Cardiovascular Disease In Adolescents Research Articles

From Real-World Data to Causally Interpretable Models: A Bayesian Network to Predict Cardiovascular Diseases in Adolescents and Young Adults with Breast Cancer.

Background: In the last decades, the increasing number of adolescent and young adult (AYA) survivors of breast cancer (BC) has highlighted the cardiotoxic role of cancer therapies, making cardiovascular diseases (CVDs) among the most frequent, although rare, long-term sequalae. Leveraging innovative artificial intelligence (AI) tools and real-world data (RWD), we aimed to develop a causally interpretable model to identify young BC survivors at risk of developing CVDs. Methods: We designed and trained a Bayesian network (BN), an AI model, making use of expert knowledge and data from population-based (1036 patients) and clinical (339 patient) cohorts of female AYA (i.e., aged 18 to 39 years) 1-year survivors of BC, diagnosed in 2009-2019. The performance achieved by the BN model was validated against standard classification metrics, and two clinical applications were proposed. Results: The model showed a very good classification performance and a clear causal semantic. According to the predictions made by the model, focusing on the 25% of AYA BC survivors at higher risk of developing CVDs, we could identify 81% of the patients who would actually develop it. Moreover, a desktop-based app was implemented to calculate the individual patient's risk. Conclusions: In this study, we developed the first causal model for predicting the CVD risk in AYA survivors of BC, also proposing an innovative AI approach that could be useful for all researchers dealing with RWD. The model could be pivotal for clinicians who aim to plan personalized follow-up strategies for AYA BC survivors.

Neighbourhood Environments and Lifestyle Behaviours in Adolescents With Type 1 Diabetes

ObjectivesEarly prevention strategies are needed to mitigate the high risk of cardiovascular disease in adolescents with type 1 diabetes (T1D). Residential neighbourhood features can promote healthy lifestyle behaviours and reduce cardiovascular risk, but less is known about their role in lifestyle behaviours in adolescents with T1D, and no studies used comparisons to healthy controls. MethodsWe examined associations between residential neighbourhood features and lifestyle behaviours in adolescents with T1D and healthy controls. Data were analyzed from the CARdiovascular Disease risk factors in pEdiatric type 1 diAbetes (CARDEA) study, a cross-sectional investigation of 100 adolescents with T1D (14 to 18 years) from a pediatric diabetes clinic in Montréal, Canada, and 97 healthy controls. Outcomes included physical activity and sedentary behaviour (accelerometry), screen time and sleep duration (questionnaires), and dietary habits (24-hour recalls). Cluster analysis of selected neighbourhood indicators computed for participants’ postal codes resulted in 2 neighbourhood types: central urban and peri-urban. Central urban neighbourhoods were characterized by very high population density, high active living index, numerous points of interest, higher social deprivation, higher residential mobility, and lower median household income compared with peri-urban neighbourhoods. Associations of neighbourhood type with lifestyle behaviours were estimated with multiple linear regressions and interactions by T1D status were tested. ResultsLiving in central urban neighbourhoods was associated with greater daily minutes of moderate-to-vigourous physical activity (beta = 8.61, 95% confidence interval 1.79 to 15.44) compared with living in peri-urban neighbourhoods. No associations were observed for other lifestyle behaviours, and no statistically significant interactions were found between neighbourhood type and T1D status. ConclusionFeatures that characterize central urban built environments appear to promote physical activity in adolescents, regardless of T1D status.

The global burden and risk factors of cardiovascular diseases in adolescent and young adults, 1990–2019

BackgroundTo provide details of the burden and the trend of the cardiovascular disease (CVD) and its risk factors in adolescent and young adults.MethodsAge-standardized rates (ASRs) of incidence, mortality and Disability-Adjusted Life Years (DALYs) were used to describe the burden of CVD in adolescents and young adults. Estimated Annual Percentage Changes (EAPCs) of ASRs were used to describe the trend from 1990 to 2019. Risk factors were calculated by Population Attributable Fractions (PAFs).ResultsIn 2019, the age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR) and age-standardized DALYs rate (ASDR) of CVD were 129.85 per 100 000 (95% Confidence interval (CI): 102.60, 160.31), 15.12 per 100 000 (95% CI: 13.89, 16.48) and 990.64 per 100 000 (95% CI: 911.06, 1076.46). The highest ASRs were seen in low sociodemographic index (SDI) and low-middle SDI regions. The burden was heavier in male and individuals aged 35–39. From 1990 to 2019, 72 (35.29%) countries showed an increasing trend of ASIR and more than 80% countries showed a downward trend in ASMR and ASDR. Rheumatic heart disease had the highest ASIR and Ischemic Heart Disease was the highest in both ASMR and ASDR. The main attributable risk factor for death and DALYs were high systolic blood pressure, high body-mass index and high LDL cholesterol.ConclusionsThe burden of CVD in adolescent and young adults is a significant global health challenge. It is crucial to take into account the disparities in SDI levels among countries, gender and age characteristics of the population, primary types of CVD, and the attributable risk factors when formulating and implementing prevention strategies.

