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Published in: Pediatric Nephrology 3/2010

01-03-2010 | Original Article

Metabolic syndrome risk factors and estimated glomerular filtration rate among children and adolescents

Authors: Efstathios Koulouridis, Kostantinos Georgalidis, Ioulia Kostimpa, Ioannis Koulouridis, Angeliki Krokida, Despina Houliara

Published in: Pediatric Nephrology | Issue 3/2010

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Abstract

The aim of this study was to seek the possible relationship between estimated glomerular filtration rate (e-GFR) and anthropometric indexes, lipids, insulin sensitivity, and metabolic syndrome risk factors among healthy children and adolescents. Sufficient evidence suggest that obesity is related with a novel form of glomerulopathy named obesity-related glomerulopathy (ORG) among adults, children, and adolescents. Glomerular filtration rate was estimated from serum creatinine in 166 healthy children and adolescents [79 males, 87 females; age 10.6 ± 3.3 (3–18) years]. Anthropometric indexes and systolic and diastolic blood pressure were measured. Fasting insulin, glucose, creatinine, uric acid, total cholesterol, high-density lipoprotein (HDL)-cholesterol, low-density lipoprotein (LDL)-cholesterol, and triglycerides were estimated. Insulin sensitivity was estimated from known formulas. The presence of certain metabolic syndrome risk factors was checked among the studied population. Boys showed higher e-GFR rates than girls (f = 8.49, p = 0.004). We found a strong positive correlation between e-GFR and body weight (r = 0.415), body mass index (BMI) (r = 0.28), waist circumference (r = 0.419), hip circumference (r = 0.364), birth weight (r = 0.164), systolic blood pressure (SBP) (r = 0.305), and mean arterial pressure (MAP) (r = 0.207). A negative correlation was found between e-GFR and fasting glucose (r = -0.19), total cholesterol (r = -0.27) and LDL-cholesterol (r = -0.26). Clustering of metabolic syndrome risk factors among certain individuals was correlated with higher e-GFR rates (f = 3.606, p = 0.007). The results of this study suggest that gender, anthropometric indexes, and SBP are strong positive determinants of e-GFR among children and adolescents. Waist circumference is the most powerful determinant of e-GFR. Fasting glucose and lipid abnormalities are negative determinants of e-GFR among the studied population. Clustering of metabolic syndrome risk factors is coupled with higher e-GFR rates.
Literature
1.
go back to reference Steinberg J, Daniels SR (2003) Obesity, insulin resistance, diabetes, and cardiovascular risk in children: an American Heart Association Scientific Statement from the Atherosclerosis, Hypertension, and Obesity in the Young Committee (Council on Cardiovascular Disease in the Young) and the Diabetes Committee (Council on Nutrition, Physical Activity, and Metabolism). Circulation 107:1448–1453CrossRef Steinberg J, Daniels SR (2003) Obesity, insulin resistance, diabetes, and cardiovascular risk in children: an American Heart Association Scientific Statement from the Atherosclerosis, Hypertension, and Obesity in the Young Committee (Council on Cardiovascular Disease in the Young) and the Diabetes Committee (Council on Nutrition, Physical Activity, and Metabolism). Circulation 107:1448–1453CrossRef
2.
go back to reference Crutz ML, Weigensberg MJ, Huang T, Ball G, Shaibi GQ, Goram MI (2004) The metabolic syndrome in overweight Hispanic youth and the role of insulin sensitivity. J Clin Endocrinol Metab 89:108–113CrossRef Crutz ML, Weigensberg MJ, Huang T, Ball G, Shaibi GQ, Goram MI (2004) The metabolic syndrome in overweight Hispanic youth and the role of insulin sensitivity. J Clin Endocrinol Metab 89:108–113CrossRef
3.
go back to reference Kambham N, Markowitz GS, Valeri AM, D’Agati VD (2001) Obesity-related glomerulopathy; an emerging epidemic. Kidney Int 59:1498–1509CrossRefPubMed Kambham N, Markowitz GS, Valeri AM, D’Agati VD (2001) Obesity-related glomerulopathy; an emerging epidemic. Kidney Int 59:1498–1509CrossRefPubMed
4.
