Relation between circulating oxidized-LDL and metabolic syndrome in children with obesity: the role of hypertriglyceridemic waist phenotype
-
Valeria Calcaterra
,
Rachele De Giuseppe
Abstract
Background:
The association between oxidative stress (OS) and metabolic syndrome (MetS) has been reported in adults. We analyzed the relation between circulating oxidized low-density lipoproteins (Ox-LDL) and MetS in pediatric ages in order to define whether plasma Ox-LDL levels are correlated to obesity and whether oxidative damage, using serum Ox-LDL levels as a proxy, are associated with MetS.
Methods:
We enrolled 178 children (11.8±2.6 years). On the basis of a body mass index (BMI) threshold, the subjects were classified as: normal weight BMI <75th percentile; overweight BMI 75–97th percentile; obese BMI >97th percentile. Patients were classified as having MetS if they met three or more of the following criteria for age and sex: BMI >97th percentile, triglyceride levels >95th percentile, high-density lipoprotein (HDL) cholesterol level <5th percentile, systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) >95th percentile and impaired glucose tolerance.
Results:
Obese children showed increased MetS prevalence (p=0.001) and higher Ox-LDL levels compared to normal- and overweight subjects (p<0.05), with a limited relation between Ox-LDL and MetS (p=0.06). Waist-to-height ratio (W/HtR) (p=0.02), triglycerides (TG) (p=0.001) and LDL-cholesterol (p<0.001) resulted independent predictors of increased plasma Ox-LDL levels.
Conclusions:
Oxidative damage was correlated with a hypertriglyceridemic waist phenotype and can be a precocious marker of MetS and cardiometabolic risk in obese children.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
References
1. Mameli C, Zuccotti GV, Carnovale C, Galli E, Nannini P, et al. An update on the assessment and management of metabolic syndrome, a growing medical emergency in paediatric populations. Pharmacol Res 2017;119:99–117.10.1016/j.phrs.2017.01.017Search in Google Scholar PubMed
2. Titmuss AT, Srinivasan S. Metabolic syndrome in children and adolescents: old concepts in a young population. J Paediatr Child Health 2016;52:928–34.10.1111/jpc.13190Search in Google Scholar PubMed
3. Calcaterra V, Klersy C, Muratori T, Telli S, Caramagna C, et al. Prevalence of metabolic syndrome (MS) in children and adolescents with varying degrees of obesity. Clin Endocrinol 2008;68:868–72.10.1111/j.1365-2265.2007.03115.xSearch in Google Scholar PubMed
4. Yeste D, Carrascosa A. Obesity-related metabolic disorders in childhood and adolescence. An Pediatr (Barc) 2011;75:135.e1–9.10.1016/j.anpedi.2011.03.025Search in Google Scholar PubMed
5. Rutigliano I, Vinci R, De Filippo G, Mancini M, Stoppino L, et al. Metabolic syndrome, hepatic steatosis, and cardiovascular risk in children. Nutrition 2017;36:1–7.10.1016/j.nut.2016.10.017Search in Google Scholar PubMed
6. Agirbasli M, Tanrikulu AM, Berenson GS. Metabolic syndrome: bridging the gap from childhood to adulthood. Cardiovasc Ther 2016;34:30–6.10.1111/1755-5922.12165Search in Google Scholar PubMed
7. Higgins V, Adeli K. Pediatric metabolic syndrome: pathophysiology and laboratory assessment. Electron J Int Fed Clin Chem 2017;28:25–42.Search in Google Scholar
8. Ho E, Karimi Galougahi K, Liu CC, Bhindi R, Figtree GA. Biological markers of oxidative stress: applications to cardiovascular research and practice. Redox Biol 2013;1:483–91.10.1016/j.redox.2013.07.006Search in Google Scholar PubMed PubMed Central
9. Yadav UC, Rani V, Deep G, Singh RK, Palle K. Oxidative stress in metabolic disorders: pathogenesis, prevention, and therapeutics. Oxid Med Cell Longev 2016;2016:9137629.10.1155/2016/9137629Search in Google Scholar PubMed PubMed Central
10. Jadeja RN, Devkar RV, Nammi S. Oxidative stress in liver diseases: pathogenesis, prevention, and therapeutics. Oxid Med Cell Longev 2017;2017:8341286.10.1155/2017/8341286Search in Google Scholar PubMed PubMed Central
11. Holvoet P, De Keyzer D, Jacobs DR Jr. Oxidized LDL and the metabolic syndrome. Future Lipidol 2008;3:637–49.10.2217/17460875.3.6.637Search in Google Scholar PubMed PubMed Central
12. Hurtado-Roca Y, Bueno H, Fernandez-Ortiz A, Ordovas JM, Ibañez B, et al. Oxidized LDL is associated with metabolic syndrome traits independently of central obesity and insulin resistance. Diabetes 2017;66:474–82.10.2337/db16-0933Search in Google Scholar PubMed
