OBESITY, METABOLIC SYNDROME AND BIOIMPEDANSOMETRY IN MODERN PEDIATRIC PRACTICE (LITERATURE REVIEW)

The review presents current literature data on the prevalence of obesity and metabolic syndrome in children. According to the WHO’s prognosis, over 25% of children will be overweight and obese and about 7% of children will have metabolic syndrome in Europe by 2025. Long-lasting improper diet combined with reduced physical activity, with daily caloric food value exceeding vital energy requirements, is the main cause of excess body weight and obesity. It has been presented new, never-before-seen, properties of adipose tissue being the largest endocrine organ, which contains receptors for many hormones and produces its own peptide hormones-adipokines (leptin, adiponectin, resistin, tumor necrosis factor-alpha, etc.). It has been indicated that patients suffering from obesity and metabolic syndrome have impaired incretin effect (glucose-dependent insulin stimulation, decreased glucagon secretion) in response to the action of incretin hormones (glucagon-like peptide-1, glucose-dependent insulinotropic polypeptide) caused by acquired receptor defects . It has been noted that differentiation of mesenchymal stem cells into two pools of cells (Myf5-positive and Myf5-negative) is subsequently completed with their transformation into white, brown and previously unknown beige adipose tissue. Metabolically healthy obesity, the phenotype of which is mainly due to the gene expression in the CNS, and Metabolically Unhealthy Obesity, the phenotype of which is due to the expression of peripheral tissue genes, are the most common phenotypes of polygenic obesity. It has been emphasized that Metabolically Unhealthy Obesity is considered by some authors to be the modernized name of the metabolic syndrome. The metabolic syndrome is known to be pathogenetically associated with obesity, hypertension, dyslipidemia, impaired glucose tolerance, and type 2 diabetes mellitus. It has been noted that until recently there were no uniform criteria for determining the metabolic syndrome in children. Nowadays, researchers keep to the criteria for Metabolically Unhealthy Оbesity in children, recommended by the American Association of Clinical Endocrinologists and the American College of Endocrinologists (AACE / ACE), 2014; and the European Society of Endocrinologists (ESE) and the Pediatric Endocrinology Society (PES), 2017. Early diagnosis and timely correction of obesity and metabolic syndrome is impossible without modern innovative medical technologies. The use of bioimpedancemetry for the diagnosis of total fat, visceral fat and metabolic age makes it possible to accurately diagnose visceral obesity, which is not recognized by body mass index, and timely administer a personalized lifestyle correction. Consequently, the widespread introduction of bioimpedancemetric analysis in paediatric practice will facilitate the early primary and secondary prophylaxis and development of comprehensive personalized treatment programs for obesity and metabolic syndrome in children.

Download Full-text

Obesity is the basis of metabolic syndrome

Obesity and metabolism ◽

10.14341/omet12707 ◽

2021 ◽

Vol 18 (2) ◽

pp. 142-149

Author(s):

A. F. Verbovoy ◽

N. I. Verbovaya ◽

Yu. A. Dolgikh

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Adipose Tissue ◽

Subcutaneous Fat ◽

Visceral Obesity ◽

Cardiovascular Risks ◽

The Metabolic Syndrome ◽

Symptom Complex ◽

Visceral Adipose ◽

Positive Effect

Metabolic syndrome is a symptom complex that is based on visceral obesity and insulin resistance. Its prevalence is quite high, which is a big problem, since this condition increases the risk of developing cardiovascular diseases and mortality from them. Metabolic syndrome includes, in addition to abdominal obesity, arterial hypertension, disorders of carbohydrate, lipid and purine metabolism. Visceral adipose tissue plays a key role in the formation of insulin resistance and other components of the metabolic syndrome. This is due to the fact that abdominal fat, in contrast to subcutaneous fat, synthesizes pro-inflammatory cytokines, as well as adipokines — adipose tissue hormones that are involved in the formation of insulin resistance, affect carbohydrate and fat metabolism and the cardiovascular system. These include leptin, adiponectin, resistin, apelin and others. Some adipokines have an adverse effect on metabolism and increase cardiovascular risks, while others, on the contrary, have a positive effect. Taking into account their role in the development of the components of the metabolic syndrome, the possibilities of a therapeutic effect on the hormones of adipose tissue to improve metabolic processes and prevent complications associated with it are discussed.