Effect of high-intensity interval training and moderate-intensity continuous training on cardiovascular risk factors in adolescents: Systematic review and meta-analysis of randomized controlled trials

BackgroundIn recent years, cardiovascular diseases in adolescents have become more serious. High intensity interval training (HIIT) and moderate intensity continuous training (MICT) have been shown to improve cardiovascular diseases in adolescents. Meta-analysis was conducted to compare the effects of HIIT and MICT on cardiovascular risk factors in adolescents. MethodsRandomised controlled trials of HIIT and MICT for cardiovascular risk factors in adolescents up to January 2023 were searched using authoritative databases such as CNKI, Web of Science, PubMed, and EBSCO. Data analysis was performed using Review Manage 5.4 and Stata 14.0. ResultsA total of 12 studies involving 468 participants, mean age 15.19±4.35, were included in the study. The findings showed that compared with MICT, HIIT reduced adolescents' body weight (SMD=-0.18, 95 %CI=-0.58, 0.21) and increased maximal oxygen uptake (SMD=0.56, 95 %CI=0.20, 0.93) and high-density lipoprotein (SMD=-0.47, 95 % CI=-1.11, 0.17), and improved systolic blood pressure (SMD=-0.35, 95 %CI=-0.78, 0.09), glucose (SMD=-1.53, 95 %CI=-2.93, -0.13), and insulin (SMD=-0.66, 95 % CI=-1.73, 0.41), p<0.05. HIIT and MICT improved BMI, fat mass, diastolic blood pressure, triglycerides, total cholesterol, and LDL, with no significant difference between these training types. ConclusionHIIT was better than MICT for improving cardiovascular health in adolescents, with better effects on body weight, BMI, fat mass, systolic blood pressure, diastolic blood pressure, maximal oxygen uptake, triglyceride, total cholesterol, LDL, HDL, glucose, and insulin levels.

RISK FACTORS FOR THE DEVELOPMENT OF CARDIOVASCULAR DISEASES IN ADOLESCENTS IN YAKUTSK, SAKHA REPUBLIC (YAKUTIA)

The article presents data on the frequency of risk factors for cardiovascular diseases in adolescents. A statistical analysis was also conducted to determine the correlations between the risk factors when an individual has multiple risk factors. The following risk factors for cardiovascular diseases, already occurring frequently in adolescence, were evaluated: high blood pressure, overweight, elevated cholesterol levels, carbohydrate metabolism disorders, low physical activity, eating disorders, and stress perception. A total of 712 adolescents aged 15 –16 years were examined, including 360 girls and 352 boys, residing in the city of Yakutsk, Sakha Republic (Yakutia). The study revealed that among adolescents, low physical activity showed the highest frequency among the risk factors, followed by others in descending order: restrictive eating behavior, high cholesterol and glucose levels, overweight and obesity, and high stress perception. The differences found were based on gender, with boys being more susceptible to obesity. Correlation analyses using Spearman’s (rs) and Pearson’s (rp) coefficients and Pearson’s chi-square test were used to identify relationships between risk factors for cardiovascular diseases. The analysis showed that high blood pressure is associated with adolescents who have high body mass index. Gender-based analysis showed that girls are more prone to arterial pressure disorders and elevated cholesterol and glucose levels.

