Search

Background: Exploration of cardiometabolic alterations in the pre-adolescent stage is necessary to characterize possible patterns for matabolic syndrome (MetS) in the earliest stages of the life. However, defining specific cutoff points for metabolic and vascular markers represents a complex task in pre-adolescent populations. This study aimed to estimate the prevalence of MetS and its components in children aged 5-9 years old by using the MetS definition for adolescents with the lowest cut-off points, and evaluate its relationship with overweight and socio-demographic determinants., Methods: A total of 494 children were evaluated. Multivariate models with filtered variables in preliminary univarite analyses were built to find predictive factors of MetS and its components., Results: The prevalence of MetS was 8.7% in the studied children. Multivariate models showed that age, overweight and low socioeconomic stratum were associated with MetS; low high-density lipoprotein cholesterol was not significantly associated with any variable; high triglycerides were positively associated with age, overweight and inversely associated with kilocalories/day; female gender was the only variable significantly associated with high fasting glucose (inverse association); and age, gender and overweight were significant factors for increased waist circumference. In the case of high blood pressure, no variable was classified to the multivariate analysis., Conclusion: This study showed disturbing figures regarding cardiometabolic risk in the children based on comparisons with studies in adolescents. Further studies are needed to confirm the utility of the de Ferranti Mets definition in children.

Scope: Very few studies have evaluated serum hepcidin in patients with type 2 diabetes and they have reported conflicting results. In addition, the effect of antidiabetic drugs on circulating hepcidin has not been explored so far. The aims of the study were to evaluate hepcidin concentrations and hepcidin/ferritin ratio in type 2 diabetes subjects and healthy non-diabetic controls and to evaluate the effect of metformin on hepcidin concentrations., Methods and Results: Study 1: Cross-sectional multivariate study of 239 non-diabetic individuals and 65 people with type 2 diabetes. The multivariate analysis included covariates of chronic inflammation, BMI, pharmacological treatment, menopausal status and insulin resistance. Study 2: Randomized, double-blinded, placebo-controlled 4-month trial metformin compared to placebo among 36 type 2 diabetic patients. In both groups diet was controlled by maintaining a hypocaloric intake across the trial. Hepcidin levels were significantly lower in patients with type 2 diabetes than in non-diabetic individuals either in crude or adjusted regression models (P<0.05). Hepcidin decreased in both arms of the trial (Placebo, p = 0.004; metformin, p = 0.022)., Conclusion: Circulating hepcidin was significantly and independently lower in type 2 diabetes. Metformin treatment is not associated with reductions in hepcidin but hypocaloric diet could be involved., (© 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Objective: To evaluate the Relationship between maternal and newborn endothelial function and oxidative stress., Methods: Forty-three pregnant women and their offspring were evaluated. As markers of endothelial function, the flow-mediated dilation (FMD) was measured in pregnant women in the second and third trimesters, and nitric oxide (NO) was quantified in the endothelial cells of the umbilical cord vein. Malondialdehyde (MDA), as a marker of oxidative stress, was measured in the maternal plasma (second and third trimesters) and plasma from umbilical cord blood. Gestational age and birth weight were recorded. Correlations between variables were estimated, and adjustments were made for specific gestational week of measurement, gestational age at birth, and complications during pregnancy and/or at delivery., Results: Maternal FMD at second trimester correlated positively with newborn MDA, although with marginal significance (P = 0.090). The change in maternal FMD was positively correlated with newborn NO (P = 0.039), although adjustment for gestational age and specific week of gestation attenuated this relationship (P = 0.070). Maternal MDA at second trimester correlated positively with newborn MDA independently of gestational age at birth, specific week of gestation of the measurement, and having complications during pregnancy or at delivery (P = 0.032). After adjustments, the change in maternal MDA correlated with newborn MDA but marginally (P = 0.077)., Conclusion: Study findings suggest that under physiological conditions, enhanced endothelial function and/or oxidative stress in the mother may impact on normal fetal development. Future studies are recommended, employing larger sample sizes, a more extensive set of markers of oxidative stress, and comparisons of complicated versus normal pregnancies., (© 2015 Wiley Periodicals, Inc.)

