Loreana Sanches Silveira

Intra-abdominal fat is related to metabolic syndrome and non-alcoholic fat liver disease in obese youth

BackgroundPrevious studies have shown an association between adiposity, especially intra-abdominal adipose tissue, and hemodynamic/metabolic comorbidities in adults, however it is not clear in pediatric population. The aim of the study was to analyze the relationship between non-alcoholic fatty liver disease (NAFLD) and components of metabolic syndrome (MS) with values of intra-abdominal (IAAT) and subcutaneous (SCAT) adipose tissue in obese children and adolescents.MethodsCross-sectional study. Subjects: 182 obese sedentary children and adolescents (aged 6 to 16 y), identified by the body mass index (BMI). Measurements: Body composition and trunk fat by dual-energy X-ray absorptiometry- DXA; lipid profile, blood pressure and pubertal stage were also assessed. NAFLD was classified as absent (0), mild (1), moderate (2) and severe (3), and intra-abdominal and subcutaneous abdominal fat thickness were identified by ultrasound. The MS was identified according to the cut offs proposed by World Health Organization adapted for children and adolescents. The chi-square test was used to compare categorical variables, and the binary logistic regression indicated the magnitude of the associations adjusted by potential cofounders (sex, age, maturation, NAFLD and HOMA-IR).ResultsHigher quartile of SCAT was associated with elevated blood pressure (p = 0.015), but not associated with NAFLD (p = 0.665). Higher IAAT was positively associated with increased dyslipidemia (p = 0.001), MS (p = 0.013) and NAFLD (p = 0.005). Intermediate (p = 0.007) and highest (p = 0.001) quartile of IAAT were also associated with dyslipidemia, independently of age, sex, maturation, NAFLD and HOMA-IR (homeostatic model assessment-insulin resistance).ConclusionObese children and adolescents, with higher IAAT are more prone to develop MS and NAFLD than those with higher values of SCAT, independent of possible confounding variables.

Body composition variables as predictors of NAFLD by ultrasound in obese children and adolescents

BackgroundNonalcoholic fatty liver disease (NAFLD) is a disorder associated with excessive fat accumulation, mainly in the intra-abdominal region. A simple technique to estimate abdominal fat in this region could be useful to assess the presence of NAFLD, in obese subjects who are more vulnerable to this disease. The aim of this cross-sectional study was to verify the reliability of waist circumference and body composition variables to identify the occurrence of NAFLD in obese children and adolescents.MethodsSample was composed of 145 subjects, aged 11 to 17 years. Assessments of waist circumference (WC), trunk fat mass (TFM) and fat mass (FM) by dual-energy X-ray absorptiometry (DXA) and ultrasound for diagnosis of NAFLD and intra-abdominal adipose tissue (IAAT) were used. Correlation between variables was made by Spearman’s coefficients; ROC curve parameters (sensitivity, specificity, area under curve) were used to assess the reliability of body composition variables to assess the presence of NAFLD. Statistical significance was set at 5%.ResultsSignificant correlations were observed between NAFLD and WC (p = 0.001), TFM (p = 0.002) and IAAT (p = 0.001). The higher values of area under the ROC curve were for WC (AUC = 0.720), TFM (AUC = 0.661) and IAAT (AUC = 0.741).ConclusionsOur findings indicated that TFM, IAAT and WC present high potential to identify NAFLD in obese children and adolescents.

Effect of concurrent training on risk factors and hepatic steatosis in obese adolescents

OBJECTIVE To analyze the effects of a 20-week concurrent training on the variables of body composition, lipid profile, and fatty liver diagnosis in obese adolescents. METHODS An open clinical trial was carried out with 34 obese adolescents aged between 12 and 15 years. Total body fat, trunk fat mass, total cholesterol and its fractions (HDL, LDL and VLDL), and triglycerides were analyzed; an upper abdominal ultrasound was performed in order to diagnose fatty liver. The participants underwent concurrent training (association of weight training with aerobic training) three times per week, lasting one hour for 20 weeks. Statistical analysis included paired Studentâ€(tm)s t-test and frequency analysis in order to verify the relative and absolute reductions of fatty liver diagnosis, being significant p<0.05. RESULTS The studied adolescents showed statistically significant improvement in body composition, with a decrease of total body fat percentage, total fat mass, trunk fat, and an a increase in the lean body mass. They also presented reduced size of liver lobes, decrease in total cholesterol and in LDL-cholesterol, with a lower prevalence of fatty liver. CONCLUSIONS The concurrent training was effective for promoting significant improvements in body fat composition and lipid profile variables, besides reducing fatty liver prevalence rate.

