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Current Atherosclerosis Reports Sep 2023In this review, we provide insight into and raise awareness of the impact of the COVID-19 pandemic on the prevalence of acquired atherosclerotic cardiovascular disease... (Meta-Analysis)
Meta-Analysis Review
PURPOSE OF REVIEW
In this review, we provide insight into and raise awareness of the impact of the COVID-19 pandemic on the prevalence of acquired atherosclerotic cardiovascular disease (ASCVD) risk factors in adolescents. We highlight data that could be used to guide the response to a future pandemic with the goal of reducing premature cardiovascular disease (CVD)-related morbidity and premature mortality.
RECENT FINDINGS
During the global COVID-19 pandemic, many individuals, including youth, voluntarily or were mandated to alter the usual lifestyle in order to limit exposure and reduce the spread of the virus. Some of these changes resulted in unintended consequences, particularly acquisition of risk factors such as excessive weight gain, insulin resistance/diabetes, and dyslipidemia, commonly associated with ASCVD. A study from China examined changes in the prevalence of obesity and found a 2.4% rise attributable to the pandemic. Adequate daily physical activity plays an important role in ASCVD risk reduction. A systematic review and meta-analysis showed a 20% (90% CI, -34 to -4%) reduction in physical activity from before vs. during the COVID-19 pandemic. Another study of patients with type 2 diabetes found the mean HbA1c was significantly elevated during the COVID-19 pandemic (7.53 ± 1.02% in 2020) compared with the previous 2 years. In addition, there has been an alarming rise of childhood mental health concerns and suicide during the pandemic. Early identification and optimum management of CVD risk factors play an important role helping prevent future cardiovascular disease. Following the rapid spread of the virus, the World Health Organization (WHO) officially declared COVID-19 a global pandemic on March 11th, 2020. In an attempt to avoid infection and reduce the spread of the virus, many alterations in lifestyle were adopted on an international scale. While necessary, these modifications resulted in many adverse unintended health consequences in children and adolescents. This paper reviews the impact of the pandemic and the associated lifestyle changes on the prevalence of acquired atherosclerotic cardiovascular disease (ASCVD) risk factors in youth. In addition to providing insight, we hope to raise awareness of the pandemic's impact, and highlight specific data that could be used to guide the response to a future pandemic.
Topics: Humans; Adolescent; Child; Pandemics; Cardiovascular Diseases; Diabetes Mellitus, Type 2; COVID-19; Risk Factors; Atherosclerosis
PubMed: 37470956
DOI: 10.1007/s11883-023-01130-1 -
Obesity Reviews : An Official Journal... Feb 2024Bariatric surgery and weight loss devices have been considered as a therapeutic option in some settings for adolescents with severe obesity. We conducted a systematic... (Review)
Review
BACKGROUND
Bariatric surgery and weight loss devices have been considered as a therapeutic option in some settings for adolescents with severe obesity. We conducted a systematic review and qualitative evidence synthesis of factors affecting adolescent and caregiver decision-making processes around such interventions, as well as post-surgery demands and challenges, so that their experiences might be better understood and improved support given. No previous qualitative evidence synthesis has been published on this topic.
METHODS AND FINDINGS
We searched 10 bibliographic databases and followed-up gray literature and citations sources. We performed a qualitative evidence synthesis on 19 primary qualitative research studies in adolescents aged 13 years or older. They reported diverse motivations and incentives for considering these interventions, including the physical and social problems resulting from living with obesity, and an awareness of the benefits and limitations of interventions. They reported that they need: information, physical and emotional support and, in some cases, financial assistance. There was high confidence in a majority of these findings (GRADE CERQual).
CONCLUSIONS
We found that supportive interventions accompanying bariatric surgery should be in place to offer: practical help; address anxieties and uncertainties; and facilitate both appropriate decision-making and the achievement of young people's desired outcomes.
Topics: Adolescent; Humans; Caregivers; Pediatric Obesity; Bariatric Surgery; Obesity, Morbid; Weight Loss; Qualitative Research
PubMed: 37916534
DOI: 10.1111/obr.13654 -
Jornal de Pediatria 2024This paper aims to review data on the association of obesity and iron deficiency in children and adolescents, exposing the possible involvement of hepcidin and... (Review)
Review
OBJECTIVES
This paper aims to review data on the association of obesity and iron deficiency in children and adolescents, exposing the possible involvement of hepcidin and interleukin-6 (IL-6), obesity's inflammation biomarkers.
DATA SOURCE
Articles from PUBMED and WEB OF SCIENCE database with no chronological limit were reviewed to write this systematic review. Keywords such as children, obesity, iron deficiency, and hepcidin were used. After deleting duplicated and review articles, 91 were screened, and 39 were selected as eligible. Sixteen articles were included because they involved serum hepcidin levels in obese children and adolescents as outcomes.