Download Full-text

The contribution of omental adipose tissue to adipokine concentrations in patients with the metabolic syndrome

Clinical & Investigative Medicine ◽

10.25011/cim.v30i5.2895 ◽

2007 ◽

Vol 30 (5) ◽

pp. 192 ◽

Cited By ~ 10

Author(s):

Giovanni Tarantino ◽

Roberto Lobello ◽

Francesco Scopacasa ◽

Franco Contaldo ◽

Fabrizio Pasanisi ◽

...

Keyword(s):

Metabolic Syndrome ◽

Adipose Tissue ◽

Venous Blood ◽

Visceral Obesity ◽

Systemic Circulation ◽

Central Adiposity ◽

Omental Adipose Tissue ◽

The Metabolic Syndrome ◽

Visceral Adipose ◽

Endothelial Growth Factor

Purpose: To examine differences in peripheral vascular endothelial growth factor (VEGF), interleukin-6 (IL6) and cortisol concentrations between patients with both visceral obesity and metabolic syndrome, and lean controls. In a subsample of metabolic patients underwent abdominal surgery, the adipokine concentrations were measured in venous blood from the omentum to determine information on some processes of synthesis. Methods: Forty-two healthy lean controls and 46 overweight-obese patients with central adiposity and stigmata of metabolic syndrome were studied. In a subsample of 11 metabolic patients undergoing non-bariatric surgery, blood samples from omental and peripheral veins were taken intraoperatively to determine VEGF, IL6 and cortisol concentrations. Results: Median levels (range) of peripheral VEGF and IL6 were higher in patients than in controls [31.5 (3-112) pg/mL vs 21.35 (9-41.9) pg/mL (P < 0.05) and 5.50 (1.40-13) pg/mL vs 1.15 (0.3-1) pg/mL (P < 0.0001)]. On the other hand, concentrations of VEGF and IL6 from the omental and peripheral veins were similar in the surgery sub-group. Peripheral cortisol concentrations were not higher in patients than in controls, nor were omental concentrations different from the peripheral. Omental and peripheral VEGF and cortisol values were correlated, whereas no association was found between omental and peripheral IL6. Conclusions: In the presence of abdominal obesity, VEGF and IL6 concentrations are increased in the systemic circulation. The contribution of visceral adipose tissue to circulating levels of VEGF and IL6 was modest.

Download Full-text

Вплив інгібіторів ароматази третього покоління на окремі компоненти перебігу експериментального метаболічного синдрому

Medical and Clinical Chemistry ◽

10.11603/mcch.2410-681x.2017.v0.i4.8306 ◽

2018 ◽

Author(s):

A. L. Zagayko ◽

D. V. Lytkin ◽

A. V. Maloshtan

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Adipose Tissue ◽

Glucose Tolerance ◽

Aromatase Inhibitors ◽

Electrochemical Method ◽

Visceral Obesity ◽

Insulin Level ◽

Third Generation ◽

The Metabolic Syndrome

Introduction. Nowadays, about 86 % among patients with metabolic syndrome have serious disorder of glucose tolerance and about 60 % of them suffer from visceral obesity. Moreover in many worldwide studies it was shown that these pathogenetic manifestations of the metabolic syndrome had a significant correlation with the imbalance of sex hormones.The aim of the study – to learn the effect of third-generation aromatase inhibitors on the parameters of insulin resistance and visceral obesity in hamsters with the experimental metabolic syndrome.Research Methods. The insulin level in the hamster`s blood serum was measured by the enzyme immunoassay method, and the glucose level by the electrochemical method. The mass coefficients of anatomical fragments of adipose tissue were calculated to estimate visceral obesity. The results were processed by using the Mann-Whitney U-test and the 4Pl method.Results and Discussion. All studied drugs, in varying degrees, influenced on the pathogenetic components of the experimental metabolic syndrome. Exemestane was demonstrated the greatest effectiveness in reducing parameter of the insulin resistance by, butletrozole – in decreasing of visceral obesity ratio.Сonclusion. Romatase inhibitors can become promising drugs for correcting the pathogenetic components of the metabolic syndrome, in particular insulin resistance and visceral obesity.

