Overweight adolescents with type 2 diabetes have significantly higher lipoprotein abnormalities than those with type 1 diabetes.

Aim: Diabetes-associated glucoregulatory derangements may precipitate atherogenesis in childhood and CVD risk, particularly with obesity. We aimed to delineate lipoprotein profile differences between children with type 1 and 2 diabetes who are overweight/obese.

Methods: Data were obtained from electronic medical records of patients ≥85th BMI percentile with type 1 (n=159) and type 2 (n=77) diabetes, ages 12-19y.

Pediatric obesity prevention: From naïve examination of energy imbalance towards strategies that influence the competition for nutrient resources among tissues.

Current pediatric obesity interventions have collectively yielded relatively unsuccessful results. In this Field of Vision, we present plausible physiologic underpinnings fostering ineffectiveness of conventional strategies grounded in requisite induction of negative energy imbalance. Moreover, such recommendations exacerbate the underlying metabolic dysfunction by further limiting metabolic fuel availability, lowering energy expenditure, and increasing hunger (recapitulating the starvation response amid apparent nutritional adequacy) which precede and promote obesity during growth and development.

Circulating levels of fibroblast growth factor-21 increase with age independently of body composition indices among healthy individuals.

Background: Circulating FGF21 levels are commonly elevated in disease states. There is limited information regarding concentrations of circulating FGF21 in the absence of disease, as well as age-related differences in body composition that may contribute to FGF21 regulation across groups.

Objective: The objectives of this study were to assess FGF21 levels across age groups (childhood to elder adulthood), and investigate whether body composition indices are associated with age-related differences in circulating FGF21.

Bone Mineral Content as a Driver of Energy Expenditure in Prepubertal and Early Pubertal Boys.

Objective: To examine the associations of bone and bone-secreted factors with measures of energy metabolism in prepubertal and early pubertal boys.

Study Design: Participants in this cross-sectional, observational study included 37 (69% black, 31% white) boys, aged 7-12 years (Tanner stage View Article and Find Full Text PDF

Associations of fibroblast growth factor-23 with markers of inflammation, insulin resistance and obesity in adults.

Introduction: Elevated fibroblast growth factor-23 (FGF23) is an established marker of cardiovascular disease. The underlying reason(s) for the rise accompanying cardiovascular health decline are unclear. Prior studies have shown that FGF23 concentrations are associated with markers of inflammation and insulin resistance but they have been limited by a focus on persons with chronic kidney disease (CKD) and lack of race and sex diversity.

Obesity, metabolic health, and the risk of end-stage renal disease.

Obesity is associated with chronic kidney disease progression. Whether metabolic risk factors modify this association is unclear. Here we examined associations of body mass index (BMI) and metabolic health with risk of end-stage renal disease (ESRD) in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study.

Associations between vascular health indices and serum total, free and bioavailable 25-hydroxyvitamin D in adolescents.

Objective: The role of vitamin D in cardiovascular health remains debated as results have been inconsistent. Previous studies have not considered the bioavailability of 25-hydroxy vitamin D [25(OH)D]. Objectives of our study were to investigate the association between serum concentrations of total, free and bioavailable 25(OH)D and independent predictors of cardiovascular risk such as flow mediated dilatation (FMD) and augmentation index (AIx).

The relationship between bioactive components in breast milk and bone mass in infants.

Human breast milk (HBM) contains numerous bioactive components, recently shown to be associated with growth and body composition in breastfed offspring. Reciprocity in adipogenic and osteogenic pathways suggests bone mass may also be influenced by these components. The association between bioactive components found in HBM and bone mineral content (BMC), to our knowledge, is unknown.

Fibroblast growth factor-21, body composition, and insulin resistance in pre-pubertal and early pubertal males and females.

Objective: Accumulating evidence derived primarily from animal models suggests that fibroblast growth factor-21 (FGF-21) may affect the musculoskeletal system via effects on the capacity of tissues to respond to insulin. A proportion of musculoskeletal properties and underpinnings of promoting/preventing insulin resistance are established early in the pubertal transition. Thus, the objective of this study was to test the hypothesis that insulin resistance and/or obesity will promote greater FGF-21 concentration which will be inversely associated with musculoskeletal parameters [lean mass and bone mineral content (BMC)] in pre-/early pubertal children.

Metabolic subtypes and risk of mortality in normal weight, overweight, and obese individuals with CKD.

Background And Objectives: Higher body mass index (BMI) is paradoxically associated with lower mortality in persons with CKD, but whether cardiometabolic abnormalities modulate this association is unclear.

Design, Setting, Participants, & Measurements: Participants with CKD from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study (n=4374) were analyzed. The harmonized criteria for metabolic syndrome were used to define metabolic health, and participants were categorized into one of six mutually exclusive categories defined by combined measures of metabolic health (metabolically healthy, <3 criteria for metabolic syndrome; metabolically unhealthy, ≥3 criteria) and weight status (normal weight, BMI 18.

Diabetes-related impairment in bone strength is established early in the life course.

Aim: To evaluate properties of bone quantity/quality using young non-obese Type 1 (T1D)-diabetic (NOD) prone and syngenic non-diabetic (NOD.scid) mice.

Methods: Quantitative bone assessment of tibia was conducted using dual-energy X-ray absorptiometry (DXA) for the evaluation of body mass, bone mineral content, body fat mass and lean mass.

The relationships among total body fat, bone mineral content and bone marrow adipose tissue in early-pubertal girls.

