Relationship between body mass index and insulin measured during oral glucose tolerance testing in severely obese children and adolescents

Primary objective: The study evaluated the accuracy of body mass index (BMI) in detecting hyperinsulinaemia during oral glucose tolerance testing (OGTT) in severely obese children.

Research design: A cross-sectional study was carried out.

Materials and methods: A total of 118 obese children and adolescents (49 females and 69?males) aged 6–19 years were consecutively studied at an outpatient paediatric clinic. Hyperinsulinaemia was defined as a value of log-transformed fasting insulin ≥?80th percentile and OGTT hyperinsulinaemia as a value of the log-transformed area under the curve (AUC) of insulin ≥?80th percentile. The study hypothesis was tested using a logistic regression model with hyperinsulinaemia as the outcome variable and the z-score of BMI corrected for age (z-BMI_age) as the predictor variable. Receiver-operator characteristic (ROC) curves were used to evaluate accuracy.

Results: The mean (SD) BMI for age of the children was 28.6 (4.0)?kg?m^?2, corresponding to 2.2 (0.5) standard deviation scores. The odds ratio (OR) of OGTT hyperinsulinaemia was 2.0 (95% CI 1.2–3.3; p = 0.007) for each unit increase of z-BMI_age and the corresponding ROC-AUC was 0.74 (95% CI 0.61–0.86; p = 0.0001). In comparison, the OR of fasting hyperinsulinaemia was 1.1 (95% CI 0.7–1.7; p = 0.716) for each unit increase of z-BMI_age and the corresponding ROC-AUC was 0.49 (95% CI 0.35–0.62; p = 0.863).

Conclusion: BMI is reasonably accurate in detecting OGTT hyperinsulinaemia in severely obese children.     

Accuracy of body mass index in detecting an elevated alanine aminotransferase level in adolescents

AIM: We evaluated the accuracy of body mass index (BMI) in detecting an elevated alanine aminotransferase (ALT) level in adolescents, taking into account the effects of gender, age, ethanol intake, hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, and drug consumption. SUBJECTS: A representative sample of 454 adolescents (11-17 years) from two cities in northern Italy was studied (the Dionysos Study). METHODS: z-BMI was calculated as the z-score of BMI using national growth charts. Logistic regression was used to quantify the contribution of the variables of interest to an elevated ALT (> 30 UL(-1)). Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated, and areas under receiver-operator characteristic curves (AUC) were used to evaluate accuracy. RESULTS: An elevated ALT was detected in 21 adolescents (4.6%). Among the studied variables, only male gender (OR=6.7, 95% CI 2.0-23.2) and z-BMI (OR=2.1, 95% CI 1.4-3.2) were significant predictors of elevated ALT. The accuracy of the prediction was 0.69 (95% CI 0.59-0.79) for gender and 0.71 (95% CI 0.59-0.81) for z-BMI. By combining gender and z-BMI, the accuracy rose to 0.80 (95% CI 0.71-0.89). CONCLUSION: BMI is a good predictor of elevated ALT in Italian adolescents and gender adds to the accuracy of the prediction.     

Is fasting insulin associated with blood pressure in obese children?

PRIMARY OBJECTIVE: We tested whether fasting insulin levels are associated with blood pressure in a large sample of obese children. SUBJECTS AND METHODS: Three hundred and fifty obese children (F:M ratio = 1.03) of 10.1 +/- 2.7 y of age (mean +/- SD) were consecutively enrolled at an Outpatient Paediatric Clinic. Obesity was diagnosed on the basis of a relative weight for age > 120% and hypertension on the basis of a systolic (SBP) or diastolic (DBP) blood pressure > 95th percentile for age after adjustment for height (Ht). MAIN OUTCOME AND RESULTS: Insulin was significantly higher in hypertensive (n = 202, 58%) than normotensive (n = 148, 42%) children (16 vs 14 microU mL(-1), geometric mean, p < 0.01, ANOVA) but the difference was not clinically relevant. Moreover, (log-transformed) insulin explained only 7 and 4% of SBP and DBP variance, respectively (p < 0.0001 for both) and this contribution disappeared after the confounding effects of age, weight or other anthropometric dimensions were taken into account (p = ns, ANCOVA). CONCLUSIONS: This study does not support the hypothesis of a clinically relevant association between fasting insulin and blood pressure in obese children.     

