Revistas
Revista:
CARDIOVASCULAR DIABETOLOGY
ISSN:
1475-2840
Año:
2023
Vol.:
22
N°:
1
Págs.:
240
ObjectiveTo assess how inaccurately the body mass index (BMI) is used to diagnose obesity compared to body fat percentage (BF%) measurement and to compare the cardiometabolic risk in children and adolescents with or without obesity according to BMI but with a similar BF%.MethodsA retrospective cross-sectional investigation was conducted including 553 (378 females/175 males) white children and adolescents aged 6-17 years, 197 with normal weight (NW), 144 with overweight (OW) and 212 with obesity (OB) according to BMI. In addition to BMI, BF% measured by air displacement plethysmography, as well as markers of cardiometabolic risk had been determined in the existing cohort.ResultsWe found that 7% of subjects considered as NW and 62% of children and adolescents classified as OW according to BMI presented a BF% within the obesity range. Children and adolescents without obesity by the BMI criterion but with obesity by BF% exhibited higher blood pressure and C-reactive protein (CRP) in boys, and higher blood pressure, glucose, uric acid, CRP and white blood cells count, as well as reduced HDL-cholesterol, in girls, similar to those with obesity by BMI and BF%. Importantly, both groups of subjects with obesity by BF% showed a similarly altered glucose homeostasis after an OGTT as compared to their NW counterparts.ConclusionsResults from the present study suggest increased cardiometabolic risk factors in children and adolescents without obesity according to BMI but with obesity based on BF%. Being aware of the difficulty in determining body composition in everyday clinical practice, our data show that its inclusion could yield clinically useful information both for the diagnosis and treatment of overweight and obesity.
Revista:
SLEEP MEDICINE
ISSN:
1389-9457
Año:
2023
Vol.:
109
Págs.:
252 - 260
Background/objective: childhood obesity and sleep disorders have a well-established cross-sectional association, but lifestyle interventions' effects on sleep quality remain under-researched. This study aimed to evaluate the sleep quality of 122 participants (7-16 years) with abdominal obesity after a 2-year necessary lifestyle intervention. Patients/methods: participants were assigned to either the intervention group (moderate hypocaloric Mediterranean Diet) or the usual care group (standard recommendations on a healthy diet). Sleep was objectively assessed using triaxial accelerometry, and sleep parameters analyzed included latency, efficiency, wake after sleep onset, total time in bed, total sleep time, number of awakenings, and awakening duration. Results and conclusions: the results showed that the intervention group significantly improved sleep latency at 12 and 24 months and improved sleep efficiency at 2 and 12 months, compared to the usual care group. Wake after sleep onset and the number of awakenings were significantly reduced at 24 months in the intervention group. Wake after sleep onset and leptin levels were positively associated in all participants. Total time in bed was inversely associated with triglycerides and metabolic score, and total sleep time was inversely associated with leptin, triglycerides, and metabolic score after the 2-month intervention. Triglyceride levels were inversely associated with total time in bed and total sleep time at one year, while the metabolic score was directly associated with wake after sleep onset and the number of awakenings and inversely associated with efficiency. In conclusion, the multidisciplinary intervention in children and adolescents with abdominal obesity reduced anthropometric parameters and improved sleep habits.
Autores:
Guerrero.-Fernandez, J.; Amat Bou, M.; Audi Parera, L.; et al.
Revista:
ENDOCRINOLOGÍA PEDIÁTRICA
ISSN:
2013-7788
Año:
2023
Vol.:
14
N°:
Supl. 2
Págs.:
21 - 38
Revista:
PEDIATRIC OBESITY
ISSN:
2047-6310
Año:
2022
Vol.:
17
N°:
8
Págs.:
e12910
Background Recent studies have associated several microRNAs (miRNAs) with childhood obesity and energy homeostasis, suggesting that an individual miRNA profile could be used as an early predictor to estimate the response to weight loss interventions in the design of precision nutrition. Objective To investigate associations between the expression of circulating adiposity-related miRNAs and the response to a weight loss intervention. Methods A total of 51 Spanish girls (age 7-16 years) with abdominal obesity underwent 8 weeks of a multidisciplinary intervention for weight loss. Participants were stratified into two groups in accordance with changes in body mass index (BMI) standard deviation score: low-responders (LR) and high-responders (HR). The expression of 39 circulating miRNAs (c-miRNAs) was evaluated in plasma of all subjects before the intervention. Results Six miRNAs were differentially expressed between LR and HR. However, after adjustment for Tanner stage, the association was maintained only for miR-126-3p and miR-221-3p with a higher expression in HR group compared to LR group. After the intervention, miR-221-3p expression decreased in all subjects with a significant difference in the change within groups. However, changes in miR-126-3p levels were not significant. The expression of miR-221-3p was positively correlated with body weight, BMI and waist circumference, and negatively correlated with quantitative insulin sensitivity check index. Conclusions Bioinformatic analysis evidenced that miR-221-3p participates in several obesity-related pathways, and more interestingly, this miRNA targets several candidate genes to childhood obesity according to DisGeNet database. Thus, miR-221-3p could be used for predicting the response to a multidisciplinary intervention for weight loss in young girls.
Autores:
Guerrero-Fernández, J. (Autor de correspondencia); González-Peramato, P.; Rodríguez Estévez, A.; et al.
Revista:
ENDOCRINOLOGÍA, DIABETES Y NUTRICIÓN
ISSN:
2530-0164
Año:
2022
Vol.:
69
N°:
8
Págs.:
629 - 645
El riesgo de padecer tumores gonadales de células germinales (TCG) se encuentra incrementado en algunos pacientes con desarrollo sexual diferente (DSD), fundamentalmente en aquellos que presentan material de cromosoma Y. Dicho riesgo, sin embargo, varía considerablemente en función de multitud de factores que dificultan enormemente la decisión de una gonadectomía profiláctica. Con el fin de hacer recomendaciones fundamentadas sobre la conveniencia de este procedimiento en los casos donde existe potencial de malignización, esta guía de consenso evalúa la última evidencia clínica existente, en general escasa, y actualiza los conocimientos en este terreno.
Revista:
APPLIED PHYSIOLOGY NUTRITION AND METABOLISM- PHYSIOLOGIE APPLIQUEE NUTRITION ET METABOLISME
ISSN:
1715-5312
Año:
2021
Vol.:
46
N°:
3
Págs.:
205 - 212
The purpose of this study was to assess the effect of physical activity (PA) changes, measured by accelerometry, on telomere length (TL) in pediatric patients with abdominal obesity after a lifestyle intervention. One hundred and twenty-one children (7-16 years old) with abdominal obesity were randomized to the intervention (a moderately hypocaloric Mediterranean diet) or the usual care group (standard pediatric recommendations) for 22 months (a 2 month intensive phase and a subsequent 20 month follow-up). Both groups were encouraged to accumulate an extra 200 min/week of PA. TL was measured by MMqPCR. Data were analyzed in 102 subjects after 2 months and 64 subjects at the first 10 months of follow-up. Light PA level decreased in both groups after 12 months of intervention. At month 2, moderate to vigorous PA (MVPA) increased in the intervention group (+5.4 min/day, p = 0.035) and so did sedentary time in the usual care group (+49.7 min/day, p = 0.010). TL changes were positively associated (p < 0.050) with metabolic equivalents (METs), MVPA level, and number of steps, and were inversely associated with sedentary and light PA levels in the intervention group after the intensive phase. In conclusion, favourable changes in PA levels in the intensive phase of a lifestyle intervention could contribute to TL maintenance in a pediatric population with abdominal obesity. Novelty Changes in physical activity levels had a direct effect on telomere length, a biomarker of cellular aging and oxidative stress. PA advice based on The American College of Sports Medicine included in this intervention is easy to implement in primary care.
