Obesidad Infantil. Recomendaciones del Comité de Nutrición de la Asociación Española de Pediatría. Parte II. Diagnóstico. Comorbilidades. Tratamiento

Serra, J. Dalmau; Franch, Margarita Alonso; López, L Gómez; Costa, Cecilia Martínez; Salinas, C. Sierra

doi:10.1157/13099693

Cited by 30 publications

(6 citation statements)

References 41 publications

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“…The non-obese group consisted of healthy children who needed a blood test, in the context of health controls (controls; N = 6), while the obese group (N = 18) was recruited among patients attending the Pediatric Endocrinology Unit of our centre, who needed an OGTT to assess their carbohydrate metabolism. Inclusion criteria were children between 4 and 14 years, with a BMI > +2 SD [ 18 ], and personal or family risk factors for metabolic complications (i.e. family history of hypertension, cardiovascular disease or diabetes mellitus in first grade relatives aged < 55 years, personal history of having been born small for gestational age, or big for gestational age from a mother with gestational diabetes, as well as presenting acanthosis nigricans).…”

Section: Methodsmentioning

confidence: 99%

Obesity induced alterations in redox homeostasis and oxidative stress are present from an early age

et al. 2018

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ObjectivesOxidative stress and inflammation have been postulated as underlying mechanisms for the development of obesity-related insulin resistance. This association however, remains elusive especially in childhood. We sought to investigate this relation by measuring oxidative stress and antioxidant response biomarkers, before and during an oral glucose tolerance test (OGTT), in different biological samples from obese children.Subjects24 children were recruited for the study, (18 obese and 6 controls). After OGTT, the obese group was subdivided in two, according to whether or not carbohydrate metabolic impairment (Ob.IR+, Ob.IR-; respectively) was found. Different biomarkers were analyzed after fasting (T = 0) and during an OGTT (T = 60 and 120 min). Lipoperoxides were measured in plasma, erythrocytes, and urine; while advanced glycation end products were determined in plasma, and redox status (GSH/GSSG ratio) in erythrocytes.ResultsWe found marked differences in the characterization of the oxidative status in urine and erythrocytes, and in the dynamics of the antioxidant response during OGTT. Specifically, Ob.IR+ children show increased oxidative stress, deficient antioxidant response and a significant imbalance in redox status, in comparison to controls and Ob.IR- children.ConclusionObese children with insulin resistance show increased levels of oxidative stress biomarkers, and a stunted antioxidant response to an OGTT leading to increased oxidative stress after a single glucose load, as detected in erythrocytes, but not in plasma. We propose erythrocytes as sensors of early and acute changes in oxidative stress associated with insulin resistance in childhood obesity. This is a pilot study, performed with a limited sample size, so data should be interpreted with caution until reproduced.

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Section: Methodsmentioning

confidence: 99%

Obesity induced alterations in redox homeostasis and oxidative stress are present from an early age

et al. 2018

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“…Visit 2 (V2): is conducted at the educational centres and consists on lifestyle assessment (Diet Quality estimation with the KIDMED index [31]), physical activity (PA) assessment with the Physical Activity Unified-7 item Screener (PAU-7S) [32], and sedentary behaviour [33], sleep duration [34], and sugar consumption assessment) through online self-reported questionnaires with the assistance of trained personnel. Finally, all subjects (whether they obtain CAP �225 dB/m and/or LSM �6.5 kPa or CAP <225 dB/m and/or LSM <6.5 kPa), and especially those with NAFLD risk factors such as obesity, DM, MetS or risky alcohol consumption are counselled on lifestyle modifications by the health care professionals involved in the study [35]. They are also referred to their corresponding healthcare providers for management of these risk factors according to each centre's own protocol (Fig 1).…”

Section: Methodsmentioning

confidence: 99%

Clinical epidemiology of non-alcoholic fatty liver disease in children and adolescents. The LiverKids: Study protocol