SUMMARY OF FINDINGS
Finally, those 16 articles were organized in two tables: one includes therapeutic interventions, and the other does not. As hepcidin was discovered in 2000, the first articles that presented serum hepcidin's quantification in obese children and adolescents, homeostasis iron markers, and their possible association with obesity's inflammatory environment began to be published in 2008.
CONCLUSIONS
Obesity's chronic inflammation state leads to the production of IL-6, which acts as a signaling molecule for hepcidin synthesis, resulting in iron deficiency, which is common in obese children and adolescents who respond inadequately to iron supplementation. On the other hand, that population responds adequately to therapeutic intervention programs that lead to weight loss, guaranteeing iron homeostasis improvement. Therefore, perhaps it is time to discuss serum hepcidin level quantification as part of evaluating children and adolescents with iron deficiency, which could guide clinical choices that might lead to better therapeutic outcomes.
Topics: Adolescent; Child; Humans; Pediatric Obesity; Hepcidins; Interleukin-6; Body Mass Index; Iron Deficiencies; Iron; Inflammation; Biomarkers; Anemia, Iron-Deficiency
PubMed: 37541648
DOI: 10.1016/j.jped.2023.06.002 -
Journal of Clinical Medicine Mar 2024Obesity is invariably accompanied by autonomic dysfunction, although data in pediatric populations are conflicting. We conducted a systematic review and meta-analysis... (Review)
Review
Obesity is invariably accompanied by autonomic dysfunction, although data in pediatric populations are conflicting. We conducted a systematic review and meta-analysis of 12 studies (totaling 1102 participants) comparing obese and normal-weight subjects (5-18 years of age), defined as body mass index >95th or <85th percentile, respectively. Using a random-effects model, we report the standardized mean differences (SMD) of sympathetic and vagal indices of heart rate variability. Autonomic dysfunction was present in the obesity group, based on the average SMD in the standard deviation of sinus intervals (at -0.5340), and on the ratio of low (LF)- to high (HF)-frequency spectra (at 0.5735). There was no difference in sympathetic activity, but the heterogeneity among the relevant studies weakens this result. SMD in HF (at 0.5876), in the root mean square of successive differences between intervals (at -0.6333), and in the number of times successive intervals exceeded 50 ms divided by the total number of intervals (at -0.5867) indicated lower vagal activity in the obesity group. Autonomic dysfunction is present in obese children and adolescents, attributed to lower vagal activity. Further studies are needed in various pediatric cohorts, placing emphasis on sympathetic activity.
PubMed: 38610619
DOI: 10.3390/jcm13071854 -
International Journal of Molecular... Apr 2024This study examines the impact of insulin-like growth factor 1 (IGF-1) and insulin-like growth factor 2 (IGF-2) on various aspects of children's health-from the realms... (Review)
Review
This study examines the impact of insulin-like growth factor 1 (IGF-1) and insulin-like growth factor 2 (IGF-2) on various aspects of children's health-from the realms of growth and puberty to the nuanced characteristics of metabolic syndrome, diabetes, liver pathology, carcinogenic potential, and cardiovascular disorders. A comprehensive literature review was conducted using PubMed, with a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method employing specific keywords related to child health, obesity, and insulin-like growth factors. This study reveals associations between insulin-like growth factor 1 and birth weight, early growth, and adiposity. Moreover, insulin-like growth factors play a pivotal role in regulating bone development and height during childhood, with potential implications for puberty onset. This research uncovers insulin-like growth factor 1 and insulin-like growth factor 2 as potential biomarkers and therapeutic targets for metabolic dysfunction-associated liver disease and hepatocellular carcinoma, and it also highlights the association between insulin-like growth factors (IGFs) and cancer. Additionally, this research explores the impact of insulin-like growth factors on cardiovascular health, noting their role in cardiomyocyte hypertrophy. Insulin-like growth factors play vital roles in human physiology, influencing growth and development from fetal stages to adulthood. The impact of maternal obesity on children's IGF levels is complex, influencing growth and carrying potential metabolic consequences. Imbalances in IGF levels are linked to a range of health conditions (e.g., insulin resistance, glucose intolerance, metabolic syndrome, and diabetes), prompting researchers to seek novel therapies and preventive strategies, offering challenges and opportunities in healthcare.
Topics: Pregnancy; Child; Female; Humans; Insulin-Like Growth Factor I; Insulin-Like Growth Factor II; Metabolic Syndrome; Obesity; Insulin-Like Peptides; Diabetes Mellitus
PubMed: 38612776
DOI: 10.3390/ijms25073966 -
Nutrition Reviews Jun 2024Over the past few decades, traditional foods have been displaced by ultra-processed foods (UPFs), with the latter being associated with health problems.
CONTEXT
Over the past few decades, traditional foods have been displaced by ultra-processed foods (UPFs), with the latter being associated with health problems.
