Development Of Metabolic Complications Research Articles

Correlation of anthropometric measurements with body mass index and estimation of the proportion of metabolic syndrome among overweight and obese children: a hospital-based cross-sectional study

BackgroundEarly identification of overweight and obesity with the help of simple anthropometric tests can prevent from development of metabolic complications in these children. Body mass index (BMI) is the most...

Gut permeability is associated with lower insulin sensitivity in youth with perinatally acquired HIV.

The relationships between alterations in the intestinal barrier, and bacterial translocation with the development of metabolic complications in youth with perinatally acquired HIV (YPHIV) have not been investigated. The PHACS Adolescent Master Protocol enrolled YPHIV across 15 U.S. sites, including Puerto Rico, from 2007 to 2009. For this analysis, we included YPHIV with HIV viral load 1000 c/ml or less, with at least one measurement of homeostatic assessment of insulin resistance (HOMA-IR) or nonhigh density lipoprotein (non-HDLc) between baseline and year 3 and plasma levels of intestinal fatty-acid binding protein (I-FABP), lipopolysaccharide-binding protein (LBP), and zonulin levels at baseline. We fit linear regression models using generalized estimating equations to assess the association of baseline log 10 gut markers with log 10 HOMA-IR and non-HDLc at all timepoints. HOMA-IR or non-HDLc was measured in 237, 189, and 170 PHIV at baseline, Yr2, and Yr3, respectively. At baseline, median age (Q1, Q3) was 12 years (10, 14), CD4 + cell count was 762 cells/μl (574, 984); 90% had HIV RNA less than 400 c/ml. For every 10-fold higher baseline I-FABP, HOMA-IR dropped 0.85-fold at baseline and Yr2. For a 10-fold higher baseline zonulin, there was a 1.35-fold increase in HOMA-IR at baseline, 1.23-fold increase in HOMA-IR at Yr2, and 1.20-fold increase in HOMA-IR at Yr3 in adjusted models. For a 10-fold higher baseline LBP, there was a 1.23-fold increase in HOMA-IR at baseline in the unadjusted model, but this was slightly attenuated in the adjusted model. Zonulin was associated with non-HDLc at baseline, but not for the other time points. Despite viral suppression, intestinal damage may influence downstream insulin sensitivity in YPHIV.

Successful pregnancy in a patient with acromegaly after somatostatin analogues and cabergoline treatment. therapy with somatostatin analogues and cabergoline

The probability of pregnancy in women with acromegaly is relatively low, however modern therapy approaches make it possible to achieve disease compensation and improve reproductive function.World expert’s experience in managing pregnancy in patients with acromegaly is currently insufficient. Pregnancy may be associated with an increased risk for both mother and fetus due to the possible growth of the tumor, the development of metabolic complications (diabetes mellitus, arterial hypertension).This article describes a case of a successful pregnancy in a woman with active acromegaly occurring after somatostatin analogues and cabergoline treatment.

Postprandial glycemic and lipidemic effects of black rice anthocyanin extract fortification in foods of varying macronutrient compositions and matrices

Anthocyanin (ACN) fortification of commonly consumed foods is significant as a dietary strategy against the development of metabolic complications by delivering ACNs at high doses. However, its bioactivity and translated metabolic effects in the presence of varying food matrices and macro-constituents is particularly unclear. This end-to-end study investigates the metabolic effects of black rice ACN extract (BRAE) fortification—from in-vitro enzyme inhibitory activities and digestibility, to downstream in vivo impacts on GI, postprandial glycemia and lipidemia. The in vivo effects were investigated in two separate crossover randomised controlled trials (RCT) of 24 healthy participants each—the first RCT determined the postprandial blood glucose, insulin, and ACN bioavailability to a starch-rich single food over 2 h, while the second RCT determined the postprandial blood glucose, insulin, lipid panel, and lipoprotein particles and subfractions to a starch- and fat-rich composite meal over 4 h. In-vitro findings confirmed the inhibitory activities of major black rice ACNs on carbohydrases (p = 0.0004), lipases (p = 0.0002), and starch digestibility (p < 0.0001). in vivo, a 27-point mean GI reduction of wheat bread was observed with BRAE fortification, despite a non-significant attenuation in postprandial glycemia. Conversely, there were no differences in postprandial glycemia when fortified bread was consumed as a composite meal, but acute lipid profiles were altered: (1) improved plasma HDL-c, ([0.0140 mmol/L, 95% CI: (0.00639, 0.0216)], p = 0.0028), Apo-A1 ([0.0296 mmol/L, 95% CI: (0.00757, 0.0515)], p = 0.0203), and Apo-B ([0.00880 mmol/L, 95% CI: (0.00243, 0.0152)], p = 0.0185), (2) modified LDL and HDL subfractions (p < 0.05), and (3) remodelled lipid distributions in HDL and LDL particles. This end-to-end study indicates the potential of ACN fortification in GI reduction and modulating postprandial lipoprotein profiles to starch- and fat-rich composite meals.

