Family History Of Metabolic Syndrome Research Articles

Paediatric Obesity Evaluation for Metabolic Susceptibility (POEMS)

IntroductionOur aim was to determine whether there are risk factors which increase the risk of developing dysglycemia in a child who has increased body mass index (BMI) (overweight/obese).Research design and...

Olanzapine-induced multifactorial chylomicronaemia syndrome: a rare but important complication.

We present a case of a 42-year-old man who developed acute onset severe hypertriglyceridaemia within days of commencing olanzapine therapy. Despite having a family history of metabolic syndrome, he had no personal history of hyperlipidaemia and had normal fasting lipids 1 week prior to treatment initiation. His case is consistent with a diagnosis of multifactorial chylomicronaemia syndrome with a possible undiagnosed underlying genetic lipid metabolism disorder. Our case highlights the difficulty in identifying patients at risk of severe hypertriglyceridaemia prior to the commencement of olanzapine. Atypical antipsychotic medications, in particular olanzapine and clozapine, are associated with metabolic side effects. Olanzapine can precipitate acute onset severe hypertriglyceridaemia consistent with multifactorial chylomicronaemia syndrome. It is difficult to predict individuals at risk of olanzapine-induced hypertriglyceridaemia. This case demonstrates the importance of metabolic screening prior to the commencement of olanzapine and the possibility of repeating fasting serum lipids soon thereafter.

Sleeping disturbances and predictor risk factors among type 2 diabetic mellitus patients.

Background:Sleep disturbance is a major health issue among people with type 2 diabetes mellitus (T2DM). The Pittsburgh Sleep Quality Index (PSQI) has been the most widely used instrument to measure subjective sleep disturbance.Aim:The aim of this study was to determine the impact of sleeping factor structure of the PSQI as potential predictor for glycosylated hemoglobin A1c (HbA1C) among people living with T2DM in the Turkish community to facilitate its use in the clinical practice and research.Subjects and Methods:This is a cross-sectional study and participants were between the age group of 25 and 65 years old who visited the diabetes and endocrinology department of Mega Medipol University Teaching Hospital, Istanbul. The PSQI was conducted on 871 patients with T2DM. Good sleep quality was defined as PSQI score <5. Multivariate logistic regression analysis was used to estimate the associated risk factors for the T2DM.Results:The current study showed significant differences between male and female patients with respect to their age in years, body mass index (BMI) (kg/m2), physical activity, smoking habit, sheesha smoking, income, family history of metabolic syndrome, coronary heart disease (CHD), and PSQI. The results revealed significant differences between HbA1c ≤7 and females and HbA1c >7 T2DM patients with respect to gender, BMI (kg/m2), CHD, and PSQI. The study demonstrated significant differences between sleeping categories PSQI as good, average, and poor sleeping among T2DM patients with respect to age and gender. Meanwhile, significant differences were reported between sleeping categories among T2DM patients with respect to their: number of sleeping hours, wake-up time, sleeping time, HbA1c, fasting blood glucose, uric acid, and systolic and diastolic blood pressure. This study showed very strong statistically significant correlations between low HbA1c and poor sleep quality in patients with T2DM patients, including subjective sleep quality r = 0.763, sleep latency r = 0.327, sleep duration r = 0.472, habitual sleep efficiency r = 0.575, sleep disturbances r = 0.564, use of sleep medication r = 0.728, and daytime dysfunction r = 0.734. Multivariate stepwise logistic regression analysis revealed that Vitamin D (mmol/L) (P < 0.001), HbA1c (P < 0.001), duration of DM (P < 0.001), uric acid (mmol/L) (P < 0.001), systolic blood pressure mmHg (P = 0.006), diastolic blood pressure mmHg (P = 0.015), and BMI (P = 0.024) were considered at higher risk as the predictors for sleeping quality among T2DM patients.Conclusion:The results suggest a strong positive correlation between PSQI with HbA1c levels, systolic and diastolic blood pressure, age, BMI, among type 2 diabetic patients. This study ascertains that poor sleep quality may be due to elevated level of HbA1c, metabolic syndrome, diabetes, obesity, and/or hypertension.

Vitamin D and Elevated Serum Uric Acid as Novel Predictors and Prognostic Markers for Type 2 Diabetes Mellitus.