Sensitivity and specificity of body mass index and skinfold thicknesses in detecting excess adiposity in children aged 8-12 years

PRIMARY OBJECTIVE: The study aimed to evaluate the sensitivity (SN) and specificity (SP) of body mass index (BMI) and skinfold thicknesses in detecting excess adiposity in children. RESEARCH DESIGN: Cross-sectional. MATERIALS AND METHODS: 986 children (500 females and 486 males) aged 10 +/- 1 years (mean +/- SD; range: 8-12 years) were studied. All underwent anthropometric measurements and bioelectrical impedance analysis (BIA). Dual-energy X-ray absorptiometry (DXA) was performed in 52 children to develop a population-specific algorithm for the assessment of fat-free mass (FFM) from BIA. The algorithm was applied to the remaining 934 children to estimate their FFM. Fat mass (FM) was obtained by subtracting FFM from weight (Wt). Values of FM:Wt were transformed in Z-scores and converted into 19 percentile categories (from 5 to 95 in steps of 5). The same procedure was performed with BMI and the log-transformed sum of four skinfold thicknesses (triceps, biceps, subscapular and suprailiac; lt-4SF). Excess adiposity was defined as a level of FM:Wt greater than the internally derived 85th percentile. SN and SP of each internally derived percentile of BMI and lt-4SF in detecting excess adiposity were calculated. RESULTS: In the pooled sample (n = 934), SN and SP were 0.39 and 0.99 for the 95th percentile of BMI, 0.65 and 0.95 for the 85th percentile of BMI, and 0.75 and 0.94 for the 85th percentile of lt-4SF. CONCLUSIONS: BMI percentiles employed in the present study have a high SP but a low SN in detecting excess adiposity in 8-12-year-old children. The use of the sum of four skinfolds has the potential to increase the SN of a screening programme for excess adiposity in children of this age.     

Sensitivity and specificity of body mass index and skinfold thicknesses in detecting excess adiposity in children aged 8-12 years

Primary objective : The study aimed to evaluate the sensitivity (SN) and specificity (SP) of body mass index (BMI) and skinfold thicknesses in detecting excess adiposity in children. Research design : Cross-sectional. Materials and methods : 986 children (500 females and 486 males) aged 10 &#45 1 years (mean &#45 SD; range: 8-12 years) were studied. All underwent anthropometric measurements and bioelectrical impedance analysis (BIA). Dual-energy X-ray absorptiometry (DXA) was performed in 52 children to develop a population-specific algorithm for the assessment of fat-free mass (FFM) from BIA. The algorithm was applied to the remaining 934 children to estimate their FFM. Fat mass (FM) was obtained by subtracting FFM from weight (Wt). Values of FM:Wt were transformed in Z -scores and converted into 19 percentile categories (from 5 to 95 in steps of 5). The same procedure was performed with BMI and the log-transformed sum of four skinfold thicknesses (triceps, biceps, subscapular and suprailiac; lt-4SF). Excess adiposity was defined as a level of FM:Wt greater than the internally derived 85th percentile. SN and SP of each internally derived percentile of BMI and lt-4SF in detecting excess adiposity were calculated. Results : In the pooled sample ( n = 934), SN and SP were 0.39 and 0.99 for the 95th percentile of BMI, 0.65 and 0.95 for the 85th percentile of BMI, and 0.75 and 0.94 for the 85th percentile of lt-4SF. Conclusions : BMI percentiles employed in the present study have a high SP but a low SN in detecting excess adiposity in 8-12-year-old children. The use of the sum of four skinfolds has the potential to increase the SN of a screening programme for excess adiposity in children of this age.     

An Individual,Community-Based Treatment for Obese Children and Their Families: The Solution-Focused Approach

