Claudio Aranda

Relationship between obesity and metabolic syndrome among Argentinean elementary school children.

BACKGROUND Argentina has experienced marked increases in the prevalence of childhood overweight (OW)/obesity over the last few decades. OBJECTIVES We examined (1) the distribution of the mean values of lipids, glucose, and HOMA-IR according to the presence of OW/obesity, age, and sex and (2) the association between metabolic syndrome and OW/obesity, Tanner stage, gender, and HOMA-IR. METHODS Data were collected from 1009 children (508 males) in 10 elementary schools between April and September 2007. BMI, waist circumference, blood pressure, Tanner, lipids, insulin, and glucose were determined. Criteria analogous to ATPIII were used for metabolic syndrome in children. RESULTS Over 1009 children (508 males) aged 9.4 + or - 2.0 years were evaluated. One hundred and sixty-five (16.4%) were obese (>95th percentile), and 166 (16.5%) were OW (85-95th). Twenty-five (2.5%) were severely obese (BMI>99th). Most of the children (62%; 613/979) were at Tanner 1. Triglycerides, insulin, and HOMA-IR were higher (p<0.001) and HDL-C lower (p<0.001) in OW/obesity in both age groups and genders. The prevalence of metabolic syndrome was 5.8% overall, 32% in severely obese, 16.4% in OW/obese and 0.4% in normal weight children. Multiple logistic regression showed that BMI (OR 24.48; 95% CI 9.14-65.57), and HOMA-IR (OR 2.09; 95% CI 1.04-4.18) were associated with metabolic syndrome adjusted by gender and Tanner stage. Multiple linear regression also showed that BMI and HOMA-IR were independently associated with the number of metabolic syndrome components (R(2)=0.46). CONCLUSIONS A substantial number of OW/obese children have the metabolic syndrome. HOMA-IR and BMI were strong predictors of metabolic syndrome in children suggesting that OW/obese school children are at a higher risk for future cardiovascular disease.

Are girls more insulin-resistant than boys?

OBJECTIVE The objective was to determine whether girls were more insulin-resistant than boys. DESIGN AND METHODS Data from 1009 children (508 males) in 10 elementary schools, between April and September, 2007 were collected. BMI, waist circumference (WC), blood pressure, Tanner stage, lipids, insulin, and glucose were obtained. RESULTS One hundred and sixty five (16.4%) of the children were obese (>95%ile), and 166 (16.5%) were overweight (85-95%ile). Mean HOMA-IR and insulin were higher among 10.0-13.9-year-old girls than boys. Multiple logistic regression using the 3rd quartile of HOMA-IR as the dependent variable showed that only BMI OR=1.18 (95% CI 1.12-1.24; p<0.001), Tanner OR=1.39 (95% CI 1.12-1.73; p=0.003) and triglycerides 1.005 (95% CI 1.00-1.01; p=0.04) were significantly associated with insulin resistance while sex and HDL-C were not. CONCLUSIONS This study showed that no significant sex-related differences were found, and HOMA-IR was associated with adiposity and pubertal stage suggesting that the higher values of HOMA-IR in girls than in boys could be due to their earlier pubertal development.

Comparison of different anthropometric indices for identifying dyslipidemia in school children

BACKGROUND Anthropometric indices have been associated with dyslipidemia. OBJECTIVE To compare the abilities of BMI, waist circumference (WC) and WC/height to identify childrens dyslipidemia. METHODS Students 1261 (639 male) age 9.5±2.1 years. were examined for anthropometry and lipid levels. Triglycerides ≥1.69 mmol/L and high-density lipoprotein cholesterol (HDL-C) <0.91 mmol/L were considered abnormal per American Heart Association. RESULTS The prevalence of abnormal triglycerides was 4.1% and HDL-C 8.1%. The areas under the receiver operator curves (ROC) were: BMI=0.87, WC=0.83, and WC/height=0.84 in predicting both low HDL-C and high triglycerides. Multiple regression analyses showed that the odds ratios (OR) were highest for WC [6.5], followed by WC/height [5.4], and BMI [4.9], for dyslipidemia. CONCLUSIONS The results suggest that WC, WC/height, and BMI similarly predicted dyslipidemia, using ROC analyses. However, regression analyses showed that WC followed by WC/height was most predictive of dyslipidemia.

Can the metabolic syndrome identify children with insulin resistance

Objective:  The metabolic syndrome is associated with insulin resistance in adults. We defined pediatric metabolic syndrome using criteria analogous to Adult Treatment Panel III. The purpose of this study was to determine whether these criteria are reliable for insulin resistance in children.

Dyslipidemia without Obesity in Indigenous Argentinean Children Living at High Altitude

OBJECTIVES To compare the prevalence of cardiovascular disease risk factors in Indian children from San Antonio de los Cobres (SAC) and children from Buenos Aires (BA), and to examine body mass index (BMI), waist circumference (WC), and WC/height as predictors of dyslipidemia in both groups. STUDY DESIGN Data were collected cross-sectionally from BMI, WC, blood pressure, Tanner scale, glucose, lipids, and insulin. Dyslipidemia was defined by the National Cholesterol Education Program and American Heart Association. RESULTS The mean ages were 10.6 ± 3.0 and 9.5 ± 2.0 years in SAC vs BA children. Of the 330 SAC children, 15 (4.5%) were overweight and 12 (3.6%) obese, and of the 603 BA, 97 (16.1%) were overweight and 82 (13.6%) obese per Centers for Disease Control. There was a significantly higher prevalence of high triglycerides (28.8% vs 3.5%) and low high-density lipoprotein cholesterol (30.0% vs 5.5%) in SAC vs BA children. The areas under the receiver operating characteristic curve in predicting high triglycerides were BMI = 0.55 (95% CI, 0.48-0.62; P = .15) in SAC and BMI = 0.65 (95% CI, 0.52-0.77; P = .02) in BA children. Similar results from the areas under the receiver operating characteristic curve were obtained when low high-density lipoprotein cholesterol was used, indicating that BMI was not a significant predictor for dyslipidemia in SAC children. When BMI was replaced by WC and WC/height, results were similar. CONCLUSIONS Anthropometric markers were not an acceptable predictor for National Cholesterol Education Program cutoffs for dyslipidemia in SAC children. Longitudinal studies should determine if SAC children are at high risk for cardiovascular diseases because of genetic background.

