Randomized controlled trial to improve adiposity, inflammation, and insulin resistance in obese African-American and Latino youth

The purpose of this study was to examine ethnic differences in the metabolic responses to a 16-week intervention designed to improve insulin sensitivity (SI), adiposity, and inflammation in obese African-American and Latino adolescents. A total of 100 participants (African Americans: n = 48, Latino: n = 52; age: 15.4 ± 1.1 years, BMI percentile: 97.3 ± 3.3) were randomly assigned to interventions: control (C; n = 30), nutrition (N; n = 39, 1×/week focused on decreasing sugar and increasing fiber intake), or nutrition + strength training (N+ST; n = 31, 2×/week). The following were measured at pre- and postintervention: strength, dietary intake, body composition (dual-energy X-ray absorptiometry/magnetic resonance imaging) and glucose/insulin indexes (oral glucose tolerance test (OGTT)/intravenous glucose tolerance test (IVGTT)) and inflammatory markers. Overall, N compared to C and N+ST reported significant improvements in SI (+16.5% vs. -32.3% vs. -6.9% respectively, P < 0.01) and disposition index (DI: +15.5% vs. -14.2% vs. -13.7% respectively, P < 0.01). N+ST compared to C and N reported significant reductions in hepatic fat fraction (HFF: -27.3% vs. -4.3% vs. 0% respectively, P < 0.01). Compared to N, N+ST reported reductions in plasminogen activator inhibitor-1 (PAI-1) (-38.3% vs. +1.0%, P < 0.01) and resistin (-18.7% vs. +11.3%, P = 0.02). There were no intervention effects for all other measures of adiposity or inflammation. Significant intervention by ethnicity interactions were found for African Americans in the N group who reported increases in total fat mass, 2-h glucose and glucose incremental areas under the curve (IAUC) compared to Latinos (P's < 0.05). These interventions yielded differential effects with N reporting favorable improvements in SI and DI and N+ST reporting marked reductions in HFF and inflammation. Both ethnic groups had significant improvements in metabolic health; however some improvements were not seen in African Americans.     

Lifestyle and socioeconomic-status modify the effects of ADRB2 and NOS3 on adiposity in European-American and African-American adolescents

The aim of the study is to investigate the influence of and interaction between lifestyle behaviors (diet and physical activity (PA)) and single-nucleotide polymorphisms (SNPs) in obesity-candidate genes (ADRB2, APOB and NOS3) on general and central adiposity. Six-hundred-and-twenty-one European-American (EA) and African-American (AA) youths aged 13-19 years were classified by ethnicity (49% AA), gender (45% male), and socioeconomic status (SES). PA and dietary intake with up to seven 24-h recalls were reported for all subjects. Percent body fat (%BF) was measured by dual-energy X-ray absorptiometry, visceral adipose tissue (VAT), and subcutaneous abdominal adipose tissue (SAAT) by magnetic resonance imaging. Reported energy intake (EI) and vigorous PA (VPA) were negative predictors of %BF and SAAT. Carriers of the NOS3 Asp298 allele had higher %BF only in the presence of an adverse environment (low SES). Compared to the most common NOS3 haplotype, homozygotes for haplotype A-non4r-Asp had 6.1% higher %BF. Significant interactions were revealed between the ADRB2 Arg16Gly SNP and VPA on VAT, SAAT and waist circumference (WC) such that Gly16 homozygotes may benefit less from increased VPA to reduce their weight. Genetic susceptibility to increased general and central adiposity is dependent on several factors, such as SES and vigorous exercise. Improved understanding of the joint effect of genes and lifestyle on adiposity will offer new insights into obesity and may provide new avenues for personalized prevention and treatment.     

