Possible Health Implications and Low Vitamin D Status during Childhood and Adolescence: An Updated Mini Review

Vitamin D deficiency is common in the developing countries and exists in both childhood and adult life. The great importance of Vitamin D is the moderation of calcium (Ca) and phosphorus (P) homeostasis as well as the absorption of Ca. While insufficiency of vitamin D is a significant contributing factor to risk of rickets in childhood, it is possible that a more marginal deficiency of vitamin D during life span contribute to osteoporosis as well as potentially to the development and various other chronic diseases such as cardiovascular disease, cancer and diabetes. This paper reviews the metabolism, epidemiology, and treatment of vitamin D and calcium insufficiency as well as its relation to various diseases during childhood and adolescence

Obese Children with Metabolic Syndrome Have 3 Times Higher Risk to Have Nonalcoholic Fatty Liver Disease Compared with Those without Metabolic Syndrome

Copyright © 2017 Dimitrios Papandreou et al. Background: The aim of this study was to investigate the relationship between metabolic syndrome (MS) and nonalcoholic fatty liver disease (NAFLD) in obese children. One hundred and twenty-five subjects aged 11-12 years old participated in the study. Methods: Anthropometric and biochemical indices were measured, including lipid and liver profile, blood glucose, serum insulin, and liver ultrasound. Results: Forty-four children (58.6%) were found to have MS. Insulin resistance was present in 78 (62.4%) children. Patients with MS were more likely to have NAFLD (P \u3c; 0.001). Children with NAFLD had significantly higher body mass index, waist circumference, triglycerides, fasting insulin, and lower high-density lipoprotein compared to patients with normal livers (P \u3c 0.001). Insulin resistance was significantly higher in children with NAFLD (P \u3c; 0.001). Obese children presenting with MS were 3.01 (2.87-3.57, P \u3c 0.002) times more likely to develop NAFLD compared to those without metabolic syndrome after adjustment of cofounders. Conclusions: Obese children with MS have a higher risk of developing NAFLD. Weight management and early prevention should be the first line of treatment to prevent any possible health issues later on

Cardiometabolic risk factors related to non-alcoholic fatty liver disease in obese children

Purpose: The aim of this study was to investigate the relation of several cardiometabolic risk factors among obese children with and without non-alcoholic fatty liver disease. One hundred-two subjects aged 8-15 years old participated in the study. Methods : Laboratory analysis included fasting blood glucose, serum insulin, serum triglycerides, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and liver biochemical profile, in addition to liver ultrasound. Results: Forty children (39%) were found to have metabolic syndrome. Insulin resistance was present in 46 (48%) children. Patients with MS were more likely to have non-alcoholic fatty liver disease (P\u3c0.001). Children with Non-alcoholic fatty liver disease had significantly higher body mass index, waist circumference, blood pressure, triglycerides, fasting insulin, and lower high-density lipoprotein compared to patients with normal liver (P\u3c 0.001). Insulin resistance was significantly higher in children with Non-alcoholic fatty liver disease (P\u3c0.001). Obese children presented with MS were 2.42 (95% CI: 2.05, 2.57) times more likely to develop NAFLD compared to those without metabolic syndrome. Conclusions: Obese children with fatty liver may have a higher risk of developing metabolic syndrome and insulin resistance. Weight management and early prevention should be the first line of treatment in order to prevent any possible health issues later on

Associations of Apolipoprotein A, High-Sensitivity C-Reactive Protein and Fasting Plasma Insulin in Obese Children With and Without Family History of Cardiovascular Disease

BACKGROUND: The worldwide prevalence of childhood obesity has increased from 4.2% to 6.7% during the last two decades. Pediatric obesity is a major health problem, which is dramatically increasing in Greece. A variety of inflammatory variables have been also found to associate with cardiometabolic (CV) risk in obese children. The purpose of this study was to identify and examine the effects of possible CV risk factors in obese and non-obese children with and without family history (FH) of cardiovascular disease (CVD). METHODS: Sixty-eight (68) healthy children and adolescents aged 7 - 13 years participated in the study. Anthropometrical and biochemical indexes were obtained from all children as well as FH of CVD. RESULTS: Systolic blood pressure (SBP), total cholesterol (TC), triglyceride (TG), high-sensitivity C-reactive protein (hsCRP), fasting plasma insulin (FPI) and homeostasis model assessment of insulin resistance (HOMA-IR) levels were found statistically significantly higher in the obese group compared to the non-obese one. High-density lipoprotein (HDL) levels were observed to be statistically significantly lower in the obese children compared to their normal peers. CONCLUSIONS: Apolipoprotein A, hsCRP and FPI levels were significantly higher in the obese children with FH of CVD compared to the ones without FH of CVD. TC and SBP were found to be independently associated with obesity (odds ratio (OR): 1.965, 95% confidence interval (CI): 1.935 - 2.97, P \u3c 0.031 and OR: 1.045, 95% CI: 1.016 - 1.074, P \u3c 0.002, respectively)

