Obesity, central adiposity and cardiometabolic risk factors in children and adolescents: a family-based study.
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ABSTRACT:
SUBMITTER: Ali O
PROVIDER: S-EPMC4114214 | biostudies-literature | 2014 Jun
REPOSITORIES: biostudies-literature
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Obesity, central adiposity and cardiometabolic risk factors in children and adolescents: a family-based study.
Ali Omar O Cerjak Diana D Kent Jack W JW James Roland R Blangero John J Zhang Yi Y
Pediatric obesity 20140327 3
<h4>Objective</h4>The objective of this study was to assess genetic and phenotypic correlations of obesity-related cardiometabolic risk factors in a family-based cohort.<h4>Methods</h4>Anthropometric, body composition and biochemical measurements were collected on 999 members of 111 extended Midwestern US families of Northern European origin. Forward stepwise regression was used to identify which of Tanner stage, sex, Tanner stage by sex, body fat mass index, body fat percentage (dual-energy X-r ...[more]
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Project description:BackgroundIt is largely unknown how TV use relates to depot-specific adiposity or cardiometabolic risk in children.PurposeTo examine relationships between having a TV in the bedroom and TV viewing time with total fat mass, abdominal subcutaneous and visceral adiposity, and cardiometabolic risk in children and adolescents.MethodsA cross-sectional study of 369 children and adolescents aged 5-18 years was conducted (2010-2011; analysis 2011-2012). Waist circumference; resting blood pressure; fasting triglycerides, high-density lipoprotein cholesterol [HDL-C] and glucose; fat mass by dual-energy x-ray absorptiometry; and abdominal subcutaneous and visceral adiposity by MRI were assessed. Cardiometabolic risk was defined as three or more risk factors including adverse levels of waist circumference, blood pressure, triglycerides, HDL-C, and glucose. Logistic regression analysis was used to compute ORs of high fat mass; subcutaneous and visceral adipose tissue mass (top age-adjusted quartile); and cardiometabolic risk, based on self-reported TV present in the bedroom and TV viewing time, controlling for age, gender, ethnicity, moderate-to-vigorous physical activity level, and unhealthy diet.ResultsIn multivariable models, presence of a TV in the bedroom and TV viewing time were associated with (p<0.05) higher odds of high waist circumference (OR=1.9-2.1); fat mass (OR=2.0-2.5); and subcutaneous adiposity (OR=2.1-2.9), whereas viewing TV ≥5 hours/day was associated with high visceral adiposity (OR=2.0). Having a TV in the bedroom was associated with elevated cardiometabolic risk (OR=2.9) and high triglycerides (OR=2.0).ConclusionsHaving a bedroom TV and TV viewing time were related to high waist circumference, fat mass, and abdominal subcutaneous adiposity. TV viewing time was related to visceral adiposity, and bedroom TV was related to cardiometabolic risk in children, controlling for moderate-to-vigorous physical activity and an unhealthy diet.RegistrationThis study is registered at Clinicaltrials.govNCT01595100.
