Thesis (M.Ph.)--Georgia State University, 2008. / Title from file title page. Ike Okosun, committee chair; Richard Rothenberg, Rodney Lyn, committee members. Electronic text (73 p.) : digital, PDF file. Description based on contents viewed November 25, 2008. Includes bibliographical references (p. 69-73).

bjetivo. Evaluar la asociación entre síndrome metabólico (SM) y carga glicémica (CG) de la ingesta alimentaria en niños y adolescentes obesos atendidos en consulta endocrinológica de un hospital de referencia pediátrica en Lima, Perú. Población y método. Estudio transversal en niños y adolescentes obesos (índice de masa corporal ≥ percentil 95) de 10 a 15 años. Se clasificó como SM según los criterios de la International Diabetes Federation. Se aplicó un recordatorio de 24 horas y se calculó la CG total y por comida. Se evaluó la asociación entre los terciles de CG (comparación con el inferior) y SM usando razones de prevalencia ajustadas (RPa) por variables demográficas, antecedentes familiares, de actividad física y consumo total de carbohidratos en modelos de regresión de Poisson con varianza robusta. Resultados. De 273 niños y adolescentes obesos, 52,4% fueron varones y 94,9% fueron físicamente inactivos. La mediana de CG fue de 213 (164,8- 287,4) y la de ingesta calórica diaria fue 2275 (1851-3024) kcal, dada principalmente por carbohidratos (62%). La prevalencia de SM fue de 22,3%; los componentes con mayor prevalencia fueron la obesidad abdominal (81,7%) y los valores de lipoproteínas de alta densidad (HDL, del inglés high density lipoprotein) bajos (63,7%). Por último, se encontró una asociación entre el consumo elevado de CG y el riesgo de presentar SM (RPa 4,5; IC 95%: 1,3-15,3). Conclusiones. Existe una asociación entre el alto consumo de CG y la presencia de SM en niños y adolescentes con obesidad. / Objective. To study the association between the metabolic syndrome (MS) and the glycemic load (GL) of food intake among obese children and adolescents seen in consultation by the endocrinology team in a pediatric referral hospital in Lima, Peru. Population and Method. Cross-sectional study among obese children and adolescents (body mass index ≥ 95 percentile), 10-15 years old. The MS was classified according to criteria of the International Diabetes Federation. A 24 hour reminder was used, and the overall and per meal GL was calculated. The association between the GL tertiles (comparison with the lower tertile) and the MS was assessed using prevalence ratios adjusted by demographic outcome measures, family history, physical activity and total carbohydrate consumption in Poisson regression models with a robust variance. Results. Out of 273 obese children and adolescents, 52.4% were male and 94.9% did not engage in any physical activity. Glycemic load median value was 213 (164.8-287.4) and the daily calorie intake value was 2275 (1851-3024) kcal, consisting mainly of carbohydrates (62%). MS prevalence was 22.3%; the most prevalent components were abdominal obesity (81.7%) and low values of high density lipoprotein (HDL) (63.7%). Lastly, an association was observed between a high consumption of GL and the risk of developing MS (aRP 4.5; 95% CI: 1.3-15.3). Conclusions. There is an association between a high consumption of GL and the presence of MS among obese children and adolescents.