Very few large studies in Latin America have evaluated the association between waist:height ratio (W-HtR) and cardiometabolic risk in children and adolescents. Further, multivariable analyses verifying the independence of located subcutaneous fat have not been conducted so far. The aim of this study was to evaluate the associations of W-HtR and waist circumference (WC) with metabolic syndrome abnormalities and high LDL-cholesterol levels in schooled adolescents before and after adjusting for trunk skinfolds and BMI. The sample consisted of 831 boys and 841 girls aged 10-17 years. Biochemical, blood pressure and anthropometrical variables were measured. Age- and sex-specific quartiles of W-HtR and WC were used in Poisson regression models to evaluate the associations. High WC values (highest quartile v. quartiles 1-3) were associated with high TAG levels in both sexes (prevalence ratio, boys: 2·57 (95 % CI 1·91, 3·44); girls: 1·92 (95 % CI 1·49, 2·47); P0·05). High W-HtR (highest quartile v. quartiles 1-3) was only independently associated with high TAG in female adolescents (1·99 (95 % CI 1·55, 2·56); P<0·05). In conclusion, WC showed better association with cardiometabolic risk than W-HtR in the children of this study. This observation does not support W-HtR as a relevant adiposity marker for cardiovascular and metabolic risk in adolescence.

Introduction: The metabolic syndrome, a set of metabolic anomalies that include insulin resistance, central obesity, dyslipidemia, hypertension and inflammation, is an important tool to explore factors associated to cardiometabolic disease., Objective: The aim of this study was to evaluate the relationship of the levels of self-reported physical activity and the International Physical Activity Questionnaire items and the metabolic syndrome and the variables related to cardiovascular risk in 89 women., Materials and Methods: The short version of International Physical Activity Questionnaire was applied to classify participating subjects into three categories: insufficient, sufficient and very active physical activity. The metabolic syndrome was assessed according to the International Diabetes Federation criteria. Biochemical and anthropometrical parameters were measured ., Results: Twenty-two participants (23%) presented metabolic syndrome and 66 women (74.2%) were classified in the insufficient physical activity category. No association was found between insufficient physical activity and metabolic syndrome . Inverse correlations were found among the days and minutes per week of physical activity of moderate-intensity, waist circumference ( r =-0.327, and r =-0.313, p<0.005, respectively), and body mass index ( r =-0.262, and r =-0.218, p<0.05, respectively)., Conclusion: A high prevalence of insufficient physical activity was found in the study participants, but this was not associated with metabolic syndrome . Moderate but not vigorous physical activity items from the International Physical Activity Questionnaire correlated inversely with anthropometrical markers related to cardiovascular risk.

Introduction: Atherosclerosis is an asymptomatic chronic disease, which begins at early age and is difficult to detect during this stage. Prospective studies suggest a causal relationship between total serum cholesterol levels during childhood and early adolescence and the development of cardiovascular diseases in adulthood., Objective: The aim of this study was to evaluate the prevalence of early atherosclerotic lesions in the aorta artery of children and its relationship with post-mortem serum cholesterol levels., Material and Methods: Post-mortem samples of blood and aorta were taken from 43 subjects aged less than 17 years old. Histopathological analysis (intimal thickening and inflammatory infiltrates) of the thoracic aorta and measurement of total serum cholesterol were performed., Results: The analysis showed thickening of the intima and lymphocyte infiltrates in 93% of children, and macrophage infiltrates in 79.1% of cases. A relationship between the highest terciles of total serum cholesterol levels and the presence of multiple lesions in the aorta wall was found ( P <0.05)., Conclusion: This group of children had a high prevalence of early inflammatory atherosclerotic lesions positively related with serum cholesterol levels. To our knowledge this study represents the first report of a relationship between post-mortem total serum cholesterol levels and pathological findings of macrophages and lymphocytes infiltrates in the aorta wall.