Revista:
NUTRIENTS
ISSN:
2072-6643
Año:
2021
Vol.:
13
N°:
2
Págs.:
289
Elevated circulating plasma levels of both lipopolysaccharide-binding protein (LBP) and chemerin are reported in patients with obesity, but few studies are available on lifestyle intervention programs. We investigated the association of both LBP and chemerin plasma levels with metabolic syndrome (MetS) outcomes in a lifestyle intervention in children and adolescents with abdominal obesity Methods: Twenty-nine patients enrolled in a randomized controlled trial were selected. The lifestyle intervention with a 2-month intensive phase and a subsequent 10-month follow-up consisted of a moderate calorie-restricted diet, recommendations to increase physical activity levels, and nutritional education. Results: Weight loss was accompanied by a significant reduction in MetS prevalence (-43%; p = 0.009). Chemerin (p = 0.029) and LBP (p = 0.033) plasma levels were significantly reduced at 2 months and 12 months, respectively. At the end of intervention, MetS components were associated with both LBP (p = 0.017) and chemerin (p < 0.001) plasma levels. Conclusions: We describe for the first time a reduction in both LBP and chemerin plasma levels and its association with MetS risk factors after a lifestyle intervention program in children and adolescents with abdominal obesity. Therefore, LBP and chemerin plasma levels could be used as biomarkers for the progression of cardiovascular risk in pediatric populations.
Revista:
NUTRIENTS
ISSN:
2072-6643
Año:
2021
Vol.:
13
N°:
4
Págs.:
1216
In children and adolescents, obesity does not seem to depend on a reduction of resting energy expenditure (REE). Moreover, in this young population, the interactions between either age and obesity or between age and gender, or the role of leptin on REE are not clearly understood. To compare the levels of REE in children and adolescents we studied 181 Caucasian individuals (62% girls) classified on the basis of age- and sex-specific body mass index (BMI) percentile as healthy weight (n = 50), with overweight (n = 34), or with obesity (n = 97) and in different age groups: 8-10 (n = 38), 11-13 (n = 50), and 14-17 years (n = 93). REE was measured by indirect calorimetry and body composition by air displacement plethysmography. Statistically significant differences in REE/fat-free mass (FFM) regarding obesity or gender were not observed. Absolute REE increases with age (p < 0.001), but REE/FFM decreases (p < 0.001) and there is an interaction between gender and age (p < 0.001) on absolute REE showing that the age-related increase is more marked in boys than in girls, in line with a higher FFM. Interestingly, the effect of obesity on absolute REE is not observed in the 8-10 year-old group, in which serum leptin concentrations correlate with the REE/FFM (r = 0.48; p = 0.011). In conclusion, REE/FFM is not affected by obesity or gender, while the effect of age on absolute REE is gender-dependent and leptin may influence the REE/FFM in 8-10 year-olds.
Revista:
NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES
ISSN:
0939-4753
Año:
2020
Vol.:
30
N°:
4
Págs.:
694 - 700
In lifestyle intervention studies, we demonstrated that changes in telomere length (TL) were associated with changes in anthropometric indices. Therefore, our new hypothesis is that TL could be a predictor of changes in anthropometric or metabolic measures in children with abdominal obesity. The aim of the study was to evaluate the association between anthropometric and biochemical measurements with TL before and after an 8-week lifestyle intervention in children with abdominal obesity (7-16 years old).
We assessed anthropometric and biochemical outcomes at baseline and after 8-week lifestyle intervention in 106 children with abdominal obesity (11.30 ± 2.49 years old, 63% girls). TL was measured by monochrome multiplex real-time quantitative PCR. After the lifestyle intervention, anthropometric parameters and glucose metabolism indicators significantly improved in the participants. TL did not change after the intervention in participants. Significant negative correlations between baseline TL and anthropometric measures (BMI, body weight and waist circumference) were observed. Furthermore, baseline TL was a predictor for changes in blood glucose levels after the lifestyle intervention.
An inverse correlation between TL and obesity traits was observed in children with abdominal obesity. Interestingly, we found that baseline TL could predict changes in blood glucose levels.
Revista:
PEDIATRIC OBESITY
ISSN:
2047-6310
Año:
2020
Vol.:
15
N°:
11
Págs.:
e12661
Background Dietary factors seem to influence telomere length. Moreover, associations between changes in adiposity indices and telomere length (TL) have been found in intervention studies. Objective We evaluated changes in two diet quality indices and their association with TL in children with abdominal obesity in a 12-month lifestyle intervention. Methods Eighty-seven participants (7-16 years old) were assigned to the intervention (moderate hypocaloric Mediterranean diet) or usual care group (standard paediatric recommendations) for a 2-month intensive phase and a subsequent 10-month follow-up. Diet quality was assessed using the Diet Quality Index for Adolescents (DQI-A) and the Healthy Lifestyle Diet Index (HLD-I). TL was measured by monochrome multiplex real-time quantitative PCR. The intra-class correlation coefficient for TL was 0.793 (95% CI 0.707, 0.857). Results After a 12-month lifestyle intervention, a significant reduction in BMI-SDS (-0.57 and -0.49 for the intervention and usual care groups, respectively) and fat mass was observed in all subjects without differences between groups. Changes in DQI-A (+12.36% vs +5.53%,P= .005) and HLD-I (+4.43 vs +1.09,P < .001) were higher in the intervention subjects compared with usual care subjects after 2 months. Interestingly, we observed a positive change in TL between 2 and 12 months (P= .025), which was associated with higher scores on the DQI-A (beta= 0.008,R-2= 0.088,P= .010) and HLD-I (beta= 0.022,R-2= 0.198,P= .015), in the intervention group after the 2-month intensive phase. Conclusion Favourable changes in diet quality indices could contribute to telomere integrity in children with abdominal obesity enrolled in an intensive lifestyle intervention.
Revista:
BMC PEDIATRIC
ISSN:
1471-2431
Año:
2019
Vol.:
19
N°:
1
Págs.:
90
Background: Physical activity (PA) is associated with changes in body composition that affect insulin sensitivity and leptin levels. Few studies have assessed the effect of lifestyle interventions on changes in objectively measured PA levels in obese children. To evaluate the effects of a multidisciplinary lifestyle intervention on anthropometric indices, biochemical parameters and accelerometer measured PA in abdominal obese children.
Methods: A randomized control trial was performed in 106 children and adolescents with abdominal obesity. Participants were randomly assigned to usual or intensive care group for 8-week. PA was measured by accelerometry over four days including, at least, two weekdays in all participants. Both groups were encouraged to accumulate an extra time of 200 min per week in their PA.
Results: At baseline, 75% of subjects do not fulfill the WHO recommendation of being more than 60 min/day on moderate-to-vigorous PA (MVPA). The intensive care group achieved a significant reduction in anthropometric indexes compared to the usual care but no significant change was found in biochemical or PA parameters. Both groups achieved a significant reduction in light PA. Interestingly, intensive care participants significantly increased MVPA in 5.5 min/day. Moreover, an inverse association between changes in MVPA and leptin levels was found.
Conclusion: The two lifestyle intervention reduced anthropometric indexes and lowered light PA in abdominal obese children. No significant differences were observed between intensive care and usual care in regard to PA. Intensive care participants significantly increase physical activity (MVPA) and, changes in MVPA were inversely associated with changes in leptin levels after the intervention.
Trial registration: ClinicalTrials.gov , Identifier: NCT03147261 . Registered 10 May 2017. Retrospectively registered.
Revista:
BMC PEDIATRICS
ISSN:
1471-2431
Año:
2019
Vol.:
19
Págs.:
90
BackgroundPhysical activity (PA) is associated with changes in body composition that affect insulin sensitivity and leptin levels. Few studies have assessed the effect of lifestyle interventions on changes in objectively measured PA levels in obese children. To evaluate the effects of a multidisciplinary lifestyle intervention on anthropometric indices, biochemical parameters and accelerometer measured PA in abdominal obese children.MethodsA randomized control trial was performed in 106 children and adolescents with abdominal obesity. Participants were randomly assigned to usual or intensive care group for 8-week. PA was measured by accelerometry over four days including, at least, two weekdays in all participants. Both groups were encouraged to accumulate an extra time of 200min per week in their PA.ResultsAt baseline, 75% of subjects do not fulfill the WHO recommendation of being more than 60min/day on moderate-to-vigorous PA (MVPA). The intensive care group achieved a significant reduction in anthropometric indexes compared to the usual care but no significant change was found in biochemical or PA parameters. Both groups achieved a significant reduction in light PA. Interestingly, intensive care participants significantly increased MVPA in 5.5min/day. Moreover, an inverse association between changes in MVPA and leptin levels was found.ConclusionThe two lifestyle intervention reduced anthropometric indexes and lowered light PA in abdominal obese children. No significant differences were observed between intensive care and usual care in regard to PA. Intensive care participants significantly increase physical activity (MVPA) and, changes in MVPA were inversely associated with changes in leptin levels after the intervention.