BACKGROUND: Risk factors associated with Metabolic Syndrome (MetS) have been implicated in cardiovascular disease (CVD) development and outcomes. Few studies have investigated relationships between psychological variables, MetS factors, and indices of cardiac structure and function (CSF) among healthy individuals in a single conceptual model. No studies to date have analyzed such relationships in patients with CVD. METHODS: The present study examined associations between cynical hostility (CynHo), MetS factors, and CSF in 186 multi-ethnic post-myocardial infarction (MI) patients. Structural equation modeling was used to test a theory driven model of MetS that had good statistical fit. Primary MetS variables included waist circumference (WC), the homeostatic model of insulin resistance (HOMA-IR), glucose area under the curve (G-AUC), triglycerides (TRIG), high-density lipoprotein cholesterol (HDL-C), and diastolic blood pressures (DBP). Secondary MetS variables included plasminogen activator inhibitor-1 (PAI-1) and a latent inflammation variable comprised of CRP and IL-6. Cardiac function variables were fractional shortening (FS), E/A ratio, and rate-pressure product (RPP). A latent cardiac mass (CM) variable was also created. RESULTS: The final structural model had good model fit (Chi-Square(102)=100.65, p=0.52, CFI=1.00, RMSEA=0.00, and SRMR=0.04). Direct paths were supported between WC and CM and all MetS factors except TRIG and G-AUC. WC was indirectly associated with DBP via CM. The model supported positive direct paths between HOMA-IR and G-AUC, TRIG, and PAI-1, but not inflammation or HDL-C. HOMA-IR demonstrated a direct positive association with RPP and direct inverse associations with FS and E/A ratio. No direct paths were supported between other MetS variables except one between TRIG and HDL-C. CynHo demonstrated a direct positive relationship with HOMA-IR. CONCLUSIONS: Similar to findings in healthy individuals, central adiposity and IR play primary roles in CSF impairment in post-MI patients. Findings suggest that CynHo could promote the progression of metabolic dysfunction and cardiac disease via factors that influence the efficiency of glucose metabolism. Interventions for post-MI patients should take into account both direct and indirect effects of CynHo, central adiposity, and IR on the progression of CVD in this population to reduce adverse outcomes and improve quality of life.

Fat tissue plays a main role in the development of the metabolic syndrome. Many components of the metabolic syndrome may be improved by dietary arrangements, including an increased intake of n-3 PUFA. In addition to the positive effect of n-3 PUFA, a possible effect of a higher calcium intake on influencing weight loss and energy metabolism has also been discussed for a long time. In addition to nutritional factors, genetic factors significantly contribute to influencing weight and lipid and glucose metabolism. In study A, 40 obese women were observed during three weeks of weight reduction management. Women were randomly divided into two groups. The first group received yogurt enriched with n-3 PUFA, and the second group consumed yoghurt without the supplementation. The results show that low-dose supplementation with n-3 PUFA in yogurt in combination with a reduced energy intake increases n-3 PUFA content in serum lipids and prevents adverse changes in the composition of FA in serum after a short-term low-calorie diet. In study B, we monitored the influence of n-3 PUFA supplementation on short-term weight management with VLCD in 20 women with severe obesity, who were randomly divided into two groups. The first group received VLCD enriched with n-3 PUFA, the second group VLCD with a placebo. The addition of...

Fat tissue plays a main role in the development of the metabolic syndrome. Many components of the metabolic syndrome may be improved by dietary arrangements, including an increased intake of n-3 PUFA. In addition to the positive effect of n-3 PUFA, a possible effect of a higher calcium intake on influencing weight loss and energy metabolism has also been discussed for a long time. In addition to nutritional factors, genetic factors significantly contribute to influencing weight and lipid and glucose metabolism. In study A, 40 obese women were observed during three weeks of weight reduction management. Women were randomly divided into two groups. The first group received yogurt enriched with n-3 PUFA, and the second group consumed yoghurt without the supplementation. The results show that low-dose supplementation with n-3 PUFA in yogurt in combination with a reduced energy intake increases n-3 PUFA content in serum lipids and prevents adverse changes in the composition of FA in serum after a short-term low-calorie diet. In study B, we monitored the influence of n-3 PUFA supplementation on short-term weight management with VLCD in 20 women with severe obesity, who were randomly divided into two groups. The first group received VLCD enriched with n-3 PUFA, the second group VLCD with a placebo. The addition of...

