Effects of Perilipin (PLIN) Gene Variation on Metabolic Syndrome Risk and Weight Loss in Obese Children and Adolescents

Context: Genetic polymorphisms at the perilipin (PLIN) locus have been investigated for their potential utility as markers for obesity and metabolic syndrome (MS). We examined in obese children and adolescents (OCA) aged 7–14 yr the association of single-nucleotide polymorphisms (SNP) at the PLIN locus with anthropometric, metabolic traits, and weight loss after 20-wk multidisciplinary behavioral and nutritional treatment without medication. Design: A total of 234 OCA [body mass index (BMI = 30.4 ± 4.4 kg/m2; BMI Z-score = 2.31 ± 0.4) were evaluated at baseline and after intervention. We genotyped four SNPs (PLIN1 6209T→C, PLIN4 11482G→A, PLIN5 13041A→G, and PLIN6 14995A→T). Results: Allele frequencies were similar to other populations, PLIN1 and PLIN4 were in linkage disequilibrium (D′ = 0.999; P < 0.001). At baseline, no anthropometric differences were observed, but minor allele A at PLIN4 was associated with higher triglycerides (111 ± 49 vs. 94 ± 42 mg/dl; P = 0.003), lower high-density lipoprotein cholesterol (40 ± 9 vs. 44 ± 10 mg/dl; P = 0.003) and higher homeostasis model assessment for insulin resistance (4.0 ± 2.3 vs. 3.5 ± 2.1; P = 0.015). Minor allele A at PLIN4 was associated with MS risk (age and sex adjusted) hazard ratio 2.4 (95% confidence interval = 1.1–4.9) for genotype GA and 3.5 (95% confidence interval = 1.2–9.9) for AA. After intervention, subjects carrying minor allele T at PLIN6 had increased weight loss (3.3 ± 3.7 vs. 1.9 ± 3.4 kg; P = 0.002) and increased loss of the BMI Z-score (0.23 ± 0.18 vs. 0.18 ± 0.15; P = 0.003). Due to group size, risk of by-chance findings cannot be excluded. Conclusion: The minor A allele at PLIN4 was associated with higher risk of MS at baseline, whereas the PLIN6 SNP was associated with better weight loss, suggesting that these polymorphisms may predict outcome strategies based on multidisciplinary treatment for OCA.

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Weight Change for Pediatric Completers in a National Weight Loss Program

Global Pediatric Health ◽

10.1177/2333794x211057716 ◽

2021 ◽

Vol 8 ◽

pp. 2333794X2110577

Author(s):

Rochelle Cason-Wilkerson ◽

Darcy Thompson ◽

Nia Mitchell

Keyword(s):

Weight Loss ◽

Children And Adolescents ◽

Low Income ◽

Weight Change ◽

Low Cost ◽

Weight Loss Program ◽

Z Score ◽

Obese Children ◽

Children And Adolescent ◽

Cumulative Change

Overweight and obese children in low-income households have limited access to weight loss programs. Low-cost programs should be evaluated in this population. The objective of the current study is to determine weight change among 7 to 17-year-old participants in Take Off Pounds Sensibly (TOPS), a national, low-cost weight loss program. This nonconcurrent prospective study analyzes the cumulative change in weight z-score for overweight and obese children and adolescents who joined TOPS from 2008 to 2011 and consecutively renewed their annual membership. The study includes 586 individuals. At 1-year, cumulative mean (SD) weight z-score change was −0.13 (31). In general, mean change in weight z-scores was no different in subsequent years. Mean weight z-score of children and adolescent TOPS participants who renew their program membership decreased significantly in the first year. Randomized controlled trials should prospectively evaluate this program in children and adolescents.

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Shedding “LIGHT” on the Link between Bone and Fat in Obese Children and Adolescents

International Journal of Molecular Sciences ◽

10.3390/ijms21134739 ◽

2020 ◽

Vol 21 (13) ◽

pp. 4739 ◽

Cited By ~ 1

Author(s):

Giacomina Brunetti ◽

Maria Felicia Faienza ◽

Laura Piacente ◽

Giuseppina Storlino ◽

Angela Oranger ◽

...