ABSTRACTAim:To ascertain the active role of uric acid and vitamin D as potential biomarkers for impaired glucose metabolism among people living with type 2 diabetes mellitus (T2DM) in Turkish community.Subjects and Methods:This study was based on 680 patients with T2DM and 680 healthy subjects aged between 25 and 70 years, who visited the diabetes and endocrinology department of Istanbul Mega Medipol University Teaching Hospital, Istanbul, Turkey, during January 2016 to April 2018. The investigated biochemical indices included lipid profiles (low-density lipoprotein [LDL], high-density lipoprotein, total cholesterol, and triglyceride [TG]), uric acid, blood pressure (BP), serum creatinine, glycosylated hemoglobin (HbA1c), thyroid-stimulating hormone (TSH), postprandial glucose, and any related comorbidities.Results:This study reported significant differences between family history duration of patients with T2DM of ≤5 and >5 years when compared to that of control subjects with respect to body mass index (BMI), smoking habit, sheesha smoking, income, family history of metabolic syndrome, hypertension, coronary heart disease, and nephropathy. Similarly, significant differences were found between patients with T2DM (with family history T2DM duration of less than 5 years and more than 5 years in contrast to healthy subjects’ level of LDL, TG, fasting blood glucose, HbA1c, systolic BP (SBP), bilirubin, albumin, magnesium, potassium, calcium, number of sleeping hours, and TSH. We uncovered the correlation between serum uric acid level with the clinical biochemical indices related to T2DM: serum calcium (r = 0.336), magnesium (r = 0.272), potassium (r = 0.205), HbA1c (r = 0.638), fasting blood glucose (P = 0.486), bilirubin (r = 0.251), albumin (r = 0.285), LDL (r = 0.322), TG (r = 0.434), diastolic BP (DBP) (r = 0.392), SBP (r = 0.344), BMI (r = 0.482), waist circumference (WC) (r = 0.366), age (r = 0.217), number of sleeping hours (r = 0.275), and TSH (r = 0.445). Multivariate stepwise logistic regression showed that variables, such as serum vitamin D, uric acid, TSH, HbA1c, DBP, WC, BMI, and SBP, were considered at higher risk as significant (P < 0.001) predictors for T2DM.Conclusion:The results suggest strong positive correlation between serum uric acid level with BP (SBP and DBP), age, BMI, and WC among patients with T2DM. This study ascertains that an increase in uric acid level may be due to elevated level of HbA1c, metabolic syndrome, diabetes, obesity, and/or hypertension.

Dyslipidemia and Fatty Liver Disease in Overweight and Obese Children.

Introduction Obesity is a worldwide concern. It is associated with morbidity such as dyslipidemia and liver disease. Childhood obesity has dramatically increased, particularly in the Gulf region. We aim to assess the prevalence of dyslipidemia and fatty liver disease (FLD) in overweight and obese children and analyze the association between different anthropometric measures with dyslipidemia and fatty liver disease. Methods A descriptive, cross-sectional study conducted on children referred with obesity. BMI percentiles were plotted and standardized waist circumference (WC) was generated. Family history of metabolic syndrome was recorded. Fasting lipid, liver transaminases, and ultrasound scans (US) for those with elevated enzymes were performed. Descriptive statistics were used for quantitative parameters. Results 216 participants were recruited. Mean ± SD age was 10.58 ± 2.996 years. 55.3% had dyslipidemia; 11.7% had high cholesterol, 28.6% high triglyceride, 32.7% high LDL, and 18.0% low HDL. 51 (84%) had either elevated transaminases. All had liver US, and 43 had FLD. WC was strongly associated with dyslipidemia and FLD (P=0.04 and 0.003). Conclusion Dyslipidemia is common in overweight, obese children. FLD is prevalent in those with elevated liver transaminases. WC is an easy tool that can be utilized to screen for dyslipidemia and FLD in overweight and obese children.

