Biochemical Characteristics and Risk Factors for Insulin Resistance at Different Levels of Obesity
ABSTRACT OBJECTIVE:To establish the biochemical characteristics of nonobese, overweight, and obese children as well as to determine the risk factors associated with insulin resistance in nonobese children and with non-insulin resistance in obese children in the age strata of 6 to 11 years.METHODS:A total of 3512 healthy children were enrolled in a cross-sectional study. In the absence of obesity, fasting hyperinsulinemia and hypertriglyceridemia defined nonobese, insulin-resistant (NO-IR) children. In the absence of metabolic abnormalities of fasting insulin and triglycerides levels, obese children were defined as obese, not insulin-resistant (O-NIR) children.RESULTS:The gender- and age-adjusted prevalence of NO-IR and O-NIR was 6.6% and 21.3%, respectively. In the age-, gender-, and birth weight-adjusted analysis, family history of hypertension (FHH) in both maternal and paternal branches (odds ratio [OR]: 1.514; 95% confidence interval [CI]: 1.2-3.9; P = .04) was associated with NO-IR children. In the analysis adjusted by gender, age, waist circumference (WC), BMI, FHH, and family history of diabetes, high birth weight was associated with NO-IR children (OR: 1.319; 95% CI: 1.2-2.1; P = .04). Finally, in the gender-, age-, family history-, and birth weight-adjusted analysis, a WC lower than the 95th percentile was associated with a lower odds of insulin resistance among obese children (OR: 0.96; 95% CI: 0.91-0.98; P < .0005).CONCLUSIONS:FHH and high birth weight are associated with NO-IR children, and a low WC is associated with lower odds of O-IR children.
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ABSTRACT: Air pollution exposures are linked to systemic inflammation, cardiovascular and respiratory morbidity and mortality, neuroinflammation and neuropathology in young urbanites. In particular, most Mexico City Metropolitan Area (MCMA) children exhibit subtle cognitive deficits, and neuropathology studies show 40% of them exhibiting frontal tau hyperphosphorylation and 51% amyloid-β diffuse plaques (compared to 0% in low pollution control children). We assessed whether a short cocoa intervention can be effective in decreasing plasma endothelin 1 (ET-1) and/or inflammatory mediators in MCMA children. Thirty gram of dark cocoa with 680 mg of total flavonols were given daily for 10.11 ± 3.4 days (range 9-24 days) to 18 children (10.55 years, SD = 1.45; 11F/7M). Key metabolite ratios in frontal white matter and in hippocampus pre and during cocoa intervention were quantified by magnetic resonance spectroscopy. ET-1 significantly decreased after cocoa treatment (p = 0.0002). Fifteen children (83%) showed a marginally significant individual improvement in one or both of the applied simple short memory tasks. Endothelial dysfunction is a key feature of exposure to particulate matter (PM) and decreased endothelin-1 bioavailability is likely useful for brain function in the context of air pollution. Our findings suggest that cocoa interventions may be critical for early implementation of neuroprotection of highly exposed urban children. Multi-domain nutraceutical interventions could limit the risk for endothelial dysfunction, cerebral hypoperfusion, neuroinflammation, cognitive deficits, structural volumetric detrimental brain effects, and the early development of the neuropathological hallmarks of Alzheimer's and Parkinson's diseases.Frontiers in Pharmacology 08/2013; 4:104. DOI:10.3389/fphar.2013.00104 · 3.80 Impact Factor
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ABSTRACT: Objective: In obese children bone age (BA) tends to significantly exceed chronological age (CA). In vitro studies in mice suggest that insulin may directly modulate skeletal growth. We aimed to investigate a possible association between fasting insulin and BA maturation in obese children.Methods: The study cohort comprised 74 overweight and obese children ages 4-13 years. BA divided by CA was used as an index for bone advancement. Participants were classified into tertiles based on their BA/CA ratio. Advanced BA maturation was defined as the third tertile, with BA/CA >1.21. Components of the metabolic syndrome, including fasting insulin, fasting glucose, triglycerides, and HDL levels, were measured.Results: Children with advanced BA were significantly younger, with higher BMI-Z, and taller than children with bone advancement at the lower tertiles. Females had a 4.7 times increased risk for advanced BA as males [95% CI (1.29-17.1); p=0.02]. Children with BMI-Z >1.96 and fasting insulin≤ 30 mU/l had a 3.6 increased risk of advanced BA [95% CI (1.00-12.8); p=0.02]. Moreover, hyperinsulinemia (fasting insulin >30 mU/l) was associated with a 6.8 fold increased risk for advanced BA independent of the degree of obesity [95% CI (1.45-32.1); p=0.01].Conclusion: Marked hyperinsulinemia was found to be associated with advanced BA in obese children. Insulin appears to modulate skeletal growth in humans.Endocrine Practice 09/2013; 20(1):1-20. DOI:10.4158/EP13193.OR · 2.59 Impact Factor
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ABSTRACT: The increasing number of people with type 2 diabetes (DM2) is alarming and if it is taken into account that the relative odds of developing tuberculosis in diabetic patients ranges from 2.44 to 8.33 compared with non-diabetic patients, thus in developing countries where these two diseases are encountering face to face, there is a need for prophylaxis strategies. The role of vitamin D has been widely implicated in growth control of M. tuberculosis (Mtb) during primary infection mainly through the induction of certain antimicrobial peptides (AMPs). In this study we evaluated the vitamin D serum levels, CYP27B1-hydroxylase enzyme, vitamin D receptor (VDR) and AMPs gene expression in Healthy donors, DM2 and TB patients. Results showed that DM2 group has lower VDR and AMPs expression levels. When Monocytes Derived Macrophages (MDM) from DM2 patients with low VDR expression were supplemented with vitamin D, MDMs eliminate efficiently M. tuberculosis. This preliminary study suggests the use of vitamin D as prophylaxis for tuberculosis in high DM2 endemic countries.Microbes and Infection 07/2014; 16(9). DOI:10.1016/j.micinf.2014.06.010 · 2.73 Impact Factor