BackgroundThis study evaluates an individual, community-based treatment for obese children and their families. In this program, a treatment team applied solution-focused techniques to develop a custom-made treatment plan in collaboration with the participants. The treatment plan consisted of community-based lifestyle activities.Methods559 obese children with an average BMI z-score of 2.76 ± 0.54 took part in the 12-month study, and 372 children with an average BMI z-score of 2.75 ± 0.52 took part in the 24-month study. At the start of the study, ethnicity and special school needs were recorded. Before, after 12 months, and after 24 months of the treatment, body weight and height were measured. The effect of the treatment on body weight was evaluated using BMI z-scores.Results291 children (52%) completed 12 months of treatment, whereas 22 children (4%) were dismissed earlier due to a good response. After 12 months, the children showed a significant decrease in BMI z-score by 0.16 (95% confidence interval (CI) 0.11-0.20; p ℋ 0.005). After 24 months, 103 children (28%) were participating in the program, with a significant decrease in BMI z-score of 0.15 (95% CI 0.07-0.22; p ℋ 0.005). 50 children (13%) were dismissed before the end of the second year due to significant weight loss (standard deviation z-score reduction −0.38; 95% CI 0.30-0.46; p ℋ 0.005; with an average treatment duration of 12.9 ± 6.4 months). There was a negative correlation of age and reduction in BMI z-score: children younger than 6 years showed a decrease in BMI z-score of 0.45 (95% CI 0.26-0.65) and 0.31 (95% CI 0.11-0.53) after 12 and after 24 months, respectively.ConclusionsChildren showed a significant decrease in BMI z-score after the treatment. We found a negative correlation of age and weight loss. Special attention to patients with a high risk of drop-out might further improve these results. We advise a referral to obesity treatment as early as possible since a ‘wait and see’ policy might have adverse results in obese children.Key Words: Obesity, Obesity therapy, Children, Solution-focused therapy, Community-based treatment     

Obesity is associated with the Arg389Gly ADRB1 but not with the Trp64Arg ADRB3 polymorphism in children from San Luis Potosí and León,México

This research was designed to analyze the possible associations of Arg389Gly ADRB1 and Trp64Arg ADRB3 polymorphisms in children with obesity. A cross-sectional study included 1,046 school-age Mexican participants (6-12 years old) from the cities of San Luis Potosí and León. Children were classified as non-obese or obese according to their body mass index (BMI) percentile; obese children had a BMI≥95th percentile for sex and age. Biochemical data were collected. Polymorphisms were detected using TaqMan qPCR assay. A logistic regression analysis was used to calculate the risk of obesity based on genotypes. Differences were found between groups where obese children had a significant increase in systolic and diastolic blood pressure, fasting plasma glucose, insulin, HOMAIR, LDL-cholesterol, triglycerides, and lower HDL-cholesterol compared with the normal weight group (P < 0.05).The distribution of allele frequency in the population was Arg = 87.4 and Gly = 12.6 (Hardy Weinberg equilibrium c2 = 3.16 , P = 0.07 ); Trp = 81.5 and Arg = 18.5 (Hardy Weinberg equilibrium c2 = 2.2, P = 0.14 ) for ADRB1 and ADRB3, respectively. Even though no different frequencies of Arg389Gly polymorphism between groups were found (P = 0.08), children carriers of one Gly389 ADRB1 allele had a risk for obesity of OR = 1.40 (95%CI, 1.03–1.90, P = 0.03) after adjustment for age and gender. No other association was found for Trp64Arg ADRB3 polymorphism. Only the Arg389Gly ADRB1 polymorphism was associated with risk for obesity in Mexican children.     

Predictors of Weight Loss in Obese Older Adults: Findings from the USA and the UK

ObjectiveTo examine the prevalence and demographic predictors of clinically meaningful weight loss in community samples of obese older adults in the USA and the UK.MethodsData were from obese older adults (BMI ≥ 30 kg/m²; age ≥ 52 years), free of a cancer diagnosis, from the Health and Retirement Study (HRS; n = 3398) and the English Longitudinal Study of Ageing (ELSA; n = 998). Weight change was assessed from 2004 to 2008. Multivariable logistic regression tested whether age, sex, ethnicity, marital status, education, or BMI predicted ≥ 5% weight loss.ResultsOver a quarter (28.7%) of obese participants from HRS and 16.6% from ELSA lost ≥ 5% weight. Being female (odds ratio (OR) = 1.31, 95% confidence interval (CI) = 1.11-1.54) and heavier (BMI ≥ 35 kg/m²) (OR = 1.60, 95% CI = 1.37-1.87) predicted weight loss in HRS. Trends were similar in ELSA (female: OR = 1.18, 95% CI = 0.83-1.69; BMI ≥ 35 kg/m²: OR = 1.24, 95% CI = 0.85-1.82). ORs were increased in ≥ 65-year-olds in HRS (OR = 1.55, 95% CI = 1.33-1.81), and reduced in married people in ELSA (OR = 0.69, 95% CI = 0.48-1.00). Neither education nor ethnicity predicted weight loss in either cohort.ConclusionA high proportion of obese older adults experience clinically meaningful weight loss, but few demographic variables consistently predict weight loss in this population.Key Words: Weight loss, Aging, Obesity, Prevalence, Predictors     