Association of cord blood and maternal lipid profiles

Objectives: The objectives of this study were to study the cord blood lipid profile in neonates in relation to maternal preconceptional body mass index (BMI), maternal glucose intolerance, maternal lipid profile, family history of metabolic syndrome, intrauterine fetal growth, and birth weight of baby. Methodology: It was a prospective cohort study and was carried out in Pondicherry Institute of Medical Sciences over a period of 1 year. The sample size estimated was 150 mother-infant pairs. Informed consent was obtained from mothers fulfilling the criteria and a structured pro forma was filled with details of the mother and baby. Samples were drawn for the determination of lipid profile of the baby and mothers. Independent t-test was used to compare the lipid profile parameters in mother and in cord blood. p&lt;0.05 was considered statistically significant. Results: A total of 150 babies and mothers were included in the study. 78 (52%) were male and 72 (48%) were female. The mean birth weight of babies was 3009±0.391 g; 133 (89%) were appropriate for gestational age, and 17 (11%) were small for gestation. Among the mothers, 36 (24%) had gestational diabetes, 18 (12%) were obese, and 86 (58%) women had family history of diabetes, dyslipidemia, or hypertension. No statistically significant difference was noted in the cord lipids of babies born to mothers with gestational diabetes (p=0.033). Comparison of lipid values with gestational maturity did not reveal any statistical significance (p=0.24). High-density lipoprotein was significantly low for low birth weight babies compared to normal weight babies (p=0.03). Positive family history did not show any statistically significant difference in the lipids of the baby. BMI of the mother did not show any significant effect on the cord lipids. Conclusion: There was no association of cord blood and maternal lipid profiles. BMI of the mother did not show any significant effect on the cord blood lipids. Maternal gestational diabetes, family history of hypertension, diabetes, or dyslipidemia had no effect on the cord blood lipids.

Risk Factors Associated With Non-Alcoholic Fatty Liver Disease in Indians: A Case–Control Study

NAFLD has today emerged as the leading cause of liver disorder. There is scanty data on risk factors associated with NAFLD emanating from India. The present study was conducted to identify the risk factors associated with NAFLD. 464 consecutive NAFLD patients and 181 control patients were subjected to detailed questionnaire regarding their lifestyle and dietary risk factors. Anthropometric measurements were obtained and biochemical assays were done. Comparison of different variables was made between NAFLD patients and controls using principal component analysis (PCA). NAFLD patients had higher BMI [26.25±3.80 vs 21.46±3.08kg/m(2), P=0.000], waist-hip ratio [0.96±0.12 vs 0.90±0.08, P=0.000] and waist-height ratio [0.57±0.09 vs 0.50±0.06, P=0.000] compared to controls. Fasting blood sugar [101.88±31.57 vs 90.87±10.74mg/dl] and triglyceride levels [196.16±102.66 vs 133.20±58.37mg/dl] were significantly higher in NAFLD group. HOMA-IR was also higher in NAFLD group [2.53±2.57 vs 1.16±0.58, P=0.000]. Majority (90.2%) of NAFLD patients were sedentary. Family history of metabolic syndrome (MS) was positively correlated with NAFLD. Dietary risk factors associated with NAFLD were non-vegetarian diet [35% vs 23%, P=0.002], fried food [35% vs 9%, P=0.000], spicy foods [51% vs 15%, P=0.001] and tea [55% vs 39%, P=0.001]. Diabetes, hypertension, snoring and sleep apnoea syndrome were common factors in NAFLD. On multivariate PCA, waist/height ratio and BMI were significantly higher in the NAFLD patients. The risk factors associated with NAFLD are sedentary lifestyle, obesity family history of MS, consumption of meat/fish, spicy foods, fried foods and tea. Other risk factors associated with NAFLD included snoring and MS.

Does family history of metabolic syndrome affect the metabolic profile phenotype in young healthy individuals?

