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The effect of lifestyle change and metformin therapy on serum arylesterase and paraoxonase activity in obese children

  • Atilla Çayır EMAIL logo , Mehmet İbrahim Turan , Fatih Gurbuz , Nezahat Kurt and Abdulkadir Yildirim
Published/Copyright: September 25, 2014
Journal of Pediatric Endocrinology and Metabolism
From the journal Journal of Pediatric Endocrinology and Metabolism Volume 28 Issue 5-6

Abstract

Aim: Obesity is known to be associated with many diseases in the long and short terms. Elevated oxidative stress contributes to the development of such obesity-related diseases as dyslipidemia, diabetes mellitus and hypertension. Levels of the endogenous antioxidants paraoxonase and arylesterase have been shown to decrease in such diseases. The purpose of this study was to investigate whether or not changes in lifestyle and metformin therapy would affect serum paraoxonase and arylesterase levels.

Materials and methods: The study was performed with 25 overweight, 26 obese and 25 morbidly obese patients aged 6–15 years as well as 27 healthy children. Serum paraoxonase (PON1) and arylesterase (ARE) activity levels and total cholesterol, triglyceride, low-density protein, high-density protein, very low-density protein, glucose, aspartate amino transferase and alanine amino transferase levels were measured. Enrolled patients were assessed at initial presentation and again at 6 months. No procedure was performed in the control group, while the overweight, obese and morbidly obese groups were recommended diet and exercise and given metformin therapy (insulin-resistant subjects only).

Results: Serum PON1 activity levels in patients with metabolic syndrome were significantly lower than those in individuals without metabolic syndrome (p<0.05), while lipid concentrations were significantly higher (p<0.05). Metabolic syndrome patients had higher serum glucose, total cholesterol, low-density protein, very low-density protein and triglyceride values compared to those of the control group but significantly lower high-density protein values (p<0.05). No difference was determined between the groups in terms of PON1 and ARE levels following diet and exercise and metformin therapy.

Conclusion: Measurement of PON1 and ARE enzyme levels may be useful in monitoring the effectiveness of treatment aimed at reducing oxidative stress in obese children.

Keywords: arylesterase; child; obesity; oxidative stress; paraoxonase
Corresponding author: Dr. Atilla Çayır, Departments of Pediatric Endocrinology, Regional Training and Research Hospital, Erzurum, Turkey, Phone: +90 4422 325 365/90 50526 97078, Fax: +044 223 25090, E-mail:

References

1. Ogden CL, Carroll MD, Flegal KM. High body mass index for age among US children and adolescents, 2003–2006. J Am Med Assoc 2008;299:2401–5.10.1001/jama.299.20.2401Search in Google Scholar PubMed

2. Crocker MK, Yanovski JA. Pediatric obesity: etiology and treatment. Pediatr Clin North Am 2011;58:1217–40.10.1016/j.pcl.2011.07.004Search in Google Scholar PubMed PubMed Central

3. Alfadda AA, Sallam RM. Reactive oxygen species in health and disease. J Biomed Biotechnol 2012;2012:936486.Search in Google Scholar

4. Calder PC, Ahluwalia N, Brouns F, Buetler T, Clement K, et al. Dietary factors and low-grade inflammation in relation to overweight and obesity. Br J Nutr 2011;106(Suppl 3):S5–78.10.1017/S0007114511005460Search in Google Scholar PubMed

5. Fearon IM, Faux SP. Oxidative stress and cardiovascular disease: novel tools give (free) radical insight. J Mol Cell Cardiol 2009;47:372–81.10.1016/j.yjmcc.2009.05.013Search in Google Scholar PubMed

6. Daniels SR, Arnett DK, Eckel RH, Gidding SS, Hayman LL, et al. Overweight in children and adolescents: pathophysiology, consequences, prevention, and treatment. Circulation 2005;111:1999–2012.10.1161/01.CIR.0000161369.71722.10Search in Google Scholar PubMed

