Charilaos Stylianou

Elevated circulating levels of the serum acute-phase protein YKL-40 (chitinase 3-like protein 1) are a marker of obesity and insulin resistance in prepubertal children.

YKL-40 (chitinase 3-like protein 1) is a newly recognized protein that is secreted by activated macrophages and neutrophils and expressed in a broad spectrum of inflammatory conditions and cancers. It has also been associated with endothelial dysfunction and diabetes in adults. Its role in childhood obesity has not been evaluated yet. Our aim was to evaluate the associations of serum YKL-40 levels with markers of obesity, inflammation, and insulin resistance in children. Forty-one obese prepubertal children and 41 age- and sex-matched lean controls were included, and serum YKL-40 levels were determined. Body mass index (BMI), blood pressure (BP), body fat percentage, fasting glucose, insulin, homeostasis model assessment for insulin resistance (HOMA-IR) index, whole-body insulin sensitivity index, lipids, white blood cell (WBC) count, C-reactive protein, and fibrinogen levels were also assessed. Obese children had higher YKL-40 levels compared with controls (P = .003). Insulin-resistant individuals showed higher YKL-40 compared with non-insulin-resistant individuals after adjusting for age and BMI (adjusted P = .039). Serum YKL-40 levels were positively correlated with age, BMI, body fat percentage, fasting glucose and insulin, HOMA-IR index, whole-body insulin sensitivity index, systolic BP, mean BP, and WBC count (P < .05). After adjustment for age, sex, BMI, WBC count, and systolic BP, HOMA-IR index remained significantly associated with YKL-40 levels (P < .001). The study suggests that YKL-40 levels are elevated in obese youth and represent a marker of insulin resistance even in childhood. Prospective studies are needed to determine whether children with elevated YKL-40 levels are at higher risk for future cardiovascular disease.

Diabese youngsters have 3.7 more chances in developing metabolic syndrome compared with the obese.

Background and aims: Diabesity, the coexistence of diabetes and obesity, is a new health epidemic. The present case-control study aimed in assessing the prevalence of metabolic syndrome (MS) between diabese and obese children and adolescents. Methods and results: One-hundred and fifty-four obese children and adolescents aged 4–16 yr were recruited and divided in 2 groups: the diabese (no.=85) who were diagnosed with obesity and impaired glucose tolerance (IGT) and the obese (no.=69), who formed the controls group and did not demonstrate IGT. Von Willebrand factor (vWF), plasminogen activator inhibitor-1 (PAI-1), and uric-acid levels were measured. Being diabese increased the odds ratio (OR) for developing MS (OR: 3.714), demonstrating increased serum triglycerides (TG) (OR: 9.067) and low HDL-cholesterol (HDL-C) (OR: 1.405), developing hypertension (OR: 0.750) and acanthosis nigricans (OR: 2.882). In the total sample, low HDL-C was the most common MS criterion, diagnosed in 68% of the diabese and 62% of the obese subjects. Age and weight-adjustment of the continuous data demonstrated that the diabese subjects had higher fat mass index, blood pressure, and TG levels, however the obese exhibited lower HDLC concentrations. Principal component analysis demonstrated that among the inflammatory biomarkers PAI-1 and vWF contributed to the prevalence of MS. Conclusion: The present study is the first to demonstrate that the diabese youngsters have 3.7 times more chances in developing MS compared with the obese. From the examined atherosclerotic biomarkers, PAI-1 and vWF contributed to the prevalence of the syndrome and both indicate the initiation of endothelial dysfunction.

Ghrelin serum levels during oral glucose tolerance test in prepubertal obese children with insulin resistance.

BACKGROUND An involvement of ghrelin in glucose metabolism has been suggested; nevertheless, the relationship between ghrelin and insulin resistance (IR) remains unclear. AIMS 1. To investigate the effect of glucose loading on ghrelin in prepubertal obese children with IR. 2. To assess possible correlations between IR and changes in circulating ghrelin. PATIENTS AND METHODS Twenty prepubertal obese, insulin-resistant and 18 age- and sex-matched lean children were studied. Fasting glucose, insulin and ghrelin levels were measured. In the obese group, measurements were repeated during an OGTT. RESULTS Ghrelin levels were decreased at 60 min, but thereafter increased to baseline values. The fall in circulating ghrelin was negatively correlated with IR and the respective rise in insulin levels. CONCLUSIONS In prepubertal, insulin-resistant obese children, ghrelin is significantly suppressed shortly after glucose intake. It is possible that the above effect is attenuated by IR and the resultant increase in insulin levels.

Association between magnesium concentration and HbA1c in children and adolescents with type 1 diabetes mellitus (儿童与青少年1型糖尿病患者的镁浓度与HbA1c之间的关系)

Magnesium levels may be decreased in patients with type 1 diabetes mellitus (T1DM), influencing disease control. Relevant studies concern mainly adults and there are few data from the pediatric population. The aim of the present study was to evaluate magnesium levels and examine their possible association with glycemic control in youths with T1DM.

A preliminary case-control study on nutritional status, body composition, and glycemic control of Greek children and adolescents with type 1 diabetes

Background:  Because scientific data on the diet of diabetic Greek youngsters are scarce, diabetic experts use findings from international studies. However, because of diet variations between countries, this may result in problems in diabetes control. The aim of the present pilot study was to assess body composition, nutritional status, and diabetes control in Greek youngsters with type 1 diabetes mellitus (T1DM).