Low vitamin D concentrations among indigenous Argentinean children living at high altitudes.

Hypovitaminosis D is an international problem; however, there is little information about its prevalence in apparently healthy Indian children living at high altitudes.

Is albuminuria associated with obesity in school children

Hirschler V, Molinari C, Maccallini G, Aranda C. Is albuminuria associated with obesity in school children?

Measurement of fasting salivary insulin and its relationship with serum insulin in children.

Background Saliva is a useful sample as a source of hormones for the diagnosis of different diseases, particularly in pediatric patients and aged individuals, because saliva offers a noninvasive and stress-free alternative to serum collection. The aim of this study was to validate a salivary insulin method and to check its clinical application in pediatric patients. Methods Saliva samples were collected from 130 boys and 147 girls aged 6–14 years. Salivary and serum insulin levels were measured with the chemiluminescent automated method Access (Beckman Coulter, Brea, CA, USA). Serum blood glucose levels were measured with the glucose oxidase method in an autoanalyzer. Results The precision profile of the method was determined for six aliquots of different concentrations from pools of saliva, and the coefficients of variation (CV) were 2.4% for 1 μUI/ml, 4% for 0.5, 8.9% for 0.25, 19% for 0.12, 28% for 0.06, and 38% for 0.03 μUI/ml, being the functional sensibility (concentration corresponding to a 20% CV) 0.12 μUI/ml. Insulin recovery was 100.13%. Salivary insulin levels diminished 29.8% in samples stored during 7 days at 2–8 °C. Differences in insulin values were not observed when samples were stored at −20 °C during 7 days. The methods used to measure salivary and serum insulin correlated significantly (r=0.92, P<0.001). However, at levels of serum insulin >20 μUI/ml, this correlation declined (r=0.57, P=0.083). Conclusion The proposed method for salivary insulin measurement showed convenient analytical characteristics.

Association of vitamin D with insulin resistance in Argentine boys: A pilot study

Hypovitaminosis D has been associated with insulin resistance. The objectives of the study was to the prevalence of hypovitaminosis D, and the association of vitamin D concentrations with age, Tanner stage, BMI and insulin sensitivity (HOMA-IR) in a group of healthy boys. Data were collected cross-sectionally at an amateur rugby club in the Buenos Aires suburbs in May, 2010. BMI, waist circumference, Tanner staging, blood pressure, and levels of glucose, lipids, and insulin were determined. 25-hydroxyvitamin D [25(OH)D] was measured by radioimmunoassay. One hundred and sixteen boys aged 11.3 ± 2.4 y were examined; 19 (16.4%) and 40 (34.5%) boys were overweight and obese, respectively, per United States Centers for Disease Control and Prevention. 52.2% of the children were at Tanner 1. Serum concentration of [25(OH)D] had a median value of 20 ng/mL (interquartile range 18–21 ng/mL). Sixty (52.6%) boys had insufficient [25(OH)D] ([25(OH)D > 20 but ≤ 30 ng/mL), and 54 (46.6%) had deficient levels ([25(OH)D] r −0.20, P = 0.03), waist circumference ( r −0.23, P = 0.01), HOMA-IR ( r −0.25, P = 0.007), and insulin ( r −0.29, P = 0.002). Multiple regression analysis showed that [25(OH)D] concentration was significantly and inversely associated with HOMA-IR, ( B = −0.8; p = 0.02) adjusted for Tanner and BMI (R 2 = 0.35). This study demonstrated an inverse association between [25(OH)D] and HOMA-IR in healthy boys adjusted for pubertal development and BMI. It also showed a high prevalence of both [25(OH)D] deficiency and insufficiency. Further research is needed on the prospective association between vitamin D and the risk for type 2 diabetes.

Association between vitamin D and Apo B concentrations in Argentinean Indian children

OBJECTIVE The objective of the study was to determine the prevalence of vitamin D insufficiency and its association with non-traditional cardiovascular disease (CVD) risk factors such as Apo B in South American Indian school children. METHODS A cross-sectional study of 355 children (166 Males) aged 9.6±2.3 y was performed. Anthropometric measures, glucose, lipids, insulin, Apo B, Apo A, and vitamin D concentrations were measured. RESULTS The prevalence of overweight and obesity was 10.7% (38) per CDC. One child (0.3%) had optimal vitamin D concentrations [25(OH)D[>30 ng/ml. Univariate analysis showed significant associations between vitamin D and HDL-C (r=0.12 p<0.05), age (r=-0.11 p<0.05) BMI (r=-0.22 p<0.05), LDL-C (r=-0.22 p<0.01), triglycerides (r=-0.16 p<0.01), non HDL-C (r=-0.21 p<0.01), Apo B (r=-0.23 p<0.01), Apo B/Apo A (r=-0.21 p<0.01), insulin (r=-0.17 p<0.05), and HOMA-IR (r=-0.16 p<0.05). Multiple linear regression analysis showed that female gender and Apo B were significantly associated with vitamin D adjusted for confounding factors (R(2) 0.12). CONCLUSION Vitamin D deficiency was associated with increased Apo B among Indian children, suggesting that it could be used as a risk marker of CVD.