Download Full-text

Chinese herbal extracts (SK0506) as a potential candidate for the therapy of the metabolic syndrome

Clinical Science ◽

10.1042/cs20100441 ◽

2010 ◽

Vol 120 (7) ◽

pp. 297-305 ◽

Cited By ~ 19

Author(s):

Yi Tan ◽

Mohammad A. Kamal ◽

Zheng-Zhong Wang ◽

Wei Xiao ◽

John P. Seale ◽

...

Keyword(s):

Metabolic Syndrome ◽

Adipose Tissue ◽

Salvia Miltiorrhiza ◽

Glycogen Synthesis ◽

Visceral Obesity ◽

Metabolic Effects ◽

Potential Candidate ◽

Herbal Extracts ◽

The Metabolic Syndrome ◽

Promising Source

The metabolic syndrome has reached epidemic proportions worldwide, but currently there is a lack of effective therapies for this multifactorial endocrine disease. TCM (traditional Chinese medicine) has been utilized to treat a wide variety of diseases for centuries in the People's Republic of China, subsequently becoming a promising source for the development of new therapeutic agents. Chinese medicinal herbs Gynostemma pentaphyllum, Coptis chinensis and Salvia miltiorrhiza have been shown to have anti-atherosclerotic and antidiabetic properties. In this study, we have investigated the metabolic effects of a mixture of these three herbal extracts (SK0506) in a rodent model of the metabolic syndrome induced by an HFD (high-fat diet). SD (Sprague–Dawley) rats that were fed on an HFD for 4 weeks gained 33% more weight compared with chow-fed rats (P<0.05). Four weeks treatment with SK0506 prevented weight gain with decreased visceral fat (P<0.01 compared with vehicle treatment). SK0506 also significantly reduced plasma triacylglycerols (triglycerides), NEFAs (non-esterified fatty acids) and cholesterol. SK0506 exerted similar effects to RSG (rosiglitazone) on impaired glucose intolerance. SK0506 also significantly enhanced glucose uptake and glycogen synthesis in adipose tissue during hyperinsulinaemic–euglycaemic clamp. Western blotting analysis revealed that SK0506 enhanced GLUT4 (glucose transporter 4) expression in adipose tissue, and RSG markedly up-regulated GLUT4 translocation in skeletal muscle. Overall, the present study has discovered that SK0506 can reverse several components of the metabolic syndrome primarily through acting on hyperlipidaemia and visceral obesity. The results from the present study suggest that it is worthwhile to conduct a randomized clinical trial to confirm the potential that SK0506 may be a new oral agent for treating the metabolic syndrome and preventing Type 2 diabetes.

Download Full-text

Prevalence of metabolic syndrome in never treated mood disordered patientss

Clinical & Investigative Medicine ◽

10.25011/cim.v30i4.2875 ◽

2007 ◽

Vol 30 (4) ◽

pp. 95

Author(s):

Valerie Taylor ◽

Glenda M. MacQueen

Keyword(s):

