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Biomedical subjects

B Gutin

Publications and source records attributed to B Gutin.

At least 37 records · Page 2Linked to original sources
PubMed1998

Visceral adipose tissue and cardiovascular risk factors in obese children.

OBJECTIVE: In adults visceral adipose tissue (VAT) has been shown to be more highly correlated with cardiovascular (CV) risk factors than are other measures of adiposity such as subcutaneous abdominal adipose tissue (SAAT), percent body fat (%BF), or total body fat mass (TFM). We examined the relations between these measures of fatness and CV risk factors in obese children. STUDY DESIGN: Subjects were 64 obese (27% to 61% BF) children (24 black girls, 19 white girls, 11 black boys, 10 white boys) aged 7 to 11 years. VAT and SAAT were measured with magnetic resonance imaging. TFM and %BF were determined with dual x-ray absorptiometry. Hierarchical stepwise multiple regression analyses were used to determine the proportions of variance in CV risk factors explained by the demographic and adiposity measures. RESULTS: VAT but not SAAT, %BF, or TFM explained a significant proportion of the variance (r2 range = 0.10 to 0.21) in several lipid/lipoprotein risk factors including triacylglycerols, high-density lipoprotein cholesterol, the ratio of total cholesterol to high-density lipoprotein cholesterol, and low-density lipoprotein particle size. CONCLUSION: Many of the deleterious relations between VAT and lipid/lipoprotein risk factors seen in adults were already present in this sample of obese children.

Abdomen↗
PubMed1998

Relations of body composition to left ventricular geometry and function in children.

OBJECTIVE: To determine whether body composition and fasting insulin levels explained variation in left ventricular (LV) function and geometry. PARTICIPANTS: Sixty-two children, 7 to 13 years of age. RESULTS: For LV mass/height the partial correlation (age controlled) with percentage of fat was r = 0.34 (p = 0.008) and the correlation with (Ln)insulin was r = 0.25 (p = 0.051); multiple regression showed that independent proportions of the variance were explained by gender (boys > girls), ethnicity (black > white subjects), and percentage of fat (p = 0.015). Nonnormalized LV mass was correlated (age controlled) with fat-free mass (r = 0.76; p < 0.001), fat mass (r = 0.58; p < 0.001), and (Ln) insulin (r = 0.27; p = 0.0359); multiple regression showed that fat-free mass and fat mass explained independent proportions of the variance. Percentage of fat was correlated (age controlled) with greater relative wall thickness (r = 0.34; p = 0.008) and lower midwall fractional shortening (-0.37; p = 0.004). CONCLUSION: Body fatness was cross-sectionally associated with levels of LV function and geometry that in adults have been found to lead to morbidity and death. The relationship of fatness to LV mass may be due to the higher insulin concentrations in the fatter children. These cross-sectional results are consistent with the hypothesis that excess fatness may adversely influence cardiovascular health early in life.

Absorptiometry, Photon↗
PubMed1998

Fat distribution and hemostatic measures in obese children.

We examined the relation of general and visceral adiposity to plasma hemostatic factors [fibrinogen, D-dimer, and plasminogen activator inhibitor 1 (PAI-1)] in obese boys and girls 7-11 y of age (n = 41). Boys had significantly greater fibrinogen and D-dimer concentrations than girls (P < 0.05). whereas blacks had significantly greater fibrinogen and D-dimer concentrations than whites (P < 0.05). Univariate analyses revealed that fibrinogen was positively associated with percentage body fat (%BF) (r = 0.42, P < 0.01), subcutaneous abdominal adipose tissue (SAAT) (r = 0.40, P < 0.01), total fat mass (r = 0.42, P < 0.01), and body mass index (r = 0.41, P < 0.01). PAI-1 was positively associated with visceral adipose tissue (VAT) (r = 0.49, P < 0.01), SAAT (r = 0.32, P < 0.05), fat-free mass (r = 0.50, P < 0.01), and insulin (r = 0.61, P < 0.001). D-Dimer was positively associated with %BF (r = 0.40, P < 0.01), SAAT (r = 0.37, P < 0.05), total fat mass (r = 0.40, P < 0.01), and body mass index (r = 0.43, P < 0.01). Multiple regression analysis revealed that for fibrinogen, sex and higher %BF explained significant independent portions of the variance. For PAI-1, higher amounts of VAT and fat-free mass were significant predictors. For D-dimer, ethnicity was a significant predictor. These results suggest that general adiposity and VAT may play a role in regulating plasma hemostatic factors in obese children. Even early in childhood, adiposity is associated with unfavorable concentrations of hemostatic factors that are in turn implicated in cardiovascular morbidity and mortality later in life.