Association between magnesium concentration and HbA1c in children and adolescents with type 1 diabetes mellitus

Magnesium levels may be decreased in patients with type 1 diabetes mellitus (T1DM), influencing disease control. Relevant studies concern mainly adults and there are few data from the pediatric population. The aim of the present study was to evaluate magnesium levels and examine their possible association with glycemic control in youths with T1DM.

Ghrelin–leptin network influences serum chitinase 3-like protein 1 (YKL-40) levels in obese prepubertal children

OBJECTIVE This study aimed to investigate any possible interactions between hormonal regulators of weight gain and markers of subclinical inflammation in childhood obesity. Forty-one obese prepubertal children and 41 age- and gender-matched lean controls were included. Children were classified as obese or non-obese according to international age- and gender-specific body mass index (BMI) cutoff points defined by the International Obesity Task Force to define childhood obesity. Anthropometric measurements, serum insulin, chitinase 3-like protein (YKL-40), ghrelin and leptin levels as well as plasma glucose in the fasting state were determined. RESULTS Obese children as compared with controls had higher YKL-40 (50.7±15.2 vs 41.0±10.5 ng/ml, p=0.003), higher leptin (33.8±16.0 vs 9.7±7.5 ng/ml, p<0.001) and lower ghrelin serum levels (871.4±368.0 vs 1417.6±387.3 pg/ml, p<0.001). The obese children with ghrelin levels above median (43.8±10.2 ng/ml) as compared to those with ghrelin below median (57.2±16.6 ng/ml) presented lower serum YKL-40 levels (p=0.009), indicating more severe inflammation with lower levels of ghrelin. By contrast, although the obese children with leptin levels above median (49.7±16.3 ng/ml) presented lower serum YKL-40 levels as compared to those with leptin levels below median (51.6±14.6 ng/ml), this difference did not reach the level of statistical significance (p=0.726). Moreover, serum YKL-40 levels were significantly correlated with ghrelin (r=-0.359, p=0.014) but not with leptin levels (r=0.169, p=0.261). A significant negative correlation between ghrelin and leptin levels was also found (r=-0.276, p=0.041). These findings remained unchanged for obese, when analyses were done separately, whereas the significance of correlations was lost for non-obese subjects. CONCLUSIONS Ghrelin-leptin network had an impact on serum YKL-40 levels in obese prepubertal children; upregulation of YKL-40 secretion seems to be a consequence of reduced ghrelin rather than elevated leptin concentrations.

Growth, the Mediterranean diet and the buying power of adolescents in Greece.

Abstract Background The aim of the present cross-sectional study was to evaluate associations between pocket money, Mediterranean diet (MD) adherence and growth among Greek adolescents. Methods A total of 319 (157 boys and 162 girls) Greek adolescents, aged 10–18 years participated in the study. Pocket money was recorded, MD adherence was assessed with the KIDMED score and growth was evaluated using the World Health Organization (WHO) growth charts. Results Participants receiving pocket money exceeding 6.0€ daily demonstrated increased fast-food consumption and breakfast skipping. Overall, a negative relationship was revealed between pocket money and obesity. However, lower allowance receivers were less likely to be obese, consume fruit per day and more likely to consume breakfast and sweets, compared to average pocket money receivers. Increased MD adherence was associated with a lower risk of overweight and as expected, unhealthy eating habits were observed among obese adolescents. Conclusions Interrelationships tend to exist between MD adherence, pocket money and growth among adolescents.

Association between magnesium concentration and HbA1c in children and adolescents with type 1 diabetes mellitus (儿童与青少年1型糖尿病患者的镁浓度与HbA1c之间的关系): Hypomagnesemia in youths with T1DM

Magnesium levels may be decreased in patients with type 1 diabetes mellitus (T1DM), influencing disease control. Relevant studies concern mainly adults and there are few data from the pediatric population. The aim of the present study was to evaluate magnesium levels and examine their possible association with glycemic control in youths with T1DM.

A systematic review and meta-analysis of weight status among adolescents in Cyprus: scrutinizing the data for the years 2000-2010.

OBJECTIVEThe aim of the present study was to evaluate by pooled and sensitivity analyses all available data on adolescent overweight/obesity in Cyprus.DESIGNA thorough literature search determined the studies to be examined using Cypriot adolescent samples aged 10–18 years old, with weight status in each sex classified according to the IOTF criteria, published between the years 2001–2011. Eight studies were retrieved, but three fulfilled the criteria for the sensitivity analyses.RESULTSThe pooled prevalence of obesity was 9.8% in boys (n=6081). The pooled analysis classified 6.1% (n=3886) of girls as obese, whereas a higher prevalence was observed by the sensitivity analysis 6.4% (n = 1956, p ≤0.001). The boys’ prevalence of overweight was 19.3% and the girls’ 17.1%. Between sexes, boys demonstrated a higher prevalence of obesity and overweight (p ≤0.001 for both). The cumulative analyses demonstrated an increase in the prevalence of overweight/obesity until the year 2005 and thereafter a plateauing in boys and a slight decrease in girls in a non-linear manner.CONCLUSIONApproximately 1/3 of adolescent boys and 1/4 of adolescent girls in Cyprus were overweight/obese during the previous decade.