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Journal of Pediatric Endocrinology and Metabolism

Editor-in-Chief: Kiess, Wieland

Ed. by Bereket, Abdullah / Darendeliler, Feyza / Dattani, Mehul / Gustafsson, Jan / Luo, Fei Hong / Mericq, Veronica / Toppari, Jorma


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2191-0251
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Volume 30, Issue 8

Issues

Parent reported nutritional risk and laboratory indices of cardiometabolic risk and in preschool-aged children

Navindra Persaud
  • Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
  • Department of Family and Community Medicine, University of Toronto and St. Michael’s Hospital, Toronto, Ontario, Canada
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Hedyeh Ziai
  • Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Gerald Lebovic
  • Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Jonathon L. Maguire
  • Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
  • Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
  • Department of Pediatrics, St. Michael’s Hospital, Toronto, Ontario, Canada
  • Division of Pediatric Medicine and the Pediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, Ontario, Canada
  • Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Marina Khovratovich / Janis A. Randall Simpson
  • Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Khosrow Adeli
  • Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
  • Clinical Biochemistry, Department of Pediatric Laboratory Medicine, Hospital for Sick Children, Toronto, Ontario, Canada
  • Other articles by this author:
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/ Jill Hamilton
  • Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
  • Divison of Endocrinology, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Brian W. McCrindle
  • Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
  • Division of Cardiology, The Hospital for Sick Children, Toronto, Ontario, Canada
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Patricia C. Parkin
  • Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
  • Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
  • Division of Pediatric Medicine and the Pediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, Ontario, Canada
  • Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
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/ Catherine S. Birken
  • Corresponding author
  • Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
  • Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
  • Division of Pediatric Medicine and the Pediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, Ontario, Canada
  • Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
  • Division of Pediatric Medicine, The Hospital for Sick Children, University of Toronto, 686 Bay St, ON M5G 0X4, Ontario, Canada
  • Email
  • Other articles by this author:
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/
Published Online: 2017-07-19 | DOI: https://doi.org/10.1515/jpem-2016-0328

Abstract

Background:

Eating habits formed during childhood may contribute to the increasing prevalence of cardiometabolic disorders. Assessing nutritional risk in young children may help to prevent later cardiometabolic disease. The objective of this study was to determine whether parent-reported nutritional risk in preschool-aged children was associated with laboratory indices of cardiometabolic risk, namely leptin and insulin.

Methods:

In this cross-sectional study, the relationship between nutritional risk as determined by the parent-completed NutriSTEP® questionnaire was assessed and compared to the serum leptin and insulin concentrations, hormones involved in regulation of food intake and biomarkers of adiposity and cardiometabolic risk. The community-based primary care research network for children in Toronto, Canada (TARGet Kids!) was used. The participants were children aged 3–5 years recruited from TARGet Kids! A total of 1856 children were recruited from seven primary care practices. Of these, 1086 children completed laboratory testing. Laboratory data for leptin and insulin were available for 714 and 1054 of those individuals, respectively.

Results:

The total NutriSTEP® score was significantly associated with serum leptin concentrations (p=0.003); for each unit increase in the total NutriSTEP® score, there was an increase of 0.01 ng/mL (95% confidence interval [CI] 0.004–0.018) in serum leptin concentrations after adjusting for potential confounders. The total NutriSTEP® score was not significantly associated with serum insulin concentration.

Conclusions:

Parent reported nutritional risk is associated with serum leptin, but not insulin, concentrations in preschool-aged children. The NutriSTEP® questionnaire may be an effective tool for predicting future cardiometabolic risk in preschool-aged children.

Keywords: child; leptin; metabolism; nutrition assessment; preschool child

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About the article

Corresponding author: Catherine S. Birken, Associate Professor, Division of Pediatric Medicine, The Hospital for Sick Children, University of Toronto, 686 Bay St, ON M5G 0X4, Canada, Phone: +416-813-4930, Fax: +416-813-5663

TARGet Kids! Collaboration Site Investigators: Jillian Baker, Tony Barozzino, Joey Bonifacio, Douglas Campbell, Sohail Cheema, Brian Chisamore, Karoon Danayan, Paul Das, Mary Beth Derocher, Anh Do, Michael Dorey, Sloane Freeman, Keewai Fung, Charlie Guiang, Curtis Handford, Hailey Hatch, Sheila Jacobson, Tara Kiran, Holly Knowles, Bruce Kwok, Sheila Lakhoo, Margarita Lam-Antoniades, Eddy Lau, Fok-Han Leung, Jennifer Loo, Sarah Mahmoud, Rosemary Moodie, Julia Morinis, Sharon Naymark, Patricia Neelands, James Owen, Michael Peer, Marty Perlmutar, Navindra Persaud, Andrew Pinto, Michelle Porepa, Nasreen Ramji, Noor Ramji, Alana Rosenthal, Janet Saunderson, Rahul Saxena, Michael Sgro, Susan Shepherd, Barbara Smiltnieks, Carolyn Taylor, Thea Weisdors, Sheila Wijayasinghe, Peter Wong, Ethel Ying, Elizabeth Young.


Received: 2016-08-17

Accepted: 2017-05-12

Published Online: 2017-07-19

Published in Print: 2017-08-28


Author contributions: All of the authors made substantial contributions to the conception and design of the study; the acquisition, analysis and interpretation of the data; and the drafting of the manuscript or its critical revision for important intellectual content. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Research funding: This work was supported by the Canadian Institute of Health Research, Physician Services Incorporated, Paediatric Outcomes Research Team through the SickKids Foundation, and St. Michael’s Hospital Foundation (grant number MOP-119375). The funding agencies had no role in the design, analysis or writing of this article.

Employment or leadership: Navindra Persaud is an Associate Editor for CMAJ. Janis Randall Simpson has received grant funding from the Canadian Institutes of Health Research (CIHR); she is a board member for the Danone Institute of Canada; she is a consultant for Dietitians of Canada; she receives royalties for NutriSTEP© licences; and she has been reimbursed for travel expenses by the CIHR. Brian McCrindle is a board member for Medpace; he has been a consultant for Eli Lilly, Merck and Bristol-Myers-Squibb; and he has received grant funding from AstraZeneca. Patricia Parkin and Catherine Birken work for institutions that have received grants from the CIHR. No other competing interests were declared. The other authors have no financial relationships relevant to this article to declare.

Honorarium: None declared.

Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.


Citation Information: Journal of Pediatric Endocrinology and Metabolism, Volume 30, Issue 8, Pages 839–846, ISSN (Online) 2191-0251, ISSN (Print) 0334-018X, DOI: https://doi.org/10.1515/jpem-2016-0328.

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