Adipose Tissue↗
PubMed1997

Weight-independent cardiovascular fitness and coronary risk factors.

BACKGROUND: It is unclear whether cardiovascular fitness influences risk factors for coronary artery disease and non-insulin-dependent diabetes mellitus independently of level of body fat because fitness is often measured in tasks that involve moving body weight (eg, running) and because body weight and level of body fat are correlated. OBJECTIVE: To measure fitness during a task in which body weight was controlled experimentally (ie, supine cycling). DESIGN: Cross-sectional. PARTICIPANTS: Seventy-four children, 7 to 13 years of age, recruited through school flyers and newspaper advertisements, varying in level of body fat from 7% to 61%. There were 31 boys and 43 girls; 35 were white and 39 were black. MAIN INDEPENDENT VARIABLES: Cardiovascular fitness was expressed as submaximal heart rate while cycling at a power output of 49 W, and level of body fat was measured with dual x-ray absorptiometry. MAIN OUTCOME MEASURES: Blood pressure and levels of triglycerides, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, insulin, glucose, and glycohemoglobin. RESULTS: Controlling for age and sex, level of body fat was significantly (P < .01) related to unfavorable levels of systolic blood pressure (r = 0.32), triglycerides (r = 0.42), high-density lipoprotein cholesterol (r = -0.31), insulin (r = 0.50), and total cholesterol to high-density lipoprotein cholesterol ratio (r = 0.37); submaximal heart rate was not significantly correlated with any of the other variables. CONCLUSIONS: When cardiovascular fitness was measured in a weight-independent task, it was not significantly related to level of body fat or the major coronary artery disease and non-insulin-dependent diabetes mellitus risk factors. In addition, we confirmed previous findings that higher levels of body fat are associated with a very unfavorable risk profile.

Adipose Tissue↗
PubMed1997

Effect of physical training on heart-period variability in obese children.

OBJECTIVE: The beat-to-beat variability in electrocardiogram intervals (RR, i.e., heart-period variability) provides information on cardiac autonomic activity that predicts arrhythmias and mortality rate in animals and adults. We determined the effect of physical training on heart-period variability in obese children. METHODS: Thirty-five subjects were randomly assigned to physical training and control groups. The training involved 4 months of exercise, 5 days per week, 40 minutes per day. Cardiovascular fitness was measured with submaximal heart rate during supine cycling; percentage of body fat was measured with dual-energy absorptiometry; and resting heart-period variability parameters were measured in a supine position. A pretraining to posttraining change score was computed for each variable. The effect of the training was determined by comparing the changes of the training and control groups. RESULTS: Compared with the control group, the trained group (1) reduced submaximal heart rate and percentage of body fat (p < 0.01); (2) increased in the root mean square of successive differences, a time-domain parameter reflective of vagal tone (p < 0.05); (3) decreased in low-frequency power expressed as a percentage of total power, a frequency-domain index of combined sympathetic and vagal activity (p < 0.03); and (4) decreased in the ratio of low- to high-frequency power, an index of sympathetic-parasympathetic balance (p < 0.01). CONCLUSIONS: In obese children, physical training alters cardiac autonomic function favorably by reducing the ratio of sympathetic to parasympathetic activity.

Adipose Tissue↗
PubMed1997

Effects of strength or aerobic training on body composition, resting metabolic rate, and peak oxygen consumption in obese dieting subjects.