Relationship of Glucagon-like Peptide 1 and Peptide YY with Catch-up Growth in Children Born Small for Gestational Age

Children born small for gestational age (SGA) are at a greater risk of developing insulin resistance, type 2 diabetes, and cardiovascular disease in adulthood. Gastrointestinal peptides, some secreted by intestinal L cells, regulate glucose and lipid metabolism and act on the hypothalamus to regulate energy homeostasis. The aim of this study was to explore whether gastrointestinal peptides are involved in metabolic disorders in SGA, which remains unclear. The secretion of glucagon-like peptide 1 (GLP-1) and peptide YY (PYY) were investigated in prepubertal children born SGA, the differences between catch-up growth and persistent short stature were compared, and correlation with glucose and lipid metabolism was analyzed. GLP-1, PYY, insulin-like growth factor 1, glucose, insulin, and lipid concentrations were analyzed in prepubertal children aged 4-10 years, stratified into three groups: short-SGA (SGA-s), catch-up growth SGA, and normal growth appropriate for gestational age (AGA). Fasting GLP-1 and PYY concentrations were significantly lower in the SGA group than in the AGA group (p<0.05), and the GLP-1 level in infants born SGA with catch-up growth was lower than that in the SGA-s group (p<0.05). In the SGA population, GLP-1 showed a weak negative correlation with catch-up growth (r=-0.326) and positive correlation with fasting insulin (r=0.331). Lower GLP-1 concentrations may be associated with abnormal glucose metabolism in prepubertal children born SGA with catch-up growth. This is indirect evidence that impaired intestinal L cell function may be involved in the development of metabolic complications in SGA children.

Lifestyle Can Exert a Significant Impact on the Development of Metabolic Complications and Quality Life in Patients with Inflammatory Bowel Disease.

Inflammatory bowel diseases (IBDs) are associated with an increased risk of metabolic comorbidities. There is a lack of data regarding the relationship between lifestyle and metabolic diseases in IBD patients. A cross-sectional study on consecutive IBD outpatients was conducted. Adherence to the Mediterranean diet (MD) was assessed using a 14-item questionnaire from the PREDIMED study, and physical activity was evaluated using the GODIN-Leisure score. Body composition was studied based on body mass index and waist-hip ratio (WHR), while quality of life was assessed using a nine-item short questionnaire. Among the 688 evaluated IBD patients, 66% were overweight or obese, 72.7% did not lead an active lifestyle and 70.1% did not adhere to the MD. Metabolic syndrome was associated with age (OR = 1.07, p = 0.019), overweight/obesity (OR = 12.987, p < 0.001) and the inflammatory behavior of Crohn's disease (OR = 6.172, p = 0.001). Type 2 diabetes mellitus or prediabetes was associated with age (OR = 1.063 p = 0.016), overweight/obesity (OR = 3.861, p < 0.001) and the inflammatory behavior of Crohn's disease (OR = 4.716, p = 0.001). Overweight /obesity (OR = 5.494, p < 0.001), a high WHR (OR = 2.564, p = 0.005) and a non-active lifestyle (OR = 2.202, p = 0.0003) were associated with metabolic dysfunction-associated steatotic liver disease. Lifestyle, body composition and not solely systemic inflammation might exert a significant influence on the emergence of metabolic comorbidities such as MASLD, type 2 diabetes mellitus and metabolic syndrome in patients with IBD.

