scholarly journals Complications of obesity in children and adolescents during covid-19 pandemic: A narrative review

2021 ◽  
Vol 14 (Sup1) ◽  
pp. 55-61
Author(s):  
Marcio Concepción-Zavaleta ◽  
Anthony Ramos-Yataco ◽  
Carlos Alcalde-Loyola ◽  
Diego Moreno-Marreros ◽  
Julia Coronado-Arroyo ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Pediatric Obesity ◽  
Pediatric Population ◽  
Behavioral Weight Loss ◽  
Therapeutic Approaches ◽  
Nonalcoholic Fatty Liver ◽  
Weight Loss Programs ◽  
Pharmacologic Treatments ◽  
Obesity In Children

Background: Obesity in children and adolescents has increased exponentially around the world. Furthermore, the COVID-19 pandemic has led to a higher pediatric obesity rate. The excess adipose tissue generates a dysregulation of adiponectin, ghrelin, and leptin, among others. Metabolic alterations can develop cardiovascular disease, dyslipidemias, arterial hypertension, type 2 diabetes mellitus, nonalcoholic fatty liver disease, sleep disorders, and higher risk of COVID-19 severity. Obesity has different therapeutic approaches such as behavioral weight loss programs, pharmacologic treatments, and surgical procedures. Therefore, timely diagnosis and treatment are important to decrease the mortality in obesity among pediatric population.

scholarly journals Physical activity versus metformin for increasing insulin sensitivity in children and adolescents at-risk for type 2 diabetes

2016 ◽  
Vol 85 (2) ◽  
pp. 26-28
Author(s):  
Andrew D Hanna ◽  
Natalie V Scime
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
At Risk ◽  
Insulin Sensitivity ◽  
Children And Adolescents ◽  
Pediatric Population ◽  
Current Evidence ◽  
Beneficial Effects ◽  
Pediatric Populations

Global rates of type 2 diabetes (T2D) among children and adolescents are steadily rising. As such, an increasing amount of attention and research has begun to focus on strategies to prevent this chronic and burdensome disease in pediatric populations. The purpose of this article is to briefly review current evidence pertaining to the effectiveness of physical activity versus metformin in improving insulin sensitivity of children at-risk (ie, obese and/or insulin resistant) for developing T2D. Potential barriers to each preventative intervention will also be discussed. Physical activity, both aerobic and resistance, has demonstrated effectiveness in a moderate number of demographically diverse pediatric studies. However, the pediatric population is already alarmingly sedentary with barriers such as lack of motivation, social stigma and discomfort presenting a challenge. A small number of studies have demonstrated the beneficial effects of metformin in children and adolescents for improved insulin sensitivity. However, longer and larger studies are required to confirm these findings and elucidate upon the long-term safety and efficacy of this pharmaceutical in pediatric populations. While no head-to-head studies examining physical activity and metformin exist in pediatric populations and more research is needed, current evidence seems to favour the use of physical activity given the larger quantity of studies and generalizability of its beneficial effects. Thus, physical activity should be emphasized in clinical and public health practice when targeting at-risk children and adolescents to prevent a T2D diagnosis.

Evaluation and Treatment of Pediatric Obesity

2018 ◽  
Author(s):  
Nirav K Desai ◽  
Samir Softic
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Environmental Factors ◽  
Fast Food ◽  
Pediatric Obesity ◽  
Behavioral Interventions ◽  
Weight Loss Surgery ◽  
Pediatric Population ◽  
Nonalcoholic Fatty Liver ◽  
Sweetened Beverages

Obesity is one of the most significant health problems facing children and adolescents. The definition of overweight in children is a body mass index between the 85th and less than 95th percentile, whereas obesity is greater than or equal to the 95th percentile for age and sex. There are multiple comorbidities associated with obesity, including dyslipidemia, hypertension, type 2 diabetes, sleep apnea, and nonalcoholic fatty liver disease, as well as psychosocial issues. Contributors to obesity are multifactorial, including genetic and environmental factors. Environmental factors associated with obesity include increased availability of inexpensive fast food, sugar-sweetened beverages, and high-fat and -sugar convenience foods; decreased exercise; and increased screen time. Treatment begins with behavioral interventions focusing on dietary modifications and increasing physical activity. Although medications to treat obesity are an area of increased interest, options in the pediatric population are limited. Currently, orlistat is the only FDA-approved option. For the treatment of severe obesity, bariatric surgery should be considered, based on age, weight, and associated comorbidities. Weight loss associated with surgery is robust and long-lasting and results in improvement in/resolution of multiple comorbidities. However, benefits should also be weighed against the long-term risks of vitamin deficiency. This review contains 73 references, 3 figures, and 3 tables. Key words: bariatric surgery, metabolic syndrome, obesity treatment, pediatric obesity, weight loss surgery

scholarly journals Practice guideline update summary: Pharmacologic treatment for pediatric migraine prevention