Discordance Between Gh and Igf-1 Levels in Turkish Acromegalic Patients

Objective: Discordance between insulin-like growth factor-1 (IGF-1) and growth hormone (GH) levels is an important problem in the follow-up of patients diagnosed with acromegaly. Our aims were to evaluate the discordance between IGF-1 and GH levels and compare the performance of different cut-off levels for the nadir in GH (GHn) in acromegalic patients.Methods: The study included 63 acromegalic patients in a follow-up at a tertiary care university hospital facility. Levels of IGF-1, IGF binding protein-3 (IGFBP-3), and GH were investigated. The baseline GH and GHn levels were evaluated after an oral glucose tolerance test (cut-offs of 0.4 and 1 ng/mL, respectively). The discordance rates between GHn and IGF-1 levels, and IGF-1/IGFBP-3 ratios were determined.Results: We first adopted a GHn cut-off value of 1 ng/mL and found that 27 patients (42.9%) exhibited biochemical remission (BR) (IGF-1 <95^th percentile, GH <1), and 25 patients (39.7%) had no BR (NBR) (IGF-1 ≥95^th percentile, GH >1).Discordance in the presence of normal IGF-1 and nonsuppressed GH (DC1) occurred in 2 of 63 (3.2%) patients; discordance in the presence of high IGF-1 and suppressed GH (DC2) occurred in 9 of 63 (14.3%) patients. If the GHn cut-off value adopted was 0.4 ng/mL, the distributions were 17 of 63 (27.0%) patients in BR, 29 of 63 (46.0%) patients in NBR, 12 of 63 (19.0%) in DC1, and 5 of 63 (7.9%) patients in DC2. If only the baseline GH values were considered, the distributions were very similar to those with a GHn cut-off value of 0.4 ng/mL. The IGF-1/IGFBP-3 ratio was lowest in the BR group.Conclusion: Adopting a GHn cut-off value of 0.4 ng/mL did not increase the test performance compared with baseline GH only. In contrast, in the follow-up of acromegalic patients, the IGF-1/IGFBP-3 ratio might be a useful measurement when discordance between IGF-1 and GH levels occurs. We propose that these values be considered in clinical practice.Abbreviations:BR = biochemical remissionDC1 = discordance group 1DC2 = discordance group 2DM = diabetes mellitusGH = growth hormoneGHn = nadir in GHIGF-1 = insulin-like growth factor-1IGFBP-3 = IGF binding protein-3LAR = long-acting releaseNBR = not in biochemical remissionOGTT = oral glucose tolerance test     

Alcohol dependence patterns and their impact on New York City

As a follow-up to a national survey by the Community Anti-Drug Coalitions of America (CADCA), an expert panel was convened to discuss local alcoholism data from New York, NY. The impact of alcoholism on the US economy is estimated at $185 billion annually. About 15% of New Yorkers drink alcohol excessively, with the highest percentage in Manhattan (22%). Over 135,000 New York City residents are admitted for alcohol treatment. Alcohol dependency is highest among whites (21%), followed by Latinos (14.8%) and African Americans (11%). Despite lower levels of excessive drinking, African-American and Latino New Yorkers are more likely than white New Yorkers to be hospitalized or die as a result of excessive drinking. The barriers to overcome are the lack of information on treatment options, the stigma of alcoholism, the lack of physician education, and a limited number of treatment facilities/personnel. Patients need behavioral counseling, a commitment to treatment, and compliance with medication if they are to succeed in treatment.     

Race-ethnicity,nativity, neighbourhood context and reports of unfair treatment by police

This research describes how race-ethnicity, nativity and neighbourhood characteristics are associated with reports of unfair treatment by police in the previous five years by residentially stable men. Data are from waves 1 and 2 of the Los Angeles Family and Neighborhood Survey. Results suggest that foreign-born Latinos are less likely than African Americans and US-born whites to report unfair treatment. After accounting for tract percentage Latino, US-born Latinos were less likely to report unfair treatment than African Americans, which partially supports a gradient model. Neighbourhood affluence was negatively associated with reports, but poverty, percentage Latino and immigrant concentration were not. The importance of neighbourhood privilege is highlighted, as is the need to better understand Latino immigrants' experiences with police. Future work should examine immigrants' interpretation of interactions with police and their willingness to report unfair treatment.     