Association between aerobic exercise and rosiglitazone avoided the NAFLD and liver inflammation exacerbated in PPAR-α knockout mice.

Nonalcoholic fatty liver disease (NAFLD) is one of the main liver diseases today, and may progress to steatohepatitis, cirrhosis, and hepatocellular carcinoma. Some studies have shown the beneficial effects of aerobic exercise on reversing NAFLD. To verify whether chronic aerobic exercise improves the insulin resistance, liver inflammation, and steatohepatitis caused by a high fat diet (HF) and whether PPARα is involved in these actions. C57BL6 wild type (WT) and PPAR‐α knockout (KO) mice were fed with a standard diet (SD) or HF during 12 weeks; the HF mice were trained on a treadmill during the last 8 weeks. Serum glucose and insulin tolerances, serum levels of aspartate aminotransferase, hepatic content of triacylglycerol, cytokines, gene expression, and protein expression were evaluated in all animals. Chronic exposure to HF diet increased triacylglycerol accumulation in the liver, leading to NAFLD, increased aminotransferase in the serum, increased peripheral insulin resistance, and higher adiposity index. Exercise reduced all these parameters in both animal genotypes. The liver lipid accumulation was not associated with inflammation; trained KO mice, however, presented a huge inflammatory response that was probably caused by a decrease in PPAR‐γ expression. We conclude that exercise improved the damage caused by a HF independently of PPARα, apparently by a peripheral fatty acid oxidation in the skeletal muscle. We also found that the absence of PPARα together with exercise leads to a decrease in PPAR‐γ and a huge inflammatory response. J. Cell. Physiol. 232: 1008–1019, 2017.

Macadamia Oil Supplementation Attenuates Inflammation and Adipocyte Hypertrophy in Obese Mice

Excess of saturated fatty acids in the diet has been associated with obesity, leading to systemic disruption of insulin signaling, glucose intolerance, and inflammation. Macadamia oil administration has been shown to improve lipid profile in humans. We evaluated the effect of macadamia oil supplementation on insulin sensitivity, inflammation, lipid profile, and adipocyte size in high-fat diet (HF) induced obesity in mice. C57BL/6 male mice (8 weeks) were divided into four groups: (a) control diet (CD), (b) HF, (c) CD supplemented with macadamia oil by gavage at 2 g/Kg of body weight, three times per week, for 12 weeks (CD + MO), and (d) HF diet supplemented with macadamia oil (HF + MO). CD and HF mice were supplemented with water. HF mice showed hypercholesterolemia and decreased insulin sensitivity as also previously shown. HF induced inflammation in adipose tissue and peritoneal macrophages, as well as adipocyte hypertrophy. Macadamia oil supplementation attenuated hypertrophy of adipocytes and inflammation in the adipose tissue and macrophages.

Metabolic Syndrome: Criteria for Diagnosing in Children and Adolescents

Metabolic Syndrome (MS) is defined as a group of risk factors related to insulin resistance and its highest prevalence is found in obese individuals. The first observations concerning MS occurred in the 1920s, contributing to a surge of new associations between hyperglycemia and obesity. As of 1979, there was a greater understanding of one of its components: insulin resistance. The prevalence of MS varies according to the diagnostic criterion used, mainly for children and adolescents among which its prevalence has increased considerably. The principle criteria used in diagnosing the pediatric population are the International Diabetes Federation (IDF), National Cholesterol Education Program and Adult Treatment Panel III (NCEP-ATP III), World Health Organization (WHO) and I Prevention Directive against Atherosclerosis in Infancy and Adolescence, and due to their differences, the prevalence of the syndrome varies according to the diagnostic criterion used. Nevertheless, many points should be taken into consideration in choosing a criterion, such as sample size, age, applicability, risk factors to be considered and available resources. In this context, efficiency and applicability are advantages in distinct criteria.

Morphological and metabolic determinants of nonalcoholic fatty liver disease in obese youth: a pilot study

BackgroundNonalcoholic fatty liver disease (NAFLD) related to obesity has been rising in the last decades, though the morphological and metabolic determinants are remain unclear in children. The aim of this study was to analyze the morphological determinants and metabolic abnormalities in obese children and adolescents, classified either as with (P-NAFLD) or without (N-NAFLD). The sample comprised 190 individuals, aged 6 to 16 years-old, assigned into one of 4 groups according to sex and presence or absence of NAFLD. Obesity was obtained according to body mass index (BMI) cut-points. Body composition variables was estimated by Dual-Energy X-ray Absorptiometry (DEXA). Total cholesterol (TC), triglycerides (TG), HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C), insulin, fasting glucose (FG) and blood pressure were also analyzed. The diagnosis of NAFLD, as well as the measurement of intra-abdominal fat tissue thickness (IAF) and subcutaneous abdominal fat tissue thickness (SCF), was carried-out by ultrasound.ResultsMales and females belonging to P-NAFLD group showed, respectively, higher TFM and IAF. When data were adjusted for sex, age and total fat mass, those in P-NAFLD showed statistically higher IAF, TFM and TG.ConclusionOur study showed that obese youngsters who were assigned to P-NAFLD group were twice as likely to present higher concentration of triglycerides, higher levels of trunk fat, as well as intra-abdominal fat compared to their N-NAFLD counterparts even after adjustments for sex, age, pubertal stage and total body fat mass.