Insulin resistance phenotype is associated with vascular risk phenotype at the end of the second decade of life: a population-based study

We hypothesize that early events of diabetes and cardiovascular disease continuums would be ongoing and associated in adolescents. We investigated the association between the Insulin Resistance Phenotype and the Vascular Risk Phenotype at the end of the second decade of life and indirect pathways from social vulnerability, alcohol consumption, and body fat mass. It is a population-based study in the RPS cohort of 18–19 years (n = 2,515), São Luís, Brazil. The theoretical model analyzed the association between Insulin Resistance Phenotype and Vascular Risk Phenotype by sex, using structural equation modeling (SEM). The Insulin Resistance Phenotype was a latent variable deduced from the correlations of Triglyceride to HDL ratio, Triglyceride Glycemic index, and VLDL; the Vascular Risk Phenotype was deduced from Systolic Blood Pressure, Diastolic Blood Pressure, and Pulse Wave Velocity. The Insulin Resistance Phenotype was directly associated with the Vascular Risk Phenotype in males (standardized coefficient SC = 0.183; p < 0.001) and females (SC = 0.152; p < 0.001). The Insulin Resistance Phenotype was an indirect pathway in the association of alcohol consumption and higher values of fat mass index with the Vascular Risk Phenotype. VLDL presented the highest factor loading, appearing as a marker of insulin resistance linked to cardiovascular risk in young people. Lower values of socioeconomic status, harmful use of alcohol, and high body fat values were also associated with higher values of the two phenotypes. The association of the Insulin Resistance Phenotype with the Vascular Risk Phenotype suggests common pathophysiological mechanisms present in early events in the continuums of diabetes and cardiovascular disease in adolescence.

Effects Of Aerobic Exercise Intensity Levels On Blood Lipids And Lipoprotein Profiles Of Male Adolescents

PURPOSE: o evaluate the effects of aerobic exercise of different intensity levels on lipid profiles of male adolescents. METHODS: A pre-test and post-test design, in which 45 randomly selected male collegiate adolescents, aged 14-17 years were divided into three groups; low, moderate and high-intensity groups with 15 participants, respectively. Participants underwent anthropometric measurements and were tested for serum total cholesterol (TC), triglyceride (TG), low-density lipoprotein-cholesterol (LDL-C) and high-density lipoprotein-cholesterol (HDL-C) at pre/and posttest at baseline, on 6th and 12th weeks of training. The low, moderate and high-intensity groups, with the moderation of time per session, covered a constant distance of 1.5 km with heart rate maximum (HRmax) of 40-54% at 32 minutes, 2.4 km with HRmax at 42 minutes, 3.2 km with HRmax of 75-90% at 47 minutes, respectively. RESULTS: The low intensity aerobic exercise indicated significant effect of jogging exercise on lipid profiles of male adolescents with TC (F (2, 14) = 3.74 < 0.004), TG (F (2, 14) = 3.74 < 0.002), LDL-C (F (2, 14) = 3.74 < 0.007) and HDL-C (F (2, 14) = 3.74 < 0.003). Moderate intensity aerobic exercise showed significant effects on TC (F (2, 14) = 3.74 < 0.000), TG (F (2, 14) = 3.74 < 0.005), LDL-C (F (2, 14) = 3.74 < 0.008), and HDL-C (F (2, 14) = 3.74 < 0.000), while high intensity aerobic exercise showed significant effects on TC (F (2, 14) = 3.74 < 0.001), TG (F (2, 14) = 3.74 < 0.000), LDL-C (F (2, 14) = 3.74 < 0.008), and HDL-C (F (2, 14) = 3.74 < 0.009) of male adolescent. There was significant effects of aerobic exercise of different intensity levels on atherogenic index plasma (AIP) in low intensity group (F (2, 14) = 3.74 < 0.006), moderate intensity group (F (2, 14) = 3.74 < 0.002), and high intensity group ((F (2, 14) = 3.74 < 0.005). Cardiac risk ratio (CRR) was only significant in the low intensity exercise (F (2, 14) = 3.74 < 0.008). CONCLUSIONS: The decrease in TC, TG, LDL-C, and increased HDL-C demonstrates regular jogging can potentially reduce the risk for cardiovascular diseases and lessen atherosclerosis risk in male adolescents; therefore should be encouraged as a non-pharmacological measure in preventing the onset of atherosclerosis, coronary heart disease and cardiovascular diseases in adolescents.

Effects of omega-3 supplementation on endothelial function, vascular structure, and metabolic parameters in adolescents with type 1 diabetes mellitus: A randomized clinical trial.

