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2020, Acta Scientific Paediatrics
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4 pages
1 file
What is overweight and obesity? Obesity these days had become a major health problem with prevalence both in developed as well as in developing countries. Overweight and obese children are likely to stay obese into adulthood [1]. While overweight and obesity are themselves risk factors to
Frontiers in Endocrinology
Children with "metabolically healthy obesity" (MHO) are a distinct subgroup of youth with obesity, who are less prone to the clustering of cardiometabolic risk factors. Although this phenotype, frequently defined by the absence of metabolic syndrome components or insulin resistance, was first described during the early 1980s, a consensus-based definition of pediatric MHO was introduced only recently, in 2018. The purpose of this review was to concisely summarize current knowledge regarding the MHO phenomenon in youth. The prevalence of MHO in children varies from 3 to 87%, depending on the definition used and the parameters evaluated, as well as the ethnicity and the pubertal status of the sample. The most consistent predictors of MHO in youth include younger age, lower body mass index, lower waist circumference, and lower body fat measurements. Various hypotheses have been proposed to elucidate the underlying factors maintaining the favorable MHO phenotype. While preserved insulin sensitivity and lack of inflammation were previously considered to be the main etiological factors, the most recent findings have implicated adipokine levels, the number of inflammatory immune cells in the adipose tissue, and the reduction of visceral adiposity due to adipose tissue expandability. Physical activity and genetic factors also contribute to the MHO phenotype. Obesity constitutes a continuum-increased risk for cardiometabolic complications, which is less evident in children with MHO. However, some findings have highlighted the emergence of hepatic steatosis, increased carotid intima-media thickness and inflammatory biomarkers in the MHO group compared to peers without obesity. Screening should be directed at those more likely to develop clustering of cardiometabolic risk factors. Lifestyle modifications should include behavioral changes focusing on sleep duration, screen time, diet, physical activity, and tobacco smoke exposure. Weight loss has also been associated with the improvement of insulin sensitivity and inflammation. Further investigative efforts are needed in order to elucidate the mechanisms which protect against the clustering of cardiometabolic risk factors in pediatric obesity, to provide more efficient, targeted treatment approaches for children with obesity, and to identify the protective factors preserving the MHO profile, avoiding the crossover of MHO to the phenotype with metabolically unhealthy obesity.
Journal of Pediatric Endocrinology and Metabolism, 2015
New England Journal of Medicine, 2004
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.
Mayo Clinic proceedings, 2017
Childhood obesity has emerged as an important public health problem in the United States and other countries in the world. Currently 1 in 3 children in the United States is afflicted with overweight or obesity. The increasing prevalence of childhood obesity is associated with emergence of comorbidities previously considered to be "adult" diseases including type 2 diabetes mellitus, hypertension, nonalcoholic fatty liver disease, obstructive sleep apnea, and dyslipidemia. The most common cause of obesity in children is a positive energy balance due to caloric intake in excess of caloric expenditure combined with a genetic predisposition for weight gain. Most obese children do not have an underlying endocrine or single genetic cause for their weight gain. Evaluation of children with obesity is aimed at determining the cause of weight gain and assessing for comorbidities resulting from excess weight. Family-based lifestyle interventions, including dietary modifications and in...
Children
Metabolic syndrome (MetS) is defined by a cluster of several cardio-metabolic risk factors, specifically visceral obesity, hypertension, dyslipidemia, and impaired glucose metabolism, which together increase risks of developing future cardiovascular disease (CVD) and type 2 diabetes mellitus (T2D). This article is a narrative review of the literature and a summary of the main observations, conclusions, and perspectives raised in the literature and the study projects of the Working Group of Childhood Obesity (WGChO) of the Italian Society of Paediatric Endocrinology and Diabetology (ISPED) on MetS in childhood obesity. Although there is an agreement on the distinctive features of MetS, no international diagnostic criteria in a pediatric population exist. Moreover, to date, the prevalence of MetS in childhood is not certain and thus the true value of diagnosis of MetS in youth as well as its clinical implications, is unclear. The aim of this narrative review is to summarize the pathog...