7. De Marchi E, Baldassari F, Bononi A, Wieckowski MR, Pinton P. Oxidative stress in cardiovascular diseases and obesity: role of p66Shc and protein kinase C. Oxid Med Cell Longev 2013;2013:564961.10.1155/2013/564961Search in Google Scholar PubMed PubMed Central

8. Murdolo G, Piroddi M, Luchetti F, Tortoioli C, Canonico B, et al. Oxidative stress and lipid peroxidation by-products at the crossroad between adipose organ dysregulation and obesity-linked insulin resistance. Biochimie 2013;95:585–94.10.1016/j.biochi.2012.12.014Search in Google Scholar PubMed

9. Tran B, Oliver S, Rosa J, Galassetti P. Aspects of inflammation and oxidative stress in pediatric obesity and type 1 diabetes: an overview of ten years of studies. Exp Diabetes Res 2012;2012:683680.10.1155/2012/683680Search in Google Scholar PubMed PubMed Central

10. de Heredia FP, Gomez-Martinez S, Marcos A. Obesity, inflammation and the immune system. Proc Nutr Soc 2012;71:332–8.10.1017/S0029665112000092Search in Google Scholar PubMed

11. Higdon JV, Frei B. Obesity and oxidative stress: a direct link to CVD? Arterioscler Thromb Vasc Biol 2003;23:365–7.10.1161/01.ATV.0000063608.43095.E2Search in Google Scholar PubMed

12. Reddy ST, Wadleigh DJ, Grijalva V, Ng C, Hama S, et al. Human paraoxonase-3 is an HDL-associated enzyme with biological activity similar to paraoxonase-1 protein but is not regulated by oxidized lipids. Arterioscler Thromb Vasc Biol 2001;21:542–7.10.1161/01.ATV.21.4.542Search in Google Scholar

13. La Du BN, Aviram M, Billecke S, Navab M, Primo-Parmo S, et al. On the physiological role(s) of the paraoxonases. Chem Biol Interact 1999;119–20:379–88.10.1016/S0009-2797(99)00049-6Search in Google Scholar

14. Malkoç I, Mazıcıoğlu MM, Özkan B, Kondolot M, Kurtoğlu S, et al. Height, weight and body mass index percentiles of children aged 6-14 years living at moderate altitudes. J Clin Res Pediatr Endocrinol 2012;4:14–20.10.4274/jcrpe.559Search in Google Scholar

15. Hatipoğlu N, Kurtoğlu S, Oztürk A, Mazıcıoğlu MM. The weight and height percentiles in 6–18 year old children in Kayseri and comparison with Istanbul data. J Clin Res Pediatr Endocrinol 2009;1:129–35.10.4008/jcrpe.v1i3.47Search in Google Scholar

16. Kiess W, Galler A, Reich A, Müller G, Kapellen T, et al. Clinical aspects of obesity in childhood and adolescence. Obes Rev 2001;2:29–36.10.1046/j.1467-789x.2001.00017.xSearch in Google Scholar

17. Ross MM, Kolbash S, Cohen GM, Skelton JA. Multidisciplinary treatment of pediatric obesity: nutrition evaluation and management. Nutr Clin Pract 2010;25:327–34.10.1177/0884533610373771Search in Google Scholar

18. Spear BA, Barlow SE, Ervin C, Ludwig DS, Saelens BE, et al. Recommendations for treatment of child and adolescent overweight and obesity. Pediatrics 2007;120(Suppl 4):S254–88.10.1542/peds.2007-2329FSearch in Google Scholar

19. Guideline for Diabetes in Childhood and Adolescence. In: IDF/ISPAD G, ed, 2011. Available at: http://www.idf.org/sites/default/files/Diabetes-in-Childhood-and-Adolescence-Guidelines.pdf.Search in Google Scholar

20. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985;28:412–9.10.1007/BF00280883Search in Google Scholar