BackgroundVascular dysfunction is a major complication of diabetes mellitus that leads to cardiovascular disease (CVD). This study aimed to examine the effects of omega-3 consumption on endothelial function, vascular structure, and metabolic parameters in adolescents with type 1 diabetes mellitus (T1DM).MethodsIn this randomized, double-blind, placebo-controlled clinical trial, 51 adolescents (10–18 years) with T1DM completed the study. Patients received 600 mg/day [containing 180 mg eicosapentaenoic acid (EPA) and 120 mg docosahexaenoic acid (DHA)] of omega-3 or placebo for 12 weeks. Flow-mediated dilation (FMD), carotid intima-media thickness (CIMT), high-sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol, blood urea nitrogen (BUN), creatinine, fasting blood sugar (FBS), hemoglobin A1C (HbA1c), homeostatic model assessment for insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), serum insulin (SI), urine albumin-creatinine ratio (uACR), blood pressure, and anthropometric indices were assessed at the baseline and after the intervention.ResultsFollowing supplementation, omega-3 significantly increased FMD (3.1 ± 4.2 vs. −0.6 ± 4%, p = 0.006) and decreased TG (−7.4 ± 10.7 vs. −0.1 ± 13.1 mg/dl, p = 0.022) in comparison with the placebo group. However, no significant difference was observed regarding CIMT (-0.005 ± 0.036 vs. 0.003 ± 0.021 mm, p = 0.33). Although hs-CRP was significantly decreased within the omega-3 group (p = 0.031); however, no significant change was observed compared to placebo group (p = 0.221). Omega-3 supplementation had no significant effect on other variables.ConclusionGiven the elevation in FMD and reduction in TG, omega-3 supplementation can improve vascular function and may reduce the risk of cardiovascular disease in adolescents with T1DM patients.

Preclinical Aortic Atherosclerosis in Adolescents With Chronic Disease.

Background Adolescents with chronic disease are often exposed to inflammatory, metabolic, and hemodynamic risk factors for early atherosclerosis. Since postmortem studies have shown that atherogenesis starts in the aorta, the CDACD (Cardiovascular Disease in Adolescents with Chronic Disease) study investigated preclinical aortic atherosclerosis in these adolescents. Methods and Results The cross-sectional CDACD study enrolled 114 adolescents 12 to 18years old with chronic disorders including juvenile idiopathic arthritis, cystic fibrosis, obesity, corrected coarctation of the aorta, and healthy controls with a corrected atrial septal defect. Cardiovascular magnetic resonance was used to assess aortic pulse wave velocity and aortic wall thickness, as established aortic measures of preclinical atherosclerosis. Cardiovascular magnetic resonance showed a higher aortic pulse wave velocity, which reflects aortic stiffness, and higher aortic wall thickness in all adolescent chronic disease groups, compared with controls (P<0.05). Age (β=0.253), heart rate (β=0.236), systolic blood pressure (β=-0.264), and diastolic blood pressure (β=0.365) were identified as significant predictors for aortic pulse wave velocity, using multivariable linear regression analysis. Aortic wall thickness was predicted by body mass index (β=0.248) and fasting glucose (β=0.242), next to aortic lumen area (β=0.340). Carotid intima-media thickness was assessed using ultrasonography, and was only higher in adolescents with coarctation of the aorta, compared with controls (P<0.001). Conclusions Adolescents with chronic disease showed enhanced aortic stiffness and wall thickness compared with controls. The enhanced aortic pulse wave velocity and aortic wall thickness in adolescents with chronic disease could indicate accelerated atherogenesis. Our findings underscore the importance of the aorta for assessment of early atherosclerosis, and the need for tailored cardiovascular follow-up of children with chronic disease.