Keyword(s):

Children And Adolescents ◽

Peripheral Blood ◽

Mononuclear Cells ◽

Standard Deviation Score ◽

Serum Levels ◽

Model Assessment ◽

Obese Patients ◽

Z Score ◽

Obese Children ◽

Peripheral Blood Mononuclear

Obesity may affect bone health, but literature reports are contradictory about the correlation of body mass index (BMI) and bone markers. LIGHT, one of the immunostimulatory cytokines regulating the homeostasis of bone and adipose tissue, could be involved in obesity. The study involved 111 obese subjects (12.21 ± 3.71 years) and 45 controls. Patients underwent the evaluation of bone status by quantitative ultrasonography (QUS). LIGHT amounts were evaluated in sera by ELISA, whereas its expression on peripheral blood cells was evaluated by flow cytometry. Osteoclastogenesis was performed by culturing peripheral blood mononuclear cells (PBMCs) with or without anti-LIGHT antibodies. Obese patients showed significant high BMI-standard deviation score (SDS), weight-SDS, and Homeostatic model assessment for insulin resistance (HOMA-IR) that negatively correlated with the reduced Amplitude Dependent Speed of Sound (AD-SoS)-Z-score and Bone Transmission Time (BTT-Z)-score. They displayed significantly higher serum levels of LIGHT compared with controls (497.30 ± 363.45 pg/mL vs. 186.06 ± 101.41 pg/mL, p < 0.001). LIGHT expression on monocytes, CD3+-T-cells, and neutrophils was also higher in obese patients than in the controls. Finally, in PBMC cultures, the addition of anti-LIGHT antibodies induced a significant osteoclastogenesis inhibition. Our study highlighted the high serum levels of LIGHT in obese children and adolescents, and its relationship with both the grade of obesity and bone impairment.

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Utility of wrist circumference in recognition of metabolic syndrome in overweight and obese South Indian children and adolescents

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2021-0376 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Vidhya Ahilan ◽

Varun Govind Krishna ◽

Hemchand Krishna Prasad ◽

Kannan Narayanasamy ◽

Nedunchelian Krishnamoorthy

Keyword(s):

Metabolic Syndrome ◽

Children And Adolescents ◽

Serum Insulin ◽

Tertiary Care ◽

Overweight And Obesity ◽

Z Score ◽

Obese Children ◽

Indian Children ◽

South Indian ◽

Wrist Circumference

Abstract Objective To describe the utility of wrist circumference in the identification of cardiometabolic risk in overweight and obese children. Methods A cross-sectional study was conducted in the obesity clinic of a tertiary care referral hospital over a two year period. All children and adolescents aged 5–17 years with nutritional overweight and obesity were recruited. Data pertaining to chronological age, sex, risk factors and family history were collected. Clinical assessment of anthropometry: Weight, height, body mass index (BMI), Tanner’s stage, wrist circumference, blood pressure, waist circumference and triceps skinfold thickness done as per standard criteria. Biochemical assessment of blood glucose, serum insulin, lipid profile, and Homeostatic Model for Insulin Resistance performed after 12 h of fasting. Results We recruited 118 subjects (mean age 10.9 years, 71.1% males, 87.3% obese and 12.7% overweight); 30 (25.4%) had metabolic syndrome. The mean z scores of wrist circumference of children who presented with and without metabolic syndrome was 2.7 ± 0.8 and 2.1 ± 0.7, respectively (p<0.05). We observed a fair positive correlation between wrist circumference z score and BMI z score, (r=0.5; p<0.05). On receiver operating characteristic curve analysis, 97th percentile of wrist circumference predicted metabolic syndrome among overweight and obese children with a sensitivity of 86.7% and specificity of 37.5% (AUC=0.675). Conclusions Wrist circumference with 97th percentile as a cut-off is a useful tool to identify metabolic syndrome amongst overweight and obese children and adolescents.

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Evaluation of Different Adiposity Indices and Association with Metabolic Syndrome Risk in Obese Children: Is there a Winner?

International Journal of Molecular Sciences ◽

10.3390/ijms21114083 ◽

2020 ◽

Vol 21 (11) ◽

pp. 4083

Author(s):

Alessandro Leone ◽

Sara Vizzuso ◽

Paolo Brambilla ◽

Chiara Mameli ◽

Simone Ravella ◽

...

Keyword(s):

Metabolic Syndrome ◽

Children And Adolescents ◽

Bioelectrical Impedance ◽

Shape Index ◽

Cross Sectional Study ◽

Z Score ◽

Obese Children ◽

Anthropometric Parameters ◽

Cross Sectional ◽

Relative Contribution

Body shape index (ABSI) and triponderal mass index (TMI) have been recently associated with cardiovascular risk in adults. A cross-sectional study was conducted to evaluate the relationship between different anthropometric adiposity indexes and metabolic syndrome (MetS) in Caucasian obese children and adolescents. Consecutive obese children aged ≥7 years have been enrolled. Anthropometric parameters, body composition (by bioelectrical impedance), and systolic and diastolic blood pressure have been measured. Fasting blood samples have been analyzed for lipids, insulin, glucose. A multivariate logistic regression analyses, with body mass index z-score, waist to height ratio, ABSI z-score, TMI, conicity index as predictors for MetS (IDEFICS and IDF criteria according to age) has been performed. Four hundred and three (179 boys and 224 girls) obese children, aged 7–20 years, have been evaluated. When we explored the joint contribution of each anthropometric and adiposity index of interest and BMIz on the risk of MetS, we found that the inclusion of ABSIz improved the prediction of MetS compared to BMIz alone. ABSI-BMI can be a useful index for evaluating the relative contribution of central obesity to cardiometabolic risk in clinical management of obese children and adolescents.