4 Abstract The prevalence of obesity and its related cardiometabolic complications in children remains high across the world. Obesity is a multifactorial disease caused by interaction between genes and environmental factors. Genome-wide association studies have discovered several single nucleotide polymorphisms associated with obesity. A causal role of infection in the pathogenesis of obesity has also been considered, particularly the role of adenovirus 36 (Adv36). The aim of the Ph.D. thesis was to investigate the associations of obesity susceptibility loci (TMEM18, SH2B1, KCTD15, PCSK1, BDNF, SEC16B, MC4R, FTO) and Adv36 infection with obesity-related characteristics and complications in the Czech adolescent population. The results are described in eight publications, of which six are original papers and two are reviews. Studies were performed on a cohort of Czech adolescents recruited either from the general population (1,533 individuals from the epidemiological study) and from in-patient or outpatient weight management clinics (562 overweight/obese individuals underwent an intervention). The results demonstrated an association of TMEM18, SEC16B and FTO gene variants with obesity. Some variants of the genes involved in hypothalamic regulation of energy homeostasis − MC4R, BDNF, PCSK1 − were related to...

<p>Преваленца гојазности и метаболичког синдрома у јувенилној популацији је<br />драматично у порасту и представља јавно-здравствени проблем у целом свету.<br />Гојазност, нарочито висцералног типа, је кључни аспект за појаву метаболичког<br />синдрома или појединих његових компоненти у млађој популацији. Оваква патолошка<br />стања доводе до појаве низ компликација као и фактора ризика за настанак<br />кардиоваскуларних обољења и дијабетеса типа II, касније у адултној доби. Циљ ове<br />студије био је да се утврде ефекти програма физичке активности и хипокалоријске<br />исхране на антропометријске, конституционалне, метаболичке и кардиоваскуларне<br />параметре код гојазне деце, имајући у виду да је за настанак гојазности управо<br />одговоран животни стил у смислу неадекватне исхране и хипокинезије код младих. У<br />ту сврху креиран је упитник на основу ког смо дoбили увид о животним навикама<br />испитаника и закључили да се ради о гојазној јувенилној популацији, са врло мало<br />квалитативног уноса хранљивих материја и физички неактивном у великој мери.<br />Такође присутна је и генетска предиспонираност за кардиоваскуларне и метаболичке<br />болести, на шта нам указује породична анамнеза. Програм физичке активности и<br />дијететског режима, прилагођен узрасној групи испитаника од 11-14 година &plusmn; 0.5 год,<br />био је краткорочног карактера у трајању од три месеца. У циљу провере ефекта<br />мултидисциплинарног третмана, сви испитивани параметри су мерени у три временске<br />тачке (иницијално, трансверзално и финално мерење). Дескриптивне резултати у све<br />три групе испитиваних параметара показују статистички значајне промене код свих<br />испитаника у све три временске, као и резултати једнофакторске униваријантне анализе<br />варијансе (ANOVA) за поновљена мерења (one-way repeated measures ANOVA) за Sig.&lt;<br />0,05. Телесна маса и обими трбуха су значајно редуковани као и сви остали параметри<br />циркуларне димензионалности и поткожног масног ткива, исхрањености и<br />конституције. Код физиолошких показатеља метаболичког синдрома такође је дошло<br />до редукције и позитивних промена. Потврда је добијена мултиваријатном анализом<br />варијансе за поновљена мерења (One-way repeated measures MANOVA) за Sig.&lt;0,05,<br />дате тестом Wilk&rsquo;s Lambda, чиме смо потврдили значајан ефекат спроведеног третмана<br />вежбања и редуковане исхране, који је изазвао значајне промене у свим посматраним<br />просторима.</p> / <p>Prevalenca gojaznosti i metaboličkog sindroma u juvenilnoj populaciji je<br />dramatično u porastu i predstavlja javno-zdravstveni problem u celom svetu.<br />Gojaznost, naročito visceralnog tipa, je ključni aspekt za pojavu metaboličkog<br />sindroma ili pojedinih njegovih komponenti u mlađoj populaciji. Ovakva patološka<br />stanja dovode do pojave niz komplikacija kao i faktora rizika za nastanak<br />kardiovaskularnih oboljenja i dijabetesa tipa II, kasnije u adultnoj dobi. Cilj ove<br />studije bio je da se utvrde efekti programa fizičke aktivnosti i hipokalorijske<br />ishrane na antropometrijske, konstitucionalne, metaboličke i kardiovaskularne<br />parametre kod gojazne dece, imajući u vidu da je za nastanak gojaznosti upravo<br />odgovoran životni stil u smislu neadekvatne ishrane i hipokinezije kod mladih. U<br />tu svrhu kreiran je upitnik na osnovu kog smo dobili uvid o životnim navikama<br />ispitanika i zaključili da se radi o gojaznoj juvenilnoj populaciji, sa vrlo malo<br />kvalitativnog unosa hranljivih materija i fizički neaktivnom u velikoj meri.