21. Lifshitz F. Obesity in children. J Clin Res Pediatr Endocrinol 2008;1:53–60.10.4008/jcrpe.v1i2.35Search in Google Scholar

22. Sothern MS. Exercise as a modality in the treatment of childhood obesity. Pediatr Clin North Am 2001;48:995–1015.10.1016/S0031-3955(05)70353-9Search in Google Scholar

23. Laurson KR, Eisenmann JC, Welk GJ, Wickel EE, Gentile DA, et al. Combined influence of physical activity and screen time recommendations on childhood overweight. J Pediatr 2008;153: 209–14.10.1016/j.jpeds.2008.02.042Search in Google Scholar

24. Aronne LJ, Nelinson DS, Lillo JL. Obesity as a disease state: a new paradigm for diagnosis and treatment. Clin Cornerstone 2009;9:9–25;discussion 26–9.10.1016/S1098-3597(09)80002-1Search in Google Scholar

25. Gupta N, Goel K, Shah P, Misra A. Childhood obesity in developing countries: epidemiology, determinants, and prevention. Endocr Rev 2012;33:48–70.10.1210/er.2010-0028Search in Google Scholar PubMed

26. Zhou P, Chaudhari RS, Antal Z. Gender differences in cardiovascular risks of obese adolescents in the Bronx. J Clin Res Pediatr Endocrinol 2010;2:67–71.10.4274/jcrpe.v2i2.67Search in Google Scholar PubMed PubMed Central

27. Tascilar ME, Yokusoglu M, Boyraz M, Baysan O, Köz C, et al. Cardiac autonomic functions in obese children. J Clin Res Pediatr Endocrinol 2011;3:60–4.Search in Google Scholar

28. Boyd GS, Koenigsberg J, Falkner B, Gidding S, Hassink S. Effect of obesity and high blood pressure on plasma lipid levels in children and adolescents. Pediatrics 2005;116:442–6.10.1542/peds.2004-1877Search in Google Scholar PubMed

29. Reinehr T, Kiess W, de Sousa G, Stoffel-Wagner B, Wunsch R. Intima media thickness in childhood obesity: relations to inflammatory marker, glucose metabolism, and blood pressure. Metabolism 2006;55:113–8.10.1016/j.metabol.2005.07.016Search in Google Scholar PubMed

30. Tascilar ME, Ozgen T, Cihan M, Abacı A, Yeşilkaya E, et al. The effect of insulin resistance and obesity on low-density lipoprotein particle size in children. J Clin Res Pediatr Endocrinol 2010;2:63–6.10.4274/jcrpe.v2i2.63Search in Google Scholar PubMed PubMed Central

31. Maritim AC, Sanders RA, Watkins JB, 3rd. Diabetes, oxidative stress, and antioxidants: a review. J Biochem Mol Toxicol 2003;17:24–38.10.1002/jbt.10058Search in Google Scholar PubMed

32. Zatalia SR, Sanusi H. The role of antioxidants in the pathophysiology, complications, and management of diabetes mellitus. Acta Med Indones 2013;45:141–7.Search in Google Scholar

33. Selvaraju V, Joshi M, Suresh S, Sanchez JA, Maulik N, et al. Diabetes, oxidative stress, molecular mechanism, and cardiovascular disease – an overview. Toxicol Mech Methods 2012;22:330–5.10.3109/15376516.2012.666648Search in Google Scholar PubMed

34. Abseyi N, Siklar Z, Berberoglu M, Hacıhamdioğlu B, Savaş Erdeve Ş, et al. Relationships between osteocalcin, glucose metabolism, and adiponectin in obese children: Is there crosstalk between bone tissue and glucose metabolism? J Clin Res Pediatr Endocrinol 2012;4:182–8.10.4274/Jcrpe.831Search in Google Scholar PubMed PubMed Central