Given that resting metabolic rate (RMR) is related largely to the amount of fat-free mass (FFM), the hypothesis was that strength training, which stimulates muscle hypertrophy, would help preserve both FFM and RMR during dieting. In a randomized controlled intervention trial, moderately obese subjects (aged 19-48 y) were assigned to one of three groups: diet plus strength training, diet plus aerobic training, or diet only. Sixty-five subjects (25 men and 40 women) completed the study. They received a formula diet with an energy content of 70% of RMR or 5150 +/- 1070 kJ/d (x +/- SD) during the 8-wk intervention. They were seen weekly for individual nutritional counseling. Subjects in the two exercise groups, designed to be isoenergetic, trained three times per week under supervision. Those in the strength-training group performed progressive weight-resistance exercises for the upper and lower body. Those in the aerobic group performed alternate leg and arm cycling. After 8 wk, the mean amount of weight lost, 9.0 kg, did not differ significantly among groups. The strength-training group, however, lost significantly less FFM (P < 0.05) than the aerobic and diet-only groups. The strength-training group also showed significant increases (P < 0.05) in anthropometrically measured flexed arm muscle mass and grip strength. Mean RMR declined significantly, without differing among groups. Peak oxygen consumption increased the most for the aerobic group (P = 0.03). In conclusion, strength training significantly reduced the loss of FFM during dieting but did not prevent the decline in RMR.

Adult↗
PubMed1996

Body-composition measurement in 9-11-y-old children by dual-energy X-ray absorptiometry, skinfold-thickness measurements, and bioimpedance analysis.

We compared, in 9-11-y-old children (n=43), three measures of body composition: dual-energy X-ray absorptiometry (DXA), skinfold thickness, and bioimpedance analysis (BIA). The intraclass correlation coefficient (ICC), Bland-Altman procedure, and Spearman rank correlation were used to determine test-retest reliabilities of the three methods and to compare methods. For DXA measurements, the rank correlation between fat-free soft tissue and fat-free mass (FFM) was > 0.99, indicating that bone mineral content did not provide independent information. Thus, subsequent analyses used the two-compartment model (ie, fat mass and FFM) for all three techniques, focusing especially on values for percentage of fat. The test-retest reliabilities for all methods were high (ICCs > 0.994 and no significant differences between trials 1 and 2). The range of individual differences from trial 1 to trial 2 and Bland-Altman limits of agreement suggested that the reliability was greatest for DXA, followed by BIA and skinfold-thickness measurement. The percentage of fat values for the three methods were highly intercorrelated (all Spearman r values > 0.83). However, there was a systematic tendency (P < 0.01) for DXA values (mean: 23.98) to be higher than those derived from skinfold-thickness measurements (mean: 21.05) and BIA (mean: 21.52). The variance in percentage of fat values for BIA was significantly smaller than that for the other two techniques. These findings, along with rather large limits of agreement derived from the Bland-Altman procedure, suggest that the methods should not be used interchangeably.

Absorptiometry, Photon↗
PubMed1996

Physical training, lifestyle education, and coronary risk factors in obese girls.

The effects of supervised physical training (PT) and lifestyle education (LSE) on risk factors for coronary artery disease and non-insulin-dependent diabetes mellitus were compared in obese 7- to 11-yr-old black girls. The subjects were divided into two groups. The PT group (N = 12) completed a 5-d.wk-1, 10-wk, aerobic training program; and the LSE group participated in weekly lifestyle discussions to improve exercise and eating habits. The PT group showed a significant increase in aerobic fitness (P < 0.05) and decrease in percent body fat (P < 0.05), while the LSE group declined significantly more in dietary energy and percent of energy from fat (P < 0.05). Fasting insulin did not change significantly. The LSE group declined significantly more than the PT group in glucose (P < 0.05), and glycohemoglobin declined from baseline in both groups (P < 0.05). Lipid changes were similar in the two groups: total cholesterol/high density lipoprotein cholesterol (P < 0.01) and triglycerides (P < 0.05) declined, the low density lipoprotein (LDL)/apoproteinB ratio increased (which indicates a decrease in small dense LDL) (P < 0.05) and lipoprotein(a) increased (P < 0.05). Thus, the interventions were similarly effective in improving some diabetogenic and atherogenic factors, perhaps through different pathways; i.e., the PT improved fitness and fatness, while the LSE improved diet. Exercise and diet-induced changes in lipoprotein(a) require further investigation.