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Uric acid is associated with adiposity factors, especially with fat mass reduction during weight loss in obese children and adolescents

Nutrition & Metabolism ◽

10.1186/s12986-020-00500-9 ◽

2020 ◽

Vol 17 (1) ◽

Author(s):

Yang Niu ◽

Xue-lin Zhao ◽

Hui-juan Ruan ◽

Xiao-meng Mao ◽

Qing-ya Tang

Keyword(s):

Weight Loss ◽

Body Composition ◽

Uric Acid ◽

Children And Adolescents ◽

Body Fat ◽

Fat Mass ◽

Dietary Control ◽

Obese Children ◽

Fat Percentage ◽

Before And After

Abstract Background Current adult studies suggest that uric acid (UA) is associated with body fat, but the relationship in obese children is unclear. Thus, we aim to evaluate the association between uric acid and body composition of obese children. Methods A total of 79 obese children were included in this study, and 52 children (34 boys and 18 girls) underwent a 6-week weight loss camp, including 34 boys and 18 girls. Six-week weight-loss interventions were performed on all participants through aerobic exercise and appropriate dietary control. Laboratory tests and body composition were collected before and after the intervention. Results Before the intervention, correlation analysis demonstrated that uric acid was positively correlated with height, weight, body mass index (BMI), waist circumference, hip circumference, fat mass (FM), and free fat mass (FFM) with adjusting for age and gender (P < 0.05). After 6 weeks of intervention, the participants gained 3.12 ± 0.85 cm in height, body fat percentage decreased by 7.23 ± 1.97%, and lost 10.30 ± 2.83 kg in weight. Univariate and multivariate analysis indicated that uric acid at baseline was associated with FM reduction during weight loss (P < 0.05). Conclusions This study is the first report that uric acid is associated with BMI and FM, and may play an important role in the reduction of FM during weight loss in obese children and adolescents. The interaction between UA and adiposity factors and its underlying mechanisms need to be further explored. Trial registration This study was registered in Clinical Trials.gov (NCT03490448) and approved by the Ethics Committee of Xinhua Hospital, Shanghai Jiao Tong University School of Medicine.

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Abstract P088: Obesity, Hypertension and Insulin Resistance in a Primary Pediatric Setting in Southern Italy

Circulation ◽

10.1161/circ.129.suppl_1.p088 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Giampaolo De Filippo ◽

Domenico Rendina ◽

Domenico Viggiano ◽

Antonio Fasolino ◽

Paola Sabatini ◽

...

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Body Weight ◽

Children And Adolescents ◽

Diagnostic Criteria ◽

Southern Italy ◽

Serum Insulin ◽

High Density Lipoproteins ◽

Obese Children ◽

Campania Region

Background: Obesity is the main risk factor for essential hypertension (EH) in childhood. The O.Si.Me. study (Obesity and Metabolic Syndrome in children and adolescents) evaluated the prevalence of metabolic syndrome (MetS) and its constitutive traits in a sample of obese children and adolescents living in Campania, southern Italy. Patients and methods: Four hundred and fifteen children and adolescents consecutively referred to the National Health Service participating Outpatient Clinics for minor health problems and found to have a Body Mass Index (BMI) Z-score > 2.0 were enrolled in the study. The entire sample was screened for MetS, which was defined as the presence of at least 2 of the following alterations in addition to obesity: fasting hyperglycemia, low levels of high-density lipoproteins cholesterol, hypertriglyceridemia, and EH. The present analysis evaluated the clinical characteristics of the O.Si.Me subgroup of EH participants (systolic and/or diastolic BP ≥ 95 th percentile for age, gender and height) as compared with normotensive participants. Results: The prevalence of EH in the O.Si.Me population was 23.6 % (98/415, 48M and 50F.) and two-thirds of the EH participants met the MetS diagnostic criteria. The EH participants featured serum insulin and HOMA-IR levels significantly higher compared with normotensive ones (11.6±0.6 vs. 9.5±0.4 μIU/ml, p = 0.014; 2.6±0.1 vs. 2.2±0.1, p = 0.028 for insulin and HOMA-IR, respectively). These differences were common to boys and girls and remained significant after correction for age, pubertal stage, body weight, length, BMI, gestational age at birth, duration of breastfeeding and anthropometric parental parameters. Accordingly, children and adolescents with EH had a a relative risk of being insulin resistant (defined as a HOMA-IR ≥2.5) significantly greater compared to those without. Moreover, they exhibited higher serum creatinine levels (53.8±7.1 vs. 35.4±6.8 μmol/l, p=0.025) accounting for gender and body weight. Conclusions: More than a quarter of obese children and adolescents meet the diagnostic criteria for EH in the Campania region in southern Italy. These obese boys and girls have an increased prevalence of insulin resistance and apparently an initial reduction in renal function compared with obese children and adolescents with normal BP.