Investigation of the gene polymorphism of the plasminogen activator inhibitor -1 and its serum levels, in children and adolescents with increased body mass index

Introduction. PAI-1 is the main inhibitor of plasminogen activators and thus of fibrinolysis. Increased PAI-1 plasma levels are found in various conditions, like obesity, dyslipidaemia, insulin resistance (IR), cardiovascular disease (CVD) and cancer. PAI-1 has been associated with increased atherothrombosis in those conditions. Studies have shown a correlation between plasma PAI-1 levels and the polymorphism 4G/5G 4G(rs1799762) of the promoter of the PAI-1 gene.Aim. The aim of the study was to investigate the correlation between polymorphism 4G/5G(rs1799762) and plasma PAI-1 levels in overweight/obese children and adolescents and compare them with controls of normal body mass index (BMI).Subjects and methods. 99 obese/overweight children/adolescents (mean age 9.9 (± 2.8 years) and 93 healthy controls (mean age 10 ± 2.1 years) were included in the study. Anthropometric studies were performed, serum PAI-1 levels and fasting biochemical indices (TC, HDL-C, LDL-C, Tg, Apo(A), Apo(B), Lp(a), glucose(FBG), insulin(FI), SGOT (AST), SGPT (ALT), γGT, uric acid, hsCRP), were measured. Genotypes 4G/4G, 4G/5G and 5G/5G of the 4G/5G polymorphism were studied from the isolation of DNA from whole blood with RT-PCR and High Resolution Method (HRM). Statistical analysis was performed with IBM Statistics SPSS 20.0, statistical significance was set for p<0.05.Results. The mean values of TC, Tg, Apo(B), FI, HOMA-IR, SGPT (ALT), γ-GT, uric acid, hsCRP, plasma PAI-1 levels, were found statistically significantly higher in the overweight/obese group when compared to the corresponding values of the control group, HDL-C and Apo(A) were significantly lower. No statistically significant difference was observed for variables LDL-C, Lp(a), FBG, SGOT (AST). A tendency was shown for Lp(a) to be increased in the overweight/obese children and adolescents compared to the controls. Mean plasma PAI-1 levels in the prepubertal overweight/obese group were statistically significantly higher compared to the prepubertal control group. Only for the 4G/4G and 5G/5G genotypes statistically, a significant difference was observed between overweight/obese and controls. 4G/4G genotype was found in a higher percentage in the overweight/obese, 5G/5G in the controls. No statistically significant difference was found for the 4G/5G genotype. Plasma PAI-1 mean value was statistically significantly higher only in the overweight/obese 4G/4G and 5G/5G group compared to the controls corresponding ones, no statistically significant difference was observed between 4G/4G and 5G/5G overweight/obese and between 4G/4G και 5G/5G controls. Conclusion. Overweight/obese children/adolescents had elevated plasma PAI-1 levels and significantly commoner 4G/4G genotype compared to controls where the 5G/5G genotype was commoner. No difference was found for the 4G/5G genotype between the two groups. The 4G allele maybe is a significant risk factor for the development of CVD in adulthood. However, more studies are required to draw a final conclusion.Εισαγωγή. Ο ΡΑΙ-1 είναι ο κύριος αναστολέας των ενεργοποιητών του πλασμινογόνου και της ινωδόλυσης. Αυξημένα επίπεδα PAI-1 πλάσματος βρίσκονται σε διάφορες παθολογικές καταστάσεις όπως στην παχυσαρκία, δυσλιπιδαιμία, αντίσταση στην ινσουλίνη (IR), καρδιαγγειακή νόσο (ΚΑΝ) και καρκίνο. Ο PAI-1 έχει συνδεθεί με την αυξημένη εμφάνιση αθηροθρόμβωσης σε ασθενείς με αυτές τις παθήσεις. Μελέτες έχουν δείξει συσχέτιση μεταξύ των επιπέδων πλάσματος PAI-1 και του πολυμορφισμού 4G/5G(rs1799762) του υποκινητή του γονιδίου του PAI-1. Σκοπός. Ο σκοπός της μελέτης αυτής ήταν να διερευνηθεί η συσχέτιση του πολυμορφισμού 4G/5G και των επιπέδων PAI-1 πλάσματος σε υπέρβαρα/παχύσαρκα παιδιά/εφήβους σε σύγκριση με μάρτυρες με φυσιολογικό δείκτη μάζας σώματος (ΔΜΣ). Υλικό και μέθοδοι. 