Revista:
NUTRIENTS
ISSN:
2072-6643
Año:
2019
Vol.:
11
N°:
5
Págs.:
960
Mutations leading to a reduced function of the melanocortin-4 receptor (MC4R) exert a major gene effect on extreme obesity. Recently it was shown that the bone derived hormone lipocalin 2 (LCN2) binds to the MC4R and activates a MC4R dependent anorexigenic pathway. We identified mutations in both genes and screened the effects of MC4R and LCN2 mutations on eating behavior and weight change after a lifestyle intervention. One hundred and twelve children (11.24 +/- 2.6 years, BMI-SDS 2.91 +/- 1.07) with abdominal obesity participated in a lifestyle intervention. MC4R and LCN2 coding regions were screened by Sanger sequencing. Eating behavior was assessed at baseline with the Children Eating Behavior Questionnaire (CEBQ). We detected three previously described non-synonymous MC4R variants (Glu42Lys, Thr150Ile, and Arg305Gln) and one non-synonymous polymorphism (Ile251Leu). Regarding LCN2, one known non-synonymous variant (Thr124Met) was detected. Eating behavior was described in carriers of the MC4R and LCN2 mutation and in non-carriers. MC4R and LCN2 mutations were detected in 2.42% and 0.84%, respectively, of Spanish children with abdominal obesity. A number of subjects with functional mutation variants in MC4R and LCN2 were able to achieve a reduction in BMI-SDS after a lifestyle intervention.
Autores:
De Miguel-Etayo, P. (Autor de correspondencia); Moreno, L. A.; Santabárbara, J.; et al.
Revista:
CLINICAL NUTRITION
ISSN:
0261-5614
Año:
2018
Vol.:
38
N°:
2
Págs.:
782 - 790
Background & aim: A diet quality index (DQI) is a tool that provides an overall score of an individual's dietary intake when assessing compliance with food-based dietary guidelines. A number of DQIs have emerged, albeit their associations with health-related outcomes are debated. The aim of the present study was to assess whether adherence to dietary intervention, and the overall quality of the diet, can predict body composition changes. Methods: To this purpose, overweight/obese adolescents (n = 117, aged: 13¿16 years; 51 males, 66 females) were recruited into a multi-component (diet, physical activity and psychological support) family-based group treatment programme. We measured the adolescents¿ compliance and body composition at baseline and after 2 months (intensive phase) and 13 months (extensive phase) of follow-up. Also, at baseline, after 6 months, and at the end of follow-up we calculated the DQI. Results: Global compliance with the dietary intervention was 37.4% during the intensive phase, and 14.3% during the extensive phase. Physical activity compliance was 94.1% at 2-months and 34.7% at 13months and psychological support compliance were growing over the intervention period (10.3% intensive phase and 45.3% during extensive phase). Adolescents complying with the meal frequency criteria at the end of the extensive phase had greater reductions in FMI z-scores than those did not complying (Cohen's d = 0.53). A statistically significant association was observed with the diet quality index. DQI-A variation explained 98.1% of BMI z-score changes and 95.1% of FMI changes. Conclusions: We conclude that assessment of changes in diet quality could be a useful tool in predicting body composition changes in obese adolescents involved in a diet and physical activity intervention programme backed-up by psychological and family support.
Revista:
ANALES DE PEDIATRIA
ISSN:
1695-4033
Año:
2018
Vol.:
89
N°:
5
Págs.:
315.e1 - 315.e19
Las anomalías de la diferenciación sexual (ADS) engloban un amplio espectro de discordancias entre los criterios cromosómico, gonadal y fenotípico (genital) que definen la diferenciación sexual; actualmente, se aboga por la denominación de «desarrollo sexual diferente» (DSD). Su origen es congénito; se clasifican en función de los cromosomas sexuales presentes en el cariotipo; las causas genéticas conocidas son muy diversas y heterogéneas, aunque algunos casos pueden ser secundarios a factores maternos o medioambientales. Su diagnóstico y tratamiento requieren siempre una atención médica y psicosocial multidisciplinar. El diagnóstico etiológico precisa la interacción entre las exploraciones clínicas, bioquímicas (hormonales), genéticas, de imagen y, eventualmente, quirúrgicas. El tratamiento debe abordar la asignación de género, la posible necesidad de tratamiento hormonal substitutivo (suprarrenal si hay insuficiencia suprarrenal y con esteroides sexuales si hay insuficiencia gonadal a partir de la edad puberal), la necesidad de intervenciones quirúrgicas sobre las estructuras genitales (actualmente se tiende a diferirlas) y/o sobre las gónadas (en función de los riesgos de malignización), la necesidad de apoyo psicosocial y, finalmente, una adecuada programación de la transición a la atención médica en las especialidades de adultos. Las asociaciones de personas afectadas tienen un papel fundamental en el apoyo a familias y la interacción con los medios profesionales y sociales. La utilización de Registros y la colaboración entre profesionales en Grupos de Trabajo de sociedades médicas nacionales e internacionales es fundamental para avanzar en mejorar los medios diagnósticos y terapéuticos que precisan los DSD.
Revista:
NUTRIENTS
ISSN:
2072-6643
Año:
2018
Vol.:
10
N°:
10
Págs.:
1500
High rates of childhood obesity require integral treatment with lifestyle modifications that achieve weight loss. We evaluated a lifestyle intervention on nutrient adequacy and diet quality in children and adolescents with abdominal obesity. A randomized controlled trial was performed on 107 participants, assigned either to a usual care group or to an intensive care group that followed a moderate hypocaloric Mediterranean diet and received nutritional education. Intake adequacy was evaluated using Dietary Reference Intakes and diet quality through the Diet Quality Index for Adolescents (DQI-A), the Healthy Lifestyle Diet-Index (HLD-I) and the Mediterranean Diet Quality Index (KIDMED). Both groups achieved a significant reduction in BMI standard deviation score (BMI-SDS), glucose and total cholesterol levels. Intake of Calcium, Iodine and vitamin D were higher in the intensive care group, with enhanced compliance with recommendations. Higher dietary scores were associated with lower micronutrient inadequacy. DQI-A and HLD-I were significantly higher in the intensive care group vs. usual care group after the treatment. In conclusion, we observed that an intensive lifestyle intervention was able to reduce BMI-SDS in children with abdominal obesity. Furthermore, participants significantly improved dietary indices getting closer to the nutritional recommendations. Therefore, these diet quality indices could be a valid indicator to evaluate micronutrient adequacy.
Revista:
ALLERGOLOGIA ET IMMUNOPATHOLOGIA
ISSN:
0301-0546
Año:
2018
Vol.:
46
N°:
1
Págs.:
9 - 14
Background: This study examined the relationship between different food groups and the adherence to a Mediterranean diet during pregnancy and the risk of wheezing and eczema in children aged 12-15 months. Methods: The study involves 1087 Spanish infants from the International Study of Wheezing in Infants (Estudio Internacional de Sibilancias en Lactantes, EISL). The study of the association of the different food consumption and Mediterranean diet with wheezing, recurrent wheezing and eczema was performed using different models of unconditional logistic regression to obtain adjusted prevalence odds ratios (OR) and 95% confidence intervals (95% CI). Results: No association was found between a good adherence to the Mediterranean diet during pregnancy and the development of wheezing (p= 0.372), recurrent wheezing (p= 0.118) and eczema (p= 0.315). The consumption once or twice a week of white fish (OR: 1.95[1.01-3.75]), cooked potatoes (OR: 1.75[1.22-2.51]) and industrial pastry (OR: 1.59[1.13-2.24]), and the consumption more than three times a week of industrial pastry (OR: 1.47 [1.01-2.13]) during pregnancy increases the risk of "wheezing" at 12 months. Instead, high fruit consumption during the pregnancy has a protective effect against "wheezing" in 12-month-old infants (OR: 0.44 [0.20-0.99]). No statistically significant differences were observed between food intake during pregnancy and "recurrent wheezing". No statistically significant differences were observed between the consumption of any food during pregnancy and the presence of eczema at 12 months. Conclusions The present study showed that the consumption of Mediterranean diet during pregnancy did not have a protective effect for wheezing, recurrent wheezing or eczema. (C) 2017 SEICAP. Published by Elsevier Espana, S.L.U. All rights reserved.
