Associations of Size at Birth and Metabolic Syndrome Antecedents With Serum Spexin Levels in Prepubertal Children

Background: Spexin is a novel peptide implicated in food intake and obesity. The primary aim of this study was to analyze whether serum spexin levels, along with total leptin and active ghrelin levels were different in prepubertal children born small for gestational age(SGA) and appropriate for gestational(AGA). Secondary aims were to analyze whether serum spexin, leptin and active ghrelin levels correlated with metabolic syndrome(MS)antecedents according to the Dietary and lifestyle-induced health effects in children and infants (IDEFICS)study. Subjects and Methods: We conducted a cross-sectional study on prepubertal37SGA- (median:5.6yr)and50prepubertalAGA-born children(median:5.9yr). Anthropometric data, homeostasis model assessment of insulin resistance(HOMAIR),plasma lipids, serum spexin, total leptin and active ghrelin levels were analyzed. Associations of serum spexin levels with MS antecedents according to the IDEFICS study were investigated. Results: Children bornSGA had higher body mass index and waist circumference than AGA-born peers(p <0.05). Serum total leptin levels were higher in SGA-born children than in AGA-born peers (p<0.05). Plasma active ghrelin and spexin levels were not different between the subgroups(p>0.05). Children bornSGA had higher MS risk scores than AGA-born peers(p <0.05). Small for gestational age- born children had higher plasma glucose,insulin and HOMA-IR than AGA-born peers(p<0.05). In children born SGA, the number of subjects with excess adiposity (NSGA=18(43.9%)andNAGA=7(14%),p=0.016)and insulin resistance(NSGA=14(34%) andNAGA=6(12%),p=0.035)was higher than in AGA-born peers. There was no significant difference in frequency of dyslipidemia between the subgroups(p=0.19). The frequency of children with more than one MS antecedent was higher in SGA-born children than in AGA-born peers(Chi-Square p <0.01). Metabolic syndrome risk score according to IDEFICS was higher in SGA born children than in AGA-born peers(2.2±1.8vs1.1±1.8;p=0.008). Serum spexin levels were lower in children with MS antecedents than those without MS antecedents in both AGA -and SGA-born children[Serum spexin levels in AGA-born children with and without MS antecedents: 48,5pg/mL(25-75%IQR:19.8-93.8pg/mL)and143pg/mL(25-75%IQR:104-211pg/mL),p<0.001;respectively, serum spexin levels inSGAborn children with and without MS antecedents: 31,0pg/mL(25-75%IQR:16.5-47.0 pg/mL) and79.5pg/mL(25-75% IQR:49.5-274.8pg/mL),p=0,0016;respectively]. In the whole study group, the most important factor associated with excess adiposity was history of being born SGA(OddsRatio=91.3[95%CI:2.2-374;p=0.017] Conclusions: Serum spexin levels were not different inSGA- and AGA-born children. Serum spexin levels were reduced in children with MS antecedents independent of size at birth.

Dairy Consumption at Snack Meal Occasions and the Overall Quality of Diet during Childhood. Prospective and Cross-Sectional Analyses from the IDEFICS/I.Family Cohort

There is scarce information on the influence of dairy consumption between main meals on the overall diet quality through childhood, constituting the main aim of this research. From the Identification and prevention of Dietary- and lifestyle induced health EFfects In Children and infantS (IDEFICS) study, and based on the data availability in each period due to drop outs, 8807 children aged 2 to 9.9 years from eight European countries at baseline (T0: 2007–2008); 5085 children after two years (T1); and 1991 after four years (T3), were included in these analyses. Dietary intake and the Diet Quality Index (DQI) were assessed by two 24 hours dietary recalls (24-HDR) and food frequency questionnaire. Consumption of milk and yogurt (p = 0.04) and cheese (p < 0.001) at snack meal occasions was associated with higher DQI scores in T0; milk and yogurt (p < 0.001), and cheese (p < 0.001) in T1; and cheese (p = 0.05) in T3. Consumers of milk (p = 0.02), yogurt (p < 0.001), or cheese (p < 0.001) throughout T0 and T1 at all snack moments had significantly higher scores of DQI compared to non-consumers. This was also observed with the consumption of cheese between T1 and T3 (p = 0.03). Consumption of dairy products at snack moments through childhood is associated with a better overall diet quality, being a good strategy to improve it in this period.

