Table_1_Cardiometabolic risk factors among children and adolescents with overweight and Class 1 obesity: A cross-sectional study. Insights from stratification of Class 1 obesity.docx

ContextSevere childhood obesity is associated with increased prevalence of cardiometabolic risk factors (CMRFs). Among children with Class 1 obesity, higher BMI may indicate greater cardiometabolic risk. Class 1 obesity reflects a wide spectrum of BMI values. Each 10% increase in BMI above the 95th percentile is equivalent to an average increase of 2.15 kg/m2 and 2.75 kg/m2 in BMI among children and adolescents, respectively. Such increments may be of clinical importance.ObjectivesThe study aimed to determine the prevalence and clustering of CMRFs in children and adolescents with BMI 110%-119% of the 95th BMI percentile.MethodsA cross-sectional analysis of data, from an Israeli health maintenance organization, of children and adolescents (5-17 years) with overweight or Class 1 obesity, and at least one measurement of lipid profile during Jan/2020-May/2021. CMRFs were defined as abnormal lipid profile, elevated alanine aminotransferase, hypertension, and prediabetes or diabetes. Study groups included overweight and Class 1 Obesity-A (BMI ResultsOf 7211 subjects included, 40.2% were overweight, 50.3% obesity-A, and 9.5% obesity-B. Multivariable analyses showed that children and adolescents from the Obesity-B group had increased odds for higher triglycerides, LDL cholesterol, and ALT levels; and lower HDL cholesterol levels, as compared to Obesity-A. The odds of prediabetes (insignificant) tended to be higher in the Obesity-B group, which was associated with increased CMRFs clustering.ConclusionsAmong children and adolescents with Class 1 obesity, BMI ≥ 110% of the 95th percentile was associated with higher prevalence and clustering of CMRFs.</p

Clinical characteristics of Crohn’s disease patients.

<p>Clinical characteristics of Crohn’s disease patients.</p

The Involvement of Immune Semaphorins in the Pathogenesis of Inflammatory Bowel Diseases (IBDs) - Fig 1

<p>A: The percentage of Treg cells expressing sema3A. The percentage of Treg cells expressing sema3A in peripheral blood in patients suffering from Crohn’s disease [both active (n = 15) or in remission (n = 12)], ulcerative colitis (active, n = 10), and from patients suffering from acute diverticulitis (n = 10) compared to that from healthy controls (n = 12). Note the significantly altered percentage of Treg cells expressing sema3A in all IBD patients when compared to that of normal individuals. B: A representative figure of Treg cell expressing sema3A. A representative FACS analysis of Treg cell expressing sema3A in a CD patient compared to that of normal individual.</p

Sema3A staining in IBD.

<p>A representative biopsy from an active CD patient in which sema3A is intensely stained (+3) in the macrophages of the lamina propria (similarly in all studied groups). Black arrows denote positively stained macrophages.</p

Clinical correlation.

<p>The percentage of Treg cells expressing sema3A in peripheral blood of CD patients is found to be in negative correlation with the CDAI score (r = -0.46, p = 0.016).</p

Immunohistochemistry staining of sema4A.

<p>Sema4A is clearly detected in lymphocytes of the lamina propria in a biopsy taken from a CD patient (<b>A</b>), but was not detected in a biopsy taken from a diverticulitis patient (<b>B</b>) or from a normal individual. Black arrows denote positively stained lymphocytes.</p

Serum levels of sema4A.

<p>Serum levels of sema4A are significantly lower in CD (in active disease, n = 15) and UC patients (n = 10), when compared to the level of sema4A in normal individuals (n = 30).</p