Anthropometric Profile, Serum Leptin, Antioxidant Vitamins, LEPR Q223R Polymorphism and Cardiovascular Risk Factors in Adolescents
Abstract
Abstract. Cardiovascular disease (CVD) risk factors, such as bad eating habits, are typical in adolescence and lead to the consumption of meals that are not always sufficient in vitamins A, E, β-carotene, excess calories and elevated serum leptin levels. The purpose of this research is to study the relationship between vitamin A deficiency (VAD), β-carotene deficiency (βcD), vitamin E deficiency (VED) and to explore the association of leptin receptor Q223R polymorphisms with obesity and other risk factors for CVD. Method: This observational study included 237 adolescents recruited from Adolescents Reference Center, Brazil. It was collected: socioeconomic and clinical data, laboratory and molecular samples. Results: The average age was 14.93 ± 2.18 years, 66.2 % were girls, 38.0 % had high levels of total cholesterol (TC) between 10–14 years Triceps (TSF) and subscapular skinfolds (SSF) measurements were inversely correlated with VAD. There was also an association between VAD, βcD and high triglyceride (TG) levels. Adolescents with the RR genotype presented a trend toward higher levels of body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), TC, TG, low density lipoprotein (LDLC), leptin and low levels of high-density lipoprotein (HDL-c). Conclusion: The girls had higher levels of leptin than boys. Abdominal fat, βcD and VED were observed in adolescents with VAD. Individuals with RR genotype have drawn attention to cardiovascular risk factors such as high rate of LDLC and reduced rate of HDLc. Thus, it is possible that individuals with this genotype may be more susceptible to the presence of cardiovascular risk factors.
Literature
Schneider A. Malnutrition with Obesity. Aktuelle Ernährungs medizin 2008;33:280–283.
Xanthakos SA. Nutritional deficiencies in obesity and after bariatric surgery Pediatr Clin North Am. 2009; 56:1105–1121.
Kimmons JE, Blanck HM, Tohilli BC, Zhang J, Khan LK. Associations between body mass index and the prevalence of low micronutrient levels among US adults. Med Gen Med 2006; 8:59.
Kaidar-Person O, PersonB, Somstein, Rosenthal RJ. Nutritional deficiencies in morbidly obese patients: a new form of malnutrition. Part B: minerals. Obes Surg 2008; 18:1028–1034.
Engler MM, Engler MB, Malloy MJ, Chiu EY, Schloetter MC, Paul SM, et al. Antioxidant vitamins C and E improve endothelial function in children with hyperlipidemia: Endothelial Assessment Risk from Lipids in Youth (EARLY) Trial. Circulation 2003;108: \A1059–1063.
Daryani A, Basu S, Becker W, Larsson A, Risérus U. Antioxidant intake, oxidative stress and inflammation among immigrant women from the Middle East living in Sweden: Associations with cardiovascular risk factors. Nutr Metab Cardiovasc Dis 2007; 17:748–56.
Bressan J, Hermsdorff HHM, Zulet MA, Martínez JA. Impacto hormonal e inflamatório de diferentes composições dietéticas: ênfase em padrões alimentares e fatores dietéticos específicos. Arq Bras Endocrinol Metab 2009; 53: 572–81.
Ramalho RA, Accioly E, Silva LM. Doenças cardiovasculares: Efeito antioxidante das vitaminas A, C e E. Rev Metabol Nutr. 2003; 17: 6–9.
National Institute of Health (NIH). Expert panel on integrated guidelines of cardiovascular health and risk reduction in children and adolescents summary report. Department of Health and Human Services. 2012.
Santos AFR. O polimorfismo Gln223Arg do gene do receptor da leptina e a sua associação com fatores de risco cardiovascular. [Dissertação Mestrado em Ciência da Saúde]. Faculdade de Medicina da PUCRS Porto Alegre; 2005.
Brasil. Ministério da Saúde. Secretaria de Atenção em Saúde. Departamento de Ações Programáticas Estratégicas. Diretrizes nacionais para a atenção integral à saúde de adolescentes e jovens na promoção, proteção e recuperação da saúde./Ministério da Saúde, Secretaria de Atenção em Saúde, Departamento de Ações Programáticas Estratégicas, Área Técnica de Saúde do Adolescente e do Jovem. – Brasília: Ministério da Saúde, 2010. 132 p: il. – (Série A. Normas e Manuais Técnicos).
Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. Secretaria de Atenção à Saúde. Instituto Nacional de Câncer. Coordenação de Prevenção e Vigilância. Inquérito domiciliar sobre comportamento de risco e morbidade referida de doenças a agravos não transmissíveis: Brasil, 15 capitais e Distrito Federal, 2002–2003 RJ: INCA, 2004.
De Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmanna J. Development of a WHO growth reference for school-aged children and adolescents. Bulletin of the World Health Organization 2007; 85:661–668.
Must A, Dallal GE, Dietz WH. Reference data for obesity: 85th and 95th percentiles of body mass index (wt/ht2) and triceps skinfold thickness. Am J Clin Nutr 1991; 53:839–46.
Williams DP, Going SB, Lohman TG. Body fatness and risk for elevated blood pressure, total cholesterol, and serum lipoprotein ratios in children and adolescents. Am J Public Health 1992; 82:358–363.
Sardinha LB, Going SB, Teixeira PJ, Lohman TG. Receiver operating characteristic analysis skinfold thickness and arm girth for obesity screening in children and adolescents. Am J Clin Nut. 1999; 70: 1090–5.
World Health Organization. Measuring obesity: classification and description of anthropometric data. Copenhagen; WHO Regional Office for Europe; 1989.
Lohman TG, Roche AF, Martorell R. Anthropometric standardization reference manual. Human Kinetics Books. Champaign, Illinois; 1988.
Fernández JR, Redden D, Pietrobelli A. Waist circumference percentiles in nationally representative samples of African-American, European-American, and Mexican-American children and adolescents. J Pediatr2004 145:439–444.
Sociedade Brasileira de Cardiologia. VI Diretrizes Brasileira de Hipertensão. Revista Brasileira de Hipertensão 2010; 17:7–10.
National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. (NHBPEP) Pediatrics 2004; 114: 555–76.
Sociedade Brasileira de Cardiologia (SBC). I Diretriz de prevenção da aterosclerose na infância e na adolescência. Arq Bras de Cardiol 2005; 85: 1–36.
Vuilleumier JP, Keller ME, Gysel D, Hunziker F. Clinical chemical methods for the routine assessment of the vitamin status in human populations. Part I: The fat-soluble vitamins A and E, and beta-carotene. Int J Vit Nutr Res 1983; 53:265–72.
Oliveira MNG, Almada Cezar EH, Soares EA. Comparison of the anthropometric assessment of adolescents of privileged and unprivileged social and economic levels. Nutrition Research 2000; 1423–1436.
Monteiro CA, Conde WL, Popkin BM. Independent effects of income and education on the risk of obesity in the Brazilian adult population. Journal of Nutrition 2001; 881S–886S.
Foschini D. Santos RVD. Prado WL. Piano AD. Lofrano MC. Martins AC. Platelet and leptina in obese adolescents. J Pediatr. 2008; 84: 516–521.
Gey KG. Cardiovascular disease and vitamins. Concurrent correction of “suboptimal” plasma antioxidant levels may, as important part of “optimal” nutrition, help to prevent early stages of cardiovascular disease and cancer, respectively. Bibl Nutr Dieta 1995; 52:75–91.
Batlouni M. Hipótese oxidative da aterosclerose e emprego dos antioxidantes na doença arterial coronária. Arq Bras Cardiol 1997; 68: 55–63.
Sociedade Brasileira de Cardiologia (SBC). IV Diretriz Brasileira sobre Dislipidemias e Prevenção da Aterosclerose. Departamento de aterosclerose. Arq. Bras. Cardiol. 2007; 88:2–19.
Sociedade Brasileira de Cardiologia (SBC). V Diretriz Brasileira sobre Dislipidemias e Prevenção da Aterosclerose. Arq. Bras. Cardiol. 2013; 10: 1–22.
Ramalho RA, Accioly E, Silva LM. Doenças cardiovasculares: Efeito antioxidante das vitaminas A, C e E. Rev Metabol Nutr. 2003; 17: 6–9.
Rosa MLG, Mesquita TE, Rocha ERR, Fonseca VM. Índice de massa corporal e circunferência da cintura como marcadores de hipertensão arterial em adolescentes. Arq. Bras. Cardiol. 2007; 88: 573–578.