35. Pirgon O, Bilgin H, Cekmez F, Kurku H, Dündar BN. Association between insulin resistance and oxidative stress parameters in obese adolescents with non-alcoholic fatty liver disease. J Clin Res Pediatr Endocrinol 2013;5:33–9.10.4274/Jcrpe.825Search in Google Scholar

36. Wegner M, Piorunska-Stolzmann M, Araszkiewicz A, Zozulińska-Ziółkiewicz D, Wierusz-Wysocka B. Evaluation of paraoxonase 1 arylesterase activity and lipid peroxide levels in patients with type 1 diabetes. Pol Arch Med Wewn 2011;121:448–54.10.20452/pamw.1113Search in Google Scholar

37. Tang WH, Hartiala J, Fan Y, Wu Y, Stewart AF, et al. Clinical and genetic association of serum paraoxonase and arylesterase activities with cardiovascular risk. Arterioscler Thromb Vasc Biol 2012;32:2803–12.10.1161/ATVBAHA.112.253930Search in Google Scholar

38. van Himbergen TM, Roest M, de Graaf J, Jansen EH, Hattori H, et al. Indications that paraoxonase-1 contributes to plasma high density lipoprotein levels in familial hypercholesterolemia. J Lipid Res 2005;46:445–51.10.1194/jlr.M400052-JLR200Search in Google Scholar

39. Rael LT, Bar-Or R, Aumann RM, Slone DS, Mains CW, et al. Oxidation-reduction potential and paraoxonase-arylesterase activity in trauma patients. Biochem Biophys Res Commun 2007;361:561–5.10.1016/j.bbrc.2007.07.078Search in Google Scholar

40. Novak F, Vavrova L, Kodydkova J, Novak F Sr, Hynkova M, et al. Decreased paraoxonase activity in critically ill patients with sepsis. Clin Exp Med 2010;10:21–5.10.1007/s10238-009-0059-8Search in Google Scholar

41. Krzystek-Korpacka M, Patryn E, Hotowy K, Czapińska E, Majda J, et al. Paraoxonase (PON)-1 activity in overweight and obese children and adolescents: association with obesity-related inflammation and oxidative stress. Adv Clin Exp Med 2013;22:229–36.Search in Google Scholar

42. Ruperez AI, Lopez-Guarnido O, Gil F, Olza J, Gil-Campos M, et al. Paraoxonase 1 activities and genetic variation in childhood obesity. Br J Nutr 2013;110:1639–47.10.1017/S0007114513001967Search in Google Scholar

43. Skalicky J, Muzakova V, Kandar R, Meloun M, Rousar T, et al. Evaluation of oxidative stress and inflammation in obese adults with metabolic syndrome. Clin Chem Lab Med 2008;46:499–505.10.1515/CCLM.2008.096Search in Google Scholar

44. Mackness MI, Arrol S, Abbott C, Durrington PN. Protection of low-density lipoprotein against oxidative modification by high-density lipoprotein associated paraoxonase. Atherosclerosis 1993;104:129–35.10.1016/0021-9150(93)90183-USearch in Google Scholar

45. Garin MC, Kalix B, Morabia A, James RW. Small, dense lipoprotein particles and reduced paraoxonase-1 in patients with the metabolic syndrome. J Clin Endocrinol Metab 2005;90: 2264–9.10.1210/jc.2004-1295Search in Google Scholar PubMed

Received: 2013-12-15
Accepted: 2014-8-14
Published Online: 2014-9-25
Published in Print: 2015-5-1