Association between abdominal obesity, screen time and sleep in adolescents

ObjectiveTo assess the association between abdominal obesity, food intake, sleep deprivation, and screen time in adolescents. MethodsThis cross-sectional study was conducted with 432 adolescents aged 14–19 years, from public and private schools. Anthropometric and body composition measures included body weight, waist circumference, body mass index for age, waist-to-hip ratio, waist-to-height ratio, and body fat percentage. Abdominal obesity was defined by age and sex specific cut-off points for waist circumference. Food intake, screen time, sexual maturation, and sleep duration were evaluated by self-administered questionnaires. ResultsThe prevalence of excess body weight and abdominal obesity was 16.7% and 27.5%, respectively. Students in the adult phase (post-puberty), with inadequate waist-to-height ratio, high body fat percentage, and screen time ≥ 3 h/day were, respectively, 2.5 (95% CI 1.40–4.46), 7.44 (95% CI 1.08–51.46), 2.79 (95% CI 1.04–7.50), and 1.43 (95% CI 1.24–3.89) more likely to have abdominal obesity. Low intake of unprocessed or minimally processed foods was associated with inadequate sleep duration, while high intake of ultra-processed foods was associated with high screen time. ConclusionsAbdominal obesity was associated with the adult phase, short sleep duration and high screen time. The degree of food processing was associated with screen time and sleep duration. Assessing the risk factors of abdominal obesity may be a useful strategy for preventing cardiovascular disease in adolescents.

Air pollution and preclinical atherosclerotic cardiovascular disease in adolescents living with HIV: an opportunity for prevention.

Air pollution and preclinical atherosclerotic cardiovascular disease in adolescents living with HIV: an opportunity for prevention.

Role of Physical Activity and Sedentary Behavior on Early Markers of Cardiovascular Disease in Adolescents With Type 1 Diabetes: The CARDEA Study

Modifiable determinants of cardiovascular disease (CVD) remain largely understudied in pediatric type 1 diabetes (T1D). We estimated associations of physical activity and sedentary behavior with markers of CVD in adolescents and tested whether associations differed based on T1D status.

Interplay of physical activity and genetic variants of the endothelial lipase on cardiovascular disease risk factors.

The aim of this study was to investigate the association of endothelial lipase gene (LIPG) polymorphisms with cardiovascular disease (CVD) risk factors in adolescents and their interaction with physical activity. Six polymorphisms of LIPG were genotyped in 1057 European adolescents (12-18 years old) enrolled in the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) Study. CVD risk factors related to lipid profile, blood pressure, adiposity and glucose regulation were recorded. Physical activity was objectively measured by accelerometry. The major C allele of rs2000813, the minor T allele of rs2276269 and the minor G allele of rs9951026 were associated with lower levels of several CVD risk factors related to lipid profile. We also found a significant association of the TTACA LIPG haplotype (rs2000812, rs2000813, rs8093249, rs2276269 and rs9951026) with higher concentrations of low-density cholesterol and apolipoproteinB. Finally, the interaction between physical activity and the polymorphisms rs2000813, rs2276269 and rs9951026 had a significant influence on several CVD risk factors. LIPG polymorphisms were significantly associated with CVD risk factors in European adolescents. Interestingly, alleles of these polymorphisms were associated with a better cardiovascular profile in physically active adolescents only. High physical activity may reduce the development of CVD, modulating its genetic risk. Using gene-phenotype and gene × environment analyses, we detected associations between the endothelial lipase gene and cardiovascular risk factors, along with interactions with physical activity. This study shows that physical activity may modulate the influence of LIPG gene on cardiovascular risk in adolescents. These results bring insights into the mechanisms by which physical activity positively influences CVD in adolescents.

Risk factors of cardiovascular disease in adolescents: A systematic review

Risk factors of cardiovascular disease in adolescents: A systematic review

Abstract 14477: Adolescent Lipoprotein Subclass Profile: Reference Ranges, Comparison to Adult, and Association With Carotid Intima-media Thickness

Introduction: Atherosclerosis begins in early life. Assessment of comprehensive lipoprotein subclass profiles in adolescents and their relation to atherosclerosis may enhance our understanding of the development of dyslipidemia in early life and inform early vascular prevention Hypothesis: Lipoprotein subclass profiles in adolescents are distinct from those in adults and associate with carotid intima-media thickness (cIMT). Methods: Content of lipids (cholesterol, free cholesterol, triglycerides, phospholipids) and apolipoproteins (apoB-100, apoA1, apoA2) of 17 lipoprotein subclasses (from least dense to densest: VLDL1-6, IDL, LDL1-6, HDL1-4) was measured in plasma of n=1776 14- to 19-year olds (56.6% female) and of n=3217 adults (51.5% female) by nuclear magnetic resonance. cIMT was ascertained by sonography in adolescents. Results: Adolescents compared to adults featured lower triglycerides, total, LDL, and non-HDL cholesterol, and apoB, and higher HDL cholesterol. They showed 27.2 to 60.5% lower triglyceride content of all lipoprotein subclasses and 21.7 to 50.0% lower VLDL lipid content. Concentrations of LDL-4 and LDL-5 were 40.7 to 47.3% lower, with markedly lower levels also of LDL-6 and LDL-3, but 24.3% higher HDL-1 ApoA1. In adolescents, LDL-3, LDL-4, and LDL-5 subclasses were associated with cIMT (difference in cIMT for a 1-SD higher concentration, 4.76 to 5.93μm), whereas no significant association with cIMT was observed for VLDL or HDL. Conclusions: Adolescents showed a markedly different and more favorable lipoprotein profile compared to adults. Dense LDL subclasses were the only subclasses associated with cIMT, implicating them as the potential preferred therapeutic target for primary prevention of cardiovascular disease in adolescents.