Relationship Between Markers of Chronic Inflammation and Copper Nutritional Status in Obese Women.

Adipose tissue dysfunction causes the development of metabolic complications, such as low-grade chronic inflammation, which may to alter copper homeostasis in obese individuals. Thus, the objective of this study is to analyze the relationship between markers of chronic inflammation and copper nutritional status in obese women. Cross-sectional study involved women aged 20-50years, divided into two groups: case (BMI > 35kg/m2) and control (18.5 > BMI > 24.9kg/m2). Plasma and erythrocyte copper concentrations were determined by inductively coupled plasma optical emission spectrometry (ICP-OES) method. Activity of superoxide dismutase (SOD) enzyme in the erythrocytes was determined with an automatic biochemical analyzer. Serum concentrations of interleukin (IL)-6, IL-8, IL-12, IL-10, and IL-1β and tumor necrosis factor-alpha (TNF-α) were determined by using flow cytometer. Serum IL-6 concentrations were 105% higher in the case group compared to eutrophic women. Plasma copper concentrations were 20.5% higher, and erythrocyte copper concentrations were 23.5% lower in patients with obesity. In addition, erythrocyte SOD activity was 20% lower in obese participants when compared to eutrophic women. Our study identified significant negative correlation between the cytokines TNF-α and IL-10 and the SOD activity in the case group, suggesting a possible influence of chronic inflammation on copper distribution in obese individuals.

Small fragments of hyaluronan are increased in individuals with obesity and contribute to low-grade inflammation through TLR-mediated activation of innate immune cells

Background and aimExtracellular matrix (ECM) components released during excessive fat mass expansion are considered potential endogenous danger/alarm signals contributing to innate immune system activation. The aim of the current study was to specifically measure plasma levels of low molecular weight (LMW) hyaluronan (HA) and to evaluate its role as pro-inflammatory damage-associated molecular pattern (DAMP) on leukocyte response in the context of human obesity.Subjects and methodsParticipants were selected according to their body mass index (BMI, kg/m2) as non-obese (BMI < 29.9, n = 18) and obese (BMI > 29.9, n = 33). Plasma samples were size-dependent fractionated using ion-exchange chromatography to specifically obtain LMW HA fractions that were subsequently quantified by ELISA. Cell incubation experiments with synthetic HA molecules were performed on freshly Ficoll-isolated neutrophils (PMN) and peripheral blood monocytes (PBMC). Leukocyte and adipose tissue gene expression was assessed by real-time PCR and NF-κB activation by western blot. Plasma cytokine levels were measured by fluorescent bead-based (Luminex) immunoassay.ResultsWe observed a statistically significant increase in the circulating levels of HA fragments of LMW in individuals with obesity which were consistent with significant up-regulated expression of the LMW HA synthesizing enzyme hyaluronan synthase-1 (HAS-1) in obese adipose tissue. Gene expression assessment of HA receptors revealed up-regulated levels for TLR2 in both obese PMN and PBMC. Synthetic HA molecules of different sizes were tested on leukocytes from healthy donors. LMW HA fragments (15–40 kDa) and not those from intermediate molecular sizes (75–350 kDa) induced a significant up-regulation of the expression of major pro-inflammatory cytokines such as IL-1β, MCP-1 and IL-8 in PBMC. Importantly, LMW HA was able to induce the phosphorylation of IKK α/β complex supporting its pro-inflammatory role through NF-κB activation.ConclusionCirculating LMW HA molecules are elevated in obesity and may play an important role in triggering low-grade inflammation and the development of metabolic complications.

Extracellular vesicles and metabolic diseases: Dangerous liaisons

Extracellular vesicles (EVs) correspond to a heterogeneous set of membrane nanovesicles secreted in the extracellular medium and circulating in the various fluids of the body. These EVs convey biological material (proteins, lipids, nucleic acids) that they can transfer to target cells/tissues thus modulating their response and/or phenotype. The metabolic dysfunctions characterizing metabolic diseases associated with obesity are associated with changes in circulating EV concentrations as well as alterations in their content. The growing interest in EVs as new vectors of intercellular communication has led to question about their role in the development of metabolic complications. In this review, we will discuss the literature on circulating EVs as potential markers of metabolic diseases and then detail inter-organ dialogue based on this EV trafficking underlying the development of related obesity. Finally, we will discuss future avenues of research that will help to better understand the link between EVs and metabolic diseases.