Receiver operating characteristic (ROC) curve analysis in 5-10-year-old Bengalee girls from Calcutta, India

OBJECTIVE: The purpose of the present cross-sectional study was to evaluate the sensitivity (SN) and specificity (SP) of body mass index (BMI) and skinfolds thickness: BMI (subcutaneous to overall fat) in detecting excess adiposity in pre-menarcheal Bengalee girls. METHODS: Four hundred and fifty Bengalee girls aged 7.4 +/- 1.16 years (mean +/- SD; range: 5-10 years) from Calcutta were studied. Anthropometric measures--namely height, weight, circumference of mid upper arm, waist and hip, and skinfold thickness at biceps, triceps, subscapular and suprailiac - were taken from all participants using standard protocols. BMI and the log-transformed sum of four (biceps, triceps, subscapular, suprailiac) skinfolds (log10 SF4) were computed subsequently. Values of log10 SF4 were then converted into seven percentiles category (5th, 10th, 25th, 50th, 75th, 85th and 95th). Excess adiposity was defined as a level of log10 SF4 greater than the internally derived 85th percentile (log10 SF4>85th percentile). SN and SP of each internally derived percentile of BMI and log10 SF4:BMI in detecting excess adiposity were then computed. RESULTS: SN and SP were 0.49 and 0.94 for the 95th percentile of BMI, and 0.76 and 0.82 for the 95th percentile of log10 SF4:BMI. Moreover, there was a considerable decrease in overall misclassification with the use of log10 SF4:BMI instead of BMI at the 95th percentile (11.2% vs 32%). CONCLUSION: Percentiles of BMI in the study had higher SP but low SN in detecting excess adiposity. The use of log10 SF4:BMI, on the other hand, had the merit of increasing SN in a screening programme to evaluate excess adiposity in Bengalee children aged 5-10 years.     

Obesity and time to pregnancy

BACKGROUND: Obesity may reduce fecundity. We examined the obesity-fecundity association in relation to menstrual cycle regularity, parity, smoking habits and age to gain insight into mechanisms and susceptible subgroups. METHODS: Data were provided by 7327 pregnant women enrolled in the Collaborative Perinatal Project at 12 study centres in the United States from 1959 to 1965. Prepregnancy body mass index (BMI) was analysed continuously and categorically [underweight (<18.5 kg/m2), optimal weight (18.5-24.9 kg/m2), overweight (25.0-29.9 kg/m2) and obese (>or=30.0 kg/m2)]. Adjusted fecundability odds ratios (FORs) were estimated using Cox proportional hazards modelling for discrete time data. RESULTS: Fecundity was reduced for overweight [OR=0.92, 95% confidence interval (95% CI): 0.84, 1.01] and obese (OR=0.82, 95% CI: 0.72, 0.95) women compared with optimal weight women and was more evident for obese primiparous women (OR=0.66, 95% CI: 0.49, 0.89). Fecundity remained reduced for overweight and obese women with normal menstrual cycles. Neither smoking habits nor age modified the association. CONCLUSIONS: Obesity was associated with reduced fecundity for all subgroups of women and persisted for women with regular cycles. Our results suggest that weight loss could increase fecundity for overweight and obese women, regardless of menstrual cycle regularity, parity, smoking habits and age.     

Fatness and overweight in women and children from riverine Amerindian communities of the Beni River (Bolivian Amazon).

Obesity is a worldwide public health problem impacting not only industrialized nations but also developing countries. The main objective of this paper was to analyze risk factors for overweight among Amerindian children and their mothers. Data were collected in 15 Amerindian riverside communities from the Beni River (Bolivia). The total sample was of 195 mothers and 452 children, 0-15 years of age. Information about family activity and dietary patterns was collected, and a clinical examination was performed. Stool samples were collected in children for parasitological screening. Anthropometric measurements, including weight, height, arm circumference, and four skinfolds, were taken. A bioelectrical impedance analysis was performed in mothers. In total, 12.2% (95% confidence interval (CI(95%)) 9.1-15.9%) of the children were considered overweight; less than 1% were overtly obese International Obesity Task Force (IOTF) criteria. Among their mothers, 35.3% (CI(95%), 28.7-42.5%) were overweight (BMI (weight/height (2)) >25 kg/m(2)), and 5% (CI(95%), 2.5-5.1%) were obese (BMI >30 kg/m(2)). BMI was moderately related to anthropometric indices of body composition in children, but was highly correlated with fatness in mothers. The risk of overweight was not associated with environmental factors in children. In mothers, there was a significant relationship between BMI, health status, and dietary diversity score. There was a moderate association in boys between fatness and the BMI of their mothers (R(2) = 0.12, P < 0.001), but not in girls. These findings suggest a trend toward accumulation of fat related to possible changes at the economic and agricultural levels, even in remote rural areas.     