Revista:
ANALES DE PEDIATRIA
ISSN:
1695-4033
Año:
2018
Vol.:
89
N°:
5
Págs.:
315.e1 - 315.e19
Disorders of Sex Development (DSD) include a wide range of anomalies among the chromosomal, gonadal, and phenotypic (genital) characteristics that define sexual differentiation. At present, a definition as Different Sexual Development (DSD) is currently preferred. They originate in the pre-natal stage, are classified according to the sex chromosomes present in the karyotype. The known genetic causes are numerous and heterogeneous, although, in some cases, they may be secondary to maternal factors and/or exposure to endocrine-disrupting chemicals (EDCs). The diagnosis and treatment of DSD always requires multidisciplinary medical and psychosocial care. An aetiological diagnosis needs the interaction of clinical, biochemical (hormonal), genetic, imaging and, sometimes, surgical examinations. The treatment should deal with sex assignment, the possible need for hormone replacement therapy (adrenal if adrenal function is impaired, and with sex steroids from pubertal age if gonadal function is impaired), as well as the need for surgery on genital structures (currently deferred when possible) and/or on gonads (depending on the risk of malignancy), the need of psychosocial support and, finally, an adequate organisation of the transition to adult medical specialties. Patient Support Groups have a fundamental role in the support of families, as well as the interaction with professional and social media. The use of Registries and the collaboration between professionals in Working Groups
Revista:
PEDIATRIC OBESITY
ISSN:
2047-6310
Año:
2017
Vol.:
12
N°:
3
Págs.:
257 - 263
BACKGROUND:
Shorter telomeres have been associated with elevated risk for age-related diseases. However, little is known about the biomarker role of telomere length (TL) for predicting inflammation and glucose alterations.
OBJECTIVE:
The objective of this research is to evaluate the association between TL, inflammatory markers and glucose levels after a 2-month weight-loss programme in obese adolescents.
METHODS:
Telomere length was measured using a quantitative polymerase chain reaction in 66 obese adolescents aged 12-17 years (51% men) from the EVASYON programme. The adolescents were genotyped for the polymorphism -174G/C (rs1800795) in the IL-6gene, and anthropometric and biochemical markers as well as inflammatory cytokines were analysed.
RESULTS:
Multiple-adjusted models showed that longer telomeres at baseline were associated with a higher reduction in glucose (B¿=¿-4.08, 95% confidence interval: -6.66 to -1.50) and IL-6 (B¿=¿-1.03, 95% confidence interval: -2.01 to -0.05) serum levels after 2¿months of the weight-loss treatment. The -174G/C polymorphism modulated the association between basal TL and changes in IL-6 (P interaction¿=¿0.029). Thus, subjects with the GG¿+¿GC genotype and with longer telomeres showed a higher decrease in IL-6 levels than CC homozygotes.
CONCLUSION:
Longer telomeres are associated with an improvement in glucose tolerance and inflammation after a weight-loss programme in obese adolescents. Moreover, the -174G/C polymorphism may influence the relationship between TL and IL-6 changes.
Revista:
NUTRICION HOSPITALARIA
ISSN:
0212-1611
Año:
2017
Vol.:
35
N°:
2
Págs.:
279 - 285
Background: serotonin signaling participates in body weight regulation and glucose metabolism. However, little information is available on circulating serotonin levels in obese subjects after a weight loss program. We aimed to assess the effect of a lifestyle intervention on serotonin levels in obese children and possible associations with anthropometric and blood glucose measurements.
Methods: forty-four obese children were enrolled in a ten-week lifestyle intervention consisting of a moderate caloric restriction diet, nutritional education and familial involvement. They were distributed according to the weight loss response. Subjects who lost > 0.5 BMI-SDS were considered as high responders (HR; n = 22) and those who lost 0.5 BMI-SDS, as low responders (LR; n = 22). Anthropometric, biochemical parameters and plasma serotonin levels were measured as pre and post-intervention values.
Results: obese children (HR and LR groups) were able to reduce anthropometric indices and to improve glucose profile after the intervention. Interestingly, plasma serotonin levels were significantly (p < 0.05) reduced in all subjects (-35.14 nmol/I HR group and -30.63 nmol/I LR group). Moreover, multiple-adjusted regression models showed a significant association between pre-intervention (R-2 = 0.224, B = 0.047; p = 0.004) and post-intervention (R-2 = 0.140; B = 0.055; p = 0.042) plasma serotonin and glucose levels. In addition, in HR subjects changes in plasma serotonin were associated with changes in glucose levels (R-2 = 0.292; b = 0.04; p = 0.045). Interestingly, pre and post-intervention plasma serotonin levels were inversely associated (p < 0.05) with anthropometric measures.
Conclusions: serotonin levels were reduced after a lifestyle intervention independently of the program response. Moreover, plasma serotonin levels were associated with glucose and anthropometric measures in obese children.
Autores:
Guerendiain, M.; Mayneris-Perxachs, J.; Montes, R.; et al.
Revista:
CLINICAL NUTRITION
ISSN:
0261-5614
Año:
2017
Vol.:
36
N°:
1
Págs.:
209 - 217
Background & aims: In vivo and in vitro evidence suggests that antioxidant vitamins and carotenoids may be key factors in the treatment and prevention of obesity and obesity-associated disorders. Hence, the objective of the present study was to determine the relationship between plasma lipid-soluble antioxidant vitamin and carotenoid levels and adiposity and cardio-metabolic risk markers in overweight and obese adolescents participating in a multidisciplinary weight loss programme.
Methods: A therapeutic programme was conducted with 103 adolescents aged 12-17 years old and diagnosed with overweight or obesity. Plasma concentrations of ¿-tocopherol, retinol, ß-carotene and lycopene, anthropometric indicators of general and central adiposity, blood pressure and biochemical parameters were analysed at baseline and at 2 and 6 months of treatment.
Results: Lipid-corrected retinol (P < 0.05), ß-carotene (P = 0.001) and ¿-tocopherol (P < 0.001) plasma levels increased significantly, whereas lipid-corrected lycopene levels remained unaltered during the treatment. Anthropometric indicators of adiposity (P < 0.001), blood pressure (P < 0.01) and biochemical parameters (P < 0.05) decreased significantly, whereas fat free mass increased significantly (P < 0.001). These clinical and biochemical improvements were related to changes in plasma lipid-corrected antioxidant vitamin and carotenoid levels. The adolescents who experienced the greatest weight loss also showed the largest decrease in anthropometric indicators of adiposity and biochemical parameters and the highest increase in fat free mass. Weight loss in these adolescents was related to an increase in plasma levels of lipid-corrected ¿-tocopherol (P = 0.001), ß-carotene (P = 0.034) and lycopene (P = 0.019).
Conclusions: Plasma lipid-soluble antioxidant vitamin and carotenoid levels are associated with reduced adiposity, greater weight loss and an improved cardio-metabolic profile in overweight and obese adolescents.
Revista:
PEDIATRIC DIABETES
ISSN:
1399-543X
Año:
2017
Vol.:
19
N°:
2
Págs.:
217 - 222
BACKGROUND:
Inflammation related molecules such as tumor necrosis factor-¿ (TNF-¿), interleukin 6 (IL-6), and cardiotrophin-1 (CT-1) are highly expressed in obese individuals and could partly explain some comorbidities associated to obesity. In obese children, lifestyle interventions are able to lower inflammation and reduce cardiovascular risk factors associated with obesity. The aim of the present work was to study changes in inflammation-related molecules serum and peripheral blood mononuclear cells (PBMC) transcript levels after a 10-week lifestyle intervention in obese children and asses their potential association with glucose metabolism.
METHODS:
Twenty-three obese children (mean age 11.5 years; 48% males) underwent a 10-week lifestyle not controlled intervention trial. Anthropometric and biochemical measurements were analyzed. Transcript analysis for CT-1, IL-6, and TNF-¿ in PBMC were performed by RT-PCR. Serum cytokine levels were also measured at baseline and after 10-weeks.
RESULTS:
Participants achieved a significant reduction in body adiposity (0.34 decrease in body mass index-standard deviation), total cholesterol, and glucose levels after 10-weeks. A Significant decrease in serum TNF-¿ and C reactive protein (CRP) were observed. CT-1 transcript levels were significantly reduced (P = .005) after lifestyle intervention, and these changes were significantly correlated with changes in serum CT-1 levels (r = 0.451; P = .031). In multiple regression analysis baseline CT-1 transcript levels were positively associated with final insulin (R2 = 0.506; P = .035) and HOMA-IR values (R2 = 0.473; P = .034).