Clinical guidelines «Obesity in children»

Childhood obesity is an urgent problem of pediatric endocrinology due to the widespread occurrence, the development of metabolic complications and their steady tracking into adulthood. The developed clinical guidelines are the main working tool of the practitioner. They briefly and structurally present the main information about the epidemiology and modern classification of obesity, methods of its diagnosis and treatment based on the principles of evidence-based medicine.

Comparative Analysis of the Hypoglycaemic and Hypolipidemic Effects of Aqueous Extract of some Ethno medicinal Plants in Alloxan Induced Diabetic Rats

Diabetes mellitus is a complex metabolic disorder associated with the development of metabolic complications. This research evaluated the hypoglycemic and hypolipidaemic effects of Moringa oleifera (MO), Treculia africana (TA) and Albizzia chevalieri (AC) plant extracts on diabetes. Albino rats were randomly divided into six (six) main groups; MC, MO, TA, AC, Normal Control (NC) and Diabetic Control (DC) groups. Group MO, TA and AC were further subdivide into three sub groups. Diabetes mellitus was induced by a single dose intraperitoneal injection of alloxan 150 mg/kg body weight. Fasting blood glucose level and lipid profile were assayed using standard methods. Intraperitoneal injection of 150 mg/kg of Alloxan in the albino rats resulted in significant (p&lt;0.05) elevation of serum glucose, total cholesterol (TC), triglyceride (TG), very low density lipoprotein (VLDL-C), and low density lipoprotein (LDL-C). Also, there was significant decrease (p&lt;0.05) in HDL-C and body weight of the albino rats compared with that of the NC group. Oral administration of MO, TA and AC to diabetic albino rats for 21 days significantly (p&lt;0.05) reduced fasting blood glucose level, normalized lipid profile and restore body weight of the albino rats in treated groups compared to diabetic control groups. All the plant extracts studied in this research significantly (p&lt;0.05) increase the regeneration of damaged pancreatic β cells. Treatment with MO (800 mg/kg) confirmed highly significant (p&lt;0.05) effect compared to TA and AC.

Associations of Diet with Cardiometabolic and Inflammatory Profiles in Pregnant Women at Risk for Metabolic Complications.

Dietary intakes play an important role in the development of metabolic complications during pregnancy. While reported observational studies reveal an inverse association of healthy diets with weight gain, gestational diabetes, and hypertensive complications during pregnancy, there is a paucity of studies conducted among women of specific ethnicities vulnerable to higher risks of pregnancy complications. This is a secondary cross sectional analysis using baseline data from a previously reported clinical trial. We aim to identify associations of maternal habitual dietary intakes with cardiometabolic risks and inflammatory profiles in primarily African American (AA) and Hispanic women in the first half of pregnancy. Fifty-two women met the study criteria and anthropometric, clinical, and dietary data were obtained at baseline. Linear regression analysis was used to determine associations after covariate adjustments. Among the maternal dietary nutrient intakes, total fats were positively associated with maternal body weight, BMI, and serum CRP (β ± SE: 0.25 ± 0.13, 0.28 ± 0.18, and 0.29 ± 0.14, respectively, all p < 0.05), and saturated fats were positively associated with glycated hemoglobin (0.32 ± 0.12). Dietary fiber intake showed a consistent inverse association with body weight (−0.26 ± 0.13), BMI (−0.19 ± 0.15), glycated hemoglobin (−0.22 ± 0.16), as well as serum CRP (−0.19 ± 0.14). Among the maternal food group intakes, dairy intake was inversely associated with systolic blood pressure (−0.18 ± 0.15) and serum IL-6 (−0.22 ± 0.17), and vegetable intake showed an inverse association with serum CRP (−0.17 ± 0.12) all in adjusted analyses (all p < 0.05). Thus, maternal diet modifications, especially decreasing fats and increasing fiber and dairy may help address obesity and inflammation leading to pregnancy complications in AA and Hispanic women.

