Criança , Humanos , Síndrome Metabólica/dietoterapia , Circunferência Abdominal , Fatores de Risco , Doenças Cardiovasculares/dietoterapia , Doenças Cardiovasculares/prevenção & controle , Resistência à Insulina/fisiologia , Obesidade/complicações , Estudos Transversais/métodos , Estudos Transversais/tendências , Protocolos Clínicos , Hiperuricemia/complicações , Hiperuricemia/dietoterapia , Hiperuricemia/prevenção & controleRESUMO
Introducción. El síndrome metabólico es uno de los principales problemas de salud a nivel mundial del cual no escapan los pacientes con cáncer. Objetivos: conocer y comparar la prevalencia del síndrome metabólico en niños con diferentes neoplasias durante el tratamiento con quimioterapia. Métodos. A través de un estudio prospectivo, longitudinal, comparativo y analítico se realizaron mediciones antropométricas, de indicadores clínicos y sanguíneos del síndrome metabólico a un grupo de pacientes pediátricos con cáncer. El análisis de datos fue con estadística no paramétrica. Resultados. Participaron 58 pacientes. La prevalencia global del síndrome fue de inicio 32.75, y 79.31% al final. Se encontró diferencia entre las 3 mediciones para indicadores del síndrome y número de pacientes positivos a ellos (P <0.05). La tensión arterial, talla y peso mostraron asociación moderada con los perímetros de cintura y cadera. Conclusiones. La prevalencia del síndrome metabólico en el grupo es muy alta, sin mostrar diferencia de acuerdo al tumor.
Introduction. Metabolic syndrome is one of the main health problem worldwide including cancer patients. Objectives. To know and to compare the prevalence of the metabolic syndrome in children with different neoplasms over chemotherapy treatment. Methods. Through prospective, longitudinal, comparative and analytical study, anthropometric, clinical and blood measurements were carried out in a group of pediatrics patients with cancer. Results. Fifty-eight patients participated. The global prevalence of the syndrome was 32.75 at the beginning, and 79.31% at the end. The 3 measurements were different for syndrome indicators as well as the number of positive patients (P <0.05). Blood pressure, height and weight were moderately associated with waist and hip perimeters. Conclusions. The metabolic syndrome prevalence in pediatric cancer patients is very high, with no difference due to cancer type.