BackgroundEarly identification of high-risk individuals is key for the prevention of cardiovascular disease (CVD). The aim of this study was to assess the potential impact of a family history of metabolic syndrome (fhMetS) on the risk of metabolic disorders (abnormal body mass, lipid profile, glucose metabolism, insulin resistance, and blood pressure) in healthy young individuals.MethodsWe studied CVD risk factors in 90 healthy volunteers, aged 27–39 years; of these, 78 had fhMetS and 12 were without fhMetS (control group). Fasting serum lipids, glucose, and insulin levels were assayed, and anthropometric parameters and blood pressure using, an ambulatory blood pressure monitoring system, were measured. Nutritional and physical activity habits were assessed.ResultsDespite similar nutritional and physical activity habits, abnormal body mass was found in 53.2% of the fhMetS participants and 46.1% of the control participants (p = 0.54). The occurrence of obesity was 19.4% and 0%, respectively (p = 0.69). Compared to the control participants, fhMetS was associated with significantly higher total cholesterol (5.46 mmol/L vs. 4.69 mmol/L, p < 0.030), low-density lipoprotein cholesterol ( 3.28 mmol/L vs. 2.90 mmol/L, p < 0.032), and non-high-density lipoprotein cholesterol ( 3.74 mmol/L vs. 3.25 mmol/L, p < 0.016) levels, in addition to lower fasting glucose levels ( 4.51 mmol/L vs. 4.81 mmol/L, p < 0.042). A positive correlation between fasting glucose and insulin levels (r = 0.28; p < 0.015) was detected in the fhMetS participants. Higher mean daytime systolic blood pressure (121.5 mmHg vs. 113.3 mmHg, p < 0.035), mean daytime diastolic blood pressure ( 79.0 mmHg vs. 74.5 mmHg, p < 0.045), and mean nighttime diastolic blood pressure ( 64.0 mmHg vs. 59.5 mmHg, p < 0.019) were observed in the fhMetS group.ConclusionsMore than 50% of the fhMetS participants had excess weight or a lipid disorder, which may indicate an increased risk of cardiovascular disease and the need for regular ambulatory assessment of serum lipid concentrations in young people with a family history of MetS.

Effects of magnesium supplements on blood pressure, endothelial function and metabolic parameters in healthy young men with a family history of metabolic syndrome

Background and aimsMagnesium plays an important role in the modulation of vascular tone and endothelial function and can regulate glucose and lipid metabolism. Patients with hypertension, metabolic syndrome (MetS) and diabetes mellitus (T2DM) have low body magnesium content; indeed, magnesium supplementation has been shown to have a positive effect on blood pressure (BP) and gluco-metabolic parameters. The aim of our study was to evaluate the effect of magnesium supplements on hemodynamic and metabolic parameters in healthy men with a positive family history of MetS or T2DM. Methods and resultsIn a randomized, double-blind, placebo-controlled 8-week crossover trial with a 4 week wash-out period, oral supplements of 8.1 mmol of magnesium-pidolate or placebo were administered twice a day to 14 healthy normomagnesemic participants, aged 23–33 years. The primary endpoint was office BP, measured with a semiautomatic oscillometric device. Secondary endpoints included characteristics of the MetS, namely endothelial function, arterial stiffness and inflammation. Plasma and urinary magnesium were measured in all participants while free intracellular magnesium was measured only in a subsample.There was no significant difference in either systolic and diastolic BP in participants post-magnesium supplementation and post-placebo treatment when compared to baseline BP measurements. Further, the metabolic, inflammatory and hemodynamic parameters did not vary significantly during the study. ConclusionsOur study showed no beneficial effect of magnesium supplements on BP, vascular function and glycolipid profile in young men with a family history of MetS/T2DM (trial registration at clinicaltrial.gov ID: NCT01181830; 12th of Aug 2010).

The potential impact of family history of metabolic syndrome and risk of type 2 diabetes mellitus: In a highly endogamous population.