Деякі аспекти діагностики абдомінального ожиріння в міського населення України

Актуальність. Оптимізація профілактичних підходів щодо розвитку коморбідної патології в осіб із надлишком ваги різного ступеня — актуальна проблема медичної науки. Ефективність таких підходів залежить від усього спектра патогенетичних факторів щодо метаболічних ускладнень ожиріння — основи розвитку коморбідної патології та виділення найбільш інформативних маркерів їх розвитку. Такими факторами є зміни адипокіноцитокінової системи (маркером яких є вміст у сироватці крові фракталкіну, кластерину, васпіну, оментину) та пов’язані з ними порушення метаболізму вільних жирних кислот. Проте виявлення вищезазначених маркерів у більшості лікувальних закладів не проводиться. Дослідження інформативності обох цих критеріїв щодо оцінки зміни адипокіноцитокінової системи та пов’язаних із ними порушень метаболізму вільних жирних кислот у представників української популяції не здійснювалися. Мета: оцінити інформативність таких критеріїв абдомінального ожиріння, як окружність талії та співвідношення окружність талії/окружність стегон, щодо ризику розвитку локального запалення жирової тканини, системного низькоінтенсивного запалення в організмі, змін секреторної функції жирової тканини та метаболічних особливостей у міських мешканців — представників української популяції. Матеріали та методи. Обстежено 250 осіб віком 65,48 ± 11,86 року, у яких імуноферментним методом визначено вміст фракталкіну, кластерину, васпіну, оментину та лептину в циркуляції; методом Данкомба — вільних жирних кислот. Проаналізовано характер взаємозв’язків вищезазначених параметрів з окружністю талії та стегон, співвідношенням окружність талії/окружність стегон. Виявлено характер вірогідних відмінностей щодо цих параметрів за наявності та відсутності абдомінального ожиріння згідно з критерієм «окружність талії/окружність стегон». Результати. Визначено, що параметр «окружність талії» є інформативним критерієм ризику розвитку запальних процесів в організмі, змін метаболізму васпіну, оментину, лептину та вільних жирних кіслот; параметр «окружність талії/окружність стегон» — змін метаболізму лептину та вільних жирних кислот. Висновки. Розвиток абдомінального ожиріння супроводжується збільшеним ризиком локального запалення жирової тканини, системного низькоінтенсивного запалення в організмі, змінами її секреторної функції щодо адипокінів васпіну та оментину, зростанням рівнів вільних жирних кислот та лептину в циркуляції. Визначено вірогідний взаємозв’язок між ступенем накопичення жирової тканини як у вісцеральному, так і в глютеофеморальному жировому депо із змінами метаболізму адипокінів васпіну та оментину.

КЛИНИЧЕСКИЕ РЕКОМЕНДАЦИИ «ОЖИРЕНИЕ У ДЕТЕЙ»

Childhood obesity is an urgent problem of pediatric endocrinology due to the widespread occurrence, the development of metabolic complications and their steady tracking into adulthood. The developed clinical guidelines are the main working tool of the practitioner. They briefly and structurally present the main information about the epidemiology and modern classification of obesity, methods of its diagnosis and treatment based on the principles of evidence-based medicine.

Implicating androgen excess in propagating metabolic disease in polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS) has been traditionally perceived as a reproductive disorder due to its most common presentation with menstrual dysfunction and infertility. However, it is now clear that women with PCOS are at increased risk of metabolic dysfunction, from impaired glucose tolerance and type 2 diabetes mellitus to nonalcoholic fatty liver disease and cardiovascular disease. PCOS is characterised by androgen excess, with cross-sectional data showing that hyperandrogenism is directly complicit in the development of metabolic complications. Recent studies have also shown that C11-oxy C19 androgens are emerging to be clinically and biochemically significant in PCOS, thus emphasising the importance of understanding the impact of both classic and C11-oxy C19 androgens on women’s health. Here we discuss androgen metabolism in the context of PCOS, and dissect the role played by androgens in the development of metabolic disease through their effects on metabolic target tissues in women.

Visceral fat does not contribute to metabolic disease in lipodystrophy.