Neurology ◽  
2019 ◽  
Vol 93 (11) ◽  
pp. 500-509 ◽  
Author(s):  
Maryam Oskoui ◽  
Tamara Pringsheim ◽  
Lori Billinghurst ◽  
Sonja Potrebic ◽  
Elaine M. Gersz ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Children And Adolescents ◽  
Behavioral Therapy ◽  
Pediatric Population ◽  
Cognitive Behavioral ◽  
Headache Frequency ◽  
Pharmacologic Treatment ◽  
Migraine Prevention ◽  
Pediatric Migraine ◽  
Pharmacologic Treatments

ObjectiveTo provide updated evidence-based recommendations for migraine prevention using pharmacologic treatment with or without cognitive behavioral therapy in the pediatric population.MethodsThe authors systematically reviewed literature from January 2003 to August 2017 and developed practice recommendations using the American Academy of Neurology 2011 process, as amended.ResultsFifteen Class I–III studies on migraine prevention in children and adolescents met inclusion criteria. There is insufficient evidence to determine if children and adolescents receiving divalproex, onabotulinumtoxinA, amitriptyline, nimodipine, or flunarizine are more or less likely than those receiving placebo to have a reduction in headache frequency. Children with migraine receiving propranolol are possibly more likely than those receiving placebo to have an at least 50% reduction in headache frequency. Children and adolescents receiving topiramate and cinnarizine are probably more likely than those receiving placebo to have a decrease in headache frequency. Children with migraine receiving amitriptyline plus cognitive behavioral therapy are more likely than those receiving amitriptyline plus headache education to have a reduction in headache frequency.RecommendationsThe majority of randomized controlled trials studying the efficacy of preventive medications for pediatric migraine fail to demonstrate superiority to placebo. Recommendations for the prevention of migraine in children include counseling on lifestyle and behavioral factors that influence headache frequency and assessment and management of comorbid disorders associated with headache persistence. Clinicians should engage in shared decision-making with patients and caregivers regarding the use of preventive treatments for migraine, including discussion of the limitations in the evidence to support pharmacologic treatments.

scholarly journals Circulating miRNAs as Biomarkers of Obesity and Obesity-Associated Comorbidities in Children and Adolescents: A Systematic Review

Nutrients ◽  
2019 ◽  
Vol 11 (12) ◽  
pp. 2890 ◽  
Author(s):  
Maddi Oses ◽  
Javier Margareto Sanchez ◽  
Maria P. Portillo ◽  
Concepción María Aguilera ◽  
Idoia Labayen
Keyword(s):  
Systematic Review ◽  
Children And Adolescents ◽  
Normal Weight ◽  
Circulating Mirnas ◽  
Obese Children ◽  
Diagnostic Biomarkers ◽  
Nonalcoholic Fatty Liver ◽  
Cardiometabolic Diseases ◽  
Larger Sample

Early detection of obesity and its associated comorbidities in children needs priority for the development of effective therapeutic intervention. Circulating miRNAs (microRNAs) have been proposed as biomarkers for obesity and its comorbidities; therefore, we conducted a systematic review to summarize results of studies that have quantified the profile of miRNAs in children and adolescents with obesity and/or associated disorders. Nine studies aiming to examine differences in miRNA expression levels between children with normal weight and obesity or between obese children with or without cardiometabolic diseases were included in this review. We identified four miRNAs overexpressed in obesity (miR-222, miR-142–3, miR-140-5p, and miR-143) and two miRNAs (miR-122 and miR-34a) overexpressed in children with obesity and nonalcoholic fatty liver disease (NAFLD) and/or insulin resistance. In conclusion, circulating miRNAs are promising diagnostic biomarkers of obesity-associated diseases such as NAFLD and type 2 diabetes already in childhood. However, more studies in children, using massive search technology and with larger sample sizes, are required to draw any firm conclusions.

Evaluation and Treatment of Pediatric Obesity

2018 ◽  
Author(s):  
Nirav K Desai ◽  
Samir Softic
Keyword(s):  
Bariatric Surgery ◽  
Pediatric Obesity ◽  
Fatty Liver Disease ◽  
Weight Loss Surgery ◽  
Psychosocial Issues ◽  
Nonalcoholic Fatty Liver ◽  
Definition Of ◽  
Significant Health ◽  
Age And Sex

Obesity is one of the most significant health problems facing children and adolescents. The definition of overweight in children is a body mass index between the 85th and less than 95th percentile, whereas obesity is greater than or equal to the 95th percentile for age and sex. There are multiple comorbidities associated with obesity, including dyslipidemia, hypertension, type 2 diabetes, sleep apnea, and nonalcoholic fatty liver disease, as well as psychosocial issues.  This review contains 3 figures, 4 tables and 63 references. Key Words bariatric surgery, metabolic syndrome, obesity treatment, pediatric obesity, weight loss surgery