©2015 by De Gruyter

Articles in the same Issue

  1. Frontmatter
  2. Highlight: Obesity
  3. Childhood obesity at the crossroads
  4. Obesogenic environments: environmental approaches to obesity prevention
  5. Childhood obesity and eating behaviour
  6. Hypothalamic obesity in children: pathophysiology to clinical management
  7. The reliability of body mass index in the diagnosis of obesity and metabolic risk in children
  8. Determining abdominal obesity cut-offs and relevant risk factors for anthropometric indices in Turkish children and adolescents
  9. The effect of body mass index on blood pressure varies by race among obese children
  10. Insulin secretion response during oral glucose tolerance test is related to low cardiorespiratory fitness in obese adolescents
  11. Is there a relationship between cardiovascular risk factors and dehydroepiandrosterone sulfate levels in childhood obesity?
  12. The effect of lifestyle change and metformin therapy on serum arylesterase and paraoxonase activity in obese children
  13. Childhood obesity, thyroid function, and insulin resistance – is there a link? A longitudinal study
  14. Associations between IGF-I, IGF-binding proteins and bone turnover markers in prepubertal obese children
  15. Osteocalcin is inversely associated with adiposity and leptin in adolescent boys
  16. Association between cardiovascular risk factors and carotid intima-media thickness in prepubertal Brazilian children
  17. Insulin resistance and cardiometabolic risk factors in obese children and adolescents: a hierarchical approach
  18. The role of apolipoprotein E polymorphism in improving dyslipidemia in obese adolescents following physical exercise and National Cholesterol Education Program Step II intervention
  19. Review article
  20. Is ultrasound useful in the diagnosis of adolescents with polycystic ovary syndrome?
  21. Original articles
  22. IGF-II expression and methylation in small for gestational age infants
  23. Early screening of FTO and MC4R variants in newborns of Greek origin
  24. Pitfalls in hormonal diagnosis of 17-beta hydroxysteroid dehydrogenase III deficiency
  25. The prevalence of vitamin D deficiency among schoolchildren: a cohort study from Xinxiang, China
  26. Management of testosterone therapy in adolescents and young men with hypogonadism: are we following adult clinical practice guidelines?
  27. Vitamin D status and its associations with components of metabolic syndrome in healthy children
  28. Metformin treatment improves weight and dyslipidemia in children with metabolic syndrome
  29. Patient reports
  30. Hypothyroidism caused by the combination of two heterozygous mutations: one in the TSH receptor gene the other in the DUOX2 gene
  31. Ovarian carcinoma in a 14-year-old with classical salt-wasting congenital adrenal hyperplasia and bilateral adrenalectomy
  32. An asymptomatic mother diagnosed with 3-methylcrotonyl-CoA carboxylase deficiency after newborn screening
  33. A new missense mutation in the BCKDHB gene causes the classic form of maple syrup urine disease (MSUD)
  34. Ovotesticular disorder of sex development with unusual karyotype: patient report
  35. First case report of medium-chain acyl-coenzyme A dehydrogenase deficiency in China
  36. Virilizing adrenal oncocytoma in a 9-year-old girl: rare neoplasm with an intriguing postoperative course
  37. Unexpected clinical features in a female patient with proopiomelanocortin (POMC) deficiency
  38. Sirolimus therapy in a patient with severe hyperinsulinaemic hypoglycaemia due to a compound heterozygous ABCC8 gene mutation
  39. Cross-reactivity of adrenal steroids with aldosterone may prevent the accurate diagnosis of congenital adrenal hyperplasia
  40. Hyperthyroidism hidden by congenital central hypoventilation syndrome
  41. The use of pamidronate for acute vitamin D intoxication, clinical experience with three cases
  42. Chondrocalcinosis related to familial hypomagnesemia with hypercalciuria and nephrocalcinosis
  43. Cushing syndrome related to leukemic infiltration of the central nervous system
  44. Hashimoto’s encephalopathy: a rare pediatric brain disease
  45. Short communication
  46. A novel ABCD1 gene mutation in a Chinese patient with X-linked adrenoleukodystrophy
https://doi.org/10.1515/jpem-2013-0486
Keywords for this article
arylesterase; child; obesity; oxidative stress; paraoxonase