SummaryObjectivesLipodystrophies are characterized by regional or generalized loss of adipose tissue and severe metabolic complications. The role of visceral adipose tissue (VAT) in the development of metabolic derangements in lipodystrophy is unknown. The study aim was to investigate VAT contribution to metabolic disease in lipodystrophy versus healthy controls.MethodsAnalysis of correlations between VAT volume and biomarkers of metabolic disease in 93 patients and 93 age/sex‐matched healthy controls.ResultsPatients with generalized lipodystrophy (n = 43) had lower VAT compared with matched controls, while those with partial lipodystrophy (n = 50) had higher VAT versus controls. Both groups with lipodystrophy had lower leg fat mass versus controls (p < 0.05 for all; unpaired t‐test). In both generalized and partial lipodystrophy, there was no correlation between VAT and glucose, triglycerides or high‐density lipoprotein cholesterol (p > 0.05 for all; Spearman correlation). In controls matched to patients with generalized or partial lipodystrophy, VAT correlated with glucose (R = 0.42 and 0.36), triglycerides (R = 0.36 and 0.60) and high‐density lipoprotein cholesterol (R = −0.34 and −0.64) (p < 0.05 for all; Spearman correlation).ConclusionsIn contrast to healthy controls, metabolic derangements in lipodystrophy did not correlate with VAT volume. These data suggest that, in lipodystrophy, impaired peripheral subcutaneous fat deposition may exert a larger effect than VAT accumulation on the development of metabolic complications. Interventions aimed at increasing functional subcutaneous adipose tissue may provide metabolic benefit.

Inflammation and Metabolic Complications in HIV.

We aim to provide an in-depth review of recent literature highlighting the role of inflammation involving the adipose tissue, liver, skeletal muscles, and gastrointestinal tract in the development of metabolic complications among persons living with HIV (PLWH). Recent studies in PLWH have demonstrated a significant association between circulating inflammatory markers and development of insulin resistance and metabolic complications. In adipose tissue, pro-inflammatory cytokine expression inhibits adipocyte insulin signaling, which alters lipid and glucose homeostasis. Increased lipolysis and lipogenesis elevate levels of circulating free fatty acids and promote ectopic fat deposition in liver and skeletal muscles. This leads to lipotoxicity characterized by a pro-inflammatory response with worsening insulin resistance. Finally, HIV is associated with gastrointestinal tract inflammation and changes in the gut microbiome resulting in reduced diversity, which is an additional risk factor for diabetes. Metabolic complications in PLWH are in part due to chronic, multisite tissue inflammation resulting in dysregulation of glucose and lipid trafficking, utilization, and storage.

Clinical Food Addiction Is Not Associated with Development of Metabolic Complications in Liver Transplant Recipients.

Background and Aims: Given the increased risk of post-transplant metabolic syndrome (PTMS; defined by hypertension, diabetes mellitus and hyperlipidemia), we aimed to identify the potential role of food addiction in the development of metabolic complications in the post-liver transplant population.Methods: Inclusion criteria included adult liver transplant recipients followed at our institution between June 2016 and November 2016. Participants were administered a demographic survey as well as the Yale Food Assessment Scale 2.0, a 35-item questionnaire used to assess frequency of food addiction in accordance with the DSM-V guidelines of substance use disorders. Demographic and clinical data were collected.Results: Our study included 236 liver transplant recipients (139 males, 97 females). The median (interquartile range [IQR]) BMI of participants was 26.8 kg/m2 (24.2, 30.4), and median (IQR) time since transplantation was 50.9 months (19.6, 119.8). The prevalence rates of hypertension, hypercholesterolemia and diabetes mellitus were 54.7%, 25.0% and 27.1%, respectively. Twelve participants (5.1%) were found to have a diagnosis of food addiction. A diagnosis of food misuse was made in 94 (39.8%) of the transplant recipients.Conclusions: Our findings are consistent with prior data that indicate high prevalence of metabolic complications among liver transplant recipients. Food addiction was not predictive of metabolic complications within this population. Nevertheless, we found that this population was at high risk of demonstrating symptoms of food misuse, and they were not likely to appreciate the risks of pathologic patterns of eating. Given the increasing risk of cardiovascular morbidity and mortality in this population, efforts should be made to identify risk factors for the development of PTMS.

