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Obesity and the Metabolic Syndrome in Children and Adolescents

Published on Jun 3, 2004in The New England Journal of Medicine70.67
· DOI :10.1056/NEJMoa031049
Ram Weiss33
Estimated H-index: 33
,
James Dziura57
Estimated H-index: 57
+ 9 AuthorsSonia Caprio65
Estimated H-index: 65
Cite
Abstract
background The prevalence and magnitude of childhood obesity are increasing dramatically. We examined the effect of varying degrees of obesity on the prevalence of the metabolic syndrome and its relation to insulin resistance and to C-reactive protein and adiponectin levels in a large, multiethnic, multiracial cohort of children and adolescents. methods We administered a standard glucose-tolerance test to 439 obese, 31 overweight, and 20 nonobese children and adolescents. Baseline measurements included blood pressure and plasma lipid, C-reactive protein, and adiponectin levels. Levels of triglycerides, high-density lipoprotein cholesterol, and blood pressure were adjusted for age and sex. Because the body-mass index varies according to age, we standardized the value for age and sex with the use of conversion to a z score. results The prevalence of the metabolic syndrome increased with the severity of obesity and reached 50 percent in severely obese youngsters. Each half-unit increase in the bodymass index, converted to a z score, was associated with an increase in the risk of the metabolic syndrome among overweight and obese subjects (odds ratio, 1.55; 95 percent confidence interval, 1.16 to 2.08), as was each unit of increase in insulin resistance as assessed with the homeostatic model (odds ratio, 1.12; 95 percent confidence interval, 1.07 to 1.18 for each additional unit of insulin resistance). The prevalence of the metabolic syndrome increased significantly with increasing insulin resistance (P for trend, <0.001) after adjustment for race or ethnic group and the degree of obesity. C-reactive protein levels increased and adiponectin levels decreased with increasing obesity. conclusions The prevalence of the metabolic syndrome is high among obese children and adolescents, and it increases with worsening obesity. Biomarkers of an increased risk of adverse cardiovascular outcomes are already present in these youngsters.
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  • References (35)
  • Citations (2710)
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References35
Newest
Published on Sep 2, 2003in Circulation23.05
Earl S. Ford110
Estimated H-index: 110
(CDC: Centers for Disease Control and Prevention)
Background— C-reactive protein is an emerging risk factor for cardiovascular disease. Although the relations between C-reactive protein and other risk factors for cardiovascular disease have been extensively studied in adults, the relations in children are not well understood. Methods and Results— Data from 2846 boys and girls 3 to 17 years of age who participated in the National Health and Nutrition Examination Survey, 1999 to 2000, a cross-sectional survey of the US population, were used. In u...
Published on Aug 1, 2003in Diabetes Care15.27
Kathryn C.B. Tan25
Estimated H-index: 25
,
Nelson M.S. Wat20
Estimated H-index: 20
+ 3 AuthorsKaren S.L. Lam66
Estimated H-index: 66
OBJECTIVE —Recent studies have shown that C-reactive protein (CRP) predicts future risk of diabetes in healthy Caucasians. We determined whether plasma CRP level was elevated in Chinese subjects with impaired glucose tolerance (IGT) and whether CRP level could be used to predict progression to type 2 diabetes or reversion to normal glucose tolerance (NGT) in these high-risk individuals. RESEARCH DESIGN AND METHODS —A total of 228 subjects with IGT at baseline from the Hong Kong Cardiovascular Ri...
Published on Aug 1, 2003in JAMA Pediatrics12.00
Stephen Cook25
Estimated H-index: 25
,
Michael Weitzman53
Estimated H-index: 53
+ 2 AuthorsWilliam H. Dietz97
Estimated H-index: 97
Background In adults the metabolic syndrome imposes a substantial risk for type 2 diabetes mellitus and premature coronary heart disease. Even so, no national estimate is currently available of the prevalence of this syndrome in adolescents. Objective To estimate the prevalence and distribution of a metabolic syndrome among adolescents in the United States. Design and Setting Analyses of cross-sectional data obtained from the Third National Health and Nutrition Examination Survey (1988-1994), wh...
Published on Jun 19, 2003in FEBS Letters2.67
Bettina Zietz15
Estimated H-index: 15
(University of Regensburg),
Hans H Herfarth52
Estimated H-index: 52
(University of Regensburg)
+ 4 AuthorsAndreas Schäffler42
Estimated H-index: 42
(University of Regensburg)
Low levels of high-density lipoprotein (HDL)-cholesterol represent an independent cardiovascular risk factor and, besides reduced physical activity, mechanisms leading to decreased HDL-cholesterol levels are not known. We aimed to test the hypothesis, that adiponectin provides a missing link between type 2 diabetes and low levels of HDL-cholesterol, independent from common metabolic risk factors. 523 patients with type 2 diabetes were investigated for adiponectin serum levels and parameters of l...