Articles in the same Issue

  1. Frontmatter
  2. Highlight: Obesity
  3. Childhood obesity at the crossroads
  4. Obesogenic environments: environmental approaches to obesity prevention
  5. Childhood obesity and eating behaviour
  6. Hypothalamic obesity in children: pathophysiology to clinical management
  7. The reliability of body mass index in the diagnosis of obesity and metabolic risk in children
  8. Determining abdominal obesity cut-offs and relevant risk factors for anthropometric indices in Turkish children and adolescents
  9. The effect of body mass index on blood pressure varies by race among obese children
  10. Insulin secretion response during oral glucose tolerance test is related to low cardiorespiratory fitness in obese adolescents
  11. Is there a relationship between cardiovascular risk factors and dehydroepiandrosterone sulfate levels in childhood obesity?
  12. The effect of lifestyle change and metformin therapy on serum arylesterase and paraoxonase activity in obese children
  13. Childhood obesity, thyroid function, and insulin resistance – is there a link? A longitudinal study
  14. Associations between IGF-I, IGF-binding proteins and bone turnover markers in prepubertal obese children
  15. Osteocalcin is inversely associated with adiposity and leptin in adolescent boys
  16. Association between cardiovascular risk factors and carotid intima-media thickness in prepubertal Brazilian children
  17. Insulin resistance and cardiometabolic risk factors in obese children and adolescents: a hierarchical approach
  18. The role of apolipoprotein E polymorphism in improving dyslipidemia in obese adolescents following physical exercise and National Cholesterol Education Program Step II intervention
  19. Review article
  20. Is ultrasound useful in the diagnosis of adolescents with polycystic ovary syndrome?
  21. Original articles
  22. IGF-II expression and methylation in small for gestational age infants
  23. Early screening of FTO and MC4R variants in newborns of Greek origin
  24. Pitfalls in hormonal diagnosis of 17-beta hydroxysteroid dehydrogenase III deficiency
  25. The prevalence of vitamin D deficiency among schoolchildren: a cohort study from Xinxiang, China
  26. Management of testosterone therapy in adolescents and young men with hypogonadism: are we following adult clinical practice guidelines?
  27. Vitamin D status and its associations with components of metabolic syndrome in healthy children
  28. Metformin treatment improves weight and dyslipidemia in children with metabolic syndrome
  29. Patient reports
  30. Hypothyroidism caused by the combination of two heterozygous mutations: one in the TSH receptor gene the other in the DUOX2 gene
  31. Ovarian carcinoma in a 14-year-old with classical salt-wasting congenital adrenal hyperplasia and bilateral adrenalectomy
  32. An asymptomatic mother diagnosed with 3-methylcrotonyl-CoA carboxylase deficiency after newborn screening
  33. A new missense mutation in the BCKDHB gene causes the classic form of maple syrup urine disease (MSUD)
  34. Ovotesticular disorder of sex development with unusual karyotype: patient report
  35. First case report of medium-chain acyl-coenzyme A dehydrogenase deficiency in China
  36. Virilizing adrenal oncocytoma in a 9-year-old girl: rare neoplasm with an intriguing postoperative course
  37. Unexpected clinical features in a female patient with proopiomelanocortin (POMC) deficiency
  38. Sirolimus therapy in a patient with severe hyperinsulinaemic hypoglycaemia due to a compound heterozygous ABCC8 gene mutation
  39. Cross-reactivity of adrenal steroids with aldosterone may prevent the accurate diagnosis of congenital adrenal hyperplasia
  40. Hyperthyroidism hidden by congenital central hypoventilation syndrome
  41. The use of pamidronate for acute vitamin D intoxication, clinical experience with three cases
  42. Chondrocalcinosis related to familial hypomagnesemia with hypercalciuria and nephrocalcinosis
  43. Cushing syndrome related to leukemic infiltration of the central nervous system
  44. Hashimoto’s encephalopathy: a rare pediatric brain disease
  45. Short communication
  46. A novel ABCD1 gene mutation in a Chinese patient with X-linked adrenoleukodystrophy
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