The relationship between asthma and overweight in urban minority children

BACKGROUND: This study was performed to determine the relationship between overweight [body mass index (BMI) > or = 85th percentile] and asthma as determined by spirometry. METHOD: Spirometry was performed according to the American Thoracic Society guidelines, and BMI was calculated. Asthma was defined as a forced expiratory volume in 1 second (FEV1) <80% predicted and FEV1/forced vital capacity (FVC) >5% lower than predicted for age and sex. RESULTS: One-hundred-nine children (age 14.7 +/- 1.6 years) were enrolled. Eighty children (73%) were African-American, and 29 children (27%) were white. Fifty-eight (53%) children were overweight. Twelve (11%) children, of whom nine (75%) were overweight, met the criteria for asthma. Baseline FEV1 percent predicted (87 +/- 6% vs. 83 +/- 7%, p=0.03), FEV1/FVC (93 +/- 6 vs. 87 +/- 8, p<0.001), and FEV1 percent predicted following albuterol administration (94 +/- 7 vs. 89 +/- 7%, p=0.03) were all lower in overweight children. Children with asthma were almost 1.5 times more likely to be overweight compared with children without asthma (relative risk: 1.49, 95% confidence interval: 1.015-2.17). CONCLUSIONS: Inner-city children are more likely to be overweight compared to the general population. Asthma is a risk factor for overweight in these children.     

Low Body Mass Index Is Associated with Increased Risk of Acute GVHD after Umbilical Cord Blood Transplantation in Children and Young Adults with Acute Leukemia: A Study on Behalf of Eurocord and the EBMT Pediatric Disease Working Party

Body mass index (BMI) may influence outcomes after allogeneic hematopoietic stem cell transplantation (HSCT). However, the impact of BMI on survival in children undergoing HSCT is not well defined, with conflicting results being reported on this issue. We analyzed 855 patients age 2 to 20 years with diagnosis of acute leukemia who underwent umbilical cord blood transplantation (UCBT) from 1990 to 2015. Patients were classified according to BMI as normal (fifth to 85th percentile), underweight (less than fifth percentile), overweight (85th to 95th percentile), and obese (>95th percentile) using growth charts for age and sex. All patients received single-unit UCBT after a myeloablative conditioning regimen. Diagnosis was acute lymphoblastic leukemia in 68% of the patients. Sixty-one percent of patients (n?=?523) were in the normal BMI category, 11% (n?=?96) were underweight, 16% (n?=?137) overweight, and 12% (n?=?99) obese. The cumulative incidence of grade II to IV acute graft-versus-host disease (aGVHD) was 35% (32% to 38%). According to pretransplantation BMI, aGVHD was 46% (33% to 59%) for underweight, 34% (31% to 42%) for normal, 36% (18% to 38%) for overweight, and 27% (15% to 37%) for obese (P?=?.04). In multivariate analysis, a BMI less than the fifth percentile was associated with higher incidence of acute grade II to IV GVHD compared with normal-BMI patients (hazard ratio,? 1.61; 95% confidence interval, 1.15 to 2.26; P?=?.006). Our results show that being underweight at the time of transplantation is associated with an increased risk of aGVHD, highlighting the importance of nutritional status before UCBT.     