Objective: To evaluate the relationship of copper and zinc dietary intakes with metabolic syndrome (MetS) in adolescents., Methods: The sample consisted of 1,311 adolescents aged 11-16 years, and MetS definition by de Ferranti et al. was used. Nutritional intakes, anthropometrical and biochemical markers were measured., Results: In males, highest quartile of zinc intake was inversely associated with MetS without and with adjustment by covariables. Without adjustment, highest quartile of copper intake was inversely associated (marginal significance) with MetS, but with adjustment, the relationship was not maintained. Likewise in male gender, elevated waist circumference was the only MetS component inversely associated with highest quartiles of zinc (without and with adjustment) and copper (significant in crude analysis and marginal significant in adjustment by covariables) intakes. In the girls, only waist circumference was significant and inversely associated with highest quartiles of zinc and copper intakes but the association did not remain significant after adjustments., Discussion: In the adolescents of this study, zinc intake could be more associated to a clustering of anthropometric, vascular, and metabolic alterations than to these alterations separately, and also it is inversely related to this clustering (MetS). However, studies in other populations are necessary to confirm and explain the finding of exclusive association zinc intake-MetS in male gender adolescents. Further research is required to explore biomarkers of physiological processes (antioxidant function, blood flow regulation, and epigenetic modulation dependent of zinc) in relation to zinc intake and MetS in pediatric and adult populations., (Copyright © 2013 Wiley Periodicals, Inc.)

Objective: The aim of this study was to evaluate the relationship of tricipital (TS), abdominal (AS), subscapular (SS), and suprailiac (SIS) skinfolds, Body Mass Index (BMI), and Waist Circumference (WC) with 1) variables related to cardiovascular risk (CVR) and 2) the clustering of cardiovascular risk factors (CVRF) - referenced pediatric cut-off points - in a multivariate analysis., Materials/methods: The sample was 1672 adolescents. Glucose, lipid profile, blood pressure and anthropometric variables were measured., Results: Adjusting for age, gender, and caloric intake, the highest quartile (Q4) of adiposity markers was associated to Q4 of biochemical and blood pressure variables. However, the association was not found for WC, SS and TS with glucose, and for diastolic blood pressure (DBP) with TS, SS, and SIS. Triglycerides Q4 was related to Q4 of SS, AS, and SIS after further adjustments, as well as HDL cholesterol (HDL-C) Q1 with Q4 of SS and AS. Glucose Q4 was associated to BMI, AS (Not adjusting for BMI and SIS), and SIS Q4 (Not adjusting for BMI and TS). LDL-Cholesterol (LDL-C) Q4 was associated to TS and SS Q4. The associations of LDL-C Q4 and HDL-C Q1 with WC Q4 were not significant after further adjustments. All the adiposity markers, except WC and TS, were associated to CVRF clustering in all the adjustments., Conclusions: In the adolescents, subcutaneous fat from the trunk (SS, AS, SIS) was better and independently associated to CVR variables and with CVRF clustering than visceral fat (WC). Further research is required to explain the specificity in the described associations., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Objectives: Evidence about the relationship between familial history (FH) of cardiometabolic disease (CMD) and metabolic syndrome (MetS) in Latin American populations is scarce. The aim of this study was to evaluate the relationship of FH of CMD and of dyslipidemia and obesity with MetS in healthy men., Methods: One-hundred-twenty one individuals were recruited. Waist circumference and blood pressure were measured by a trained researcher using standard techniques. Glycemia and lipid profile were determined by colorimetric assays. A survey to record personal data and family antecedents in siblings, aunts/uncles, parents, and grandparents was conducted by trained interviewers., Results: Individuals having three or more familial antecedents were associated with high triglycerides level even after adjusting by age, sedentarism, fat and carbohydrates intake, and alcohol consumption. After adjusting for the same variables, FH of dyslipidemia and hypertension was also associated with high triglycerides levels and elevated waist circumference, respectively. The FH of stroke was associated with high blood pressure after adjusting for the rest of familial antecedents, and with MetS in all adjustment models., Discussion: the findings of association of this study together with the previous reports are evidence of the importance of hereditary component as independent predictor of cardiovascular risk factors and its clustering, as well as of possible specific association patterns between FH of CMD and MetS depending on evaluated population in terms of ethnic groups and geographic region. Further studies are required in other populations, as well as exploration of genetic markers of CMD regarding to MetS., (Copyright © 2013 Wiley Periodicals, Inc.)