Aim:This study aims to determine the potential impact of positive family history of Metabolic Syndrome (MetS) among two generations, on developing Type 2 Diabetes Mellitus (T2DM) and the potential relation of consanguineous marriage among patients with MetS to the risk of developing T2DM among a sample of Qataris.Design:A cross-sectional study.Setting:Primary healthcare (PHC) centers.Materials and Methods:The survey and measurement were conducted from April 2011 to December 2012 among Qatari nationals above 20 years of age. Of the 2,182 subjects, who were approached to participate in the study, 1,552 (71%) gave their consent. Face-to-face interviews were conducted using a structured questionnaire followed by anthropometric measurements and laboratory tests. Metabolic syndrome was defined using the National Cholesterol Education Program-Third Adult Treatment Panel (ATP III) as well as International Diabetes Federation (IDF).Results:Overall, the prevalence of MetS was 26.2% according to ATP III and 36.9% according to IDF (P < 0.0001). The mean age of MetS patients with T2DM was significantly higher than those without T2DM (Mean 48 ± 9.9 vs. 42.5 ± 9.2; P < 0.001). The proportion of females was higher among MetS patients with T2DM as compared to those without T2DM (61% vs. 51%; P = 0.053). In addition, there were significant differences between MetS patients with and without DM in terms of co-morbidities of hypertension, coronary heart disease, and high cholesterol. The proportion of MetS patients with positive family history for MetS was significantly higher in MetS patients with T2DM as compared to those without T2DM (46.7% vs. 33.8%; P = 0.009). The proportion of positive family history of MetS among fathers (35% vs. 21.9%; P = 0.005), mothers (30.5% vs. 18.8%; P = 0.008), maternal aunt (18.3% vs. 11.2%; P = 0.055), and maternal grand father (19.5% vs. 10%; P = 0.010) were significantly higher in MetS patients with T2DM as compared to the counterpart. The proportion of consanguineous marriages was almost two times higher among MetS patients with T2DM as compared to those without T2DM (80.9% vs. 41.9%; P < 0.001). The proportion of MetS patients with T2DM was lower than MetS patients without DM below 45 years, but after 45 years, the proportion of MetS patients with T2DM remained higher than their counterparts.Conclusion:Family history of MetS among parents, maternal aunt, maternal grandfather, and consanguineous marriages among patients of MetS are significantly associated with the development of T2DM in Qatar. These results support the necessity of earlier screening for T2DM among MetS patients with positive family history of MetS.

EPA-0223 - Prevalence of and factors associated with metabolic syndrome in patients with major depressive disorder

To examine the prevalence of and factors associated with metabolic syndrome in patients with major depressive disorder. All major depressive disorder (MDD) patients visited our psychiatric clinic were screened. Subjects who met inclusion criteria and did not have exclusion criteria were invited to join this project until reach 140 subjects. The metabolic syndrome criteria proposed by the American Heart Association/National Heart, Lung, and Blood Institute (updated ATPIII) and International Diabetes Federation were applied for diagnosing metabolic syndrome. Age, history of antidepressant and antipsychotic use, time of illness, severity of illness and family history of metabolic syndrome were assessed as factors associated with metabolic syndrome. Data was analyzed by using percentage, mean, standard deviations, student t-test, chi-square test and Fisher's exact test. There were 140 subjects recruited. The prevalence of metabolic syndrome determine by the American Heart Association/National Heart, Lung, and Blood Institute (updated ATPIII) and International Diabetes Federation were 30%(42) and 31.4%(44) respectively. Family history and time of illness were significantly associated with metabolic syndrome in patients with major depressive disorder(p≤0.05). Thai MDD patients are likely to have and develop metabolic syndrome. These findings support the importance of assessing and monitoring metabolic syndrome in MDD patients.

Prevalence of insulin resistance in obese adolescence

Childhood obesity is a global health problem with several metabolic and cardiovascular complications. The prevalence of childhood and adolescent obesity is differed in each country with several affecting factors. Insulin resistance as one common feature of obesity is known to have a link with the risk of diabetes type 2 and cardiovascular complication. Insulin resistance is also a basic mechanism of metabolic syndrome. Several mechanisms proposed the link between obesity, insulin resistance, and metabolic syndrome. This study aimed to look at the characteristics of obese adolescence with metabolic syndrome and to look for the prevalence of insulin resistance among them with several risk factors that may affect. This was a cross-sectional study on 92 obese adolescent, aged between 12 and 15 years old, in Central Jakarta, Indonesia. All adolescent underwent blood sample tests, including fasting blood glucose, lipid profile, and fasting blood insulin. Insulin resistance was defined as a HOMA-IR index of 3.8 or more. The diagnostic of metabolic syndrome was defined according to International Diabetes Federation (IDF) criteria. Insulin resistance was found in 38% of the adolescent, with a higher rate among females (57.2%) than males (42.8%) (p = 0.673). Most of them had acanthosis nigricans as the marker of insulin resistance (71.4%) (p = 0.959). Among them, 82.8% had a family history of metabolic syndrome (p = 0.646). The prevalence of metabolic syndrome among obese adolescent was 19.6% with female predominant. The prevalence of each of the component was 48.9% for high blood pressure, 78,3% for abdominal obesity, 8.7% for impaired fasting glucose level, 22.8% for low levels of high-density lipoprotein cholesterol, and 21.7% for high triglyceride level. There was a strong correlation between impaired fasting glucose level and insulin resistance (p = 0.04), with the risk of 5.7 times to get insulin resistance. Insulin resistance has a prevalence of 38% in obese adolescent population in this study. Insulin resistance has a significant association with impaired fasting glucose level.