99 παχύσαρκα/υπέρβαρα παιδιά/έφηβοι (μέση ηλικία 9.9±2.8 έτη) και 93 μάρτυρες (μέση ηλικία 10±2.1 έτη) συμμετείχαν στη μελέτη. Έγιναν ανθρωπομετρικές μετρήσεις, και μετρήθηκαν τα επίπεδα ΡΑΙ-1 πλάσματος και βιοχημικοί δείκτες νηστείας (TC, HDL-C, LDL-C, Tg, Apo(A), Apo(B), Lp(a), γλυκόζη (FBG), ινσουλίνη (FI), SGOT (AST), SGPT (ALT), γGT, ουρικό οξύ, hsCRP, HOMA-IR). Οι γονότυποι 4G/4G, 4G/5G, 5G/5G του πολυμορφισμού 4G/5G μελετήθηκαν με απομόνωση του DNA από ολικό αίμα με RΤ-PCR και ανάλυση Υψηλής Ευκρίνειας Τήξης (HRM). Η στατιστική ανάλυση έγινε με SPSS 20.0, στατιστική σημαντικότητα p<0.05. Αποτελέσματα. Οι μέσες τιμές των μεταβλητών TC, Tg, Apo(B), FI, HOMA-IR, SGPT (ALT), γ-GT, ουρικού οξέος, hsCRP, επιπέδων PAI-1 βρέθηκαν στατιστικά σημαντικά υψηλότερες στα υπέρβαρα/παχύσαρκα παιδιά/ εφήβους σε σχέση με τις αντίστοιχες τιμές των μαρτύρων, οι HDL-C, Apo(A) σημαντικά μικρότερες. Στατιστικά σημαντική διαφορά δε βρέθηκε για τις μεταβλητές LDL-C, Lp(a), FBG, SGOT(AST). Για την Lp(a), διαφάνηκε μια τάση τα υπέρβαρα/παχύσαρκα παιδιά και εφήβους να έχουν αυξημένες τιμές σε σχέση με τους μάρτυρες. Η μέση τιμή PAI-1 ορού στα προεφηβικά/υπέρβαρα παιδιά/εφήβους και εφηβικούς μάρτυρες βρέθηκε στατιστικά σημαντικά μεγαλύτερη απ’ ότι στους προεφηβικούς μάρτυρες. Μόνο για τους γονότυπους 4G/4G και 5G/5G βρέθηκε στατιστικά σημαντική διαφορά μεταξύ υπέρβαρων/παχύσαρκων παιδιών/εφήβων και μαρτύρων. Ο γονότυπος 4G/4G βρέθηκε σε μεγαλύτερο ποσοστό στην ομάδα υπέρβαρων/παχύσαρκων, ο 5G/5G στην ομάδα των μαρτύρων. Στατιστικά σημαντική διαφορά μεταξύ των δύο ομάδων δε βρέθηκε για το γονότυπο 4G/5G. Η μέση τιμή του PAI-1 πλάσματος βρέθηκε στατιστικά σημαντικά μεγαλύτερη μόνο στις ομάδες των υπέρβαρων/παχύσαρκων 4G/4G και 5G/5G από τις αντίστοιχες των μαρτύρων, ενώ δε βρέθηκε στατιστικά σημαντική διαφορά μεταξύ υπέρβαρων/ παχύσαρκων 4G/4G και 5G/5G και μεταξύ μαρτύρων 4G/4G και 5G/5G.Συμπεράσματα. Τα υπέρβαρα/παχύσαρκα παιδιά/έφηβοι είχαν αυξημένα επίπεδα PAI-1 πλάσματος και σημαντικά συχνότερο γονότυπο 4G/4G σε σχέση με τους μάρτυρες όπου ο γονότυπος 5G/5G ήταν συχνότερος. Για το γονότυπο 4G/5G δε βρέθηκε διαφορά μεταξύ των δύο ομάδων. Το αλληλόμορφο 4G του υποκινητή του γονιδίου ΡΑΙ-1 μπορεί να είναι ένας σημαντικός παράγοντας κινδύνου για την ανάπτυξη ΚΑΝ στην ενήλικη ζωή. Ωστόσο, απαιτούνται περαιτέρω μελέτες για την εξαγωγή οριστικού συμπεράσματος

Obese Children with Metabolic Syndrome Have 3 Times Higher Risk to Have Nonalcoholic Fatty Liver Disease Compared with Those without Metabolic Syndrome

Background. The aim of this study was to investigate the relationship between metabolic syndrome (MS) and nonalcoholic fatty liver disease (NAFLD) in obese children. One hundred and twenty-five subjects aged 11-12 years old participated in the study. Methods. Anthropometric and biochemical indices were measured, including lipid and liver profile, blood glucose, serum insulin, and liver ultrasound. Results. Forty-four children (58.6%) were found to have MS. Insulin resistance was present in 78 (62.4%) children. Patients with MS were more likely to have NAFLD (P<0.001). Children with NAFLD had significantly higher body mass index, waist circumference, triglycerides, fasting insulin, and lower high-density lipoprotein compared to patients with normal livers (P<0.001). Insulin resistance was significantly higher in children with NAFLD (P<0.001). Obese children presenting with MS were 3.01 (2.87–3.57, P<0.002) times more likely to develop NAFLD compared to those without metabolic syndrome after adjustment of cofounders. Conclusions. Obese children with MS have a higher risk of developing NAFLD. Weight management and early prevention should be the first line of treatment to prevent any possible health issues later on