CONCLUSIONS:
We reported that serum CRP, TNF-¿, as well as PBMC CT-1 transcript levels were reduced after lifestyle intervention in obese children. More studies are needed to clarify the role of inflammation-related molecules in glucose metabolism.
Revista:
PEDIATRIC DIABETES
ISSN:
1399-543X
Año:
2017
Vol.:
18
N°:
5
Págs.:
392 - 398
Background and aims: The oxidation of low-density lipoprotein (LDL) cholesterol particles is an early atherogeninic event. Obese pediatric populations have higher levels of oxidized LDL (oxLDL) than normal weight children. The aim of this study was to evaluate the effect of a weight loss program on the biochemical profile and oxLDL levels in Spanish obese children and adolescents. Methods: Forty obese children (mean age 11 years, 51% boys) followed a 10-week weight loss program. They were dichotomized at the median of body mass index-standard deviation score (BMI-SDS) change, as high (HR) and low responders (LR) after the intervention. The intervention included a moderate energy-restricted diet, nutritional education, and family involvement. Anthropometric and biochemical measurements were performed at the beginning and during the follow up. A cardiometabolic risk score (CMS) was calculated considering metabolic risk factors. Results: Higher baseline oxLDL levels were associated with a higher CMS in obese children (P<.001). After the intervention, oxLDL significantly decreased in the HR group. Moreover, a positive correlation between changes in oxLDL and BMI-SDS (r=0.385, P=.015) was found after the weight loss program. Interestingly, multiple-adjusted regression models showed an association between changes in total cholesterol [B: 0.127, 95% confidence interval (CI): 0.06 to 0.20] and LDL-cholesterol (B: 0.173, 95% CI: 0.08 to 0.26) with changes in oxLDL. Conclusions: Higher baseline oxLDL levels were associated with a higher CMS in obese children. After the weight loss program, a decrease in oxLDL levels was found in HR subjects and the oxLDL levels were associated with BMI-SDS and cholesterol levels.
Revista:
ALLERGOLOGIA ET IMMUNOPATHOLOGIA
ISSN:
0301-0546
Año:
2017
Vol.:
45
N°:
3
Págs.:
227 - 233
Background
The objective of the study was to examine the relationship between asthma and overweight¿obesity in Spanish children and adolescents and to determine whether this relationship was affected by gender and atopy.
Methods
The study involves 8607 Spanish children and adolescents from the International Study of Asthma and Allergies in Childhood phase III. Unconditional logistic regression was used to obtain adjusted odds ratios (OR) and 95% confidence intervals (95% CI) for the association between asthma symptoms and overweight¿obesity in the two groups. Afterwards, it was stratified by sex and rhinoconjunctivitis.
Results
The prevalence of overweight and obesity in 6¿7-year-old children was 18.6% and 5.2% respectively and in 13¿14 year-old teenagers was 11.4% and 1.1% respectively. Only the obese children, not the overweight children, of the 6¿7 year old group had a higher risk of any asthma symptoms (wheezing ever: OR 1.68 [1.15¿2.47], asthma ever: OR 2.29 [1.43¿3.68], current asthma 2.56 [1.54¿4.28], severe asthma 3.18 [1.50¿6.73], exercise-induced asthma 2.71 [1.45¿5.05]). The obese girls had an increased risk of suffering any asthma symptoms (wheezing ever: OR 1.73 [1.05¿2.91], asthma ever: OR 3.12 [1.67¿5.82], current asthma 3.20 [1.65¿6.19], severe asthma 4.83[1.94¿12.04], exercise-induced asthma 3.68 [1.67¿8.08]). The obese children without rhinoconjunctivitis had a higher risk of asthma symptoms.
Conclusions
Obesity and asthma symptoms were associated in 6¿7 year-old children but not in 13¿14 year-old teenagers. The association was stronger in non-atopic children and obese girls.
Autores:
De-Miguel-Etayo, P.; Muro, C.; Santabárbara, J.; et al.
Revista:
INTERNATIONAL JOURNAL OF OBESITY
ISSN:
0307-0565
Año:
2016
Vol.:
40
N°:
1
Págs.:
84 - 87
The aims of this study were to identify the cognitive and behavioral predictors of dropping out and to estimate the attrition rate during different phases of an intervention program to treat overweight and obesity in adolescents. Overweight/obese adolescents (n=156, aged: 13-16 years; 71 male and 85 female subjects) were included in a multicomponent (diet, physical activity and psychological support) family-based group treatment program. At baseline and after 2 months (intensive phase) and 13 months (extensive phase) of follow-up, we measured adolescents' cognitive and behavioral dimensions, together with the parents' perception of their child's behavior. Of the 156 adolescents selected, 112 completed the full program (drop-out rate of 28.2%). The risk of dropping out during the extensive phase increased by 20% for each unit increase in the adolescent's social insecurity score (odds ratio=1.20, 95% confidence interval=1.07-1.34, P=0.002). The adolescents who had a high interoceptive awareness showed a significant decrease of 13.0% in the probability of dropping out (odds ratio=0.87, 95% confidence interval=0.77-0.99, P=0.040). Adolescents' social insecurity was the main predictor of drop-out in a multicomponent family-group-based obesity treatment program. To reduce attrition rates in these programs, the individual's social insecurity level needs to be reduced, whereas the family's awareness of eating-related behavior needs adjustment
Autores:
De-Miguel-Etayo, P.; Moreno, Luis A.; Santabárbara, J.; et al.
Revista:
NUTRICION HOSPITALARIA
ISSN:
0212-1611
Año:
2015
Vol.:
32
N°:
6
Págs.:
2525 - 2534
Introduction: the main objectives of weight-loss interventions are to decrease fat mass while maintaining fatfree mass.
Objective: our aim was to address effectiveness body composition changes in overweight adolescents assessed by different body composition methods following an obesity intervention programme.
Material and Methods: the life-style intervention was multi-disciplinary, with 13 months follow-up. Participants were 13-to-16 year-old overweight, or obese, Spanish adolescents. The adolescents (n = 156; 54.8% females) had body composition measured with anthropometry, dual-energy X-ray absorptiometry and air-displacement plethysmography. All measurements were made at baseline, and after 2- and 13-months. Repeated measures analysis of covariance to compare mean anthropometric changes over time and the Bonferroni correction were applied. Imputation of anthropometric measures was performed.
Results: a high significant decrease in fat mass index was achieved in males after 2-and 13-months of intervention as measured by anthropometry (1.16 and 1.56 kg / m2, respectively), X-ray absorptiometry (1.51 and 1.91 kg / m2) and plethysmography (2.13 and 2.44 kg/m2). Moreover, a short and long-term maintenance of fat-and fat-free mass index was observed by X-ray absorptiometry in females (0.94 and 0.68 kg/m2).
Conclusion: our multidisciplinary approach to lifestyle intervention has a favourable impact on body fat mass and fat-free mass index as well as waist-to-height ratio, over 13 months intervention in overweight and obese adolescents.
Revista:
ANALES DE PEDIATRIA
ISSN:
1695-4033
Año:
2015
Vol.:
82
N°:
3
Págs.:
131 - 138
Introducción
Los cambios en el estilo de vida y la alimentación han conllevado un aumento progresivo de la prevalencia del sobrepeso-obesidad. Esta enfermedad puede conllevar importantes repercusiones físicas y psicosociales que deterioran la calidad de vida relacionada con la salud (CVRS). La adolescencia es una etapa de gran vulnerabilidad por el entorno y muy determinante en el desarrollo de la personalidad del individuo. El objetivo fue evaluar la influencia del estado ponderal en la CVRS de los adolescentes.
Población y métodos
Estudio transversal de adolescentes de 12 a 16 años. Evaluación de la CVRS mediante los cuestionarios CHIP-Adolescent Edition.
Resultados
Ochenta y nueve adolescentes, 60,7%, eran normoponderales y el 39,3% tenía sobrepeso-obesidad. Los participantes normoponderales tenían una edad media superior a los participantes con sobrepeso-obesidad, 14,2 frente a 13,6 años, respectivamente. No había otras diferencias entre las características sociodemográficas de ambos grupos. Los adolescentes con sobrepeso-obesidad reflejaron peor CVRS, concretamente refirieron menor resistencia, menor capacidad de actividad física, menor participación familiar y mayor influencia de sus iguales. Asimismo, las chicas reflejaron menor autoestima, satisfacción, resistencia y capacidad de actividad física que los chicos. Por otro lado, a medida que aumentaba la edad de los participantes, referían menor salud y seguridad en el hogar, mayor riesgo individual y mayor influencia de sus iguales.