Prevenção da síndrome metabólica em crianças obesas: uma proposta de intervenção

Objective: To analyze the effects of a 12-week intervention program based on physical activity practice, alimentary and psychological orientation on the risk factors for the development of metabolic syndrome in obese children and adolescents. Methods: A longitudinal study was conducted with 23 obese children and adolescents, aged six to 16 years (12.0±3.2 years). Total body and trunk fat mass, glycemia, total cholesterol, triglycerides, systolic and diastolic blood pressure were measured. The children were submitted to physical activity three times a week during 12 weeks. Each session of 60 minutes consisted of recreational sports activi- ties, gymnastics, circuits and track-walking. Chi-square test was used to compare categorical data for those patients who had values above the recommendations for each risk factor and Students t-test for paired data was used to compare the two moments of the study. Results: In subjects who had altered baseline values in the beginning of the study, the glycemia levels decreased 11.6% (from 105 to 93mg/dL; p=0.046) and the triglyc- erides decreased 24.9% (from 217 to 163mg/dL; p=0.013) after the intervention. On the other hand, no differences were noted for blood pressure and total cholesterol after the intervention. Conclusions: The intervention was effective in improv- ing blood glucose and triglycerides levels in children and adolescents enrolled in the study.

Desempenho de diferentes equações antropométricas na predição de gordura corporal excessiva em crianças e adolescentes

A amostra foi composta por 1.498 individuos (678 meninos e 820 meninas), com idade entre 7 e 17 anos(M=13,7, DP=2,0), da cidade de Presidente Prudente (SP). A massa corporal e a estatura foram mensuradaspara o calculo do Indice de Massa Corporal. Tambem foi realizada a mensuracao da circunferencia de cinturae das dobras cutâneas subescapular, tricipital, abdominal e da panturrilha. O percentual de gordura corporalfoi calculado por meio de quatro equacoes: Slaughter

MACRONUTRIENT INTAKE IS CORRELATED WITH DYSLIPIDEMIA AND LOW-GRADE INFLAMMATION IN CHILDHOOD OBESITY BUT MOSTLY IN MALE OBESE.

BACKGROUND & AIMS condition of hypoxia caused by hypertrophy of adipose cells in obesity triggers macrophages recruitment and production of cytokines. Additionally, high consumption of saturated fatty acids (SFA) and high glycemic index meals may contribute to oxidative stress and chronic low-grade inflammation by increases NF-kB activation. Thus, the aim of the study was to analyze the contribution of the macronutrients intake in the metabolic and inflammatory profile, by levels of lipoproteins, insulin resistance, anti and pro inflammatory cytokines, in obese adolescents according the gender. METHODS sample was composed by 37 adolescents, both genders, identified as obese by body mass index (BMI). Body composition was assessed by Dual-energy X-ray absorptiometry (DEXA) and measures of intra-abdominal adiposity (IAAT) and subcutaneous adiposity tissue (SAT) were done by ultrasound. Biochemical analyses were done and the measurement of cytokines; fatty acids and insulin were performed by the technique of immunoassay ELISA. The estimation of macronutrients consumption was made by 3 day food register regarding food intake. Statistical significance was set at p-value < 5% and the statistical software SPSS version 17.0 (SPSS Inc, Chicago, IL) performed all analyses. RESULTS BMI (p = 0.316), FM (p = 0.416), IAAT (p = 0.505) and SAT (p = 0.935) presented similarities between genders. Cytokines and metabolic variables values were similar between the groups. Only in the male group, metabolic variables and cytokines were significant correlated with the consumption of total lipids or its fractions. Was observed that insulin concentration had significant interaction with MUFA(g) (= -18.4; p = 0.004) and adiponectin with CHO(g) (= -58.2; p = 0.032) in the group male and female, respectively. CONCLUSIONS macronutrients intake is associated with low-grade inflammation in obesity, by production of inflammatory cytokines and alteration of the lipid profile, especially male obese adolescents which seem to be more responsive of this consumption when compared with female obese adolescents.