Child↗
PubMed1995

Physical training improves body composition of black obese 7- to 11-year-old girls.

We determined the effect of supervised physical training without dietary intervention, on body composition of obese girls. The subjects were 25 obese 7- to 11-year-old black girls, divided into physical training and lifestyle education groups which were comparable on baseline body composition; 22 girls finished all aspects of the study. Twelve girls engaged in aerobic training (10 weeks, 5 days/week) while 10 engaged in weekly lifestyle discussions without formal physical training. Total body and regional body composition were measured with dual energy x-ray absorptiometry, skinfolds and circumferences. Aerobic fitness was measured by heart rate response to submaximal treadmill exercise. The physical training group attended 94% of scheduled sessions and kept their heart rates at an average of 163 bpm for 28 minutes/session. The lifestyle group attended 95% of their sessions; they remained stable in aerobic fitness and most body composition measurements. The physical training group showed a significant improvement in aerobic fitness and a significant decline of 1.4% body fat. Skinfold and circumference indices of fatness also declined significantly in the training group. We conclude that controlled physical training, without dietary intervention, improved the fitness and body composition of obese black girls.

Absorptiometry, Photon↗
PubMed1995

Fasting insulin concentration is related to cardiovascular reactivity to exercise in children.

OBJECTIVE: One mechanism through which hyperinsulinemia is linked to hypertension is through its stimulation of sympathetic nervous activity. Thus, insulin concentration may be correlated with indices of sympathetic activity before it is associated with resting blood pressure. We tested this hypothesis by determining the relationship of insulin concentration and sympathetically mediated cardiovascular reactivity to exercise in children. DESIGN: Survey. SETTING: General community. PARTICIPANTS: Volunteer sample of 46 black and white boys and girls, 9 to 11 years of age. INTERVENTIONS: None. Fasting insulin concentration was the main independent variable. MAIN OUTCOME MEASURES: Systolic blood pressure and heart rate during a standard submaximal bout of treadmill exercise, and systolic blood pressure at peak effort. RESULTS: The hypothesis was tested by multiple regression analyses controlled for resting values. Insulin contributed significantly to the regression models for submaximal heart rate (P < .001), submaximal systolic blood pressure (P = .001), and peak systolic blood pressure (P = .006). CONCLUSIONS: Fasting insulin concentration is associated with cardiovascular reactivity to exercise in young children. This supports the hypothesis that the relationship between hyperinsulinemia and hypertension is mediated by sympathetic nervous tone and that the process begins in childhood. Because percent body fat was positively associated with both insulin and cardiovascular reactivity to exercise, prevention of childhood obesity may be a valuable prophylactic measure for these health problems.

Analysis of Variance↗
PubMed1994

Knowledge, beliefs, and behaviors among college women concerning the prevention of osteoporosis.