Larger Amounts of Visceral Adipose Tissue in Asian Americans

Objective: Excess visceral adipose tissue (VAT) is recognized as an important risk factor for the development of coronary heart disease and type 2 diabetes. Several studies have reported less VAT in African Americans compared with whites. As little is known about the levels of VAT in Asians, we compared whole‐body VAT in Asian Americans with European Americans. Research Methods and Procedures: VAT was measured using whole‐body multislice magnetic resonance imaging in 54 women (18 Asian Americans, 36 European Americans) and 53 men (19 Asian Americans, 34 European Americans) with body mass index (measured in kilograms per square meter) < 30. Data were analyzed by multiple regression modeling. Results: Asian American women had higher log‐transformed VAT compared with European American women (p < 0.05), after adjusting for age and total body fat. There was a significant age by race interaction such that race differences in VAT were most evident over the age of 30 years. No differences in VAT could be detected between Asian American and European American men, even after adjusting for potential covariates, including total adiposity. %Discussion: These data are the first to demonstrate higher amounts of VAT in healthy Asian Americans, a finding that suggests normative VAT values or standards derived from whites may not be applicable to Asians.     

Comparison of Regional Fat Distribution and Health Risk Factors in Middle‐Aged White and African American Women: The Healthy Transitions Study

Objective: Both ethnicity and menopause appear to influence intra‐abdominal fat distribution. This study evaluated intra‐abdominal fat distribution and obesity‐related health risks in perimenopausal white and African American women. Research Methods and Procedures: Baseline data from a longitudinal study of changes in body composition and energy balance during menopause are reported. Healthy women (55 African Americans and 103 whites) who were on no medication and had at least five menstrual cycles in the previous 6 months were recruited. Body composition was assessed by DXA, and visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were assessed by computed tomography scan. SAT was divided into deep and superficial layers demarcated by the fascia superficialis. Results: African American women were slightly younger (46.7 ± 0.2 vs. 47.7 ± 0.2 years, p = 0.002) and fatter (42.4% ± 1.0% vs. 39.4% ± 0.8% body fat, p = 0.02) than white women. In unadjusted data, African Americans had significantly more total abdominal fat and total, deep, and superficial SAT than whites. After adjustment for percent body fat and age, only total and superficial SAT remained significantly higher in African Americans. VAT although slightly less in African American women, did not differ significantly by race. In multiple regression analysis, VAT was the strongest predictor of serum lipids, glucose, and insulin in women of both races, although superficial SAT was significantly associated with fasting glucose in whites. Conclusions: Middle‐aged African American women have larger SAT depots, adjusted for total body fatness, but do not differ from white women with regard to VAT. The complexity of the relationship between abdominal fat and metabolic risk is increased by ethnic differences in such associations.     

4周有氧运动与饮食控制对肥胖女青少年血清IGF-1和IGF-1结合蛋白-3水平的影响

目的：研究4周中等强度有氧运动结合饮食控制对肥胖女青年、少年血清总胰岛素样生长因子1（IGF-1）、IGF-1结合蛋白3（IGFBP-3）水平和IGF-1活性的影响及其在体脂减少和糖脂代谢改善中的作用。方法：招募9名18~19岁肥胖女青年和30名14~16岁肥胖女少年,进行全封闭的4周中等强度有氧运动结合饮食控制干预。运动项目有游泳、跑步、健身操等,每周运动6 d,每天运动4 h,每运动30 min,休息5 min。运动强度从第1周的低强度（运动后即刻心率约100~120次/分）递增至第2~4周的中强度（运动后即刻心率约120~140次/分）。根据基础代谢率给予每日1 400或1 600 kcal的总能量。另招募正常体重女青年和女少年各9名作为对照组。检测肥胖女青年、少年在4周干预前、后和对照组女青年、少年的体重、身体质量指数（BMI）、腰围、空腹血糖、胰岛素和血脂水平以及血清总IGF-1和IGFBP-3的水平和IGF-1活性。结果：①与对照组相比,肥胖女青年、少年的血清总IGF-1和IGFBP-3水平均降低且肥胖女少年的IGF-1活性降低;②4周中等强度有氧运动结合饮食控制在显著降低肥胖女青年、少年的体脂、腰围和改善糖脂代谢的同时,降低血清IGFBP-3水平、增加IGF-1活性,但血清总IGF-1水平没有显著改变。且相关性分析显示IGF-1活性增加可能与肥胖女青年的腰围减少有关,但血清IGFBP-3水平的降低和IGF-1活性的增加与糖脂代谢的改善没有显著相关性。结论：4周中等强度有氧运动结合饮食控制降低肥胖女青年、少年的血清IGFBP-3水平、增加IGF-1活性;且IGF-1活性的增加可能与运动结合饮食控制降低肥胖女青年的腰围有关。     