<br />Takođe prisutna je i genetska predisponiranost za kardiovaskularne i metaboličke<br />bolesti, na šta nam ukazuje porodična anamneza. Program fizičke aktivnosti i<br />dijetetskog režima, prilagođen uzrasnoj grupi ispitanika od 11-14 godina &plusmn; 0.5 god,<br />bio je kratkoročnog karaktera u trajanju od tri meseca. U cilju provere efekta<br />multidisciplinarnog tretmana, svi ispitivani parametri su mereni u tri vremenske<br />tačke (inicijalno, transverzalno i finalno merenje). Deskriptivne rezultati u sve<br />tri grupe ispitivanih parametara pokazuju statistički značajne promene kod svih<br />ispitanika u sve tri vremenske, kao i rezultati jednofaktorske univarijantne analize<br />varijanse (ANOVA) za ponovljena merenja (one-way repeated measures ANOVA) za Sig.&lt;<br />0,05. Telesna masa i obimi trbuha su značajno redukovani kao i svi ostali parametri<br />cirkularne dimenzionalnosti i potkožnog masnog tkiva, ishranjenosti i<br />konstitucije. Kod fizioloških pokazatelja metaboličkog sindroma takođe je došlo<br />do redukcije i pozitivnih promena. Potvrda je dobijena multivarijatnom analizom<br />varijanse za ponovljena merenja (One-way repeated measures MANOVA) za Sig.&lt;0,05,<br />date testom Wilk&rsquo;s Lambda, čime smo potvrdili značajan efekat sprovedenog tretmana<br />vežbanja i redukovane ishrane, koji je izazvao značajne promene u svim posmatranim<br />prostorima.</p> / <p>Prevalence of obesity and metabolic syndrome in juvenile population is increasing<br />dramatically and presents a worldwide public health problem. Obesity, the visceral type in<br />particular, is the key aspect for emergence of metabolic syndrome or some of its individual<br />components in the younger population. Pathological states of this kind lead to development of<br />a range of complications, as well as, risk factors for emergence of cardiovascular diseases and<br />diabetes type II, later in adult age. The aim of this study was to determine effects of a program<br />of physical activity and hypocaloric diet on anthropometric, constitutional, metabolic and<br />cardiovascular parameters in obese children, considering that it is lifestyle, namely inadequate<br />diet and lack of movement, which is responsible for emergence of obesity in children. With<br />this in mind, we have created a questionnaire which has given us an insight into living habits<br />of the participants, and we have determined that we are dealing with an obese juvenile<br />population which consumes very little of quality nutritious foods, and which is, to a great<br />extent, physically inactive. Also, there is a presence of genetic predisposition for<br />cardiovascular and metabolic diseases, which was indicated in family anamnesis. The<br />physical activity and diet regime program, adapted to the age group of the participants (11 to<br />14-year-olds &plusmn; 0.5 year) was short term in character and it lasted for three months. With the<br />aim of checking the effect of the multidisciplinary treatment, all the tested parameters were<br />measured at three points in time (initial, transversal and final measurements). Descriptive<br />results in all three groups of the measured parameters indicate statistically significant changes<br />in all the participants, at all three time points, as do the results of one-way repeated measures<br />ANOVA for Sig.&lt; 0,05. Body mass and abdominal circumferences were reduced<br />significantly, as were all the other parameters of circulatory dimensions and subcutaneous fat,<br />nourishment and constitution. Reduction and positive changes were also measured in<br />physiological indicators for metabolic syndrome. The results were confirmed by one-way<br />repeated measures MANOVA for Sig.&lt; 0.05, using the Wilk&rsquo;s Lambda test, through which<br />we have confirmed a significant effect of the applied treatment which has caused significant<br />changes in all the measured parameters.</p>