Prospective associations between combined physical activity and sedentary behaviours and milk and yogurt consumption. Results from the IDEFICS study

BackgroundThe knowledge about the association of physical activity (PA) and sedentary behaviours (SB) with the most considered healthy dairy products consumption, as milk and yogurt, in childhood is scared.AimTo assess the longitudinal relationship between specific lifestyle behaviours (PA and SB) and combined dairy consumption (milk + yogurt) in a sample of European children.MethodsTwo measurements, with 2 years’ interval (T0 and T1), were conducted in 1 688 (50.8% boys) childrenfrom the IDEFICS study. Dietary information was parental-registered by a 24-hour dietary recall. At both time points, sedentary behaviour and objective estimation of PA was obtained by accelerometers. Different groups were defined according to the international children's PA and SB behaviours recommendations over time. The cut-offs for the SB and PA recommendations were established on 2hour/day of SB and 2 hour/day of moderate to vigorous PA. Multilevel ordinal logistic regression models were used to assess the group's association with the combined dairy consumption (milk + yogurt), adjusted for potential confounders (sex, body mass index zscore, intervention versus control region, parental education level, dietary quality index, energy intake and the consumption by each dairy group at T0).ResultsNine groups of meeting or not both recommendations (SB and PA) were obtained. Those children who meeting both lifestyle recommendations at both measurement points, had higher probability to consume more milk and yogurt (p < 0.05), in comparison to the rest of combinations.Those children who did not meet any recommendations at both time points were less likely to consume milk + yogurt (OR: 0.47, 95%CI:0.26–0.83) than those who met both recommendations at both time points. Those children which improved one behaviours (PA or SB) between both measurement point were associated with low consumption of milk + yogurt (OR:0.41, 95%CI 0.22;0.74; OR:0.40, 95%CI 0.22,0.72), compared with those who meet both lifestyle recommendations at both periods (T0 and T1). Also, those which improved both behaviours (PA and SB) were less likely to consume milk + yogurt (OR:0.34, 95%CI 0.15–0.80) than those who were physically active and low sedentary at both time points.ConclusionsThese results suggest that European children with a healthy lifestyle regarding PA and SB over time, had the highest milk and yogurt consumption in comparison with other children.

Association between a metabolic syndrome score and high sensitivity C-reactive protein in European children: the IDEFICS study

IntroductionMetabolic syndrome (MetS) is a combination of risk factors that may be present already in childhood. MetS has been associated with inflammatory biomarkers such as high sensitivity C-reactive protein (hsCRP) in aduls. In 2014, Ahrens et al, published reference standards for a paediatric MetS score based on reference values from European children. The aim of this study is to assess longitudinally the relationship between a MetS score and hsCRP in a sample of European children.Materials and MethodsOut of the baseline sample of the IDEFICS Study, 2913 children aged 2–9 years were included in this study. Inclusion criteria was having available data of waist circumference (WC), diastolic and systolic blood pressure (DBP, SBP), high density lipoprotein (HDL) cholesterol, triglycerides (TG), glucose and insulin, to calculate the homeostasis model assessment index (HOMA); and hs-CRP as a marker of inflammation, at baseline (T0) and two years later (T1). hs-CRP was categorized into two categories as some children had lower concentration than the detection limit of 0.02mg/dL. Student t-test and logistic regression were used to assess these associations. Logistic regression was adjusted by age, sex, body mass index (BMI), socioeconomic level and country.ResultsDifferences of mean values of the components of the MetS and the two categories of hs-CRP were observed between both time points. Mean values of SBP, DBP, WC, TG and HOMA were significantly higher in children with a higher category of hsCRP (p < 0.005). In addition, MetS score was significantly higher in those with a higher category of hs-CRP (p < 0.001) at both measurement points, T0 and T1. Finally, logistic regression between components of MetS and categories of hs-CRP, at both time points, showed significant associations (p < 0.001) for WC (OR = 1.06 at T0 and OR = 1.04 at T1) and HDL (OR = 0.98 at T0 and OR = 0.98 at T1) and the MetS score (OR = 1.07) score at T1.DiscussionThe association between MetS and inflammation is already present in children. Out of the components of the MetS, WC and HDL were the ones more associated with an inflammatory state at two times points. Also the MetS score, but only at the follow-up, was associated with the hs-CRP. Therefore, in order to prevent the inflammatory state in childhood, efforts to improve the metabolic profile, specially WC and HDL, need to be made.