Relationships between serum IGF-1, IGFBP-2, interleukin-1beta and interleukin-6 in inflammatory bowel disease

AIMS: To study the relationships between serum IGF-1, IGFBP-3 and IGFBP-2 and interleukin (IL)-1beta and IL-6 in inflammatory bowel disease (IBD). METHODS: Thirty-seven patients (18 males, 19 females, aged 8.8-26.1 years) with IBD (Crohn's disease, CD, n = 17, and ulcerative colitis, UC, n = 20) were studied. Patients were in relapse or remission according to established criteria. Serum IGF-1, IGFBP-3, IGFBP-2, IL-1beta and IL-6 levels were determined in patients and 15 healthy controls (aged 8.2-19.0 years). RESULTS: IGF-1 levels were lower in patients with CD in relapse compared with controls (p < 0.05). IGFBP-2 levels were higher in CD in relapse compared with other groups (all p < 0.05). In CD and UC patients (n = 37), IGF-1 levels were inversely correlated with the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). IGFBP-2 levels correlated positively with ESR and IL-1beta. IL-6 levels correlated positively with ESR and CRP. IL-1beta levels were elevated in CD in relapse compared to controls (p < 0.05) and were higher in UC in relapse than in other groups (all p < 0.05). In combined CD/UC patients in relapse (n = 20), IL-1beta levels were higher (p < 0.05) in patients with recto-sigmoiditis (n = 5) than in other patients. CONCLUSIONS: IGF-1, IGFBP-2 levels were related to IL levels, disease activity and anatomical distribution, consistent with active inflammation modifying the IGF-IGFBP system, possibly relevant to disturbance of growth.     

Body fat and racial genetic admixture are associated with aerobic fitness levels in a multiethnic pediatric population

Aerobic fitness and adiposity are each independently associated with health outcomes among children, although the relationship between these two variables is unclear. Our objectives were to evaluate (i) the association of adiposity with aerobic fitness using objectively measured levels of percent body fat, compared to BMI as a percentile proxy for adiposity while controlling for genetic admixture, and (ii) the congruence of BMI categories with high and low body fat categories of objectively measured percent body fat. Participants were 232 African-American (AA), European-American (EA), and Hispanic-American (HA) children aged 7-12 years (Tanner stage <3). Aerobic fitness was measured via a submaximal indirect calorimetry treadmill test (VO(2-170)), and physical activity levels with accelerometry. Genetic admixture estimates were obtained using 140 genetic ancestry informative markers to estimate European, African, and Amerindian admixture. Fat mass was determined using dual-energy x-ray absorptiometry (DXA). Children were classified into a low body fat group (<25% in males, <30% in females) or a high body fat group based on their percent body fat; children were also categorized according to BMI percentile. Children in the low body fat group had significantly higher aerobic fitness (P < 0.05) regardless of BMI percentile classification. Higher African genetic admixture was associated with lower aerobic fitness (P < 0.05), while physical activity was positively associated with fitness (P < 0.01). In conclusion, aerobic fitness levels differ by percent body fat and genetic admixture irrespective of BMI classification, and such differences should be taken into account when evaluating outcomes of health interventions.     

