RESUMEN
BACKGROUND: Hepcidin is a protein that regulates the metabolism of iron. In addition, a high iron load can cause insulin resistance and subsequent diabetes. OBJECTIVE: To investigate the association between hepcidin levels and glucose, insulin, lipids, HOMA-IR, and inflammatory markers, C reactive protein (CRP), ferritin, Lp (a), and leucocytes, in indigenous school children living at 4000 m above sea level. Data were collected cross-sectionally from the four schools in San Antonio de los Cobres (SAC). BMI, glucose, insulin, lipids, CRP, hemoglobin, leucocytes, iron, ferritin, transferrin, and hepcidin levels were obtained. RESULTS: Three hundred and seventy-six children (170 males) aged 9.6 ± 2.3 y were included. Fifty-five(15.2 %) children were underweight, 28 (7.4 %) overweight and 10 (2.7 %) obese. Univariate analysis showed a significant inverse correlation between hepcidin and glucose (r = -0.14) and HOMA-IR (r = -0.30). Furthermore, hepcidin was found to be directly and significantly correlated with Lp(a) (r = 0.18), leucocytes (r = 0.24,) CRP (r = 0.32), and ferritin (r = 0.32). Multiple linear regression analysis indicated that hepcidin was significantly and inversely associated with glucose and BMI and directly with Lp(a), CRP, leucocytes, and ferritin; adjusted for age and gender (R2 0.26). CONCLUSION: In this study, which included indigenous children living at high altitudes (4000 m), hepcidin was significantly and inversely associated with glucose and BMI and directly associated with inflammatory markers such as CRP, Lp(a), leucocytes, and ferritin, suggesting that hepcidin could be a reliable marker of future type 2 diabetes.
Asunto(s)
Diabetes Mellitus Tipo 2 , Hepcidinas , Niño , Masculino , Humanos , Hepcidinas/metabolismo , Altitud , Biomarcadores , Ferritinas , Proteína C-Reactiva/metabolismo , Insulina/metabolismo , Glucosa , Hierro/metabolismo , LípidosRESUMEN
BACKGROUND: Whether apolipoproteins (Apos) are better cardiovascular disease (CVD) markers than metabolic syndrome (MS) is widely debated. Measurement of Apo B is standardized, simple, and inexpensive and does not require fasting. The aim of this study was to compare the ability of nontraditional CVD markers such as Apo B, Apo B/Apo A, non-high-density lipoprotein cholesterol (HDL-C), vitamin D, and homeostasis model assessment of insulin resistance (HOMA-IR) to identify children with MS. SUBJECTS AND METHODS: A cross-sectional study of 355 Argentinean Koya schoolchildren (166 boys) 9.6±2.3 years old was performed in November 2011. Anthropometric measures, blood pressure, Tanner stages, and serum levels of glucose, lipids, insulin, Apo A, Apo B, and vitamin D were measured. RESULTS: The prevalence of overweight/obesity was 10.7% (n=38), and that of underweight was 14.6% (n=52) using Centers for Disease Control and Prevention criteria. The prevalence of central obesity was 10.9% (38/355), high triglycerides was 11.1% (39/355), low HDL-C was 44.9% (158/355), hypertension was 12.8% (45/355), hyperglycemia was 0.3% (1/355), and MS was 4.2% (15/355). Several multiple logistic regression analyses showed that MS was significantly associated with HOMA-IR (odds ratio [OR], 3.6 [95% confidence interval (CI) 1.51-8.52]), non-HDL-C (OR, 1.03 [95% CI 1.007-1.049]), Apo B (OR, 1.06 [95% CI 1.03-1.09]), and Apo B/Apo A (OR, 78.3 [95% CI 3.67-1,674.4]) adjusted for age and gender. Furthermore, the areas under the receiver operator characteristic curves were as follows: Apo B, 0.77 (95% CI 0.63-0.90); Apo B/Apo A, 0.76 (95% CI 0.63-0.88); non-HDL-C, 0.72 (95% CI 0.57-0.85); and HOMA-IR, 0.69 (95% CI 0.49-0.90). These values indicate that these variables were acceptable predictors for MS. CONCLUSIONS: This is the first study of nontraditional markers in South American Indian children. MS was associated with multiple nontraditional markers of future CVD risk such as non-HDL-C, Apo B, and Apo B/Apo A. However, Apo B was the best predictor for MS, suggesting that it could be used as a risk marker of future CVD in this community.