OBJECTIVE
This scoping systematic review aimed to identify the relationship between UPF intake and overweight/obesity as well as other cardiometabolic risk factors during childhood and adolescence.
DATA SOURCES
The guidance for this protocol is the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P). A systematic search was undertaken on PubMed, Scopus, and Cochrane Library electronic databases based on prespecified inclusion and exclusion criteria up to 6 February 2022.
DATA EXTRACTION
A total of 17 observational studies-9 cross-sectional, 7 cohort-longitudinal, and 1 study reporting both cross-sectional and longitudinal outcomes-among children and adolescents aged ≤18 years were eligible for inclusion in this review. Fourteen studies evaluated the consumption of UPFs in association with overweight/obesity and 9 studies examined the association of UPF consumption and cardiometabolic-related risk factors.
DATA ANALYSIS
Most studies (14/17) showed that an increase in UPFs was associated with a higher prevalence of overweight/obesity and cardiometabolic comorbidities among children and adolescents, whereas 4 of 17 studies (3 cross-sectional and 1 cohort) found no association. Most cohort and cross-sectional studies showed good quality according to the National Institutes of Health and Newcastle-Ottawa quality assessment, respectively.
CONCLUSION
The positive association found between UPFs and overweight/obesity and cardiometabolic comorbidities among children and adolescents raises concerns for future health. Further investigation is recommended to explore the role of specific types of UPFs on cardiometabolic conditions and to identify the amount of daily intake that increase risk in order to shape appropriate public health policies.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO registration no. CRD42022316432.
Topics: Humans; Child; Adolescent; Pediatric Obesity; Fast Foods; Cardiovascular Diseases; Cardiometabolic Risk Factors; Comorbidity; Diet; Food, Processed
PubMed: 37550263
DOI: 10.1093/nutrit/nuad095 -
Indian Pediatrics Apr 2024The preconception period is the earliest window of opportunity to ensure optimal human development. Pregnancy and childbirth outcomes can be improved by interventions... (Review)
Review
JUSTIFICATION
The preconception period is the earliest window of opportunity to ensure optimal human development. Pregnancy and childbirth outcomes can be improved by interventions offered to support the health and well-being of women and couples prior to conception. Thus, preconception care is essential in preparing for the first thousand days of life. Adolescence, the stage of life that typically comes before the preconception stage, is characterized by various high-risk behaviors like substance abuse, sexual experimentation, injuries, obesity, and mental health issues which can adversely affect their health in adult life. Thus, a Consensus Guideline for pediatricians on providing preconception care to adolescents and young adults can go a long way in making the generations to come, healthier and more productive.
OBJECTIVES
The purpose of these recommendations is to formulate an evidence-based Consensus Statement that can serve as a guidance for medical professionals to provide preconception care for young adults and adolescents.
INTENDED USERS
All obstetric, pediatric, and adolescent health care providers.
TARGET POPULATION
Adolescents and young adults.
PROCESS
A large proportion of adolescents seek care from pediatricians and there is a lack of Consensus Guidelines on preconception care. Therefore, the Indian Academy of Pediatrics called an online National Consultative Meeting on April 03, 2023, under the chairmanship of Dr MKC Nair and the National Convenor Dr Himabindu Singh. A group of pediatricians with wide experience and expertise in adolescent health care were assigned the task of formulating evidence-based guidelines on preconception care. The group conducted a comprehensive review of existing evidence by searching resources including PubMed and Cochrane databases. Subsequently, a physical meeting was held at Amritsar on October 07, 2023 during which the consensus was reached through discussions and voting. The level of evidence (LoE) of each recommendation was graded as per the Oxford Centre for Evidence-Based Medicine (OCEBM) 2011.
RECOMMENDATIONS
Every woman planning a pregnancy needs to attain and maintain a eumetabolic state. Prospective couples need to be counselled on the importance of a healthy lifestyle including a nutritious diet, avoidance of substance abuse, and timely screening for genetic disorders. Screening for and management of sexually transmitted diseases in males and females, appropriate vaccination and addressing mental health concerns are also recommended.
Topics: Adolescent; Female; Humans; Male; Pregnancy; Young Adult; Asian People; Consensus; Preconception Care; Prospective Studies; Substance-Related Disorders
PubMed: 38597099
DOI: No ID Found -
Pediatric Obesity Dec 2023The progress of genome-wide association studies (GWAS) in childhood obesity and its indicators is challenging and there are differences in genetic studies in children... (Review)
Review
BACKGROUND
The progress of genome-wide association studies (GWAS) in childhood obesity and its indicators is challenging and there are differences in genetic studies in children and adults.
OBJECTIVE
To illustrate the history of the development of GWAS in childhood obesity and its indicators and summarize the GWAS loci.