Mercapturic Acids Derived from the Toxicants Acrolein and Crotonaldehyde in the Urine of Cigarette Smokers from Five Ethnic Groups with Differing Risks for Lung Cancer

The Multiethnic Cohort epidemiology study has clearly demonstrated that, compared to Whites and for the same number of cigarettes smoked, African Americans and Native Hawaiians have a higher risk for lung cancer whereas Latinos and Japanese Americans have a lower risk. Acrolein and crotonaldehyde are two important constituents of cigarette smoke which have well documented toxic effects and could play a role in lung cancer etiology. Their urinary metabolites 3-hydroxypropylmercapturic acid (3-HPMA) and 3-hydroxy-1-methylpropylmercapturic acid (HMPMA), respectively, are validated biomarkers of acrolein and crotonaldehyde exposure. We quantified levels of 3-HPMA and HMPMA in the urine of more than 2200 smokers from these five ethnic groups, and also carried out a genome wide association study using blood samples from these subjects. After adjusting for age, sex, creatinine, and total nicotine equivalents, geometric mean levels of 3-HPMA and HMPMA were significantly different in the five groups (P<0.0001). Native Hawaiians had the highest and Latinos the lowest geometric mean levels of both 3-HPMA and HMPMA. Levels of 3-HPMA and HMPMA were 3787 and 2759 pmol/ml urine, respectively, in Native Hawaiians and 1720 and 2210 pmol/ml urine in Latinos. These results suggest that acrolein and crotonaldehyde may be involved in lung cancer etiology, and that their divergent levels may partially explain the differing risks of Native Hawaiian and Latino smokers. No strong signals were associated with 3-HPMA in the genome wide association study, suggesting that formation of the glutathione conjugate of acrolein is mainly non-enzymatic, while the top significant association with HMPMA was located on chromosome 12 near the TBX3 gene, but its relationship to HMPMA excretion is not clear.     

Beyond Socioeconomics: Explaining Ethnic Group Differences in Parenting Through Cultural and Immigration Processes

This study examined both socioeconomic and cultural factors in explaining ethnic differences in monitoring, behavioral control, and warmth—part of a series of coordinated studies presented in this special issue. Socioeconomic variables included mother's and father's educational levels, employment status, home ownership, number of siblings in the household, and single parent status. Cultural factors included nationality or ethnicity, immigrant status of child, mother's/father's age of arrival in the United States, mother's/father's English language use with the child, child's native fluency, and cultural values for independence and interdependence. The sample consisted of 591 European American, 123 African American, 1,614 Asian American, and 597 Latino students in the ninth grade. All the ethnic minority groups were higher than European Americans on behavioral control, and Latinos were also higher than European Americans on monitoring. However, European Americans were higher on parental warmth than Asian Americans and African Americans. These ethnic group differences primarily remained even after controlling for the socioeconomic factors. Finally, in analyses looking within the Asian and Latino groups, differences in parenting were found within both groups due to nationality or ethnicity, youth's fluency in the native language, and cultural values of interdependence, although values of independence were also related to the parenting of Asian Americans.     

Benzene Uptake and Glutathione S-transferase T1 Status as Determinants of S-Phenylmercapturic Acid in Cigarette Smokers in the Multiethnic Cohort

Research from the Multiethnic Cohort (MEC) demonstrated that, for the same quantity of cigarette smoking, African Americans and Native Hawaiians have a higher lung cancer risk than Whites, while Latinos and Japanese Americans are less susceptible. We collected urine samples from 2,239 cigarette smokers from five different ethnic groups in the MEC and analyzed each sample for S-phenylmercapturic acid (SPMA), a specific biomarker of benzene uptake. African Americans had significantly higher (geometric mean [SE] 3.69 [0.2], p<0.005) SPMA/ml urine than Whites (2.67 [0.13]) while Japanese Americans had significantly lower levels than Whites (1.65 [0.07], p<0.005). SPMA levels in Native Hawaiians and Latinos were not significantly different from those of Whites. We also conducted a genome-wide association study in search of genetic risk factors related to benzene exposure. The glutathione S-transferase T1 (GSTT1) deletion explained between 14.2–31.6% (p = 5.4x10^-157) and the GSTM1 deletion explained between 0.2%-2.4% of the variance (p = 1.1x10^-9) of SPMA levels in these populations. Ethnic differences in levels of SPMA remained strong even after controlling for the effects of these two deletions. These results demonstrate the powerful effect of GSTT1 status on SPMA levels in urine and show that uptake of benzene in African American, White, and Japanese American cigarette smokers is consistent with their lung cancer risk in the MEC. While benzene is not generally considered a cause of lung cancer, its metabolite SPMA could be a biomarker for other volatile lung carcinogens in cigarette smoke.     