| S-EPMC3527837 | biostudies-literature
Project description:BACKGROUND:Mendelian randomization studies in adults suggest that abdominal adiposity is causally associated with increased risk of type 2 diabetes and coronary artery disease in adults, but its causal effect on cardiometabolic risk in children remains unclear. OBJECTIVE:We aimed to study the causal relation of abdominal adiposity with cardiometabolic risk factors in children by applying Mendelian randomization. METHODS:We constructed a genetic risk score (GRS) using variants previously associated with waist-to-hip ratio adjusted for BMI (WHRadjBMI) and examined its associations with cardiometabolic factors by linear regression and Mendelian randomization in a meta-analysis of 6 cohorts, including 9895 European children and adolescents aged 3-17 y. RESULTS:WHRadjBMI GRS was associated with higher WHRadjBMI (? = 0.021 SD/allele; 95% CI: 0.016, 0.026 SD/allele; P = 3 × 10-15) and with unfavorable concentrations of blood lipids (higher LDL cholesterol: ? = 0.006 SD/allele; 95% CI: 0.001, 0.011 SD/allele; P = 0.025; lower HDL cholesterol: ? = -0.007 SD/allele; 95% CI: -0.012, -0.002 SD/allele; P = 0.009; higher triglycerides: ? = 0.007 SD/allele; 95% CI: 0.002, 0.012 SD/allele; P = 0.006). No differences were detected between prepubertal and pubertal/postpubertal children. The WHRadjBMI GRS had a stronger association with fasting insulin in children and adolescents with overweight/obesity (? = 0.016 SD/allele; 95% CI: 0.001, 0.032 SD/allele; P = 0.037) than in those with normal weight (? = -0.002 SD/allele; 95% CI: -0.010, 0.006 SD/allele; P = 0.605) (P for difference = 0.034). In a 2-stage least-squares regression analysis, each genetically instrumented 1-SD increase in WHRadjBMI increased circulating triglycerides by 0.17 mmol/L (0.35 SD, P = 0.040), suggesting that the relation between abdominal adiposity and circulating triglycerides may be causal. CONCLUSIONS:Abdominal adiposity may have a causal, unfavorable effect on plasma triglycerides and potentially other cardiometabolic risk factors starting in childhood. The results highlight the importance of early weight management through healthy dietary habits and physically active lifestyle among children with a tendency for abdominal adiposity.
| S-EPMC6904295 | biostudies-literature
Project description:Sagittal abdominal diameter (SAD) was obtained in 65 adolescents referred for assessment of cardiometabolic risk. We found that SAD was associated with cardiometabolic risk factors independent of BMI in males, but that SAD was not superior to BMI or other measures of abdominal adiposity for the detection of metabolic syndrome.
| S-EPMC4384445 | biostudies-literature
Project description:Objective: We aimed to assess the role of adipose tissue distribution in cardiometabolic risk (in particular insulin sensitivity) in a population of children and adolescents with obesity. Methods: In this cross-sectional study, participants were 479 children and adolescents with obesity (322 boys and 157 girls) aged 3 to 18 years attending the Children's Hospital at Zhejiang University School of Medicine (Hangzhou, China). Clinical assessments included anthropometry, body composition (DXA scans), carotid artery ultrasounds, and OGTT. Insulin sensitivity was assessed using the Matsuda index. Participants were stratified into groups by sex and pubertal stage. Key predictors were DXA-derived android-to-gynoid-fat ratio (A/G) and total body fat percentage (TBF%). Results: Irrespective of sex and pubertal stage, there was a strong association between increasing A/G (i.e., greater abdominal adiposity) and lower insulin sensitivity. In multivariable models, every 0.1 increase in A/G was associated with a reduction in insulin sensitivity in prepubertal boys [-29% (95% CI -36%, -20%); p < 0.0001], pubertal boys [-13% (95% CI -21%, -6%); p = 0.001], and pubertal girls [-16% (95% CI -24%, -6%); p = 0.002]. In contrast, TBF% was not associated with insulin sensitivity when A/G was adjusted for, irrespective of pubertal stage or sex. In addition, every 0.1 increase in A/G was associated with increased likelihood of dyslipidemia in prepubertal boys [adjusted odds ratio (aOR) 1.62 (95% CI 1.05, 2.49)], impaired glucose tolerance in pubertal boys [aOR 1.64 (95% CI 1.07, 2.51)] and pubertal girls [aOR 1.81 (95% CI 1.10, 2.98)], and odds of NAFLD in both prepubertal [aOR 2.57 (95% CI 1.56, 4.21)] and pubertal [aOR 1.69 (95% CI 1.18, 2.40)] boys. In contrast, higher TBF% was only associated with higher fasting insulin and ALT in pubertal boys, being also predictive of NAFLD in this group [aOR 1.15 per percentage point (95% CI 1.06, 1.26)], but was not associated with the likelihood of other cardiometabolic outcomes assessed in any group. Conclusions: A/G is a much stronger independent predictor of cardiometabolic risk factors in children and adolescents with obesity in China, particularly glucose metabolism.