Chacón,

Arteaga,

Martínez-Escudé

et al. 2023

PLoS ONE

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Background Non-alcoholic fatty liver disease (NAFLD) is rapidly increasing alongside overweight and obesity, not only in adults but also in children and adolescents. It is unknown what impact the development of NAFLD in childhood may have in later life. The importance of early detection and treatment lies in its potential for progression to cirrhosis, liver cancer and liver-related death, as well as its associated extrahepatic comorbidities. Vibration-Controlled Transient Elastography (VCTE) with Controlled Attenuation Parameter (CAP) is an effective, non-invasive and safe diagnostic method to estimate the degree of fibrosis and steatosis in the liver, but little is known about its applicability in the paediatric population. Aims 1) To assess the prevalence of significant liver fibrosis (Liver Stiffness Measurement (LSM) ≥6.5 kPa) using VCTE, and that of non-alcoholic fatty liver disease (≥225 dB/m) using CAP in children and adolescents. 2) To determine the optimal cut-off points of the CAP to achieve maximum concordance with the Magnetic Resonance Imaging (MRI) findings in the diagnosis of mild, moderate and severe NAFLD in children and adolescents. Methods Cross-sectional population-based study which will include 2,866 subjects aged between 9 and 16 years. Participants will undergo: anamnesis, physical examination, blood extraction, VCTE, MRI and questionnaires on socio-demographic data, personal and family medical history and lifestyle assessment. Applicability and relevance The study aims to establish the foundations for the use of VCTE in children and adolescents in order to achieve early diagnosis of NAFLD. Moreover, it will serve to understand in further detail the disease and to identify the risk groups of children and adolescents who may be at risk of developing it. Ultimately, this will help determine to which subgroups of the population we need to target resources for prevention and early detection of this entity, as well as possible intervention for its treatment. Trial registration The LiverKids study is registered on Clinicaltrials.gov (NCT05526274).

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“…All obese children were offered the chance to take part in the 9-month obesity intervention program. This program consisted of behavioral components, physical exercise and nutritional education both for the individual and for his or her family, following the recommendations of the Nutrition Committee of the Spanish Association of Pediatricians [16]. Dietary intervention was based on the principle of matching energy and nutrient input to the child's real needs by means of a 2-level strategy: error correction and active dietary intervention.…”

Section: Methodsmentioning

confidence: 99%

Relationship between Changes in Plasma Leptin Concentrations and Plasminogen Activator Inhibitor-1 in Obese Prepubertal Children after Nine Months of Treatment

Jiménez

Martos²,

Morales

et al. 2013

Ann Nutr Metab

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Background/Aims: The metabolic syndrome (MS) is associated with insulin resistance (IR), inappropriate fibrinolysis and high plasma leptin concentrations. The aim of this study was to quantify fibrinolysis and MS-related variables in obese prepubertal children and to evaluate changes in these variables as a result of improved body mass index (BMI), IR and leptin levels following 9 months of treatment. Methods: The homeostasis model assessment for insulin resistance (HOMA-IR), leptin, plasminogen activator inhibitor-1 (PAI-1) and lipid profile were studied at baseline in obese (n = 50) and nonobese children (n = 50), and after 9 months of treatment in obese children. Results: In the cross-sectional study the mean values for insulin, HOMA-IR, triglycerides, leptin and PAI-1 were significantly higher in obese children than in controls. High-density lipoprotein cholesterol (HDLc) and apolipoprotein A-1 were significantly lower. In the longitudinal study, after 9 months, children with lowered BMI standard deviation score displayed a significant decrease in insulin, HOMA-IR, PAI-1, leptin and triglyceride levels, and an increase in HDLc. Only leptin proved to be an independent predictive factor for changes in PAI-1 (p = 0.010). Conclusion: Obesity-linked disorders appear in obese children prior to puberty; these disorders can be improved by decreasing BMI. Changes in leptin levels were found to independently predict changes in PAI-1 in obese children and can help to diagnose complications associated with the obesity.

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Obesidad Infantil. Recomendaciones del Comité de Nutrición de la Asociación Española de Pediatría. Parte II. Diagnóstico. Comorbilidades. Tratamiento

Cited by 30 publications

References 41 publications

Obesity induced alterations in redox homeostasis and oxidative stress are present from an early age

Obesity induced alterations in redox homeostasis and oxidative stress are present from an early age

Clinical epidemiology of non-alcoholic fatty liver disease in children and adolescents. The LiverKids: Study protocol

Relationship between Changes in Plasma Leptin Concentrations and Plasminogen Activator Inhibitor-1 in Obese Prepubertal Children after Nine Months of Treatment

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