OBJECTIVE: To assess the knowledge of osteoporosis risk factors among young women, their beliefs about the disease, and to what extent they practice preventive behaviors, such as adequate calcium intake and physical activity. DESIGN: Cross-sectional survey. SETTING/PARTICIPANTS: One hundred twenty-seven women (mean age, 19.6 years; 92% were white) enrolled in a required undergraduate health course at a midwestern state university. RESULTS: One hundred fourteen (90%) of the survey respondents had heard about osteoporosis, but only 49 (43%) of the 114 had received information from either a health care provider or a school. There was a significant relationship between receiving osteoporosis information and the ability to correctly identify risk factors (P < or = .006). Only 6.7% of the women reported getting both adequate "osteoprotective" exercise per week and the recommended 1200 mg of calcium per day. Respondents believed that it was unlikely that osteoporosis would develop in them. They also expressed less responsibility and concern about osteoporosis and believed that it is less serious than other common causes of morbidity and mortality in women, such as heart disease and breast cancer (P < or = .02). There was no significant relationship between risk-factor identification and exercise habits, calcium intake, or beliefs about osteoporosis. CONCLUSIONS: The majority of young women are not consuming the recommended daily amount of calcium and are lacking sufficient osteoprotective exercise for building healthy bone. Health care providers and educational institutions either have missed opportunities to educate young women about osteoporosis or such information has not been received and retained. Increasing levels of osteoporosis awareness may not be associated with influencing beliefs or behaviors. However, because of the importance of building an adequate bone mass in early life, our data suggest that the development and evaluation of comprehensive osteoporosis educational interventions targeted at younger women are warranted.

Adolescent↗
PubMed1994

Relation of percentage of body fat and maximal aerobic capacity to risk factors for atherosclerosis and diabetes in black and white seven- to eleven-year-old children.

OBJECTIVE: To determine whether body fatness, aerobic capacity, and fat distribution are associated with levels of cardiovascular risk factors in children. METHODS: Subjects (N = 57) were 7 to 11 years of age; their percentage of body fat ranged from 10% to 58%. The percentage of fat was measured with dual-energy x-ray absorptiometry, maximal aerobic capacity was measured on a treadmill, fat distribution was expressed as the waist/hip circumference ratio, and blood pressures were measured with an automated monitor. Measurements of several lipoproteins and apoproteins were combined into one atherogenic index. RESULTS: The percentage of fat was related to the atherogenic index (p = 0.38; p > 0.01) and insulin level (p = 0.78; p > 0.001). Aerobic capacity was inversely related to the atherogenic index (p = -0.27; p > 0.05) and insulin level (p = -0.72; p > 0.001). The waist/hip ratio was not related to the risk factors, and blood pressures were not related to fatness or aerobic capacity. In multiple regression analyses, only fatness explained significant independent proportions of the variance in the atherogenic index and insulin level. After control for fatness, the black children had higher insulin levels (p > 0.05). CONCLUSION: At early ages (7- to 11-year-old children), fatness was related to risk factors for cardiovascular disease and diabetes.

Absorptiometry, Photon↗
PubMed1994

Association of apolipoprotein(a) phenotypes in children with family history of premature coronary artery disease.

Although blacks have higher plasma levels of lipoprotein(a) [Lp(a)] than whites, the Lp(a) levels are not associated with clinical coronary artery disease (CAD) or parental history of myocardial infarction in blacks. To explore whether ethnic differences in the pathogenicity of Lp(a) are related to the thrombogenic component of Lp(a), this study investigated in children the associations of apolipoprotein(a) [apo(a)] phenotypes and Lp(a) levels with family history of premature CAD. Subjects were 46 children aged 7 to 11 years divided according to family history of premature CAD and assessed for Lp(a), apo(a) phenotypes, and other lipids and lipoproteins. The prevalence of small isoforms was higher in children with positive family history of premature CAD than in children with negative family history of premature CAD (32% versus 10%). Large isoforms were more prevalent in whites (24% versus 6%), and medium-sized isoforms were more prevalent in blacks (75% versus 52%). The black/white difference was smaller (19% versus 24%) in regard to small isoforms. Lp(a) levels were inversely related to apo(a) size in both blacks and whites (P = .084 and P = .049, respectively). Single-banded small apo(a) isoforms predicted positive family history of premature CAD, independent of ethnicity and Lp(a) levels. Small apo(a) isoforms in children were independent predictors of family history of premature CAD. Unlike Lp(a), they appear to be equally pathogenic for blacks and whites.

Age of Onset↗
PubMed1994

The rate of increase in blood pressure in children 5 years of age is related to changes in aerobic fitness and body mass index.