Serum Branched Chain and Aromatic Amino Acids Are Associated to Overweight, Obesity and Metabolic Alterations in School‐Aged Children

BackgroundChildhood overweight and obesity are risk factors for metabolic alterations that could ultimately lead to pathological states. Metabolomics has emerged as a powerful tool to identify biomarkers for metabolic alterations. Multiple metabolomics studies have associated childhood obesity to serum amino acids and acylcarnitines, particularly to an increase in branched chain amino acids (BCAA). Despite these findings, so far there are no studies evaluating the serum amino acid profile in Mexican children. Therefore we aimed to identify amino acids associated to overweight, obesity and its metabolic alterations in Mexican school‐aged children.MethodologyAnthropometric and biochemical measurements were conducted in 845 children (6–12 years old) from a cross‐sectional study in Mexico City. Targeted metabolomics was performed by mass spectrometry. Children were classified according to their BMI percentile (BMIp) as low weight (LW; BMIp&lt;5th), normal weight (NW; 5th&lt;BMIp&lt;85th), overweight (OW; 85th&lt;BMIp&lt;95th) and obese (OB; 95th&lt;BMIp).ResultsOW and OB children had higher serum levels of BCAA and aromatic amino acids (AA) than NW and LW children (p&lt;0.001). BCAA and AA correlated with higher HOMA (r=0.11, p=0.002 and r=0.15, p&lt;0.001, respectively) and serum triglycerides (r=0.18, p&lt;0.001 and r=0.19, p&lt;0.001, respectively), after adjusting for age, sex and BMI percentile. Since insulin resistance (IR) and hypertriglyceridemia (hTG) are the most common metabolic alterations in Mexican children, those with both abnormalities were classified as Metabolically Compromised (MC), while those with none of these as Metabolically Healthy (MH). In NW, BCAA and AA were higher in MC than in MH children (p&lt;0.001), concomitant to an increase in adiposity, suggesting that the higher levels of amino acids could respond to the higher degree of adiposity. However in OW children, BCAA an AA were also higher in MC children than in MH children (p&lt;0.002), despite same percentage of adiposity between these two groups. Previous studies have suggested that a dysfunctional adipose tissue plays a role in the accumulation of these amino acids in serum and, in the development of metabolic complications. Thus we hypothesize that in OW children the adipose tissue functionality could be playing a role in the presence of metabolic complications, however the latter requires further research.ConclusionsBCAA and AA are associated to higher degree of overweight, likely related to a higher adiposity. However, their association with IR and hTG seems to be related to other factors besides adiposity. This highlights the importance of BCAA and AA in differentiating MH children from MC children.Support or Funding InformationThis work was supported by CONACYT grant 248765 to SM‐R

Assessment of serum lipid profile and liver function parameters in children with epilepsy on phenytoin or valproic acid monotherapy for 6 months and beyond

Objectives: The highest incidence of epilepsy in children coupled with the need of long-term antiepileptic treatment could lead to development of metabolic complications at an early age. Phenytoin and valproic acid are commonly used antiepileptic drugs in children. This study aimed to assess the serum lipid profile and liver function tests in children with epilepsy on phenytoin or valproic acid monotherapy for 6 months and beyond. Materials and Methods: This prospective descriptive study recruited children from the pediatric outpatient department of a tertiary care GB Pant Children Hospital, Srinagar, Kashmir, India from August 2009 to September 2011. All consecutive children diagnosed with epilepsy as per International League Against Epilepsy definition aged 3–18 years on phenytoin or valproic acid monotherapy for 6 months or beyond were enrolled. After baseline clinical and anthropometric evaluation (including body mass index [BMI]), the fasting blood samples were analyzed for serum lipid profile and liver enzyme changes. Results: Total of 75 children were enrolled. There were 25 patients each in phenytoin, valproic acid, and control group. We observed statistically significant high mean total cholesterol and alkaline phosphatase levels in group receiving phenytoin when compared with valproic acid or control group. Conclusion: The lipid and liver enzyme abnormalities may be observed in children on phenytoin or valproic acid therapy, which warrants careful screening and monitoring.