Influencia étnica en la prevalencia de síndrome metabólico en población pediátrica obesa

IntroductionObesity in children is becoming more prevalent. Obesity and type 2 diabetes is higher in the Latin American immigrant population. ObjectiveTo analyze the influence of ethnicity on the prevalence of metabolic syndrome (MS) and its components in an obese pediatric population. Patients and methodsA retrospective study of 616 obese children and adolescents (BMI ≥2 SD [Hernández 88-04]), was conducted on 142 Latin American children and 474 Caucasians, which compared the prevalence of metabolic syndrome and its components according to modified Cook criteria (2003): obesity+2 or more of the following components: HDL-cholesterol <40mg/dl, triglycerides >110mg/dl, systolic and/or diastolic blood pressure >p90 (Task Force 2004), and impaired glucose metabolism (ADA 2011). Hepatic function, family history of MS, HbA1c, insulin resistance (HOMA) and BMI evolution at one year of treatment with changes in lifestyle (diet and exercise) were also assessed. ResultsAlmost one-third (30.5%) of Latin American children had MS compared to 15.5% of Caucasians (OR=2.4 [CI 95%: 1.5-3.8]), P<.005] and OR=2.5 adjusting for sex, SD-BMI and puberty. Latin American children also had a higher insulin resistance (58.6% vs 42.8%, P<.005) and a worse outcome after one year of treatment. ConclusionThere is a higher prevalence of MS in our Latin American obese pediatric population with poor adherence to the measures of change in lifestyle, making these patients a group with potentially increased risks of cardiovascular disease in adulthood

Early metabolic imprinting as a determinant of childhood obesity

AimsChildhood obesity has seen an alarming increase in recent decades. This study was designed to assess the role of family history and perinatal programming in the aetiology of childhood obesity in a population known to have a high risk of developing metabolic syndrome. MethodologyThe study was carried out among two study populations of children. The first was a population of 206 mixed-gender 5-year-old children; the second of 230 mixed-gender 9-year-old children. The children underwent standard anthropomorphic measurements that were correlated to family history of metabolic syndrome-related illness, the child’s birth weight and a history of breastfeeding in early infant life. ResultsNo statistically significant correlation was noted with a family history of metabolic syndrome; but a definite (P=0.04) negative correlation was noted with breastfeeding in the 5-year-old children. Children of low birth weight appeared to retain a lower body weight at five years of age than their higher birth weight counterparts (P=0.002). The pattern changed to suggest a U-shaped distribution of obesity among the various birth weight groups of children, though statistical significance was noted only for the macrosomic group (P=0.002). ConclusionsThe study confirms the importance of intrauterine and early infant nutrition towards the development of childhood and later obesity. Children of low or high birth weight should be considered at risk and parents are advised actively regarding health lifestyle and nutrition options.

Umbilical Waist-to-Height Ratio and Trunk Fat Mass Index (DXA) as Markers of Central Adiposity and Insulin Resistance in Argentinean Children with a Family History of Metabolic Syndrome

Central adiposity is increasing in childhood. To find a simple index of central fatness that accurately predicts insulin resistance we studied 55 obese children and 53 siblings, aged 6-16 years. We recorded the family metabolic score, calculated clinical and DXA-derived fat distribution indexes and HOMA-IR. Umbilical waist-to-height ratio (W-to-Ht) had the best combination of ROC area (0.99, IC95: 0.93 to 1.0), Youden's index (0.976), coefficient of variation (4.9) and correlation with HOMA-IR (r = 0.58, p < 0.0001); it also correlated (p < 0.001) with BMI (r = 0.95) and DXA-trunk fat mass index (r = 0.93). It was the best predictor of insulin resistance in a multiple regression model (p < 0.0001). Odds ratios for insulin resistance were 9.33 when the family score was >10 (p < 0.01) and 14.35 when umbilical W-to-Ht was >0.54 (p < 0.0001). Umbilical W-to-Ht, a simple marker of central adiposity, strongly relates to children's DXA-trunk fat mass index and insulin resistance.