Conclusión
El sobrepeso-obesidad repercute negativamente en la CVRS de los adolescentes. Consideramos importante evaluar los aspectos psicosociales desde la perspectiva del paciente para poder ofrecerle una atención personalizada y multidisciplinar.
Revista:
BRITISH JOURNAL OF NUTRITION
ISSN:
0007-1145
Año:
2015
Vol.:
113
N°:
2
Págs.:
331 - 342
The present study analyses the gene expression profile of peripheral blood mononuclear cells (PBMC) from obese boys. The aims of the present study were to identify baseline differences between low responders (LR) and high responders (HR) after 10 weeks of a moderate energy-restricted dietary intervention, and to compare the gene expression profile between the baseline and the endpoint of the nutritional intervention. Spanish obese boys (age 10-14 years) were advised to follow a 10-week moderate energy-restricted diet. Participants were classified into two groups based on the association between the response to the nutritional intervention and the changes in BMI standard deviation score (BMI-SDS): HR group (n 6), who had a more decreased BMI-SDS; LR group (n 6), who either maintained or had an even increased BMI-SDS. The expression of 28 869 genes was analysed in PBMC from both groups at baseline and after the nutritional intervention, using the Affymetrix Human Gene 1.1 ST 24-Array plate microarray. At baseline, the HR group showed a lower expression of inflammation and immune response-related pathways, which suggests that the LR group could have a more developed pro-inflammatory phenotype. Concomitantly, LEPR and SIRPB1 genes were highly expressed in the LR group, indicating a tendency towards an impaired immune response and leptin resistance. Moreover, the moderate energy-restricted diet was able to down-regulate the inflammatory 'mitogen-activated protein kinase signalling pathway' in the HR group, as well as some inflammatory genes (AREG and TNFAIP3). The present study confirms that changes in the gene expression profile of PBMC in obese boys may help to understand the weight-loss response. However, further research is required to confirm these findings.
Revista:
INTERNATIONAL JOURNAL OF PEDIATRIC RESEARCH
ISSN:
2469-5769
Año:
2015
Vol.:
1
N°:
1
Págs.:
1 - 6
Objective: To assess the effect of metformin on weight, BMI, body fat, and insulin sensitivity in obese children and adolescents.
Methodology: The study was prospective, and included 21 patients with obesity (8 male, 13 female) with a mean age of 12.31 (3.87) years. Inclusion criteria were a fat mass percentage (FM%) of over 25% in males and over 30% in females, a BMI of greater than the 95th percentile, and a lack of response to nutritional and lifestyle changes over three months. Informed consent was obtained from children, parents and the treatment was approved by the hospital's Ethics Committee, and the Spanish health ministry. All subjects received treatment with metformin for six months and each month was instructed to follow nutritional and lifestyle changes. The oral glucose tolerance test (OGTT) was done for 95% of the patients.
Results: A decrease in weight-SDS (p< 0.001), BMI-SDS (p< 0.001), FM% (p = 0.002), waist/hip ratio (p = 0.141), HOMA (p = 0.198 and plasma glucose level at 120 min. (p = 0.008) was observed after six months of metformin therapy in association with nutritional and lifestyle changes. At the onset of the study, plasma glucose level at 120 min. was above 140 mg/dL in 38% (n = 8) of patients, and the HOMA index was above 3.8 in 42% (n = 9). Altogether, 11 patients had insulin resistance. Mean dose of metformin was built up to a maximum of 1275 mg/day. Twenty-four percent of the subjects complained of dyspepsia or diarrhea or both.
Conclusion: In this study, metformin, combined with diet and lifestyle changes, contributed to an improvement in BMI and to a loss of weight and body fat in children with obesity, whether or not that obesity was associated with insulin resistance.
Revista:
NUTRICION HOSPITALARIA
ISSN:
0212-1611
Año:
2014
Vol.:
30
N°:
1
Págs.:
75 - 83
Background: Some SNPs related to lipid and energy metabolism may be implicated not only in the development of obesity and associated comorbidities, but also in the weight loss response after a nutritional intervention. Objective: In this context, the present study analyzed four SNPs located within four genes known to be associated with obesity and other obesity-related complications, and their putative role in a weight-loss intervention in overweight/obese adolescents. Methods: The study population consisted of 199 overweight/obese adolescents (13-16 yr old) undergoing 10 weeks of a weight loss multidisciplinary intervention: the EVASYON programme (www.estudioevasyon.org). Adolescents were genotyped for 4 SNPs, and anthropometric measurements and biochemical markers were analyzed at the beginning and after the intervention. Results: Interestingly, APOA5(rs662799) was associated with the baseline anthropometric and biochemical outcomes, whereas FTO (rs9939609) seemed to be related with the change of these values after the 10-week intervention. The other two SNPs, located in the CETP (rs1800777) and the APOA1 (rs670) genes, showed important relationships with adiposity markers. Specifically, a combined model including both SNPs turned up to explain up to 24% of BMI-SDS change after 10 weeks of the multidisciplinary intervention, which may contribute to under - stand the weight loss response. Conclusion: Common variants in genes related to lipid and energy metabolism may influence not only biochemical outcomes but also weight loss response after a multidisciplinary intervention carried out in obese/overweight adolescents.
Revista:
NUTRICION HOSPITALARIA
ISSN:
0212-1611
Año:
2014
Vol.:
30
N°:
3
Págs.:
519-525
La obesidad en niños esta relacionada con los síntomas de asma. Las niñas obesas presentan un mayor riesgo y mayor gravedad de síntomas de asma que los niños.
Revista:
NUTRICION HOSPITALARIA
ISSN:
0212-1611
Año:
2014
Vol.:
30
N°:
3
Págs.:
519 - 525
Objectives: The objective of this study is to determine the prevalence of asthma symptoms and overweight-obese in children aged 6-7 years and adolescents aged 13-14 years within the metropolitan area of Pamplona, and analyse the risk of asthma within the age groups and the influences if sex on this relationship.
Methods: The study is based on data of asthma symptoms and body mass index of 4,413 children and adolescents obtained from the International Study of Asthma and Allergies phase III questionnaire. Unconditional logistic regression was used to obtain adjusted odds ratios (OR) and 95% confidence intervals (95% CI) for overweight-obesity and asthma symptoms in both groups, taking as reference the group of normal weight. Afterwards, it was stratified by sex.
Results: The prevalence of overweight-obesity in the group aged 6-7 years was 23.9% and in the group of teenagers was 11.5%. The prevalence of asthma symptoms in both age groups was lower than the Spanish average. The obese children aged 6-7 years had a higher risk of asthma symptoms. When it was stratified by sex, an increased risk in all asthma symptoms was observed only in obese girls. No relationship between obesity and asthma was observed n the adolescents group.
Conclusions: Obesity in children is related to asthma symptoms. Obese girls have an increased risk and more severe asthma symptoms than boys.
Revista:
PLOS ONE
ISSN:
1932-6203
Año:
2014
Vol.:
9
N°:
2
Págs.:
e89828
Context: Telomeres are biomarkers of biological aging. Shorter telomeres have been associated with increased adiposity in adults. However, this relationship remains unclear in children and adolescents. Objective: To evaluate the association between telomere length (TL) and adiposity markers in overweight/obese adolescents after an intensive program. We hypothesize that greater TL at baseline would predict a better response to a weight loss treatment. Design, Setting, Patients and Intervention: The EVASYON is a multidisciplinary treatment program for adolescents with overweight and obesity that is aimed at applying the intervention to all possibly involved areas of the individual, such as dietary habits, physical activity and cognitive and psychological profiles. Seventy-four participants (36 males, 38 females, 12-16 yr) were enrolled in the intervention program: 2 months of an energy-restricted diet and a follow-up period (6 months). Main Outcome: TL was measured by quantitative real-time polymerase chain reaction at baseline and after 2 months; meanwhile, anthropometric variables were also assessed after 6 months of follow-up. Results: TL lengthened in participants during the intensive period (+1.9±1.0, p<0.001) being greater in overweight/obese adolescents with the shortest telomeres at baseline (r = -0.962, p<0.001). Multivariable linear regression analysis showed that higher baseline TL significantly predicted a higher decrease in body weight (B = -1.53, p = 0.005; B = -2.25, p = 0.047) and in standard deviation score for body mass index (BMI-SDS) (B = -0.22, p = 0.010; B = -0.47, p = 0.005) after the intensive and extensive period treatment respectively, in boys. Conclusion: Our study shows that a weight loss intervention is accompanied by a significant increase in TL in overweight/obese adolescents. Moreover, we suggest that initial longer TL could be a potential predictor for a better weight loss response.