International Journal of Science and Research (IJSR), 2015
Introduction: Obesity and overweight that occurs in childhood tend to persist into adulthood. Chronic Obesity and overweight leads to another condition called metabolic syndrome that strongly associated with Type 2 diabetes and cardiovascular disease. Materials and Methods: A cross-sectional study had been conducted from April until June 2015 on several students of Junior High School in Nusantara's, Athirah's and Frater's in Makassar. The study samples that met the criteria were 80 children of 13-15 years old students. These samples were divided into two groups: 40 children were overweight and the 40 children were obese. Results: The frequency of metabolic syndrome were higher in the group of obese than the group of overweight children (p = 0.000, OR 7.000 with a 95% CI (2.276 to 21.529). Conclusion: This study indicated that obesity status had a higher incidence of metabolic syndrome than overweight status. Nutritional status was correlated to childhood metabolic syndrome.
Journal of Medical Biochemistry, 2014
Summary Background: In the past decades, the obesity epidemic in children of all ages has been an important research field for detecting the metabolic causes and consequences of obe- sity, the major focus being on insulin and adipocytokine lev- els. Metabolic work-up in obese children is recommended in the age group as young as 2-6 years. There is evidence that birth weight can be a factor causing obesity later in life accompanied by metabolic complications. Methods: Insulin, leptin, and adiponectin levels were ana- lyzed in 269 obese children and 60 controls, as well as 110 newborn children with different birth weight and different length of gestation, using standard methods. Results: In 53.6% of the obese children, complications of obesity such as diabetes mellitus, obesity, hyperlipidemia, heart attack or stroke were found in family members. The peak insulinemia on OGTT was significantly higher in the pubertal compared to the prepubertal group (110.5± 75.9 μU/mL versus 72.2±62.7 ...
PAKISTAN PAEDIATRIC JOURNAL, 2018
Introduction: Childhood obesity is increasing all over the world and is associated with metabolic and endocrine derangements. We studied the clinical profile and biochemical parameters in obese and overweight children to assess the presence of metabolic syndrome (Met S). Methods: A hospital based cross sectional study carried out over a period of 2 months. A total of 25 overweight and obese children of less than 18 years with BMI more than 85 th percentile were included. Anthropometric measurement of weight, standing height, waist circumference, body mass index and blood pressure were taken .A blood sample was collected in the morning after 8hours of fast for lipid profile and fasting blood sugar. Met S was defined according to the International Diabetes Federation criteria. Results: Mean age of the study population was 9.7 years .Mean values along with standard deviation of total cholesterol (174.6 + 73.37), triglyceride (124.8 + 51.62), HDL cholesterol (39.1 + 8.84), LDL cholesterol (84.6 + 3.12), VLDL cholesterol (30.9 + 2.67) and fasting blood glucose(90.52 + 1.16) respectively. Prevalence of Metabolic syndrome was identified in 8(32%) subjects of which five male and three female. In the present study Met S was seen in 6(75%) obese children and 2 (11.76%) overweight children. Conclusion: Metabolic syndrome can occur not only in the obese but also in the overweight children which necessitates early interventions for better outcomes with respect to cardiovascular risk factors.
Endocrinology and Metabolism Clinics of North America, 2005
Frontiers in Endocrinology
Editorial on the Research Topic Endocrine and metabolic consequences of childhood obesity During a very short period of time (approximately four decades), obesity has become a global epidemic and an urgent health and economical burden due to its impact on public health and on the whole society. Obesity is a complex multifactorial disease defined by excessive adiposity and is linked to an increased risk for many noncommunicable diseases (NCDs). Overweight and obesity affect almost 60% of adults and nearly one in three children (29% of boys and 27% of girls) in the European Region according to the latest report of the World Health Organization (1). Childhood obesity is associated with early metabolic sequelae and also linked to increased risk of persistent obesity in adulthood and long-term complications. Obesity increases the risk of the development of the metabolic syndrome, cardiovascular disease, childhood-onset type 2 diabetes mellitus and its associated retinal and renal complications, non-alcoholic fatty liver disease, obstructive sleep apnea, premature menarche, polycystic ovary syndrome, infertility, asthma, orthopedic complications, psychiatric disease, and increased rates of malignancies. Obviously, the present Research Topic could not address all the above listed consequences but rather focused on selected endocrine and metabolic aspects. In this timely Frontiers Research Topic, researchers practicing world wide and having different disciplines contributed reviews (two narrative and one systematic), and novel data on the challenges obesity presents in attempts to stimulate debate on ways forward.
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