Growth factors, insulin signaling and nutrients are important regulators of β-cell mass and function. The events linking these signals to regulation of β-cell mass are not completely understood. Recent findings indicate that mTOR pathway integrates signals from growth factors and nutrients with transcription, translation, cell size, cytoskeleton remodeling and mitochondrial metabolism. mTOR is a part of two distinct complexes; mTORC1 and mTORC2. The mammalian TORC1 is sensitive to rapamycin and contains Raptor, deptor, PRAS40 and the G protein β-subunit-like protein (GβL). mTORC1 activates key regulators of protein translation; ribosomal S6 kinase (S6K) and eukaryote initiation factor 4E-binding protein 1. This review summarizes current findings about the role of AKT/mTORC1 signaling in regulation of pancreatic β cell mass and proliferation. mTORC1 is a major regulator of β-cell cycle progression by modulation of cyclins D2, D3 and cdk4/cyclin D activity. These studies uncovered key novel pathways controlling cell cycle progression in β-cells in vivo. This information can be used to develop alternative approaches to expand β-cell mass in vivo and in vitro without the risk of oncogenic transformation. The acquisition of such knowledge is critical for the design of improved therapeutic strategies for the treatment and cure of diabetes as well as to understand the effects of mTOR inhibitors in β-cell function.

The aim of this study was to evaluate body iron stores as predictors of insulin resistance. We developed a cross-sectional study among 123 men, 25-64 years of age and determined fasting plasma glucose, insulin, serum ferritin, and C-reactive protein levels. A survey was performed to record personal antecedents and family history of non-transmissible chronic diseases. Log-transformed ferritin levels was an independent predictor for log-transformed insulin resistance index assessed by homeostatic model assessment when body mass index or waist circumference were not included in multiple linear regression models. Sedentarism, heart attack family history, and log-C reactive protein levels were also significant predictors for insulin resistance. In conclusion, documented anthropometric predictors affect the significance of ferritin as a potential prediction variable for insulin resistance. Mechanisms of how body fat could influence ferritin levels should be evaluated. To our knowledge, this is the first evaluation of the relationship between body iron stores and insulin resistance in a Latin American population.

Copper and calcium are essential for human growth and development. The present study was conducted to evaluate the relationship between calcium and copper levels, as well as their relationship to age and anthropometry in 180 preschool children ages 2-5 years old. Serum copper levels were inversely correlated with age (r = -0.184, P = 0.032) and height (r = -0.175, P = 0.043) in the whole group and with height for age Z score only in male children (r = -0.291, P = 0.016). The correlation with age is not maintained when it is analyzed for gender. Serum calcium values in the total group were inversely correlated with weight (r = -0.153, P = 0.044) and weight for height Z score (r = -0.246, P = 0.001). No differences were found for gender in the levels of both metals. A negative relationship between serum calcium and copper was found only in male children (r = -0.339, P = 0.005). Studies are required in other populations and experimental designs that can explain an inverse relationship between serum calcium and copper levels.

Postprandial lipemia has been associated with atherogenesis and other non infectious chronic diseases. A descriptive, non aleatory study of 51 healthy young adults (23.8 +/- 4 years) of different ethnic background was carried out to identify possible personal or life style factors associated with the response of plasma lipids after a mixed carbohydrate and lipid load. Personal, family, life styles including use of drugs and activity and ethnic background were recorded. Anthropometrical measurements, a short insulin and postprandial lipemia tests were done. From these observations body mass index (BMI) and area under the curve (AUC) for lipids and glucose were calculated. High mean values were observed in AUC for glucose, triacylglycerol and nonesterified fatty acids (NEFA). Postprandial glucose with differences by age (p=0.05 Bonferroni) but no ethnic, gender, BMI or insulin sensitivity related significant differences were found. Mestizos (40%) showed two, and Negroes three (27%) postprandial triglyceridemia peaks. Noteworthy, subjects presenting four peaks had elevated BMI. Higher triglyceridemia values were found in white and mestizos (p<0.05), in subjects older than 29 and in males (p<0.05). Statistical correlation (r2=0.70) between BMI and triglyceridemia and change in postprandial trigliceridemia was found in white and black subjects. NEFA declined up to the second hour, but at 6-7 hours they reached levels higher than base values. Higher than reported values for UCA and BMI and an abnormal response to fat intake with an early release of NEFA was found. The high correlation between BMI and postprandial trigliceridemia suggests that body mass index could be a good predictor of postprandial trigliceridemia.