Revista:
EUROPEAN JOURNAL OF PEDIATRICS
ISSN:
0340-6199
Año:
2014
Vol.:
173
N°:
5
Págs.:
609 - 616
Dietary and serum total antioxidant capacity (TAC) are considered appropriate tools for investigating the potential health effects of dietary antioxidants consumed in mixed diets. The aim was to analyze the impact of a dietary intervention on macronutrient intakes and to evaluate the improvement on oxidative status after weight loss (WL) by measuring dietary and serum TAC, and urinary F2-isoprostane levels as markers of oxidative stress. Forty-four overweight/obese children (mean age 11.5 years) were enrolled to undergo a 10-week WL program. They were dichotomized at the median of body mass index-standard deviation score (BMI-SDS) change, as high (HR) and low responders (LR) after intervention. Subjects were prescribed with a fixed full-day meal diet, calculated according to their basal metabolic rate and physical activity levels. A validated food-frequency questionnaire was used to retrospectively calculate TAC and daily nutrient intake. The HR subjects were able to reduce anthropometric indices and to improve lipid and glucose profile. They also significantly diminished fat intake (p¿=¿0.013). Moreover, baseline serum TAC values did significantly predict the reduction in urinary F2 isoprostane (B¿=¿-0.236 (-0.393 to -0.078); p¿=¿0.014) in the HR group after the WL program. Notably, changes in dietary TAC after the treatment were associated with a decrease in body weight after the 10-week intervention (B¿=¿-2.815 (-5.313 to -0.318), p¿=¿0.029) in the HR group. The -¿SerumTAC/¿DietaryTAC and the -¿F2Isoprostane/¿DietaryTAC ratios revealed that the relationships between oxidative markers and antioxidants dietary intake were more favorable in the HR than in the LR group. Conclusion: Our study showed that a 10-week WL program was able to reduce adiposity indices in obese children. Moreover, after the intervention changes in dietary TAC and WL were significantly associated. Our result suggests that specific food with a high TAC content (such as fruits, vegetables, and legumes) could be recommended to improve WL.
Revista:
METABOLISM-CLINICAL AND EXPERIMENTAL
ISSN:
0026-0495
Año:
2013
Vol.:
62
N°:
10
Págs.:
1429 - 1436
OBJECTIVE:
Cardiotrophin-1 (CT-1) shares some similarities with other cytokines, and participates in the control of energy metabolism. Higher circulating levels are observed in obese humans, but little information is gathered in weight loss (WL) programs. Therefore, we aimed to investigate the association of serum CT-1 levels with metabolic variables and the risk of developing metabolic syndrome (MetS) after a WL program in overweight/obese children.
SUBJECTS AND METHODS:
Forty-four overweight/obese children (mean age 11.5y; 50% males) undergoing a 10-week WL program were enrolled. Subjects were dichotomized at the median of Body Mass Index-Standard Deviation Score (BMI-SDS) change, as high and low responders after intervention.
RESULTS:
CT-1 levels were significantly reduced (-48 fmol/mL, p=0.043) in the high responder group after the WL program. They had significantly lower body weight (-3.7kg, p<0.001), body fat mass (-8%, p<0.001), BMI-SDS (-0.78, p<0.001) and waist circumference (-5.4cm, p<0.001), and a significant improvement in lipid and glucose profiles (p<0.05). Interestingly, decreased CT-1 levels significantly predicted changes in total cholesterol (41%) and LDL-cholesterol (28%). Moreover, in our participants the lower the CT-1 levels, the higher the reduction in MetS risk components, after the 10-week intervention, (p-ANCOVA=0.040, p-trend=0.024).
CONCLUSION:
We showed, for the first time, a reduction in serum CT-1 levels after a WL program and this decrease in CT-1 was strongly associated with a reduction in cholesterol levels and in MetS risk factors in overweight/obese children. Our findings may suggest that CT-1 could be an indirect marker for the diagnosis of MetS in this population.
Revista:
FASEB JOURNAL
ISSN:
0892-6638
Año:
2013
Vol.:
27
N°:
6
Págs.:
2504 - 2512
In recent years, epigenetic markers emerged as a new tool to understand the influence of lifestyle factors on obesity phenotypes. Adolescence is considered an important epigenetic window over a human¿s lifetime. The objective of this work was to explore baseline changes in DNA methylation that could be associated with a better weight loss response after a multidisciplinary intervention program in Spanish obese or overweight adolescents. Overweight or obese adolescents (n=107) undergoing 10 wk of a multidisciplinary intervention for weight loss were assigned as high or low responders to the treatment. A methylation microarray was performed to search for baseline epigenetic differences between the 2 groups (12 subjects/group), and MALDI-TOF mass spectrometry was used to validate (n=107) relevant CpG sites and surrounding regions. After validation, 5 regions located in or near AQP9, DUSP22, HIPK3, TNNT1, and TNNI3 genes showed differential methylation levels between high and low responders to the multidisciplinary weight loss intervention. Moreover, a calculated methylation score was significantly associated with changes in weight, BMI-SDS, and body fat mass loss after the treatment. In summary, we have identified 5 DNA regions that are differentially methylated depending on weight loss response. These methylation changes may help to better understand the weight loss response in obese adolescents.
Revista:
ENDOCRINOLOGIA Y NUTRICION
ISSN:
1575-0922
Año:
2013
Vol.:
60
N°:
7
Págs.:
352 - 357
Introduction: Recent studies in Spain have shown an inadequate iodine intake in a significant proportion of pregnant women. Pregnancy increases thyroid hormone requirements, and adequate iodine intake is therefore needed.
Material and methods: One hundred and forty-seven women in their third trimester (week 37) of pregnancy provided a blood sample and a 24-hour urine sample to test serum and urine iodine levels and completed a food frequency questionnaire to assess iodine intake during pregnancy. Serum TSH levels were measured in the babies born to the 140 mothers in the postpartum group.
Results: Only 10.9% of pregnant women consumed more than 250 ¿g iodine daily, and 24.4% of them consumed less than 100 ¿g daily. Mean free T4 levels were 9.37 pmol/L, and 74 women (54.41%) had levels below the hypothyroxinemia threshold. TSH levels were normal in 135 newborns (96.4%), while 5 (3.6%) had levels higher than 5 ¿U/mL.
Revista:
ENDOCRINOLOGIA Y NUTRICION
ISSN:
1575-0922
Año:
2013
Vol.:
60
N°:
7
Págs.:
352 - 357
Introduction: Recent studies in Spain have shown an inadequate iodine intake in a significant proportion of pregnant women. Pregnancy increases thyroid hormone requirements, and adequate iodine intake is therefore needed.
Material and Methods: One hundred and forty-seven women in their third trimester (week 37) of pregnancy provided a blood sample and a 24-hour urine sample to test serum and urine iodine levels and completed a food frequency questionnaire to assess iodine intake during pregnancy. Serum TSH levels were measured in the babies born to the 140 mothers in the postpartum group.
Results: Only 10.9% of pregnant women consumed more than 250 ¿g iodine daily, and 24.4% of them consumed less than 100 ¿g daily. Mean free T4 levels were 9.37 pmol/L, and 74 women (54.41%) had levels below the hypothyroxinemia threshold. TSH levels were normal in 135 newborns (96.4%), while 5 (3.6%) had levels higher than 5 ¿U/mL.
Revista:
ANALES DE PEDIATRIA CONTINUADA
ISSN:
1696-2818
Año:
2013
Vol.:
11
N°:
4
Págs.:
181 - 186
Revista:
ARCHIVOS ARGENTINOS DE PEDIATRIA
ISSN:
0325-0075
Año:
2013
Vol.:
111
N°:
6
Págs.:
508 - 515
NTRODUCTION:
Overweight-obesity, an endemic disease in developed countries, can lead to physical and psychosocial consequences that impair health-related quality of life (HRQoL). There are some aspects which can be reported by parents, but for others, the patient's subjective point of view is more relevant. The objective of this study was to assess the agreement between the perception of parents and children regarding the HRQoL of 7-11 year old children as per their weight status.