Effect of physical activity on heart rate variability in normal weight, overweight and obese subjects: results from the SAPALDIA study

Many studies have demonstrated an association of both a sedentary lifestyle and a high body mass index (BMI) with greater risk for cardiovascular disease. Within the prospective SAPALDIA cohort (Swiss cohort Study on Air Pollution and Lung Diseases in Adults), we investigated whether regular exercise was protective against reduced heart rate variability (HRV), a clinically relevant predictor of cardiovascular morbidity and mortality, and whether adverse effects of obesity and weight gain on HRV were modified by regular exercise. Twenty-four-hour electrocardiograms were recorded in 1,712 randomly selected SAPALDIA participants aged >/=50, for whom BMI was assessed in the years 1991 and 2001-2003. Other examinations included an interview investigating health status (especially respiratory and cardiovascular health and health relevant behaviours including physical activity) and measurements of blood pressure, body height and weight. The association between regular physical activity and HRV and interactions with BMI and BMI change was assessed in multivariable linear regression analyses. Compared to sedentary obese subjects, SDNN (standard deviation of all RR intervals) was 14% (95% CI: 8-20%) higher in sedentary normal weight subjects; 19% (CI: 12-27%) higher in normal weight subjects exercising regularly >/=2 h/week; and 19% (CI: 11-28%) higher in obese subjects exercising regularly >/=2 h/week. Compared with sedentary subjects who gained weight, those who gained weight but did exercise regularly had a 13% higher SDNN (CI: 7-20%). Regular physical exercise has strong beneficial effects on cardiac autonomic nervous function and thus appears to offset the negative effect of obesity on HRV.     

Comparison of methods to evaluate changes in relative body mass index in pediatric weight control.

Our objective was to compare three BMI-based adiposity measures to assess change in pediatric weight control: LMS z-BMI, BMI sympercent, and percent overBMI. Comparison 1 presents changes of +1.0, -1.0, and -2.0 BMI units for 36 hypothetical children (7-, 11-, and 15-year-old children with BMI values from 19-39 kg/m(2)). Comparison 2 presents effect sizes over 12 months and the relationship between baseline and change for 140 8-12-year-old children with BMI values ranging from 21 to 37 kg/m(2). Comparison 1 showed smaller changes in z-BMI than BMI sympercent or percent overBMI for equal changes in BMI when initial BMI values are greater. Comparison 2 showed similar effect sizes for the three measures, since there is a reduction in both standard deviation and magnitude of LMS z-BMI values as the BMI values increase. The three measures perform differently when considering the relationship of initial value to change. Initial percent overBMI shows a negative relationship with change, as heavier children show larger changes, LMS z-BMI shows a positive relationship, as children with lower baseline values show larger changes, and BMI sympercent changes were inconsistently related to baseline BMI sympercent values. Although all three measures result in similar effect sizes when evaluating treatment over time, we conclude that LMS z-BMI is less appropriate for comparing individuals and percent overBMI is the only measure that shows heavier children have greater change.     

Genetic interactions of KIR and G1M immunoglobulin allotypes differ in obese from non-obese individuals with type 2 diabetes

We analyzed the natural killer cell immunoglobulin-like receptor (KIR) genes and immunoglobulin allotypes in the development of type 2 diabetes (T2D) based on body mass index (BMI) measurements (obese vs. non-obese) in Puerto Rican Americans. Genetic interactions between the KIR haplotype A homozygotes (HAH) and its fraction containing two inhibitory receptors 2DL3 and 2DL1 and the activating receptor 2DS4 with immunoglobulin allotypes were studied. We found a significant association between the HAH and T2D (p=0.002; OR=7.97) and its interaction with the immunoglobulin allotype z: GM f/f (-) (p=<0.0001; OR, not determined) only in non-obese individuals. This association were due to the interactions between the 2DL3/2DL3, 2DL1/2DL1, and 2DS4 fragment with GM f/f (-) in T2D patients (p=0.0017; OR=3.45). Analysis based on BMI demonstrated associations in both obese (p=0.037; OR=2.43; 95% CI=0.97-6.31) and non-obese individuals (p=<0.0001; OR=8.38; 95% CI=2.49-29.31). By contrast, the interaction of the GM allotype f/f (-) with the HAH fragment was associated with T2D only in non-obese individuals (p=<0.0001; OR=18.2; 95% CI=3.71-113.4). As expected, interaction of both HAH and its fragment with HLA-C group's ligands were significant. We used informative short tandem repeats (STRs) that distinguish major populations to determine genetic admixture and found that there was no genetic stratification in our cohort. Our findings are consistent with the possibility of an autoimmune and/or innateimmune component in the pathogenesis of T2D: NK receptors with chronic inflammation in obese and genetic interactions with G1M allotype in T2D non-obese possibly mediating autoimmunity.     