| S-EPMC7498567 | biostudies-literature
Project description:BackgroundDeveloping dietary strategies to prevent excess weight gain during childhood is critical to stem the current obesity epidemic and associated adverse cardiometabolic consequences.ObjectivesWe aimed to assess how participation in a family-based weight-management intervention affected nutrient biomarkers and cardiometabolic risk factors (CMRFs) in children (7-12 y old; n = 321) with baseline BMI z score (BMIz) ≥85th percentile.MethodsThis was a secondary analysis from a randomized-controlled, parallel-arm clinical trial. Families of children, recruited from a largely Hispanic population, were assigned to Standard Care (SC; American Academy of Pediatrics overweight/obesity recommendations), or SC + Enhanced Program (SC + EP; 8 skill-building cores, monthly support sessions, targeted diet/physical activity strategies). Nutrient biomarkers (plasma carotenoids, fat-soluble vitamins, RBC fatty acid profiles, desaturase indexes) and CMRFs were measured in archived blood samples collected at baseline and the end of the 1-y intervention.ResultsChildren in both groups had significantly lower trans fatty acid and higher pentadecylic acid (15:0), PUFA n-3, and β-carotene concentrations, indicative of decreased hydrogenated fat and increased dairy, vegetable oil, fish, and fruit/vegetable intake, respectively. Similar changes were seen in de novo lipogenesis and desaturase indexes, as well as CMRFs (BMIz, lipid profile, inflammation, adipokines, liver enzymes) in both groups. Using multiple logistic regression, increase in carotenoids and decrease in endogenously synthesized SFA, MUFA, PUFA n-6, and desaturase indexes were associated with improvements in BMIz, blood pressure, lipid profile, glucose metabolism, inflammatory biomarkers, adipokines, and liver enzymes. Trans fatty acids were associated with improvements in BMIz, glucose metabolism, and leptin, with less favorable effects on inflammatory markers and adiponectin.ConclusionsProviding targeted family-based behavioral counseling, as part of SC, can help overweight/obese children adopt healthier eating patterns that are associated with modest improvements in BMIz and several CMRFs. Limited additional benefit was observed with SC + EP. These results provide critical data to design subsequent interventions to increase the impact of family-based obesity prevention programs.This trial was registered at clinicaltrials.gov as NCT00851201.
| S-EPMC6943838 | biostudies-literature
Project description:PurposeThe aim of the study was to assess the associations of meeting physical activity (PA), sleep, and dietary guidelines with cardiometabolic risk factors and adiposity in adolescents.MethodsThe sample included adolescents aged 10-16 years. Accelerometry was used to measure PA and sleep over 7 days, 24 h/d. The PA guideline was defined as ≥60 min/d of moderate-to-vigorous PA. The sleep guideline was 9-11 hours (10-13 years) or 8-10 hours (14-16 years) per night. The dietary guideline was based on the Healthy Eating Index calculated from dietary recalls. Cardiometabolic risk factors and adiposity were assessed in an in-patient setting. Linear regression was used to examine the association between meeting each guideline and cardiometabolic risk factors/adiposity, adjusted for confounders and meeting other guidelines.ResultsOf the 342 participants, 251 (73%) provided complete measurements. Adolescents were 12.5 ± 1.9 years (African American [37%] and white [57%], girls [54%], and overweight or obesity [48%]). Half met the sleep guideline (52%), few met the PA guideline (11%), and the top quintile was preselected as meeting the diet guideline (20%). Most met one (47%) or no guidelines (35%), and few met multiple guidelines (18%). Meeting the PA guideline was associated with lower cardiometabolic risk factors and adiposity (p < .05 for all). Compared with meeting no guidelines, those who met multiple guidelines had lower cardiometabolic risk factors and adiposity (p < .05 for all).ConclusionsFew met the PA or multiple guidelines, and those not meeting guidelines were associated with adverse cardiometabolic factors and adiposity. Multidisciplinary strategies for improving multiple behaviors are needed to improve adolescent health.