Arner P. The adipocyte in insulin resistance: Key molecules and the impact of the triazolidinediones. Trends Endocrinol MeTab. 2003; 14: 137–45.
Farrell GC and Larter C. Nonalcoholic fatty liver disease: from steatosis to cirrhosis. Hepatology, 2006; 43: S99 –S112.
Associação Brasileira para o Estudo da Obesidade e da Síndrome Metabólica. Diretrizes Brasileiras de Obesidade 2009/2010/ABESO – Associação Brasileira para o Estudo da Obesidade e da Síndrome Metabólica. 3a ed. Itapevi, SP: AC Farmacêutica, 2009.
Higgins PB, Gower BA, Hunter GR, Goran MI. Defining health-related obesity in prepubertal children. Obes Res 2001; 9: 233–40.
Kim SM, Ryabets-Lienhard A, Dao-Tran A, Mittelman SD, Gilsanz V, Schrager SM and Geffner ME. Increased Abdominal Adiposity in Adolescents and Young Adults With Classical Congenital Adrenal Hyperplasia due to 21-Hydroxylase Deficiency. 100(8), pp. E1153–E1159. June 10, 2015. DOI: http://dx.doi.org/10.1210/jc.2014–4033.
Oliveira, Raquel de, Cerda, Alvaro, Genvigir, Fabiana Dalla Vecchia, Sampaio, MarceloFerraz, Armaganijan, Dikran, Bernik, Marcia Martins Silveira, Dorea, Egidio Lima, Hirata,Mario Hiroyuki, Hinuy, Hamilton Massayuki, & Hirata, Rosario Dominguez Crespo. Leptin receptor gene polymorphisms are associated with adiposity and metabolic alterations in Brazilian individuals. Arq. Bras. Endocrinol & Metabol. 2015. 57: 677–684.
Jiménez-Salas Z. Solís-Pérez E. Carrera-Quintanar L. Mora-Delgado M. Aguilar-Martínez MT. Campos-Góngora E. Frequenciadel polimorfismo Q223R delgend el receptor de leptina em uma muestra de niños com obesidade em Monterrey N.L Resplyn-Edición Especial No. 7–2004. 2do Congreso Internacional de Nutriologia y Obesidad2 y 3 deljuliodel 2004; Monterrey N. L., México.
Chagnon YC, Chung WK, Pérusse L, Chagnon M, Leibel RL, Bouchard C. Linkages and association between the leptin receptor LEPR gene and human body composition in the Québec Family Study (QFS). In J Obes 1999 23:278–286.
Guízar-Mendoza JM, Amador-Licona N, Flores-Martínez SE, López-Cardona MG, Ahuatzin-Trémary R, Sánchez-Corona J. Association analysis of the Gln223Arg polymorphism in the human leptin receptor gene and traits related to obesity in Mexican adolescents. Journal of Human Hypertension 2005; 19:341–46.
Thompson DB, Ravussin E, Bennett PH, Bogardus C. Structure and sequence variation at the human leptin receptor gene in lean and obese Pima Indians. Hum Mol Gent 1997; 6: 675–876.
Matsuoka N, Ogawa Y, Hosoda K. Human leptin receptor gene in obese Japanese subjects evidence against either obesity-causing mutations or association of sequence variants with obesity. Diabetologia 1997; 40:1204–1210.
Duarte SF, Francishetti GA, Genelhu VA, Cabello PH, Pimentel MM LEPR Q223R, beta3-AR p.W64R and LEP c–2548G>A gene variants in obese Brazilian subjects. Genet Mol Res 2007; 6:1035–43.
Rosmond R, Chagnon YC, Holm G. Hypertension in obesity and the leptin receptor gene locus. J Clin Endocrinol MeTab. 2000; 85:3126–3131.
Chagnon YC, Wilmore JH, Borecki IB, Chagnon J, Pérusse L. Chagnon M, Collier GR et al. Association between the leptin receptor gene and adiposity in middle-aged Caucasian males from the HERITAGE Family Study. J Clin Endocrinol MeTab. 2000; 85: 29–34.
Boni A, Pugliese C, Cláudio CC, Patin RV, Oliveira FLC. Vitaminas antioxidantes e prevenção da arteriosclerose na infância. Rev Paul Pediatr 2010; 28: 373–80.