OBJECTIVE: To determine whether changes in aerobic fitness and body mass index are related to the age-related rise in blood pressure in healthy preschool children. STUDY DESIGN: Longitudinal analyses of 196 free-living children aged 5 years at baseline who were followed over a mean of 19.7 months. Aerobic fitness was assessed using a treadmill. All measures were obtained on multiple occasions at scheduled visits as part of a longitudinal cohort study. SETTING: An inner-city medical center. OUTCOME MEASURES: Blood pressure was measured using an automated Dinamap device. RESULTS: Mean systolic blood pressure was 95.3 mmHg (SD 8.38) at baseline and increased by 4.46 mmHg per year. Mean diastolic blood pressure was 53.9 mmHg (SD 5.81) at baseline and did not change significantly. Children in the highest quintile of increase in fitness had a significantly smaller increase in systolic blood pressure compared to children in the lowest quintile (2.92 vs 5.10 mmHg/year; P = .03). Children in the lowest quintile of increase in body mass index did not differ significantly in rate of increase in systolic blood pressure compared to children in the highest quintile (3.92 vs 4.96 mmHg/year). In a multiple regression model including baseline systolic blood pressure, fitness, height, body mass index, and other covariates, greater increase in fitness (P = .03) and lesser increase in body mass index (P < .01) were associated with lower rates of increase in systolic blood pressure. In a similar multivariate analysis, an increase in fitness was also associated with a lower rate of increase in diastolic blood pressure (P = .02). CONCLUSION: Young children who increase their aerobic fitness or decrease their body mass index reduce the rate of the age-related increase in blood pressure. These observations may have implications for development of interventions directed at the primary prevention of hypertension.

Age Factors↗
PubMed1994

Low density lipoprotein cholesterol/apolipoprotein B-100 ratio: interaction of family history of premature atherosclerotic coronary artery disease with race and gender in 7 to 11 year olds.

BACKGROUND: In adults, a low density lipoprotein cholesterol (LDL-C)/apolipoprotein B-100 (ApoB) ratio is an indicator of ApoB-enriched small dense LDL, which is associated with premature coronary artery disease (CAD). Since this LDL subclass may be inherited, we investigated whether a low LDL-C/ApoB ratio was associated with a positive family history of premature CAD in young children. METHODS: Subjects were 66 children aged 7 to 11 years who were recruited through a school-based family history survey, flyers, and hospital newspaper advertisements. They were divided according to family history and assessed for fatness, blood pressure, lipids, lipoproteins, and apoproteins. RESULTS: Family history interacted with gender such that girls with a positive family history had a lower LDL-C/ApoB ratio than girls with a negative family history, while the opposite was true in boys; ie, family history-positive boys had a higher ratio than family history-negative boys. The association of a low ratio with a positive family history was seen most clearly in white girls. Family history-positive whites had higher ApoB than family history-negative whites, whereas the pattern was reversed in the blacks. The LDL-C/ApoB ratio and ApoB were not related to other CAD risk factors such as fatness, blood pressure, or other lipids and lipoproteins. CONCLUSION: In young children, a low LDL-C/ApoB ratio and high ApoB levels were associated with a positive family history of CAD only in the white girls, suggesting that this group is at increased risk of genetically mediated CAD.

Apolipoprotein B-100↗
PubMed1993

Effect of a walking program on gait characteristics in patients with osteoarthritis.

This paper reports the results of a study of the gait of 102 patients with osteoarthritis of the knee. Functional status was measured by a 6-min test of walking distance; the stride characteristics associated with the walk test were assessed. Stride characteristics were measured by a Stride Analyzer. Patients were randomized to an 8-week educational and walking program (the intervention group) or to a weekly telephone survey (the control group). The intervention group patients had a 15% increase in walking distance (P < 0.0001) and increases of 9.1% in stride length at free walking speeds (P < 0.007) and 17% in stride length at fast walking speeds (P < 0.01) compared to the control group. The results of this study have shown that the walking and educational program was effective in improving gait function in patients with osteoarthritis of the knee.

Adult↗