| S-EPMC7263948 | biostudies-literature
Project description:Objective: Adiposity induces the clustering of cardiometabolic risk factors, and pediatric adiposity is a better indicator for adulthood cardiometabolic diseases than pediatric metabolic syndrome. However, the observed prevalence of pediatric adiposity depends on the methods and cut-points used. Therefore, we aimed to define diagnostic criteria for adiposity which enable more valid identification of prepubertal children at increased cardiometabolic risk. Methods: The participants were 470 prepubertal children (249 boys) aged 6-8 years. The measures of adiposity included body mass index-standard deviation score (BMI-SDS), waist-to-height ratio (WHtR) and body fat percentage (BF%) assessed by bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA). Criteria for adiposity were determined by increased cardiometabolic risk. Cardiometabolic risk factors which correlated with BF% assessed by DXA in the upper but not lower half of BF% (serum insulin and plasma high-density lipoprotein cholesterol, triglycerides, gamma-glutamyl transferase, high-sensitivity C-reactive protein and uric acid) were included in the cardiometabolic risk score (CMS). We computed receiver operating characteristics curves for the measures of adiposity using the ≥90th percentile of CMS as a measure of increased cardiometabolic risk, and local regression curves were graphed to demonstrate the associations of the measures of adiposity with CMS. Results: In girls, WHtR of 0.445 (area under curve 0.778, its 95% confidence interval 0.65-0.91, sensitivity and specificity 0.73) and BF% of 19.5% assessed by BIA (0.801, 0.70-0.90, 0.73) were the best overall criteria for increased cardiometabolic risk. In boys, BMI-SDS of 0.48 (0.833, 0.75-0.92, 0.76) was the best overall criterion for increased cardiometabolic risk. While local regression curves in girls showed that WHtR of 0.445 corresponds well to a point where CMS began to increase, in boys local regression curves suggest that CMS began to increase even at a lower level of BMI-SDS than 0.48. Moreover, the diagnostic ability of the measures of adiposity to exclude increased cardiometabolic risk was poorer than the ability to detect it. Conclusions: In general, the measures of adiposity have sufficient diagnostic accuracy to be utilized as the screening tool for increased cardiometabolic risk. The observed cut-points for adiposity were lower than the traditional cut-points for adiposity.
| S-EPMC6606693 | biostudies-literature
Project description:AIM:We aimed to compare modifiable cardiometabolic risk factors among treatment-seeking adolescents with obesity in Italy, Germany and Norway. METHODS:This retrospective, registry-based, cross-sectional cohort study included 2,327 (59% girls) 12-18 year-old adolescents with obesity from three tertiary care outpatient clinics in Europe, between 1999 and 2015. The prevalence of cardiometabolic risk factors was compared between clinics, and multivariate logistic regression models including gender, age, waist circumference and body mass index were used to assess the associations between population and cardiometabolic risk. RESULTS:In total, 1,396 adolescents (60% girls) from Italy, 654 (58% girls) from Germany and 277 (51% girls) from Norway were included. The mean ± SD age was 15.2 ± 1.6 years, body mass index 38.8 ± 6.5 kg/m2 and body mass index standard deviation score 3.21 ± 0.43. The prevalence of elevated nonhigh-density lipoprotein-cholesterol in Norway, Germany and Italy was 60%, 54% and 45%, while the prevalence of high systolic or diastolic blood pressure (≥130 or ≥85 mmHg) were 15%, 46% and 66%, respectively. CONCLUSION:Cardiometabolic risk factors among treatment-seeking adolescents with obesity from Italy, Germany and Norway differed across the populations in this study, which might imply that preventive clinical work should reflect such differences.