13. EFSA Panel on dietetic Products, Nutrition and Allergies (NDA). Guidance on the scientific requirements for health claims related to antioxidants, oxidative damage and cardiovascular health. EFSA J 2011;9:2474.10.2903/j.efsa.2011.2474Search in Google Scholar
14. Kelishadi R, Hashemipour M, Adeli K, Tavakoli N, Movahedian-Attar A, et al. Effect of zinc supplementation on markers of insulin resistance, oxidative stress, and inflammation among prepubescent children with metabolic syndrome. Metab Syndr Relat Disord 2010;8:505–10.10.1089/met.2010.0020Search in Google Scholar PubMed
15. Cole TJ, Lobstein T. Extended international (IOFT) body mass index cut-offs for thinness, overweight and obesity. Pediatric Obes 2012;7:284–94.10.1111/j.2047-6310.2012.00064.xSearch in Google Scholar PubMed
16. Valerio G, Balsamo A, Baroni MG, Brufani C, Forziato C, et al. Childhood obesity classification systems and cardiometabolic risk factors: a comparison of the Italian, World Health Organization and International Obesity Task Force references. Ital J Pediatr 2017;43:19.10.1186/s13052-017-0338-zSearch in Google Scholar PubMed PubMed Central
17. Marshall WA, Tanner JM. Variations in patterns of pubertal changes in boys. Arch Dis Child 1969;45:13–23.10.1136/adc.45.239.13Search in Google Scholar PubMed PubMed Central
18. Marshall WA, Tanner JM. Variations in patterns of pubertal changes in girls. Arch Dis Child 1969;44:291–303.10.1136/adc.44.235.291Search in Google Scholar PubMed PubMed Central
19. Maffeis C, Banzato C, Talamini G, Obesity Study Group of the Italian Society of Pediatric Endocrinology and Diabetology. Waist-to-height ratio, a useful index to identify high metabolic risk in overweight children. J Pediatr 2008;152:207–13.10.1016/j.jpeds.2007.09.021Search in Google Scholar PubMed
20. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 2004;114:555–76.10.1542/peds.114.S2.555Search in Google Scholar PubMed
21. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, et al. Homeostasis model assessment: insulin resistance and -cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985;28:412–9.10.1007/BF00280883Search in Google Scholar PubMed
22. Holvoet P, Macy E, Landeloos M, Jones D, Jenny NS, et al. Analytical performance and diagnostic accuracy of immunometric assays for the measurement of circulating oxidized LDL. Clin Chem 2006;52:760–4.10.1373/clinchem.2005.064337Search in Google Scholar PubMed
23. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Third Report of the National Cholesterol Education Program (NCEP). Circulation 2002;106:3143–421.10.1161/circ.106.25.3143Search in Google Scholar
24. d’Annunzio G, Vanelli M, Pistorio A, Minuto N, Bergamino L, et al. Insulin resistance and secretion indexes in healthy Italian children and adolescents: a multicentre study. Acta Biomedica 2009;80:21–8.Search in Google Scholar
25. Weiss R, Dziura J, Burgert TS, Tamboriane WV, Taksali SE, et al. Obesity and the metabolic syndrome in children and adolescents. N Engl J Med 2004;350;23.10.1056/NEJMoa031049Search in Google Scholar
26. The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care 1999;22(Suppl 1):S5–19.10.2337/diacare.21.1.S5Search in Google Scholar
27. Teixeira FC, Pereira FE, Pereira AF, Ribeiro BG. Metabolic syndrome’s risk factors and its association with nutritional status in schoolchildren. Prev Med Rep 2017;6:27–32.10.1016/j.pmedr.2017.02.002Search in Google Scholar PubMed
28. Hübers M, Geisler C, Plachta-Danielzik S, Müller MJ. Association between individual fat depots and cardio-metabolic traits in normal- and overweight children, adolescents and adults. Nutr Diabetes 2017;7:e267.10.1038/nutd.2017.20Search in Google Scholar PubMed
29. Lemieux I, Poirier P, Bergeron J, Alméras N, Lamarche B, et al. Hypertriglyceridemic waist: a useful screening phenotype in preventive cardiology? Can J Cardiol 2007;23(Suppl B):23B–31B.10.1016/S0828-282X(07)71007-3Search in Google Scholar
30. Ceriello A. Possible role of oxidative stress in the pathogenesis of hypertension. Diabetes Care 2008;31(Suppl 2):S181–4.10.2337/dc08-s245Search in Google Scholar PubMed