Spinal clinic for obesity outpatient project (SCOOP): a pilot study

Obesity in patients with spinal cord injuries (SCI) is an ongoing clinical and public health problem that often goes undetected and unmanaged. It is estimated that 24 000 individuals with SCI are overweight and obese in the UK (1) . Epidemiological data suggest that patients with SCI are more likely to become obese or overweight when compared with able-bodied population (60% v. 40 % respectively) (2,3) . Obesity in SCI is mainly a result of the sedentary lifestyle secondary to paralysis and change in body composition when compared with able-bodied individuals. The link between obesity and other chronic diseases such as type 2 diabetes, CVD and certain forms of cancer is well documented (4) . The consequences of an obesity epidemic include increased risk of premature death and it is estimated to cost the NHS £3.5 · 10 9 /year to treat obesity-related complications (4) . There is no obesity management clinic operating in UK spinal injuries centres. This project is the first in the UK that aims to assess the effectiveness of a dietitian-led weight-management programme in individuals with chronic SCI. A total of nineteen individuals (23‐73 years) with chronic SCI who were overweight or obese (BMI 28‐45 kg/m 2 ) were referred for consultation covering nutrition, exercise and cognitive behaviour therapy in three consultations over 3 months. Outcome measures included body composition from anthropometric measurements of BMI, mid upper arm circumference (MUAC), triceps skinfold thickness (TSF) and mid-arm muscle circumference (MAMC) and dietary assessment of nutrient intake by 7 d food diaries. Of the twelve individuals who returned to follow-up seven (58 %) reported that they had a family history of metabolic syndrome and six (50%) had one or more co-morbidities. Mean weight loss was 2.1 (SD 1.1) kg at week 4 and 3.2 (SD 3.7) kg at week 12. Analysis of the pre- to post-intervention differences (using t test) showed a significant reduction in weight (109.2 (SD 23.4) kg v. 105.1 (SD 23.1) kg; P = 0.008) and BMI (37.8 (SD 6.49) kg/m 2 v. 36.6 (SD 6.9) kg/m 2 ; P = 0.011). No significant changes were found in MUAC (39.3 (SD 2.6) cm v. 39.1 (SD 2.83) cm; P = 0.59), TSF (31.2 (SD 8.7) mm v. 27.2 (SD 7.1) mm; P = 0.21) and MAMC (30.2 (SD 3.9) cm v. 30.4 (SD 4.8) cm; P = 0.51). The 7 d food diary showed an average daily energy intake of 6.5 (SD 4.1) MJ (1565 (SD 982) kcal), which is 6 % below the estimated requirement. The findings of the present study suggest that the clinic may be able to help patients with SCI to achieve weight loss without compromising total lean body mass. Current guidance on nutritional requirement may be overestimated in the SCI population. Further research with a larger sample size is warranted in order to determine the effectiveness of the weight management clinic and the optimal nutritional requirements in individuals with SCI.

111: Comparison of adipokines between healthy persons with positive and negative family history of metabolic syndrome and type 2 diabetes mellitus

111: Comparison of adipokines between healthy persons with positive and negative family history of metabolic syndrome and type 2 diabetes mellitus

Triagem de mutações nos receptores de Angiotensina II, AGTR1 e AGTR2 e avaliação dos polimorfismos C573T e A1166C do gene AGTR1 em pacientes com adrenarca precoce idiopática

Precocious pubarche is the appearance of pubic hair before the age of 8 years in girls and 9 years in boys. The most frequent etiology is idiopathic precocious adrenarche, suggested, after long-term follow-up, to be associated with metabolic syndrome. One of the factors involved in the genesis of precocious adrenarche is Angiotensin II (Ang II), which promotes cell proliferation and steroidogenesis through type 1 (AT1) and type 2 (AT2) receptors. In order to study Ang II receptors mutations, 50 children with idiopathic precocious adrenarche were evaluated and compared to a control group of normal individuals. Mutations were not detected in the AGTR1 and AGTR2 genes; however, two polymorphisms were identified in the AGTR1 gene: the C573T (exon 5) and the A1166C (3' untranslated region). The polymorphic allele T573 was found in 35% of the patients and 38% of controls. The polymorphic allele C1166 was present in 24% of the patients and 26% of controls. There was no statistical difference between groups. There was also no correlation between the polymorphisms and clinical and laboratory findings, as well as their family history of metabolic syndrome.