Carla Pedrosa

Obesity and metabolic syndrome in 7-9 years-old Portuguese schoolchildren

BackgroundBody fat is related to changes in lipid profile, blood pressure and metabolism of insulin and glucose, known as the metabolic syndrome (MS). The aim of this study was to estimate the prevalence of metabolic syndrome (MS) and its components among overweight and obese Portuguese schoolchildren, and to identify associated clinical and biochemical characteristics.MethodsA total of 82 children (14 overweight and 68 obese; 40 boys and 42 girls) aged 7-9 years, underwent anthropometric measurements. A blood sample was obtained to assess biochemical parameters. Insulin resistance (IR) was determined by the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). MS was defined by the National Cholesterol Education Program Adult Treatment Panel III criteria modified by Cook.ResultsThe prevalence of MS was 15.8%. Abdominal obesity was present in all children. Frequency of elevated blood pressure, low HDL-cholesterol and elevated triglyceride concentrations were 62.6%, 13.4% and 11.0%, respectively. None of the children presented impaired fasting glucose, however hyperinsulinemia (7.3%) and IR (8.5%) were observed. The number of components of MS was higher in children with higher z-BMI (ρ = 0.411; p < 0.001). MS was associated with higher leptin concentrations. No association was found with adiponectin or ghrelin levels. Leptin correlated positively with obesity, glucose metabolism, lipid profile, hepatic function and C-reactive protein, and negatively with HDL and Apolipoprotein A-I/B ratio.ConclusionsThis study shows a significant prevalence of MS among obese schoolchildren. Abdominal obesity and elevated blood pressure were the most frequent components of this syndrome. Dyslipidemia, IR and high levels of leptin were also associated with MS in this young group.

Prevalence of overweight and obesity among 7–9-year-old children in Aveiro, Portugal: comparison between IOTF and CDC references

OBJECTIVE To estimate the prevalence of overweight and obesity in schoolchildren from Aveiro, Portugal, according to two criteria: the International Obesity Task Force (IOTF) and the US Centers for Disease Control and Prevention (CDC) cut-offs. DESIGN Weight, height and waist circumference were measured. Using the BMI, gender- and age-specific prevalences of overweight and obesity were determined according to the IOTF cut-offs extrapolated from an adult BMI of 25 and 30 kg/m2 and the CDC cut-off values of 85th and 95th BMI percentile. SETTING Aveiro, Portugal. SUBJECTS A random representative sample of 905 children (457 boys; 448 girls) aged 7-9 years. RESULTS The prevalence of excess weight (overweight and obesity) was lowest according to IOTF cut-offs compared to CDC (28.1 % v. 31.2 %), especially obesity (8.1 % v. 14.0 %). However, the CDC and IOTF criteria have a strong agreement (Cohens k = 0.755; P < 0.001). There were significant differences in excess weight between boys and girls according to the CDC (26.9 % v. 35.7 %; P = 0.003). Obese children are younger and the majority present abdominal obesity. CONCLUSIONS The present study shows a high prevalence of excess weight in Aveiro children, similar to other Portuguese regions and among the highest in Europe, especially in the female gender. The IOTF cut-off values give a lower prevalence of excess weight, namely obesity.

Fetal heart development in the nitrofen-induced CDH rat model: The role of mechanical and nonmechanical factors

BACKGROUND/PURPOSE In congenital diaphragmatic hernia (CDH), it was recently shown that early and late gestational lung underdevelopment is caused by nonmechanical and mechanical factors, respectively. Heart underdevelopment, which might predict lung hypoplasia, is commonly attributed to mechanical factors. The authors analyzed whether nonmechanical and mechanical factors affect cardiac growth and correlations between lung and heart weights during gestation. METHODS Left-sided CDH was induced in pregnant Wistar rats by administration of nitrofen on E9.5. At selected gestational ages (E18, E20, and E22), the lungs and heart were harvested, weighed, and analyzed for DNA and protein contents. Left lung and heart weights were correlated at those gestational ages. Two experimental groups: nitrofen without CDH (nitrofen), and nitrofen with CDH (CDH), were compared with normal controls. RESULTS At E18, both nitrofen-exposed groups presented similar and significant left lung (LL) hypoplasia. As gestation progressed (E20 and E22), in the nitrofen group left lung (LL) hypoplasia decreased, whereas in the CDH group LL hypoplasia was exacerbated relative to normal controls. In contrast, at E18 and E20, heart-to-body weight ratios as well as cardiac DNA and protein contents were reduced significantly in all animals exposed to nitrofen, with no significant differences observed between nitrofen and CDH groups. As gestation progressed, the difference between cardiac parameters in nitrofen-exposed and normal control rats diminished, and at E22 no significant differences were documented. In the CDH group, significant correlations were seen between lung and heart weights at E18 (r = 0.65; P <.05) and E20 (r = 0.4; P <.05), whereas at term gestation (E22) no significant correlation was observed (r = 0.21, not significant). CONCLUSIONS Nonmechanical factors, which might be directed by nitrofen, play a role in the pathogenesis of lung and heart hypoplasia manifested precociously in fetal life, whereas mechanical compression might influence only lung growth during late gestation. Heart weight predicts lung weight only in early gestational ages.