补偿生长对异育银鲫IGF-1、IGFBP-1水平及IGF-1、IGF-1RmRNA表达的影响

该实验分析饥饿和恢复投喂对异育银鲫血液IGF-1和IGFBP-1水平和肝脏IGF-1、白肌IGF-1RmRNA表达量的影响。结果显示:饥饿期(14d)血液中IGF-1和IGFBP-1水平逐渐下降,在饥饿第14天均出现显著性降低(P<0.05);恢复投喂后第1天IGF-1迅速恢复到对照组水平,而IGFBP-1水平仍显著低于对照组(P<0.05),随后逐渐升高,直至于恢复投喂第14天后显著高于对照组水平(P<0.05);饥饿期肝脏IGF-1mRNA表达量呈下降趋势,但与对照组无显著性差异(P>0.05);恢复投喂初期(第1、3天),IGF-1mRNA表达量仍继续下降(P<0.05),对营养条件的变化反应滞后,至第7天,表达水平恢复到对照组水平。白肌IGF-1RmRNA表达水平在饥饿第3天出现显著性下降(P<0.05),继续饥饿其水平出现补偿性升高;恢复投喂后第14天IGF-1RmRNA表达量显著高于对照组水平(P<0.05)。该结果揭示恢复投喂期高水平的IGFBP-1含量和IGF-1RmRNA表达量可能通过提高IGF-1的促生长作用参与异育银鲫的补偿生长调节。     

Analysis of FTO gene variants with measures of obesity and glucose homeostasis in the IRAS Family Study

Multiple studies have identified FTO gene variants associated with measures of adiposity in European-derived populations. The objective of the study was to determine whether FTO variants were associated with adiposity, including visceral and subcutaneous adipose tissue (VAT, SAT), and glucose homeostasis measures in the Insulin Resistance Atherosclerosis Family Study (IRASFS). A total of 27 SNPs in FTO intron 1, including SNPs prominent in the literature (rs9939609, rs8050136, rs1121980, rs17817449, rs1421085, and rs3751812), were genotyped in 1,424 Hispanic Americans and 604 African Americans. Multiple SNPs were associated with BMI and SAT (P values ranging from 0.001 to 0.033), and trending or associated with waist circumference (P values ranging from 0.008 to 0.099) in the Hispanic Americans. No association was observed with VAT, illustrating that FTO variants are associated with overall fat mass instead of specific fat depots. For the glucose homeostasis measures, variants were associated with fasting insulin but, consistent with other studies, after BMI adjustment, no evidence of association remained. The lack of association of FTO SNPs with insulin sensitivity is consistent with the lack of association with VAT, since these traits are strongly correlated. In the African Americans, only rs8050136 and rs9939609 were associated with BMI and WAIST (P values of 0.011 and 0.034), and associated or trending towards association with SAT (P values of 0.038 and 0.058). These results confirm that FTO variants are associated with adiposity measures, predisposing individuals to obesity by increasing overall fat mass in Hispanic Americans and to a lesser degree in African Americans.     

ApoE and ApoC-I polymorphisms: association of genotype with cardiovascular disease phenotype in African Americans

Apolipoproteins (apo) E and C-I are components of triglyceride (TG)-rich lipoproteins and impact their metabolism. Functional polymorphisms have been established in apoE but not in apoC-I. We studied the relationship between apoE and apoC-I gene polymorphisms and plasma lipoproteins and coronary artery disease (CAD) in 211 African Americans and 306 Caucasians. In African Americans but not in Caucasians, apoC-I H2-carriers had significantly lower total and LDL cholesterol and apoB levels, and higher glucose, insulin, and HOMA-IR levels compared with H1 homozygotes. Differences across CAD phenotypes were seen for the apoC-I polymorphism. African-American H2-carriers without CAD had significantly lower total cholesterol (P < 0.001), LDL cholesterol (P < 0.001), and apoB (P < 0.001) levels compared with H1 homozygotes, whereas no differences were found across apoC-I genotypes for African Americans with CAD. Among African-American apoC-I H1 homozygotes, subjects with CAD had a profile similar to the metabolic syndrome (i.e., higher triglyceride, glucose, and insulin) compared with subjects without CAD. For African-American H2-carriers, subjects with CAD had a pro-atherogenic lipid pattern (i.e., higher LDL cholesterol and apoB levels), compared with subjects without CAD. ApoC-I genotypes showed an ethnically distinct phenotype relationship with regard to CAD and CAD risk factors.     