Intrauterine exposure to diabetes and risk of cardiovascular disease in adolescence and early adulthood: a population-based birth cohort study.

It is unclear whether intrauterine exposure to maternal diabetes is associated with risk factors for cardiovascular disease and related end points in adulthood. We examined this potential association in a population-based birth cohort followed up to age 35 years. We performed a cohort study of offspring born between 1979 and 2005 (n = 293 546) and followed until March 2015 in Manitoba, Canada, using registry-based administrative data. The primary exposures were intrauterine exposure to gestational diabetes and type 2 diabetes mellitus. The primary outcome was a composite measure of incident cardiovascular disease events, and the secondary outcome was a composite of risk factors for cardiovascular disease in offspring followed up to age 35 years. The cohort provided 3 628 576 person-years of data (mean age at latest follow-up 20.5 [standard deviation 6.4] years, 49.3% female); 2765 (0.9%) of the offspring experienced a cardiovascular disease end point, and 12 673 (4.3%) experienced a cardiovascular disease risk factor. After propensity score matching, the hazard for cardiovascular disease end points was elevated in offspring exposed to gestational diabetes (adjusted hazard ratio [HR] 1.42, 95% confidence interval [CI] 1.12-1.79) but not type 2 diabetes (adjusted HR 1.40, 95% CI 0.98-2.01). A similar association was observed for cardiovascular disease risk factors (gestational diabetes: adjusted HR 1.92, 95% CI 1.75-2.11; type 2 diabetes: adjusted HR 3.40, 95% CI 3.00-3.85). Intrauterine exposure to maternal diabetes was associated with higher morbidity and risk related to cardiovascular disease among offspring up to 35 years of age.

Dietary Sodium Intake and Risk of Cardiovascular Disease: A Systematic Review and Dose-Response Meta-Analysis.

Dietary sodium intake has received considerable attention as a potential risk factor of cardiovascular disease. However, evidence on the dose-response association between dietary sodium intake and cardiovascular disease risk is unclear. Embase and PubMed were searched from their inception to 17 August 2020 and studies that examined the association between sodium intake and cardiovascular disease in adolescents were not included in this review. We conducted a meta-analysis to estimate the effect of high sodium intake using a random effects model. The Newcastle-Ottawa Scale assessment was performed. A random-effects dose-response model was used to estimate the linear and nonlinear dose-response relationships. Subgroup analyses and meta-regression were conducted to explain the observed heterogeneity. We identified 36 reports, which included a total of 616,905 participants, and 20 of these reports were also used for a dose-response meta-analysis. Compared with individuals with low sodium intake, individuals with high sodium intake had a higher adjusted risk of cardiovascular disease (Rate ratio: 1.19, 95% confidence intervals = 1.08–1.30). Our findings suggest that there is a significant linear relationship between dietary sodium intake and cardiovascular disease risk. The risk of cardiovascular disease increased up to 6% for every 1 g increase in dietary sodium intake. A low-sodium diet should be encouraged and education regarding reduced sodium intake should be provided.

Effects of exercise modality on body composition and cardiovascular disease risk factors in adolescents with obesity: a randomized clinical trial.