Metabolic Syndrome ◽

Mood Disorders ◽

Population Attributable Risk ◽

Disease Process ◽

Visceral Obesity ◽

Premature Mortality ◽

Overweight And Obesity ◽

The Metabolic Syndrome ◽

Increased Risk ◽

Bipolar Patients

Bipolar disorder and major depression are life-shortening illnesses. Unnatural causes such as suicide and accidents account for only a portion of this premature mortality1 Research is beginning to identify that mood disordered patients have a higher incidence of metabolic syndrome, an illness characterized by dyslipidemia, impaired glucose tolerance, hypertension and obesity.2 Metabolic syndrome is associated with an increased risk for a variety of physical illnesses. Hypothesis: Never treated patients with mood disorders have preexisting elevations in the prevalence of the component variables of metabolic syndrome. Central obesity will be especially elevated, predicting increased premature mortality. Methods: We assessed never treated patients with mood disorders for metabolic syndrome and its component variables. Patients were assessed at baseline and followed up at 6-month intervals. All psychiatric pharmacotherapy was documented. Body mass index (BMI) was also obtained and the percentage of deaths attributable to overweight and obesity was calculated using the population attributable risk (PAR). [PAR= ∑[P (RR-1)/RR] Results: Prior to the initiation of treatment, patients did not differ from population norms with respect to metabolic syndrome or BMI. At 2-year follow-up, BMI had increased for unipolar patients 2.02 points and 1.92 points for bipolar patients. (p < .001) This increase in BMI predicted an increase in mortality of 19.4%. Conclusion: An increase in visceral obesity is often the first component of metabolic syndrome to appear and may indicate the initiation of this disease process prematurely in this group. The increase in BMI places patients with mood disorders at risk for premature mortality and indicates a need for early intervention. References 1.Osby U, Brandt L, Correia N, Ekbom A & Sparen P. Excess mortability in bipolar and Unipolar disorder rin Sweden. Archives of General Psychiatry, 2001;58: 844-850 2.Toalson P, Saeeduddin A, Hardy T & Kabinoff G. The metabolic syndrome in patients with severe mental illness. Journal of Clinical Psychiatry, 2004; 6(4): 152-158

Download Full-text

Faculty Opinions recommendation of A transgenic model of visceral obesity and the metabolic syndrome.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1004400.149207 ◽

2002 ◽

Author(s):

Laurence H. Tecott

Keyword(s):

Metabolic Syndrome ◽

Visceral Obesity ◽

Transgenic Model ◽

The Metabolic Syndrome

Download Full-text

Abstract 3672: Loss of Perivascular Adipocyte Paracrine Function Leads to Increased Vascular Tone and Glucose Intolerance in Hypertension

Circulation ◽

10.1161/circ.118.suppl_18.s_463-b ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Kaivan Khavandi ◽

Adam Greenstein ◽

Sarah Withers ◽

Kazuhiko Sonoyama ◽

Sarah Lewis ◽

...

Keyword(s):

Oxidative Stress ◽

Metabolic Syndrome ◽

Adipose Tissue ◽

Vascular Tone ◽

Tnf Alpha ◽

Perivascular Adipose Tissue ◽

The Metabolic Syndrome ◽

Adipocyte Cell ◽

Therapeutic Opportunity

In order to investigate the contribution of perivascular adipose tissue (PVAT) to arterial function, a total of 55 small arteries harvested from 35 skin biopsies of patients with Metabolic Syndrome and matched controls were mounted as ring preparations in a wire myograph. Contractility to cumulative doses of Norepinephrine in the presence or absence of PVAT showed an anticontractile effect in arteries from healthy volunteers (p=0.009), which was lost in patients with Metabolic Syndrome. Bioassay studies confirmed that PVAT releases a hydrophilic anticontractile factor in health, which is absent in obesity. Using a soluble fragment of the human Type 1 receptor, we identified that the anticontractile factor was adiponectin, which is the sole mediator of vasodilation, acting by increasing endothelial bioavailability of nitric oxide. Significant endothelial dysfunction was observed in patients with Metabolic Syndrome (p<0.001). Quantitative image analysis of adipose tissue revealed significantly increased adipocyte cell size in patients with Metabolic Syndrome, compared with healthy controls (p<0.006). There was immunohistochemical evidence of inflammation with upregulation of TNF-alpha receptor 1 in these patients (p<0.001). Application of exogenous TNF-alpha abolished the anticontractile effect of PVAT by reducing adiponectin bioavailability. Oxidative stress also induced by cytokines TNF-alpha and IL-6 but not IL-1, reduced adiponectin production from PVAT and increased basal tone. When the obese microenvironment was replicated in vitro by inflicting hypoxia on PVAT, adiponectin activity was lost but then rescued by incubation with cytokine antagonists. Further application of the adiponectin receptor fragment abolished PVAT relaxation. We conclude that in healthy arteries, PVAT releases adiponectin which reduces vascular tone. In obesity, this is lost by a cascade of adipocyte hypertrophy, hypoxia, inflammation and oxidative stress. The resulting vasoconstriction contributes to hypertension, hypertriglyceridaemia and insulin resistance. Direct targeting of adiponectin release from PVAT therefore provides a novel therapeutic opportunity in the Metabolic Syndrome.

Download Full-text