Impact of Race/Ethnicity on the Relationship Between Visceral Fat and Inflammatory Biomarkers

The purpose of this study was to determine whether racial/ethnic differences exist in the relationship between visceral adipose tissue (VAT) and selected inflammatory biomarkers. Subjects included 136 African‐American, 133 Hispanic, and 100 white men and women, aged ≥45. Waist circumference and BMI were measured using standard methods. Total VAT, and VAT and subcutaneous adipose tissue (SAT) at the L4L5 spinal level were measured using computed tomography. Interleukin‐6 (IL‐6), C‐reactive protein (CRP), and fibrinogen were measured from fasting blood samples. Results revealed that waist circumference and BMI were similar among groups but African Americans had significantly lower L4L5 VAT compared with Hispanics and whites. Despite lower VAT, African‐American men had similar concentrations of inflammatory biomarkers. On the other hand, African‐American women had higher CRP and IL‐6 than white women, and higher fibrinogen than both Hispanic and white women. After controlling for L4L5 VAT, L4L5 SAT, and age, African‐American women had higher concentrations of IL‐6 and fibrinogen. Stratified analyses for CRP indicated that L4L5 SAT was associated with CRP in African‐American and white women after controlling for L4L5 VAT and age, but that the reverse was not true. These data indicate that African Americans had lower VAT but similar or higher concentrations of inflammatory biomarkers. African‐American women consistently displayed greater inflammation compared with whites, even after controlling for VAT or SAT.     

Visceral fat, waist circumference, and BMI: impact of race/ethnicity

Objective: BMI and waist circumference are used to define risk from excess body fat. Limited data in women suggest that there may be racial/ethnic differences in visceral adipose tissue (VAT) at a given BMI or waist circumference. This study tested the hypothesis that racial/ethnic differences exist in both men and women in the relationship of anthropometric measures of body composition and computed tomography (CT)‐determined VAT or subcutaneous adipose tissue (SAT). Methods and Procedures: Subjects included 66 African American, 72 Hispanic, and 47 white men and women, aged ≥ 45. Waist circumference and BMI were measured using standard methods. Total abdominal and L4L5 VAT and SAT were measured using CT. Results: Among both men and women, groups did not differ in waist circumference or BMI. White men had greater L4L5 VAT than African‐American men, and both white and Hispanic men had greater total VAT than African‐American men. Among women, Hispanics and whites had greater L4L5 VAT than African Americans, and Hispanics had greater total VAT than African Americans. The slope of the linear relationship between BMI or waist circumference and VAT was lower in African Americans than in Hispanics and/or whites. Discussion: Middle‐aged and older African‐American men and women had lower VAT despite similar BMI and waist circumference measurements. Altered relationships between anthropometric measures and VAT may have implications for defining metabolic risk in different populations. Different waist circumference or BMI cutoff points may be necessary to adequately reflect risk in different racial/ethnic groups.     

Serum IGF-1, IGFBP-3 and growth hormone levels in children with congenital heart disease: relationship with nutritional status, cyanosis and left ventricular functions