go back to reference Kurella M, Lo JC, Chertow GM (2005) Metabolic syndrome and the risk for chronic kidney disease among nondiabetic adults. J Am Soc Nephrol 16:2134–2140CrossRefPubMed Kurella M, Lo JC, Chertow GM (2005) Metabolic syndrome and the risk for chronic kidney disease among nondiabetic adults. J Am Soc Nephrol 16:2134–2140CrossRefPubMed
5.
go back to reference Tuttle KR (2005) Renal manifestations of the metabolic syndrome. Nephrol Dial Transplant 20:861–864CrossRefPubMed Tuttle KR (2005) Renal manifestations of the metabolic syndrome. Nephrol Dial Transplant 20:861–864CrossRefPubMed
6.
go back to reference Chagnac A, Weinstein T, Korzets A, Ramadan E, Hirsh J, Gafter U (2000) Glomerular hemodynamics in severe obesity. Am J Physiol Renal Physiol 278:F817–F822PubMed Chagnac A, Weinstein T, Korzets A, Ramadan E, Hirsh J, Gafter U (2000) Glomerular hemodynamics in severe obesity. Am J Physiol Renal Physiol 278:F817–F822PubMed
7.
go back to reference Tomaszewski M, Charchar FJ, Maric C, McClure J, Crawford L, Grzeszcak W, Sattar N, Zukowska-Szczechowska E, Dominiczak AF (2007) Glomerular hyperfiltration: A new marker of metabolic risk. Kidney Int 71:816–821CrossRefPubMed Tomaszewski M, Charchar FJ, Maric C, McClure J, Crawford L, Grzeszcak W, Sattar N, Zukowska-Szczechowska E, Dominiczak AF (2007) Glomerular hyperfiltration: A new marker of metabolic risk. Kidney Int 71:816–821CrossRefPubMed
8.
go back to reference Schwartz GJ, Haycock GB, Edelman CM Jr, Spitzer A (1976) A simple estimate of glomerular filtration rate in children derived from body length and plasma creatinine. Pediatrics 58:259–263PubMed Schwartz GJ, Haycock GB, Edelman CM Jr, Spitzer A (1976) A simple estimate of glomerular filtration rate in children derived from body length and plasma creatinine. Pediatrics 58:259–263PubMed
9.
go back to reference Zappitelli M, Joseph L, Gupta IR, Bell L, Paradis G (2007) Validation of child serum creatinine-based prediction equations for glomerular filtration rate. Pediatr Nephrol 23:272–281CrossRef Zappitelli M, Joseph L, Gupta IR, Bell L, Paradis G (2007) Validation of child serum creatinine-based prediction equations for glomerular filtration rate. Pediatr Nephrol 23:272–281CrossRef
10.
go back to reference Matthews DR, Hosker JP, Rudensky AS, Naylor BA, Treacher DF, Turner RC (1988) Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma and insulin concentrations in man. Diabetologia 28:412–419CrossRef Matthews DR, Hosker JP, Rudensky AS, Naylor BA, Treacher DF, Turner RC (1988) Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma and insulin concentrations in man. Diabetologia 28:412–419CrossRef
11.
go back to reference Katz A, Nambi SS, Mather K, Baron AD, Follman DA, Sullivan G, Quon MJ (2000) Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans. J Clin Endocrinol Metab 85:2402–2410CrossRefPubMed Katz A, Nambi SS, Mather K, Baron AD, Follman DA, Sullivan G, Quon MJ (2000) Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans. J Clin Endocrinol Metab 85:2402–2410CrossRefPubMed
12.
go back to reference National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents (2004) The fourth report on the diagnosis, evaluation and treatment of high blood pressure in children and adolescents. Pediatrics 114:555–576CrossRef National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents (2004) The fourth report on the diagnosis, evaluation and treatment of high blood pressure in children and adolescents. Pediatrics 114:555–576CrossRef
13.
go back to reference Ford ES, Chaoyang L (2008) Defining the metabolic syndrome in children and adolescents: will the real definition please stand up? J Pediatr 152:160–164CrossRefPubMed Ford ES, Chaoyang L (2008) Defining the metabolic syndrome in children and adolescents: will the real definition please stand up? J Pediatr 152:160–164CrossRefPubMed
14.
go back to reference Hannon TS, Janosky J, Arslanian SA (2006) Longitudinal study of physiologic insulin resistance and metabolic changes of puberty. Pediatr Res 60:759–763CrossRefPubMed Hannon TS, Janosky J, Arslanian SA (2006) Longitudinal study of physiologic insulin resistance and metabolic changes of puberty. Pediatr Res 60:759–763CrossRefPubMed
15.
go back to reference Daniels SR, Greer FR, Committee on Nutrition (2008) Lipid screening and cardiovascular health in childhood. Pediatrics 122:198–208CrossRefPubMed Daniels SR, Greer FR, Committee on Nutrition (2008) Lipid screening and cardiovascular health in childhood. Pediatrics 122:198–208CrossRefPubMed