Evaluation and Treatment of Pediatric Obesity

2018 ◽  
Author(s):  
Nirav K Desai ◽  
Samir Softic
Keyword(s):  
Bariatric Surgery ◽  
Pediatric Obesity ◽  
Fatty Liver Disease ◽  
Weight Loss Surgery ◽  
Psychosocial Issues ◽  
Nonalcoholic Fatty Liver ◽  
Definition Of ◽  
Significant Health ◽  
Age And Sex

Obesity is one of the most significant health problems facing children and adolescents. The definition of overweight in children is a body mass index between the 85th and less than 95th percentile, whereas obesity is greater than or equal to the 95th percentile for age and sex. There are multiple comorbidities associated with obesity, including dyslipidemia, hypertension, type 2 diabetes, sleep apnea, and nonalcoholic fatty liver disease, as well as psychosocial issues.  This review contains 3 figures, 4 tables and 63 references. Key Words bariatric surgery, metabolic syndrome, obesity treatment, pediatric obesity, weight loss surgery

scholarly journals Association between Irisin, hs-CRP, and Metabolic Status in Children and Adolescents with Type 2 Diabetes Mellitus

2019 ◽  
Vol 2019 ◽  
pp. 1-13 ◽  
Author(s):  
Leticia Elizondo-Montemayor ◽  
Adrian M. Gonzalez-Gil ◽  
Oscar Tamez-Rivera ◽  
Carla Toledo-Salinas ◽  
Mariana Peschard-Franco ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Children And Adolescents ◽  
Pediatric Population ◽  
Surrogate Marker ◽  
Metabolic Effects ◽  
Mexican Children ◽  
Hs Crp

Proinflammatory cytokines and the novel myokine irisin, a cleavage product of FNDC5, have been found to play a role in obesity and type 2 diabetes mellitus (T2DM). Irisin has been shown to increase browning of adipose tissue, thermogenesis, energy expenditure, and insulin sensitivity, yet its association with inflammatory markers is still limited. Circulating irisin has been found to be increased in obesity, while in adult subjects with T2DM decreased levels have been found. However, data establishing the association of circulating irisin in children and adolescents with T2DM has not been described in the literature. The objective of this study was to determine irisin plasma concentration and its association with metabolic and adiposity markers and with hs-CRP, a surrogate marker of inflammation used in clinical practice, in a pediatric population with T2DM. A cross-sample of 40 Mexican children and adolescents aged 7-17 were recruited, 20 diagnosed with T2DM and 20 healthy controls. Plasma irisin levels were found to be lower in the T2DM group compared with controls, which could be attributed to a reduced PGC-1α activity in muscle tissue with a consequent decrease in FNDC5 and irisin expression. Irisin concentration was found to be positively correlated with HDL-c, LDL-c, and total cholesterol, while negatively correlated with BMI, waist circumference, and triglycerides. However, after multiple regression analysis, only HDL-c correlation remained significant. hs-CRP was higher in the T2DM group and positively associated with adiposity markers, unfavorable lipid profile, insulin levels, and HOMA-IR, but no association with irisin was found. Given the favorable metabolic effects attributed to irisin, the low plasma levels found in children and adolescents with T2DM could exacerbate the inflammatory and metabolic imbalances and the intrinsic cardiovascular risk of this disease. We propose an “irisin-proinflammatory/anti-inflammatory axis” to explain the role of irisin as a metabolic regulator in obesity and T2DM.

Glycated hemoglobin A1c as a screening test for detecting type 2 diabetes mellitus in obese children and adolescents

2018 ◽  
Vol 31 (5) ◽  
pp. 503-506 ◽  
Author(s):  
Jong Seo Yoon ◽  
Cheol Hwan So ◽  
Hae Sang Lee ◽  
Jin Soon Hwang
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Children And Adolescents ◽  
Glycated Hemoglobin ◽  
Pediatric Population ◽  
Oral Glucose ◽  
Lower Sensitivity ◽  
Obese Children

Abstract Background: The diagnostic cutoff points for indicators of type 2 diabetes mellitus (T2DM) in the pediatric population have not been defined thus far. Methods: A retrospective, single-center study was conducted from April 2003 to May 2016. We enrolled 236 overweight or obese children and adolescents aged 4–17 years. Thirty-nine (26.9%) of 145 patients had T2DM according to the oral glucose tolerance test results. Results: A glycated hemoglobin (HbA1c) level of 6.5% had a sensitivity and specificity of 87.2% and 98.5%, respectively, for detecting T2DM. The optimal HbA1c cutoff level for T2DM was >6.2% (94.7% sensitivity, 95.5% specificity). Conclusions: We observed that the use of an HbA1c level of 6.5% had a lower sensitivity for detecting T2DM than an HbA1c level of >6.2%.

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