Children Clinical Trial
Official title:
Metabolic Syndrome in Adolescents. Associations With Endothelial Dysfunction and Early Programming Influences
The purpose of this study was to cross-sectionally evaluate nutritional status and the metabolic syndrome in a sample of school-age children 10-15 years of age from 20 public schools in Santiago, Chile. In addition, the investigators retrospectively assessed the association of those variables with perinatal variables (birth weight, birth length, and gestational age at delivery).
Subjects and methods Subjects The study was conducted in 2009-2011 in a cross-sectional way
in 3,325 children attending 5th and 6th grade in 20 public schools of Santiago, Chile. All
students were invited to participate in the study.
Anthropometry and other physical examinations Field measurements were performed by a nurse
and a nutritionist. Height and weight were measured with children barefoot and lightly
clothed using a stadiometer and a beam-scale Seca ®, with an accuracy of 50 g. The
individual height and weight values were established by averaging three measurements of each
parameter. BMI was calculated and expressed in percentiles and z-scores (13): z-scores were
calculated according to Center for Disease Control-National Center of Statistics 2000.
Nutritional status was classified according to BMI percentiles in the obese category as ≥ 95
(14). WC was measured with an inextensible tape on the upper lateral border of the right
ilium in the mid-axillary line at the end of an exhalation (15) ; two measurements were
averaged and the ≥ 90th percentile was used as cutoff value (16). The triceps and
subscapular skin folds were measured with a Harpenden ® caliper using a standard technique
(15); both were used to calculate the percentage of FM using Slaughter equations (17)
previously validated in Chilean children (18, 19). Elevated FM was established as ≥ 42% for
girls with 10-15 years old, ≥ 38% for boys with ≤ 12 years old, and 40% for boys with ≥ 13
years old (20).
A Critikon ® Dinamap Pro 100 BP monitor was used according to international norms and the
averages of three measurements of systolic BP (SBP) were obtained and classified as abnormal
using the ≥ 90 percentile of the same reference (21). A voluntary private self-report of
pubertal status was requested by observation of standardized photos of breast development in
girls and genitalia in boys including the presence of pubic hair (22). Maternal years of
education were registered to estimate socio-economic level (23).
Blood samples Subjects were instructed to fast (water was allowed) for 12 hours prior to
drawing of blood; non compliers were asked to return another day for the blood sampling. A
single laboratory was used for all blood analyses at the Faculty of Medicine, Pontificia
Universidad Católica de Chile.
Fasting venous blood samples were collected for determination of glucose (Gluco-quant
method, Glucose / Hexokinase, Roche Diagnostics GmbH, Mannheim) and insulin (immunoassay
direct luminometer chemotherapy, ADVIA Centaur ® XP, Bayer HealthCare LLC, Kyowa Medex Co.
Japan); this method measures concentrations of insulin from 0.5 to 300 mUI / mL (sensitivity
0.5 mUI / mL) with a coefficient of variation of 3.48% and 6.17% for concentrations of 23.51
mUI / mL and 62.49 mUI / mL. respectively. Triglycerides and HDL-C were analyzed on the
Modular Analytics P-800 platform (Roche Diagnostics GmbH, Mannheim, Germany).
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