16.
go back to reference Forman JP, Brenner BM (2006) Hypertension and microalbuminuria: the bell tolls for thee. Kidney Int 69:22–28CrossRefPubMed Forman JP, Brenner BM (2006) Hypertension and microalbuminuria: the bell tolls for thee. Kidney Int 69:22–28CrossRefPubMed
17.
go back to reference Wilkin TJ, Murpy MJ (2006) The gender insulin hypothesis: why girls are born lighter than boys, and the implications for insulin resistance. Int J Obes (Lond) 30:1056–1061CrossRef Wilkin TJ, Murpy MJ (2006) The gender insulin hypothesis: why girls are born lighter than boys, and the implications for insulin resistance. Int J Obes (Lond) 30:1056–1061CrossRef
18.
go back to reference Pinto-Sietsma SJ, Navis G, Janssen WM, de Zeeuw D, Gans RO, de Jong PE (2003) A central body fat distribution is related to renal function impairment, even in lean subjects. Am J Kidney Dis 41:733–741CrossRefPubMed Pinto-Sietsma SJ, Navis G, Janssen WM, de Zeeuw D, Gans RO, de Jong PE (2003) A central body fat distribution is related to renal function impairment, even in lean subjects. Am J Kidney Dis 41:733–741CrossRefPubMed
19.
go back to reference Brenner BM, Lawler EV, Mackenzie HS (1996) The hyperfiltration theory: a paradigm shift in nephrology. Kidney Int 49:1774–1777CrossRefPubMed Brenner BM, Lawler EV, Mackenzie HS (1996) The hyperfiltration theory: a paradigm shift in nephrology. Kidney Int 49:1774–1777CrossRefPubMed
20.
go back to reference Li S, Chen S-C, Shlipak M, Bakris G, McCollough PA, Sowers J, Stevens L, Jurkovitz C, McFarlane S, Norris K, Vassalotti J, Klag MJ, Brown WW, Narva A, Calthoun D, Johnson B, Obialo C, Whaley-Connell A, Becker B, Collins AJ (2008) Low birth weight is associated with chronic kidney disease only in men. Kidney Int 73:637–642CrossRefPubMed Li S, Chen S-C, Shlipak M, Bakris G, McCollough PA, Sowers J, Stevens L, Jurkovitz C, McFarlane S, Norris K, Vassalotti J, Klag MJ, Brown WW, Narva A, Calthoun D, Johnson B, Obialo C, Whaley-Connell A, Becker B, Collins AJ (2008) Low birth weight is associated with chronic kidney disease only in men. Kidney Int 73:637–642CrossRefPubMed
21.
go back to reference Gielen M, Pinto-Sietsma S-J, Zeegers MP, Loos RJ, Fagard R, de Leeuw PW, Beunen G, Derom C, Vlietinck R (2005) Birth weight and creatinine clearance in young adult twins: influence of genetic, prenatal and maternal factors. J Am Soc Nephrol 16:2471–2476CrossRefPubMed Gielen M, Pinto-Sietsma S-J, Zeegers MP, Loos RJ, Fagard R, de Leeuw PW, Beunen G, Derom C, Vlietinck R (2005) Birth weight and creatinine clearance in young adult twins: influence of genetic, prenatal and maternal factors. J Am Soc Nephrol 16:2471–2476CrossRefPubMed
22.
go back to reference Keijzer-Veen MG, Schrevel M, Finken MJJ, Dekker FW, Nauta J, Hille ETM, Frolich M, van der Heijden BJ (2005) Microalbuminuria and lower glomerular filtration rate at young adult age in subjects born very premature and after intrauterine growth retardation. J Am Soc Nephrol 16:2762–2768CrossRefPubMed Keijzer-Veen MG, Schrevel M, Finken MJJ, Dekker FW, Nauta J, Hille ETM, Frolich M, van der Heijden BJ (2005) Microalbuminuria and lower glomerular filtration rate at young adult age in subjects born very premature and after intrauterine growth retardation. J Am Soc Nephrol 16:2762–2768CrossRefPubMed
23.
go back to reference Franco MC, Nishida SK, Sesso R (2008) GFR estimated from cistatin C versus creatinine born small for gestational age. Am J Kidney Dis 51:925–932CrossRefPubMed Franco MC, Nishida SK, Sesso R (2008) GFR estimated from cistatin C versus creatinine born small for gestational age. Am J Kidney Dis 51:925–932CrossRefPubMed
Metadata
Title
Metabolic syndrome risk factors and estimated glomerular filtration rate among children and adolescents
Authors
Efstathios Koulouridis
Kostantinos Georgalidis
Ioulia Kostimpa
Ioannis Koulouridis
Angeliki Krokida
Despina Houliara
Publication date
01-03-2010
Publisher
Springer-Verlag
Published in
Pediatric Nephrology / Issue 3/2010
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-009-1364-x

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