In this study we aimed to evaluate serum insulin-like growth factor-1 (IGF-1), insulin-like growth factor binding protein-3 (IGFBP-3) and growth hormone (GH) levels in children with congenital heart disease (CHD) and to determine if these parameters have any relationship to the cyanosis, nutritional status and the left ventricular systolic function. This study is prospective-randomized study which conducted in 94 CHD patients (36 girls and 58 boys, aged between one 1-192 months, 19 cyanotic CHD and 75 acyanotic CHD) and age-sex matched 54 children (26 girls and 28 boys) with no CHD. In the study group, 37 out of the 94 CHD patients (39.4%) and 16 out of the 54 controls (29.6%) had malnutrition. The difference between the cyanotic and acyanotic patients in respect to malnutrition was significant (57.9% and 34.6%, p<0.05). Serum IGF-1 levels were lower (41.8+/-3.9 microg/L, 106.9+/-17.9 microg/L respectively, p<0.001) and GH levels were higher (6.43+/-0.9 ng/ml, 3.87+/-0.5 respectively, p<0.05) in CHD patient group than the controls. Serum IGF-1 levels were significantly lower in cyanotic CHD patients than the acyanotic patients (17.2+/-3.2 microg/L, 48.7.0+/-4.6 microg/L respectively, p<0.001) and serum IGF-1 levels were both lower in acyanotic and cyanotic CHD patients than the controls (p<0.001 for both). Serum IGF-1 and GH levels were similar between the well-nourished CHD patients and CHD patients with malnutrition (p>0.05). In total study group, the most effective factors on serum IGF-1 levels was presence of CHD (p<0.001), in CHD patients, the presence of cyanosis is the most effective factor on serum IGF-1 level, the presence of malnutrition is the most effective factor on serum IGFBP-3 levels (p<0.01). In the acyanotic, cyanotic, and the entire CHD patient groups, we find no correlations between the serum IGF-1, IGFBP-3 levels and left ventricular systolic function measurements. But serum GH levels were negatively correlated with diastolic left ventricular interseptum diameter, diastolic left ventricular mass and left ventricular end-diastolic volume measurements in CHD patients. In conclusion, we determined that the most important factor on serum IGF-1 levels is cyanosis. Reduced IGF1 levels and decreased left ventricular mass with an elevated GH levels in CHD patients and these findings are prominent in the cases with cyanosis and malnutrition. For this reason we believe that chronic hypoxia plays a significant role in the pathogenesis of malnutrition and also we believe that IGF-1 deficiency seen in CHD patients may be responsible in the etiology of the decrease in left ventricular mass independently from GH.     

特发性矮小症患儿治疗前后血清IGF-1、IGFBP-3、25（OH）D、皮质醇水平变化及其与体格发育和骨龄的相关性分析

摘要 目的：探究特发性矮小症（ISS）患儿治疗前后血清胰岛素样生长因子1（IGF-1）、胰岛素样生长因子结合蛋白3（IGFBP-3）、25羟维生素D[25（OH）D]、皮质醇水平变化及其与体格发育和骨龄的相关性。方法：选取安徽省儿童医院于2017年7月～2021年3月收治的88例ISS患儿作为研究组。另选取同期体检健康儿童88例作为对照组。比较两组血清IGF-1、IGFBP-3、25（OH）D及皮质醇水平。比较ISS患儿治疗前后血清IGF-1、IGFBP-3、25（OH）D及皮质醇水平,体格指标以及骨龄指标。通过Pearson相关性分析ISS患儿血清IGF-1、IGFBP-3、25（OH）D及皮质醇水平与体格指标、骨龄指标的相关性。结果：研究组患儿血清IGF-1、IGFBP-3、25（OH）D水平均低于对照组,而皮质醇水平高于对照组（均P＜0.05）。ISS患儿治疗后血清IGF-1、IGFBP-3、25（OH）D水平均高于治疗前,而皮质醇水平低于治疗前（均P＜0.05）。ISS患儿治疗后身高、体重、骨龄年龄差（BAD）、骨龄指数（BAI）以及体质指数（BMI）均高于治疗前（均P＜0.05）。经Pearson相关性分析发现：ISS患儿血清IGF-1、IGFBP-3、25（OH）D水平与身高、体重、BAD、BAI以及BMI均呈正相关;皮质醇与身高、体重、BAD、BAI以及BMI均呈负相关（均P＜0.05）。结论：ISS患儿血清IGF-1、IGFBP-3、25（OH）D水平异常降低,皮质醇水平升高,且上述四项指标均和身高、体重、BAD以及BAI有关。