| S-EPMC6585823 | biostudies-literature
Project description:The family environment has a crucial role in the development of childhood obesity and related cardiometabolic disorders. This study aims to investigate the association of parental obesity and cardiometabolic risk factors in their children.This multicentric cross-sectional study was performed on 14400 students (aged 7-18 years) and one of their parents. Students were recruited by multistage, stratified cluster sampling from urban and rural areas of 30 provinces of Iran. Fasting venous blood was obtained from a random sample of 4200 students. Demographic, anthropometric and clinical variables were collected.Data of 14002 students and results of blood samples of 3483 of them were complete and included in the current study. The prevalence of obesity in children, fathers, and mothers was 11.4%, 10.6%, and 24.2%, respectively. In students, the most commonly observed metabolic abnormality was low HDL-C (29.5%); the prevalence of metabolic syndrome and dyslipidemia was 5% and 55.7%, respectively. Significant correlations were observed between the body mass index (BMI) and waist circumference of parents and weight, height, BMI, and waist circumference, as well as systolic and diastolic blood pressure (BP) of their children (P< 0.05). In the multivariate model, the risk of excess weight (OR: 1.30, 95%CI: 1.17-1.44), obesity (OR: 1.36, 95%CI: 1.18-1.59), abdominal obesity (OR: 1.16, 95%CI: 1.05-1.29) and elevated BP (OR: 1.17, 95%CI: 1.04-1.31) were higher in those students whose parents had excess weight compared with other students. Parental obesity did not have significant association with metabolic syndrome and dyslipidemia in their children.Parental history of obesity could be used as a practical approach for the early preventive measures and identification of children at risk of cardiometabolic complications.
| S-EPMC5894970 | biostudies-literature
Project description:Cardiometabolic risk factors or their precursors are observed in childhood and may continue into adulthood. We investigated the effects of parental overweight and cardiometabolic diseases and pediatric lifestyle factors on the clustering of cardiovascular risk factors among adolescents, and examined the mediating and modifying effects of pediatric adiposity on these associations. Representative adolescents (n = 2727; age, 12-16 years) were randomly recruited through multistage stratified sampling from 36 schools in Southern Taiwan. Adolescent and parent surveys were conducted in schools and participant homes, respectively. Their demographic factors, diet patterns, and physical, anthropometric, and clinical parameters were collected and analyzed. Adolescents with 1-2 and ?3 risk components for pediatric metabolic syndrome (MetS) were defined as potential MetS (pot-MetS) and MetS, respectively. Adolescents whose parents were overweight/obese, or with diabetes and hypertension had a higher prevalence ratio of pot-MetS and MetS (1.5-1.6 and 1.9-4.2-fold, respectively). Low physical activity (<952.4 MET·min/week), long screen time (?3 h/day) and high sugar-sweetened beverage intake (>500 mL/day) were associated with a 3.3- (95% confidence intervals (CI) = 1.5-7.3), 2.2- (95% CI = 1.1-4.4), and 26.9-fold (95% CI = 3.2-229.0) odds ratio (OR) of MetS, respectively. Pediatric body mass index (BMI) accounted for 18.8%-95.6% and 16.9%-60.3% increased prevalence ratios of these parental and pediatric risk factors for MetS. The OR of pot-MetS + MetS for sugar-sweetened beverage consumption was multiplicatively enhanced among adolescents with overweight/obesity (combined OR, 8.6-fold (95% CI = 4.3-17.3); p for multiplicative interaction, 0.009). The results suggest that parental overweight and cardiometabolic diseases and pediatric sedentary and high sugar-intake lifestyles correlate with the development of adolescent MetS, and an elevated child BMI explains a part of these associations. Pediatric adiposity might be multiplicatively associated with sugar-sweetened beverage consumption for enhancing the MetS prevalence ratio among adolescents.
| S-EPMC5037552 | biostudies-literature