We compared the effects of aerobic exercise, resistance exercise, and combined aerobic and resistance exercise on total, regional subcutaneous adipose tissue (SAT) and visceral AT (VAT), skeletal muscle (SM), and biomarkers of cardiovascular disease in adolescents. Adolescents with overweight/obesity (N = 118; body mass index ≥ 85th percentile; age, 12-17 years) were randomized to 1 of the following groups for 6 months (3 days/week, 180 min/week): aerobic exercise (n = 38), resistance exercise (n = 40), or combined aerobic and resistance exercise (n = 40). After accounting for age, sex, and baseline value, there was a greater (P < 0.05) reduction in body weight in the aerobic exercise group compared with the resistance exercise group and the combined groups. There were reductions (P < 0.05) in total and regional SAT within the aerobic exercise group only, and the reductions in lower-body SAT were greater (P = 0.02) than the combined group. All groups had reductions (P < 0.01) in VAT, with no group differences. There were significant increases in total and regional SM mass in the resistance exercise and combined group, and not in the aerobic exercise group. Although all exercise modalities are effective in reducing VAT, aerobic exercise is superior at reducing total and regional SAT, but inferior for increasing SM in adolescents with obesity. Despite reductions in VAT, carotid-femoral pulse wave velocity and carotid intima-media thickness did not improve with either exercise. Clinicaltrials.gov identifier: NCT01938950. Novelty Regular exercise (180 min/week) is associated with reductions in visceral fat independent of exercise modality. Resistance exercise alone and combined resistance and aerobic exercise are similarly effective in increasing SM mass.

Single nucleotide polymorphisms of ADIPOQ gene associated with cardiovascular disease risk factors in European adolescents: the Healthy Lifestyle in Europe by Nutrition in Adolescence study.

Cardiovascular diseases (CVDs) are responsible of 31% of all deaths worldwide. Genetic predisposition to CVDs in adolescents remains largely unknown. Aims of present research are to examine the association of ADIPOQ gene polymorphisms with cardiovascular disease risk factors in European adolescents. A total of 14 polymorphisms in the ADIPOQ gene were genotyped in 1057 European adolescents (12-18 years old) from the Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study. We measured serum lipids and a CVD risk score, along with weight, height, triceps, and subscapular skinfold thickness, leptin, insulin and other markers of glucose regulation. The rs822393, rs822395 and rs7649121 polymorphisms of ADIPOQ gene were significantly associated with several CVD risk factors [i.e. high-density lipoprotein cholesterol (HDL-C), apolipoprotein (Apo) A1, SBP and CVD risk score] in European adolescents. We also found an association of the TGAAGT ADIPOQ haplotype (rs822393, rs16861210, rs822395, rs822396, rs12495941 and rs7649121) with HDL-C and ApoA1 levels. Several individual polymorphisms (rs822393, rs822395 and rs7649121) and a haplotype of ADIPOQ gene were significantly associated with cardiovascular disease risk factors in European adolescents.

Association of UCP1, UCP2 and UCP3 gene polymorphisms with cardiovascular disease risk factors in European adolescents: the HELENA study.

Cardiovascular diseases (CVDs) are responsible for 31% of all deaths worldwide. Genetic predisposition to CVDs in adolescents remains largely unknown. The aim of this study was to examine the association of UCP1, UCP2 and UCP3 gene polymorphisms with CVD risk factors in European adolescents. A cross-sectional study that involves 1.057 European adolescents (12-18 years old) from the HELENA study. A total of 18 polymorphisms of UCP1, UCP2 and UCP3 genes were genotyped. We measured serum total cholesterol, high-density lipoprotein,low-density lipoprotein, ApoA1, ApoB, leptin, triglycerides, glucose, insulin and blood pressure, and calculated HOMA (homeostatic model assessment), Quantitative Insulin Sensitivity Check Index (QUICKI) and a CVD risk score. The G allele of UCP2 rs2735572 and T allele of UCP2 rs17132534 were associated with higher diastolic blood pressure (P = 0.001; false discovery rate [FDR] = 0.009 and P = 8e-04; FDR = 0.009, respectively). We observed that the AATAG haplotype of UCP1 was associated with higher serum ApoB/ApoA1 (P = 0.008; FDR = 0.031) and ApoB levels (P = 0.008; FDR = 0.031). Moreover, the ACC haplotype of UCP3 was associated with a higher CVD risk score (P = 0.0036; FDR = 0.01). Two UCP2 polymorphisms and haplotypes of UCP1 and UCP3 were associated with CVD risk factors. These findings suggest that UCPs may have a role in the development of CVD already in adolescents.