166 Overweight/Obese Children, Dropping Out of Therapy, Show a Higher Metabolic Risk Profile

Angiotensin converting enzyme (ACE) plays a dominant role in renal and cardiovascular diseases, obesity and diabetes. The somatic ACE (130-190 kDa) is composed of two homologous N- and C- domains. Two soluble N-domain isoforms have been described in human urine with 65 and 90KDa. Studies have supported that N-domain ACE with 90KDa is a biomarker for hypertension, pre-eclampsia and inflammation. We analyzed the expression of somatic and soluble N-domain ACE isoforms in urine of children and adolescents with different nutritional status and cardiovascular risk profile. The volunteers aged from 6 to 19 years were classified into four groups according to their BMI percentile; underweight (n=51), normal weight (n = 53), overweight (n=53) and obese (n=49). Waist-height-ratio (WHtR) was used to assess cardiovascular risk profile dividing the participants into normal risk (n=105) and high risk (n=101). The urines were concentrated 10-fold and dialyzed with Tris-HCl pH 8 and pure water. Then, we performed western blot analysis using 50μg of lyophilized urinary protein, using the ACE polyclonal antibody Y1. Protein detection was performed by chemiluminescent and analysis in Image Lab software utilizing total protein stain for normalization. ACE expression is augmented in obese children when compared with normal weight children ( 0.09 vs 0.53 arbitrary units, p=0,04 ). The higher cardiovascular risk group also presented increased expression of ACE ( 0.27 vs 0.09 arbitrary units, p=0.046 ). The 90KDa N-domain isoform is frequently found in the high cardiovascular risk children ( p= 0.02 ). According to Spearman correlation test, the expression of 90 kDa N-domain ACE correlates positively with waist circumference, WHtR, BMI percentile and Z-score of BMI. Increased ACE expression in obese children contributes to higher cardiovascular risk once this enzyme biosynthesizes Angiotensin II which promotes blood pressure increase, sympathetic nervous system activation and release of glucocorticoids from adrenal gland. ACE expression is also augmented in children with high cardiovascular risk. Presence of 90 KDa N-domain ACE in urine of children and adolescents is a biomarker of poor prognostic for cardiovascular disease in childhood obesity.

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White Coat Hypertension, Metabolic Risk Factors and Cardiovascular Risk Profile

White Coat Hypertension ◽

10.1007/978-3-319-07410-8_6 ◽

2014 ◽

pp. 97-111

Author(s):

Michele Bombelli ◽

Rita Facchetti ◽

Gianmaria Brambilla ◽

Guido Grassi ◽

Giuseppe Mancia

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Risk Profile ◽

Metabolic Risk Factors ◽

White Coat ◽

White Coat Hypertension ◽

Metabolic Risk ◽

Cardiovascular Risk Profile

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Comparison of monounsaturated fat with carbohydrates as a replacement for saturated fat in subjects with a high metabolic risk profile: studies in the fasting and postprandial states

American Journal of Clinical Nutrition ◽

10.1093/ajcn/86.6.1611 ◽

2007 ◽

Vol 86 (6) ◽

pp. 1611-1620 ◽

Cited By ~ 70

Author(s):

Lars Berglund ◽

Michael Lefevre ◽

Henry N Ginsberg ◽

Penny M Kris-Etherton ◽

Patricia J Elmer ◽

...

Keyword(s):

Saturated Fat ◽

Risk Profile ◽

Metabolic Risk ◽

Monounsaturated Fat

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The effect of aerobic exercise on the metabolic risk profile of breast cancer survivors 2-6 months post chemotherapy.

Journal of Clinical Oncology ◽

10.1200/jco.2011.29.27_suppl.244 ◽

2011 ◽

Vol 29 (27_suppl) ◽

pp. 244-244

Author(s):

E. M. Guinan ◽

J. M. Hussey ◽

J. M. Walsh ◽

M. J. Kennedy ◽

E. M. Connolly

Keyword(s):

Breast Cancer ◽

Cancer Survivors ◽

Aerobic Exercise ◽

Breast Cancer Survivors ◽

Exercise Intervention ◽

Risk Profile ◽

Control Group ◽

Metabolic Risk ◽

Model Assessment ◽

Supervised Exercise

244 Background: Current literature suggests that weight gain during treatment for breast cancer is associated with a poorer prognosis and an increased risk of developing secondary health problems such as the metabolic syndrome (MetSyn). Physical activity (PA) can alter features of the MetSyn and improve body composition by reducing abdominal adiposity. We report metabolic results of a prospective randomized controlled trial (PEACH trial; Walsh JM, et al. [2010] BMC Cancer. 10[42]) which examines the effect of an exercise intervention on the metabolic risk profile of breast cancer survivors 2-6 months post chemotherapy. Methods: All subjects gave written informed consent and were randomized to an 8-week, twice weekly aerobic exercise intervention programme or a usual care control group consisting of routine medical advice about PA. The five clinical features of the MetSyn were measured: waist circumference (WC), resting blood pressure (BP), triglycerides, high-density lipoprotein cholesterol (HDL-C) and fasting glucose. Insulin resistance was estimated by the homeostatic model assessment (HOMA). Statistical analysis was carried out using independent sample t-tests with significance set at p < 0.05. Results: Twenty-six breast cancer survivors participated (mean (± SD) age 48.13 (8.75) years). At baseline, 50% (n = 13) of subjects were overweight and 23.1% (n = 6) were obese, with 73.1% (n = 19) centrally obese. 34.6% (n = 9) of subjects were classified with the MetSyn. There were no significant differences between groups at baseline. Intention-to-treat analysis showed no significant changes, however, analysis of those who adhered to > 70% of the supervised exercise intervention showed a significant improvement in WC when compared to the control group (p < 0.05). Conclusions: Results show that an 8-week aerobic exercise intervention significantly reduced WC but did not modify other features of the MetSyn. The decrease in WC demonstrated by this short intervention may have important implications in terms of improving survival and the metabolic risk profile of breast cancer survivors. Final follow-up assessments are ongoing and will enable change in WC over time to be evaluated further.

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