Investigation of the physiologic relevance of bone marrow adipose tissue (BMAT) during growth may promote understanding of the bone-fat axis and confluence with metabolic factors. The objective of this pilot investigation was two-fold: (1) to evaluate the relationships among total body fat, bone mineral content (BMC) and femoral BMAT during childhood and underlying metabolic determinants and (2) to determine if the relationships differ by race. Participants included white and non-Hispanic black girls (n=59) ages 4-10 years.

Vitamin D and calcium-sensing receptor polymorphisms differentially associate with resting energy expenditure in peripubertal children.

Given that calcium metabolism is influenced by genes and is tightly linked to energy-utilizing pathways, this study evaluated the association of single nucleotide polymorphisms (SNPs) in the vitamin D receptor (VDR) and calcium-sensing receptor (CASR) with resting energy expenditure (REE). In 273 boys and girls, 7-12 years of age, cross-sectional REE was measured via indirect calorimetry, body composition by DXA, and dietary measures by 24-h recall. SNPs for VDR Cdx-2 (rs11568820) and CASR A986S (rs1801725) were genotyped using the Illumina Golden Gate assay.

BMI but Not Race Contributes to Vitamin D-Parathyroid Hormone Axis in Peripubertal Girls.

Currently, there is widespread interest in establishing 25-hydroxy vitamin D (25OHD) level preventing a secondary elevation in parathyroid hormone (PTH). The aim of this study was to identify the 25OHD nadir resulting in a rise of PTH and to determine if this inflection point is weight- or race-specific during growth and development in peripubertal girls. A total of 104 normal (n = 61) and overweight (n = 43) African American (AA) and European American (EA) girls, 5 to 14 years of age, were included.

Getting to the height of the matter: the relationship between stature and adiposity in pre-pubertal children.

Objective: Height has been inversely associated with cardiometabolic disease, with adiposity as the proposed contributor. Childhood represents a time when underlying metabolic pathways converge to determine growth. Although the extent to which influence is relevant, insulin, as a key growth signaling factor, likely provides key insight into mechanisms linking height and adiposity.

Subclinical Indication of Linkage Between Markers of Skeletal and Cardiovascular Properties.

Little is known about early coincidental changes in bone and vascular properties, particularly in the context of skeletal anabolism (puberty) versus relative equilibrium (young adulthood). We aimed to determine if subclinical markers of vascular function were associated with bone mineral content (BMC) and to evaluate the contribution of systemic factors in healthy females ages 14-42 years. Endothelial function was assessed by flow mediated dilatation (FMD), arterial stiffness by pulse wave velocity (PWV) and augmentation index (AIx), blood pressure (BP) by sphygmomanometer, BMC by DXA, and systemic factors by fasting blood draw.

Macronutrient intake influences the effect of 25-hydroxy-vitamin d status on metabolic syndrome outcomes in african american girls.

The objectives were to determine the effect of macronutrient modification on vitamin D status and if change in 25-hydroxy-vitamin D concentration influences components of metabolic syndrome in obese African American girls. Methods. Five-week intervention using reduced CHO (43% carbohydrate; 27% fat: SPEC) versus standard CHO (55% carbohydrate; 40% fat: STAN) eucaloric diet.

Reduced carbohydrate diet to improve metabolic outcomes and decrease adiposity in obese peripubertal African American girls.

Objective: Obesity prevalence among African American (AA) girls is higher than that in other groups. Because typical energy-restriction obesity treatment strategies have had limited success, alterations in macronutrient composition may effectively improve metabolic outcomes in this population and affect future body composition trajectories. The objective was to evaluate the efficacy of a moderately restricted carbohydrate (CHO) versus a standard CHO diet on weight/fat loss and metabolic parameters in overweight/obese AA girls ages 9 to 14 years.

Shorter sleep may be a risk factor for impaired bone mass accrual in childhood.

The purpose of the study was to investigate whether sleep duration during early childhood was associated with fat mass and bone mineral content (BMC). BMC and fat mass were measured by dual-energy X-ray absorptiometry in children (n=336) aged 4-12 yr. Sleep was quantified according to parental report of hours slept at night and napping.

Birth weight is associated with body composition in a multiethnic pediatric cohort.

Several studies have indicated that birth weight is associated with increased risk for excess fat accumulation later in life. Our objective was to evaluate the association between birth weight and body composition measures in a multiethnic pediatric population while controlling for environmental factors previously associated with increased adiposity. Dual-energy x-ray absorptiometry was performed on 256 European-American, African-American, and Hispanic-American boys and girls.

Does fat fuel the fire: independent and interactive effects of genetic, physiological, and environmental factors on variations in fat deposition and distribution across populations.

Markers of inflammation (MOI) have been reported to influence bone health in adults, with reports of inverse associations. Adipose has also been linked to bone. In children, the interrelationships are unclear.

Role of various cytokines and growth factors in pubertal development.

Historical data suggest that body composition is intricately involved in pubertal development. Progression through puberty is dependent on the interaction between the growth hormone-insulin-like growth factor-1 (GH-IGF-1) axis, reproductive and metabolic hormones as well as pro- and anti-inflammatory cytokines which induce alterations in feedback mechanisms and therefore mediate body composition and growth. Simultaneous increases in GH and IGF-1, and the concomitant changes in the hormonal milieu (i.

Associations among calcium intake, resting energy expenditure, and body fat in a multiethnic sample of children.

Objective: The objective was to determine if calcium intake was associated with resting energy expenditure (REE) and body fat in children after accounting for ancestral genetic background.

Study Design: Participants included 315 children. REE, body composition, and dietary calcium were assessed by indirect calorimetry, dual-energy x-ray absorptiometry, and 24-hour recalls, respectively.