31. Reho JJ, Rahmouni K. Oxidative and inflammatory signals in obesity-associated vascular abnormalities. Clin Sci (Lond) 2017;131:1689–700.10.1042/CS20170219Search in Google Scholar PubMed
32. Fernández-García JC, Cardona F, Tinahones FJ. Inflammation, oxidative stress and metabolic syndrome: dietary modulation. Curr Vasc Pharmacol 2013;11:906–19.10.2174/15701611113116660175Search in Google Scholar PubMed
33. EFSA Panel on dietetic Products, Nutrition and Allergies (NDA). EFSA J 2011;9:2474.Search in Google Scholar
34. Camancho S, Ruppel A. Is the calorie concept a real solution to the obesity epidemic? Glob Health Action 2017;10:1289650.10.1080/16549716.2017.1289650Search in Google Scholar PubMed PubMed Central
©2017 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Mini Review
- Marine-Lenhart syndrome in two adolescents, including one with thyroid cancer: a case series and review of the literature
- Original Articles
- The role of enterovirus infections in type 1 diabetes in Tunisia
- Serum progranulin levels in relation to insulin resistance in childhood obesity
- Relation between circulating oxidized-LDL and metabolic syndrome in children with obesity: the role of hypertriglyceridemic waist phenotype
- Etiologies of short stature in a pediatric endocrine clinic in Southern Thailand
- Thyroid evaluation of children and adolescents with Williams syndrome in Zhejiang Province
- The use of a radiolucent template to improve bone age X-ray quality (BASIC study)
- How often are clinicians performing genital exams in children with disorders of sex development?
- Efficacy and safety of percutaneous administration of dihydrotestosterone in children of different genetic backgrounds with micropenis
- Higher phthalate concentrations are associated with precocious puberty in normal weight Thai girls
- Identification of a novel mutation of NR0B1 in a patient with X-linked adrenal hypoplasia and symptomatic treatment
- Mutation analysis of the phenylalanine hydroxylase gene and prenatal diagnosis of phenylketonuria in Shaanxi, China
- Could a combination of heterozygous ABCC8 and KCNJ11 mutations cause congenital hyperinsulinism?
- Case Reports
- Diabetic ketoacidosis, hyperuricemia and encephalopathy intractable to regular-dose insulin
- A novel DAX-1 (NR0B1) mutation in a boy with X-linked adrenal hypoplasia congenita
- High aldosterone and cortisol levels in salt wasting congenital adrenal hyperplasia: a clinical conundrum
- A newborn with combined pituitary hormone deficiency developing shock and sludge
- Acknowledgment
Articles in the same Issue
- Frontmatter
- Mini Review
- Marine-Lenhart syndrome in two adolescents, including one with thyroid cancer: a case series and review of the literature
- Original Articles
- The role of enterovirus infections in type 1 diabetes in Tunisia
- Serum progranulin levels in relation to insulin resistance in childhood obesity
- Relation between circulating oxidized-LDL and metabolic syndrome in children with obesity: the role of hypertriglyceridemic waist phenotype
- Etiologies of short stature in a pediatric endocrine clinic in Southern Thailand
- Thyroid evaluation of children and adolescents with Williams syndrome in Zhejiang Province
- The use of a radiolucent template to improve bone age X-ray quality (BASIC study)
- How often are clinicians performing genital exams in children with disorders of sex development?
- Efficacy and safety of percutaneous administration of dihydrotestosterone in children of different genetic backgrounds with micropenis
- Higher phthalate concentrations are associated with precocious puberty in normal weight Thai girls
- Identification of a novel mutation of NR0B1 in a patient with X-linked adrenal hypoplasia and symptomatic treatment
- Mutation analysis of the phenylalanine hydroxylase gene and prenatal diagnosis of phenylketonuria in Shaanxi, China
- Could a combination of heterozygous ABCC8 and KCNJ11 mutations cause congenital hyperinsulinism?
- Case Reports
- Diabetic ketoacidosis, hyperuricemia and encephalopathy intractable to regular-dose insulin
- A novel DAX-1 (NR0B1) mutation in a boy with X-linked adrenal hypoplasia congenita
- High aldosterone and cortisol levels in salt wasting congenital adrenal hyperplasia: a clinical conundrum
- A newborn with combined pituitary hormone deficiency developing shock and sludge
- Acknowledgment