POPULATION AND METHODS:
Cross-sectional study of parent and child dyads. HRQoL assessment using the CHIP-Child Edition questionnaire for children and the CHIP-Parent Report Form for parents. Agreement was assessed using intraclass correlation coefficients (ICC) and dispersion plots.
RESULTS:
A total of 152 parent-child dyads were assessed; 55.3% of children had a normal weight, and 44.7% were overweight-obese, with no differences observed in sociodemographic characteristics. Children did not show significant differences as per their weight status. Agreement between parents and children was medium-low (ICC < 0.6) in most domains, in the overall sample and when the sample was divided by weight status. The Comfort domain had a higher ICC (0.73) in the overweight-obese group. As per parents' perception, the HRQoL of overweight-obese children was significantly lower in terms of health satisfaction, physical comfort and peer relations.
CONCLUSIONS:
Agreement between parents and children in their perception of HRQoL as per the children's weight status was medium-low, without any significant differences. Parents' perceived that overweight-obese children had a significantly lower HRQoL.
Revista:
ARCHIVOS ARGENTINOS DE PEDIATRIA
ISSN:
0325-0075
Año:
2013
Vol.:
111
N°:
6
Págs.:
508-515
La concordancia entre padres e hijosen la percepción de la CVRS, según el estado ponderal de los niños, fue media-baja, pero sin diferencias significativas. La percepción de los padres fue significativamente de menor CVRS en los niños con sobrepeso-obesidad.
Revista:
Nutricion Hospitalaria
ISSN:
0212-1611
Año:
2012
Vol.:
27
N°:
1
Págs.:
165 - 176
The aim of this article is to describe the dietary intervention design and the methods used to evaluate nutritional knowledge and behavior in the EVASYON study (Development, implementation and evaluation of the efficacy of a therapeutic programme for over
Revista:
BRITISH JOURNAL OF NUTRITION
ISSN:
0007-1145
Año:
2012
Vol.:
107
N°:
4
Págs.:
533 - 538
The rs9939609 polymorphism of the fat mass and obesity-associated (FTO) gene has been widely associated with childhood obesity in several European cohorts. This association appears to be dependent on dietary macronutrients. Therefore, the aim of the present study was to evaluate whether dietary fatty acid intake distribution could interact with this FTO genetic variation and obesity in a Spanish case-control study of children and adolescents. A total of 354 Spanish children and adolescents aged 6-18 years (49% males) were genotyped for the rs9939609 variant of the FTO gene. Anthropometric parameters were taken and energy intake was measured. We observed an interaction between the consumption of SFA (percentage of total energy) and PUFA: SFA ratio and obesity risk linked to the rs9939609 SNP of the FTO gene. In the study population of the present study, the risk allele carriers consuming more than 12.6% SFA (of total energy) had an increased obesity risk compared with TT carriers. In a similar way, A allele carriers with an intake ratio lower than 0.43 PUFA: SFA presented a higher obesity risk than TT subjects. In summary, the present study reports for the first time the influence of dietary fatty acid distribution on the effect of the rs9939609 polymorphism of the FTO gene on children and adolescents' obesity risk.
Revista:
Revista Pediatría Atención Primaria
ISSN:
1139-7632
Año:
2012
Vol.:
14
N°:
53
Págs.:
61 - 67
La síntesis de andrógenos en la mujer se produce en las glándulas suprarrenales, en el ovario y en los tejidos diana periféricos para la acción androgénica (piel, músculo y tejido adiposo).
El exceso de producción androgénica (o hiperandrogenismo) en la infancia y adolescencia puede determinar alteraciones en estos tejidos diana, condicionando la aparición de hirsutismo, acné, trastornos menstruales o virilización, cuya intensidad y momento de aparición dependerán del origen del exceso de producción de andrógenos.
La etiología del hiperandrogenismo variará según la edad. Así, en el periodo prepuberal, en ausencia de maduración gonadal la hiperproducción androgénica tendrá origen en la glándula suprarrenal en la mayoría de los casos, mientras que en el periodo peripuberal y postpuberal el ovario será el responsable.
Revista:
INTERNATIONAL JOURNAL OF DEVELOPMENTAL NEUROSCIENCE
ISSN:
0736-5748
Año:
2012
Vol.:
30
N°:
6
Págs.:
435 - 438
Context Experimental studies have shown that maternal hypothyroxinemia during early pregnancy is associated with poor neurodevelopment in affected offspring.
Objective The aim of this study was to assess the impact of maternal serum free T4 on psychomotor development of offspring.
Materials and methods The study involved 147 women in the third trimester (week 37) of pregnancy. TSH and free T4 serum levels were measured at 37 week gestation. The children were evaluated between 38 and 60 months of age by the McCarthy Scales of Children's Abilities.
Results 54.4% of the women had a free T4 below the threshold of hypothyroxinemia. We find a significant effect of maternal hypothyroxinemia on the general cognitive index, and on perceptual-manipulative and memory coefficients.
Revista:
JOURNAL OF PEDIATRICS
ISSN:
0022-3476
Año:
2012
Vol.:
161
N°:
3
Págs.:
466-470
OBJECTIVE:
To estimate the contribution of 9 obesity-related polymorphisms and a genetic predisposition score (GPS) on anthropometric and biochemical variables before and after a weight loss intervention program in overweight/obese Spanish adolescents.
STUDY DESIGN:
Overweight/obese adolescents (n = 168; 12-16 years) participating in the EVASYON program were genotyped for 9 obesity-related single nucleotide polymorphisms in the FTO, MC4R, TMEM18, IL6, PPARG, and ADIPQ genes.
RESULTS:
At baseline, the GPS showed a significant association with body mass index-standard deviation score (BMI-SDS) and fat mass. After 3 months of intervention, this GPS also showed a relationship with the variation of both anthropometric measurements. After adjusting for baseline BMI-SDS, subjects with a lower GPS had a greater improvement on metabolic profile, as well as a better response to physical activity, compared with those subjects with a higher GPS.
CONCLUSIONS:
The GPS seems to have an important relationship with BMI-SDS and fat mass both at baseline and after a 3-month weight loss lifestyle intervention. Obese and overweight adolescents with a lower GPS have a greater benefit of weight loss after 3 months of a multidisciplinary lifestyle intervention.
Revista:
REVISTA DE HORMONA Y FACTORES DE CRECIMIENTO
ISSN:
1134-9824
Año:
2012
Vol.:
15
N°:
1
Págs.:
46 - 51
Revista:
REVISTA DE HORMONA Y FACTORES DE CRECIMIENTO
ISSN:
1134-9824
Año:
2012
Vol.:
15
N°:
1
Págs.:
52 - 57
Revista:
ENDOCRINOLOGÍA PEDIÁTRICA
ISSN:
2013-7788
Año:
2011
Vol.:
2
N°:
Supl.
Págs.:
37 - 41
Revista:
HORMONE RESEARCH IN PAEDIATRICS
ISSN:
1663-2818
Año:
2010
Vol.:
74
N°:
3
Págs.:
212 - 217
Background: The aim of this study was to determine the beneficial effects of long-term growth hormone (GH) treatment on final height (FH) in 26 children with Russell-Silver syndrome (RSS).
Methods: Twenty-six patients (16 males) were diagnosed with RSS at a median age of 2.9 years according to clinical criteria. All patients were prepubertal at the commencement of treatment. They received treatment with biosynthetic human GH for 9.8 years (median) and all attained FH.
Results: The median height at the commencement of treatment was -2.7 SDS and increased to -1.3 SDS (p = 0.001). However, FH did not reach target height (-0.90 SDS, p = 0.003). Predictors of FH outcome were: the height at the start of treatment (r(2) = 0.419, p < 0.001) (inversely related) and the height gain at onset of puberty (r(2) = 0.257, p < 0.001) (positively related). The overall prediction model accounted for 67.6% of height gain. Sitting height improved gradually during GH treatment (-3.3 to -1.0 SDS, p = 0.012), as did weight (-3.3 to -1.3 SDS, p < 0.001) and BMI (-1.5 to -0.2 SDS, p < 0.001).
Conclusions: A significant improvement of growth in RSS children has been shown after 10 years of GH treatment with a FH of -1.3 SDS. The shorter the patient at the start of treatment is, the greater the increment in FH. A significant response is also shown at the onset of puberty. GH treatment may also have a beneficial effect on the spinal length of RSS children.