Published on Jun 15, 2003in Journal of Clinical Investigation12.28
Mark B. Pepys97
Estimated H-index: 97
,
Gideon M. Hirschfield46
Estimated H-index: 46
In the mid 1990s, immunoassays for C-reactive protein (CRP), with greater sensitivity than those previously in routine use, revealed that increased CRP values, even within the range previously considered normal, strongly predict future coronary events. These findings triggered widespread interest, especially, remarkably, in the US, where the clinical use of CRP measurement had been largely ignored for about 30 years. CRP production is part of the nonspecific acute-phase response to most forms of...
Published on Mar 18, 2003in Circulation23.05
Julia Steinberger54
Estimated H-index: 54
,
Stephen R. Daniels125
Estimated H-index: 125
This statement was reviewed by the American Diabetes Association. The recommendations contained herein are consistent with the American Diabetes Association’s Clinical Practice Recommendations. Atherosclerotic cardiovascular disease is the No. 1 killer in the adult population of Western societies,1 but the pathological processes and risk factors associated with its development have been shown to begin during childhood.2 Obesity plays a central role in the insulin resistance syndrome, which inclu...
Published on Jan 1, 2003in Arteriosclerosis, Thrombosis, and Vascular Biology6.62
Masahiro Kumada21
Estimated H-index: 21
,
Shinji Kihara77
Estimated H-index: 77
+ 10 AuthorsHisatoyo Hiraoka24
Estimated H-index: 24
Background— Adiponectin is an adipocyte-derived plasma protein that accumulates in the injured artery and has potential antiatherogenic properties. This study was designed to determine whether a decreased plasma adiponectin level (hypoadiponectinemia) can be independently associated with the prevalence of coronary artery disease (CAD). Methods and Results— The consecutive 225 male patients were enrolled from inpatients who underwent coronary angiography. Voluntary blood donors (n=225) matched fo...
Published on Nov 1, 2002in Trends in Endocrinology and Metabolism9.78
Susan E. Ozanne64
Estimated H-index: 64
,
C. Nicholas Hales30
Estimated H-index: 30
Epidemiological studies have revealed strong inverse relationships between birthweight and the risk of developing type 2 diabetes mellitus (T2DM) and the metabolic syndrome. The mechanistic basis of these relationships remains the subject of research and debate. Evidence for the importance of the fetal environment has been obtained from both human and rodent studies. Studies of monozygotic twins have shown that genetic effects cannot explain these relationships entirely, if at all. Fetal and ear...
Published on Oct 1, 2002in Journal of Internal Medicine6.05
G. J. Blake1
Estimated H-index: 1
(Brigham and Women's Hospital),
Paul M. Ridker192
Estimated H-index: 192
(Brigham and Women's Hospital)
Abstract. Blake GJ, Ridker PM (Harvard Medical School, Boston, MA, USA). Inflammatory bio-markers and cardiovascular risk prediction (Review). J Intern Med 2002; 252: 283–294. Inflammatory processes are now recognized to play a central role in the pathogenesis of atherosclerosis and its complications. Plasma levels of several markers of inflammation have been found to be associated with future cardiovascular risk in a variety of clinical settings. These markers include cell adhesion molecules, c...
Published on Sep 1, 2002in Journal of the American College of Cardiology18.64
Fahim Abbasi47
Estimated H-index: 47
(Stanford University),
Byron William Brown3
Estimated H-index: 3
(Stanford University)
+ 2 AuthorsGerald M. Reaven113
Estimated H-index: 113
(Stanford University)
Abstract Objectives The study goals were to: 1) define the relationship between body mass index (BMI) and insulin resistance in 314 nondiabetic, normotensive, healthy volunteers; and 2) determine the relationship between each of these two variables and coronary heart disease (CHD) risk factors. Background The importance of obesity as a risk factor for type 2 diabetes and hypertension is well-recognized, but its role as a CHD risk factor in nondiabetic, normotensive individuals is less well estab...
Cited By2710
Newest
Published on 2020in Cytokine3.08
Okan Dikker (UHSA: University of Health Sciences Antigua), Nevin Cetin Dag (UHSA: University of Health Sciences Antigua)+ 2 AuthorsHüseyin Dağ (UHSA: University of Health Sciences Antigua)
Abstract Introduction Angiopoietin-like peptide 4 (ANGPTL-4) is an adipocytokine that regulates plasma lipoprotein levels by inhibiting the lipoprotein lipase enzyme. Changes in lipid profile can be seen in obese adolescents. Nonalcoholic fatty liver disease may also be a complication of obesity. Based on this information, in this study we aimed to evaluate the relationship between serum ANGPTL-4 levels and obesity and hepatosteatosis in adolescents. Materials and methods A total of 85 volunteer...