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Metabolic Syndrome in Italian Obese Children and Adolescents: Stronger Association with Central Fat Depot than with Insulin Sensitivity and Birth Weight

International Journal of Hypertension ◽

10.4061/2011/257168 ◽

2011 ◽

Vol 2011 ◽

pp. 1-6 ◽

Cited By ~ 10

Author(s):

Claudia Brufani ◽

Danilo Fintini ◽

Ugo Giordano ◽

Alberto Enrico Tozzi ◽

Fabrizio Barbetti ◽

...

Keyword(s):

Metabolic Syndrome ◽

Birth Weight ◽

Insulin Sensitivity ◽

Low Birth Weight ◽

Children And Adolescents ◽

Central Obesity ◽

Obese Children ◽

Obesity Index ◽

Central Fat ◽

Fat Depot

Aim. To evaluate whether body fat distribution, birth weight, and family history for diabetes (FHD) were associated with metabolic syndrome (MetS) in children and adolescents.Methods. A total of 439 Italian obese children and adolescents (5–18 years) were enrolled. Subjects were divided into 2 groups: prepubertal and pubertal. MetS was diagnosed according to the adapted National Cholesterol Education Program criteria. Birth weight percentile, central obesity index (measured by dual-energy X-ray absorptiometry), insulin sensitivity (ISI), and disposition index were evaluated. Multivariate logistic regression models were used to determine variables associated with MetS.Results. The prevalence of MetS was 17%, with higher percentage in adolescents than in children (21 versus 12%). In the overall population, central obesity index was a stronger predictor of MetS than insulin sensitivity and low birth weight. When the two groups were considered, central fat depot remained the strongest predictor of MetS, with ISI similarly influencing the probability of MetS in the two groups and birth weight being negatively associated to MetS only in pubertal individuals. Neither FHD nor degree of fatness was a significant predictor of MetS.Conclusion. Simple clinical parameters like increased abdominal adiposity and low birth weight could be useful tools to identify European obese adolescents at risk for metabolic complications.

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Albuminuria and glomerular filtration rate in obese children and adolescents

Brazilian Journal of Nephrology ◽

10.1590/2175-8239-jbn-2018-0006 ◽

2019 ◽

Vol 41 (2) ◽

pp. 193-199

Author(s):

Luciana Satiko Sawamura ◽

Gabrielle Gomes de Souza ◽

Juliana Dias Gonçalves dos Santos ◽

Fabíola Isabel Suano-Souza ◽

Anelise Del Vecchio Gessullo ◽

...

Keyword(s):

Glomerular Filtration Rate ◽

Children And Adolescents ◽

Glomerular Filtration ◽

Filtration Rate ◽

Cross Sectional Study ◽

Systemic Arterial Pressure ◽

Model Assessment ◽

Obese Children ◽

Cross Sectional ◽

The Mean

Abstract Objective: To describe the frequency of albuminuria in overweight and obese children and adolescents and to relate it to the severity of obesity, pubertal staging, associated morbidities and the glomerular filtration rate. Method: Cross-sectional study including 64 overweight and obese children and adolescents between 5 and 19 years of age. Data collected: weight, height, waist circumference and systemic arterial pressure. Laboratory tests: lipid profile; glycemia and insulin, used to calculate the Homeostasis Model Assessment (HOMA-IR); C-reactive protein; glutamic-pyruvic transaminase and albuminuria in an isolated urine sample (cutoff <30 mg/g). Creatinine was used to calculate the estimated glomerular filtration rate (eGFR, mL/min/1.73 m2). Results: The mean age was 11.6 ± 3.4 years, 32 (50%) and 29 (45.3%) were male and prepubertal. Forty-six (71.9%) had severe obesity. The frequency and median (min/max) of the observed values for albuminuria (> 30 mg/g) were 14 (21.9%) and 9.4 mg/g (0.70, -300.7 mg/g). The mean eGFR was 122.9 ± 24.7 mL/min/1.73 m2. There was no significant correlation between body mass index, pubertal staging, insulin and HOMA-IR with albuminuria values and neither with eGFR. Children with albuminuria tended to have higher values of diastolic blood pressure (75.0 ± 12.2 vs. 68.1 ± 12.4, p = 0.071). Conclusion: Albuminuria, although frequent in children and adolescents with obesity, was not associated with other morbidities and the glomerular filtration rate in these patients.

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