METHODS
PubMed, Web of Science, Embase and GWAS Catalog databases were systematically searched from 1 January 2005 to 19 October 2022 for literature related to GWAS of childhood BMI, body fatness and obesity. The nearest genes were used as positional genes to perform gene set analyses including the enrichment of pathways, tissues and diseases.
RESULTS
Twenty articles published between 2007 and 2021 were included in this scoping review, which identified 116 SNPs reaching genome-wide significance with childhood BMI (n = 50), body fatness (n = 31) and obesity (n = 35). The study populations were European in 16 studies, non-European in three studies (1 East Asian; 1 American; 1 Mexican) and trans-ancestry in one study. Several enriched pathways, tissues and diseases were identified through enrichment analysis of genes associated with childhood obesity and its indicators.
CONCLUSIONS
The innovations in tools and methods enable GWAS to better explore the genetic characteristics of obesity in children and adolescents. However, the number of GWAS in American, Asian and African populations is limited compared to the European population.
Topics: Adolescent; Child; Humans; Genetic Predisposition to Disease; Genome-Wide Association Study; Pediatric Obesity; Polymorphism, Single Nucleotide
PubMed: 37800454
DOI: 10.1111/ijpo.13077 -
Cureus Feb 2024Obesity is one of the primary public health problems faced by children. The increased incidence of obesity in the pediatric population poses significant challenges... (Review)
Review
Obesity is one of the primary public health problems faced by children. The increased incidence of obesity in the pediatric population poses significant challenges during and after surgical procedures. This systematic review and meta-analysis aimed to understand to what extent obesity is to surgical complications in pediatric patients. A systematic database search of PubMed, Web of Science, Scopus, and Science Direct was performed in June 2023. According to the inclusion and exclusion criteria, two evaluators independently conducted literature screening, data extraction, and quality evaluation of the retrieved literature. The Newcastle-Ottawa Scale score was used for quality evaluation, and a meta-analysis was performed using Review Manager software 5.4.1. A total of 1,170 relevant articles were initially identified, and 20 articles were finally included for data extraction and meta-analysis. The results of the meta-analysis showed that compared with normal-weight individuals, obese pediatric patients had a higher risk of developing surgical site infection (SSI) (relative risk (RR) = 1.63; 95% confidence interval (CI) = 1.33-2.00), wound dehiscence (RR = 2.01; 95% CI = 1.24-3.23), and underwent procedures that were 11.32 minutes longer (95% CI = 5.36-17.29). There were no differences in bleeding requiring transfusion, deep venous thromboembolism, postoperative abscess rate, and length of stay. Obese pediatric patients have a higher risk of SSI and dehiscence, along with a longer operative time. The established risks in obese adults undergoing surgery suggest a similar risk for obese pediatric patients. The findings of this study hold significant implications for clinical practice, suggesting the potential for additional measures to prevent surgical complications in children.
PubMed: 38510855
DOI: 10.7759/cureus.54470 -
Acta Bio-medica : Atenei Parmensis Dec 2023The relationship between precocious or early puberty and its treatment has received significant research attention, yielding diverse outcomes. This short review aims to...
BACKGROUND
The relationship between precocious or early puberty and its treatment has received significant research attention, yielding diverse outcomes. This short review aims to comprehensively analyze and summarize research articles to elucidate the potential link between precocious or early pubertal onset (CPP) and crucial health factors.
METHODS
We conducted a systematic review of studies published from -January 2000 to March 2023, sourced from databases of Medline, PubMed, Google Scholar and Web of Science. We assessed the relationship between CPP and final adult height (FHt), bone health, reproductive function, body mass index, metabolic and cardiovascular abnormalities, and increased cancer risk.
RESULTS
Upon reviewing and analyzing selected studies, the following key findings emerged: (a) treating CPP in girls before age 6-7 and in boys before age 9 improves FHt; (b) bone mineral density (BMD) decreases during GnRHa treatment but normalizes afterward, with no lasting effects on peak bone mass during puberty; (c) GnRH treatment does not negatively affect menstrual cycles; however, untreated CPP increases the risk of premature or early-onset menopause; (d) the incidence of PCOS/hyperandrogenemia may be slightly elevated in women with a history of CPP, but overall reproductive function remains largely unaffected; (e) earlier thelarche and menarche may enhance susceptibility to breast carcinogenesis; (f) CPP contributes to an increased risk of obesity and type 2 diabetes in both genders; (g) early menarche may slightly increase the risk of coronary heart disease and ischemic strokes and (h) early pubertal timing increases the risk of depression and anxiety disorders.
CONCLUSION
Monitoring and early diagnosis of these conditions are of paramount importance for successful management.
Topics: Female; Humans; Male; Child; Diabetes Mellitus, Type 2; Gonadotropin-Releasing Hormone; Puberty, Precocious; Obesity; Puberty
PubMed: 38054666
DOI: 10.23750/abm.v94i6.15316