Associations between total body fat and serum lipid concentrations in obese human adolescents

To investigate the relationships between obesity and serum lipid concentrations, we measured eight anthropometric parameters, body mass index (BMI), total body fat (TBF), and serum lipid profiles in 790 apparently healthy adolescents. TBF was assessed using a body fat analyzer. Serum concentrations of triglyceride, total cholesterol, and low- or high-density lipoprotein-cholesterol (LDL-C or HDL-C) were determined by standard enzymatic procedures. There were no significant differences in serum lipid concentrations between obese adolescents (BMI > or = 95th percentile) and lean adolescents (BMI < 5th percentile), nor between overweights (BMI > 25 kg/m2) and underweights (BMI < 19 kg/m2). However, serum lipid concentrations were significantly higher in males with TBF > 37% (TBF > 95th percentile) than in males with TBF < 6% (TBF < 5th percentile; p < 0.01). Serum lipid concentrations were more strongly correlated with TBF than with BMI. Correlation coefficients between serum lipid concentrations and TBF were higher in males than in females for cholesterol (r = 0.37 vs 0.23), triglycerides (r = 0.29 vs 0.27), HDL-C (r = -0.34 vs 0.12), and LDL-C (r = 0.24 vs 0.15). In short, compared to BMI, TBF reflects serum lipid concentrations more closely. During adolescence, the association between TBF and serum lipid concentrations is stronger in males than in females.     

Fast foods – are they a risk factor for asthma?

BACKGROUND: Lifestyle changes over the last 30 years are the most likely explanation for the increase in allergic disease over this period. AIM: This study tests the hypothesis that the consumption of fast food is related to the prevalence of asthma and allergy. METHODS: As part of the International Study of Asthma and Allergies in Childhood (ISAAC) a cross-sectional prevalence study of 1321 children (mean age = 11.4 years, range: 10.1-12.5) was conducted in Hastings, New Zealand. Using standard questions we collected data on the prevalence of asthma and asthma symptoms, as well as food frequency data. Skin prick tests were performed to common environmental allergens and exercise-induced bronchial hyperresponsiveness (BHR) was assessed according to a standard protocol. Body mass index (BMI) was calculated as weight/height2 (kg/m2) and classified into overweight and obese according to a standard international definition. RESULTS: After adjusting for lifestyle factors, including other diet and BMI variables, compared with children who never ate hamburgers, we found an independent risk of hamburger consumption on having a history of wheeze [consumption less than once a week (OR = 1.44, 95% CI: 1.06-1.96) and 1+ times a week (OR = 1.65, 95% CI: 1.07-2.52)] and on current wheeze [consumption less than once a week (OR = 1.17, 95% CI: 0.80-1.70) and 1+ times a week (OR = 1.81, 95% CI: 1.10-2.98)]. Takeaway consumption 1+ times a week was marginally significantly related to BHR (OR = 2.41, 95% CI: 0.99-5.91). There was no effect on atopy. CONCLUSIONS: Frequent consumption of hamburgers showed a dose-dependent association with asthma symptoms, and frequent takeaway consumption showed a similar association with BHR.     

Relationship between obesity and structural brain abnormality: Accumulated evidence from observational studies

We aimed to evaluate the relationship between obesity and structural brain abnormalities assessed by magnetic resonance imaging using data from 45 observational epidemiological studies, where five articles reported prospective longitudinal results. In cross-sectional studies’ analyses, the pooled weighted mean difference for total brain volume (TBV) and gray matter volume (GMV) in obese/overweight participants was -11.59 (95 % CI: -23.17 to -0.02) and -10.98 (95 % CI: -20.78 to -1.18), respectively. TBV was adversely associated with BMI and WC, GMV with BMI, and hippocampal volume with BMI, WC, and WHR. WC/WHR are associated with a risk of lacunar and white matter hyperintensity (WMH). In longitudinal studies’ analyses, BMI was not statistically associated with the overall structural brain abnormalities (for continuous BMI: RR = 1.02, 95 % CI: 0.94–1.12; for categorial BMI: RR = 1.18, 95 % CI: 0.75–1.85). Small sample size of prospective longitudinal studies limited the power of its pooled estimates. A higher BMI is associated with lower brain volume while greater WC/WHR, but not BMI, is related to a risk of lacunar infarct and WMH. Future longitudinal research is needed to further elucidate the specific causal relationships and explore preventive measures.