Published on Dec 1, 2019in Scientific Reports4.01
Sook Hyun Seo (Sacred Heart Hospital), Young Suk Shim (Sacred Heart Hospital)
This study aimed to evaluate the relationships between sleep duration and overweight/obesity, obesity, and metabolic syndrome (MetS) and its components in children and adolescents. A total of 6,048 participants aged 10–18 years were divided into the following four sleep-duration groups based on age-specific sleep duration: i) very short; ii) short; iii) recommended; and iv) long. The participants in the very short sleep-duration group had an increased odds ratio (OR) of 1.76 for overweight/obesi...
Published on Sep 1, 2018in Clinical Nutrition6.40
Hadeel A. Al-Rawaf1
Estimated H-index: 1
(KSU: King Saud University)
Summary Background Circulating microRNAs (miRNAs) as valuable biomarkers yielded important insights into the pathogenesis of obesity. Aim This study aimed to describe the circulating miRNA profile for adolescences and its association with the circulating levels leptin and adiponectin according to specific degree of obesity. Methods RT–PCR and immunoassy analysis were used to study circulating miRNA profile, adipokines; adiponectin (A), leptin (L), and L/A ratio as well as other factors of metabo...
Published on Jan 1, 2008
Martin Wabitsch51
Estimated H-index: 51
(University of Ulm),
Daniel Tews8
Estimated H-index: 8
(University of Ulm)
+ 5 AuthorsPamela Fischer-Posovszky25
Estimated H-index: 25
(University of Ulm)
The last 12 months have shown once more that obesity and weight regulation are among the most interesting biomedical fields of science. The number of high-quality papers reflects the multiple research activities which now can be documented at many places around the world. The last 12 months have also demonstrated that different governments in Europe have taken over some responsibility of the obesity epidemic as demonstrated by the European Charter on counteracting obesity (www.iotf.org). The aim...
Published on Jun 1, 2019in Obesity Medicine
Samah R Albataineh (UJ: University of Jordan), Eman Badran6
Estimated H-index: 6
(UJ: University of Jordan),
Reema F. Tayyem15
Estimated H-index: 15
(UJ: University of Jordan)
Obesity and overweight among children are global health challenges that are growing rapidly. Childhood obesity is strongly associated with adult obesity and posess serious health co-morbidities and psychosocial consequences. Growing evidence of high rate of dyslipidemia and hypertension along with impaired glycemic control have been reported in child obesity. Recent studies suggest the development of obesity-linked complications is related to the imbalance in the expression of pro- and anti-infl...
Mehdi Ebrahimi5
Estimated H-index: 5
(Tehran University of Medical Sciences),
Mohammadreza Hashemi Aghdam (Tehran University of Medical Sciences)+ 9 AuthorsMajzoubeh Taheri4
Estimated H-index: 4
Background Smoking behavior as a harmful trend among adolescents and young adults has increased over last two decades. Many children and adolescents are at the risk of “second-hand” smoking at home due to their exposure to parents’ or siblings’ smoking. These second hand smokers are called “passive smokers” and are at risk of several health complications like cardiometabolic risk factors.
Published on Aug 23, 2019in Diabetologia7.11
Christine W. Hockett3
Estimated H-index: 3
(Colorado School of Public Health),
Kylie K. Harrall3
Estimated H-index: 3
(Colorado School of Public Health)
+ 9 AuthorsBrandy M. Ringham7
Estimated H-index: 7
(Colorado School of Public Health)
Aims/hypothesis We previously showed that intrauterine exposure to gestational diabetes mellitus (GDM) increases selected markers of adiposity in pre-pubertal adolescents. In the present study, we examined these associations in adolescence, and explored whether they are strengthened as the participants transition through puberty.
Published on Aug 19, 2019in PLOS ONE2.78
Mette Stavnsbo3
Estimated H-index: 3
,
Turid Skrede4
Estimated H-index: 4
+ 5 AuthorsGeir Kåre Resaland10
Estimated H-index: 10
Published on Mar 27, 2019in Biotechnic & Histochemistry0.95
M Erdal , B. Z. Altunkaynak (Okan University)+ 2 AuthorsE. Öztas
ABSTRACTObesity is a chronic disease that is characterized by increased body fat owing to imbalance between consumed and expended energy. Inflammation generally is accompanied by accumulation of excess lipid in adipose tissue and liver. High mobility group box-1 (HMGB1) participates in the pathogenesis of inflammatory diseases. We investigated the relation of the number of HMGB1 positive cells to body mass index (BMI), liver inflammation and the number of Kupffer cells. We divided 18 female Wist...
View next paperThe Relation of Overweight to Cardiovascular Risk Factors Among Children and Adolescents: The Bogalusa Heart Study